HomeMy WebLinkAbout2013-144 Contract - Economy Plumbing
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Economy Plumbing
ASHLAND CONTACT: Daniel Meyer Pool
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 309 Kent Street Ashland Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541''-4482-4733
76~ CUg f<
DATE AGREEMENT PREPARED: FAX:
BEGINNING DATE: 5/28/13 COMPLETION DATE: 6/14/13
COMPENSATION: Initial repair Men's showers $1500.00 Follow up repair to install PRV 1275.00 If problem
still exists in women's shower repair cost: $1750.00 Total Repairs if all three phases are needed: $4525.00
GOODS AND SERVICES TO BE PROVIDED: Shower repairs at the Daniel Meyer Pool building.
ADDITIONAL TERMS:
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel
assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned
in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are
so registered, licensed and bonded. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated, payments will be made for work completed and accepted to date of termination.
Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 279B.220, 279B.225, 27913.230, 279B.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $19,494 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a
living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor
who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached
hereto as Exhibit B predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs,
judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
written notice to Contractor, or at such later date as may be established by City under any of the following
conditions:
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 1 of 5
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the 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 Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 2 of 5
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The contractor's insurance, is primary and non-contributory. The certificate will specify all of the
parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The
Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
refere e.
Contra City of Ashl
By By
Signat re Department Head
6&_Y- d S ! Ocx)1,ey
Print Name Print Name
l "_e )rPf! [cL~ 4-,- & fr3
Title [ Date
/Jowl S ~~tC',
_u4
W-9 One cop of a W-9 is to be submitted with
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 3 of 5
1 '
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria::
(1) 1 carry out the labor or services.at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
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.
S 3/ l3
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 4 of 5
OP ID: KCF
CERTIFICATE OF LIABILITY INSURANCE 0 9104112
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(lee) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement a .
PRODUCER 641.245-1111 NAMeACT KC Ferguson
United Risk PO Box 9389olutlons, Inc. 541-245.1112 P H-541-494-7762 FAr~c NO: 641.245.1112
Medford, OR 97501-0067 ~wonesa: kc.ferguson@unitedrisk.com
Workers Comp House Account _ P
CUSTOMER tp RODUCER ,ECON0IW
INSURERS AFFORDING COVERAGE NAIL0
INSURED Economy Plumbing, Inc. INSURER A:Liberty Northwest
309 Kent St. INSURER IS:
Ashland, OR 97520-1017 INSURER C:
INSURER D:
INSURER E I
NS RERF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPO OF INSURANCE INAR J= POLICY NUMBER YE F POMCONYY LIMITS
LTR GENERALLIABIMTY EACHOCCURRENCE S
COMMERCIAL GENERAL LIABILITY PREMIsEav=nerte S
CLAIMS-MADE 0000UR MEDEXPANarepenon) S
PERSONALSAOVINIURY S
GENERAL AGGREGATE S
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG S
POLICY F-IU%oi LOC S
I-I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea ax4ont)
ANY AUTO
' BODILY INJURY (Per person) S
ALL OWNEDAUTOS
BODILY INJURY (Ptr eaddanl) S
SCHEOULEDAUTOS PROPERTY DAMAGE
HIREOAUTOS (P"acciden6 S
NON,OWNEDAUTOS S
S
UMBRELLAUAR OCCUR EACHOCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE S
DEDUCTIBLE $
RETENTION 3 F- $
WORNaRS COMPENSATION X CSTI TUS ETH
AND EMPLOYERS' LIABILITY
A ANY FROFRIETOn,PARrNERIEXECUTNEYO NIA C41N0008564012 10101112 10101/13 E.1.11ACHACCIDENT $ 600,00(
OFFICER/MEMDER EXCLUDED?
(Mandalay In NH) E.L. DISEASE-EA EMPLOYE $ 500,00(
11yei des<Mw endel
DESGE N FOPERAT NSW" E.L. DISEASE -POLICYLIMIT S 500,001
DESCRIPTION OF OPERATIONS/ LOCATIONS /VENICLES(AHachACORD107,Addldoa)Rtm ,SchM.io,lfmoreapaceItrpuUtd)
RE: All Operations of the Named Insured
CERTIFICATE HOLDER CANCELLATION
CITAS01
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Purchasing ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Kariann Olson
90 N. Mountain Ave. NJTNORIUD REPRESENTATIVE
Ashland, OR 07620.2014 l% .
_~1 OPAD: RPW
CERTIFICATE OF LIABILITY INSURANCE 1 DAoe/,so
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(183) must be endorsed. If SUBROGATION IS WAIVED, subject to
the forms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such andorsement a .
PRODUCER 641.245-1111 TACT Dana Brinkley
United Risk Solutions, Inc. 641-2454112 Pxoxe •341-2464111 FAX Ne) 64,-246-1112
PO Box 938 (
Medford, OR 97501-0087 NESS dana.brinkle unltedriskeom
Jim R. Cox gOO1ssR .ECONOIC
WsuaEes)AFFORDING COVERAGE NAIC0
WSURED Economy Plumbing, Inc. INSURERA:AmCO In8Uran Ca CO
309 Kent Street INSURERe: ,
Ashland, OR 87620 INSURERG 1
INSURER e:
INSURER E:
INSURERF;
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: '
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 85LOW 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.
INSN TYPE OF UISUWWCO POUCYN MSER NY NuAmerrffn users
GENERALLMSIUTY EACH OCCURRENCE f 1,000,00
A X CQWcERCIALGENERALUASIUTY X CPMCT07606033289 081Dt112 08107113 PREMISES (Eioma Xe s 100,00
CWMSJMOE X~OCCUR. MEDEXP(Arge psn ) f 6,00
PERSONALS AWRIJURY S 1,000,00
GENERALAGGREGATE S 2,000,00
GEM AGGREGATE UMITAPPUES PER: PRODUCTS-COUPX)PAGG f 2,000,00
X POLICY P LOG f
AUTOMORMUARIUTY X COMBINED SINGLEUWT S 1,000,00
A JX ANY AUTO LPBAPD7619033269 08101/12 06101113 teaecw" -
ROOILYINJURYIPerperron) S
ALLOWNEDAUTOS e0o1LY0UUAY(PUec"nO f
SCHEOULEDAUTOS PROPERTY DAMAGE
mNEDADros (Paaddl) NON{VMEDAUTOS f
S
UMBRELLA LIAR CCCIIR EACH OCCURRENCE S
eXCE8e UAD CLAMS-MADE AGGREGATE f
DEDUcneLE is
RuTE oN Is
WoRNERS COMPENSATION A U• T •
ANDEWLOYERWUASIUTY 1LS EiL
ANYPROPRflFV0"ARTNERIEXECLMVE YIN E.L EACH ACCIDENT
OFFMERAIENSEREXCLUDED] NIA
(Wants arjln NN) E.L DISEASE •FA EMPLOYE S '
Ifyypp desaLe alder
D 6NMION OF OPERATI EA. DISEASE•POUCYUNIT i
DESCRIPRONOP OPERATIONS) LOCATMS I VEHICLES (&U ch ACORD 101,AddWw1 REtN1ItE 9cMdule, tllnere spice is ngwvd)
Certificate holder Is Additional Insured for general Ilablliltyy per attached
C07323 (11111) and for commercial auto per attached AC0102 (03110)
CERTIFICATE HOLDER CANCELLATION
CITAS01
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES dE CANCELLED BEFORE
City of Ashland Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Purchasing ACCORDANCE WITH THE POLICY PROVISIONS.
Kar(ann Olson
90 N, Mountain Ave. AUTHORIM0 REPRESENTATNR
Ashland, OR 87620.2014
1988.2009 ACORD CORPORATION. All rights reserved.
-COMMERCIALAUTO
AC 01 02 0310
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
A. CHANGES FOR TRAILERS AND FARM rental of a vehicle is an "insured" for Liability
EQUIPMENT Coverage, but only to the extent that person
1. Under the COVERED AUTOS SECTION, or organization qualifies as an "insured" un-
the following are added to Paragraph C. der the Who Is An Insured Provision con-
Certain Trailers, Mobile Equipment and SECTION in of the the LIABILITY COVERAGE
Temporary Substitute Autos: SECT Coverage Form
4. "Trailers" designed to be towed by a pri- D. REPLACED EXCLUSIONS
vate passenger type "auto" or a pickup, The Expected or Intended Injury Exclusion
panel truck or van if not used for busi- ' in the LIABILITY COVERAGE SECTION Is
ness purposes, other than farming or replaced by the following:
ranching. Expected or Intended Injury
5. Farm wagons or farm Implements while "Bodily injury" or "property damage" which Is
being towed by a covered "auto". expected or Intended by the "Insured". This
B. CHANGES FOR ADDITIONAL NEWLY exclusion applies even if the resulting "bodl-
ACQUIRED VEHICLES ly Injury" or "property damage":
2, Paragraph B.2 of the COVERED AUTOS a. Is of a different kind, quality or degree
SECTION, is replaced by the following: than initially expected or intended; or
2. If Symbol(s) 7 or 67 is entered next to b. is sustained by a different person, entity,
coverage to Item Two of the Declara- real property, or personal property than
tions, an "auto" you acquire will be a that initially expected or intended.
covered "auto" for that coverage only If., E. ADDITIONAL EXCLUSIONS
a. We already cover at least one "auto" The followilg exclusions are added to the
you own for that coverage or it rep- LIABILITY COVERAGE SECTION:
laces an "auto" you previously
owned that had that coverage; and Damage to Named tnsured's Property
b. You tall us within 30. days after you Any claim or "suit" for "property damage" by
acquire it that you want us to cover you or on your behalf against any other per-
it for that coverage. son or entity that is also a Named Insured
under
The most we will pay for Physical Damage this policy..
Coverage for "loss" under this Coverage Ex-
tension Molestation
Is $100,000 per "auto", subject to "Bodily injury" or "property damage" arising
the largest deductible applicable to any "au- out of.
to" for that Coverage. a. The actual or threatened abuse or
C. BLANKET ADDITIONAL INSURED molestation by anyone or any person
Any person or organization which you have while in the care, custody or control of
agreed to name as an additional Insured in a any "insured", or
written contract, executed prior to an acci- b. The negligent:
dent, other than a contract for the lease or 1) Employment;
AC 01 02 0310 Includes copyrighted material of Insurance Services Office, Inc„ Pagel of 4
with its permission.
AC 01 02 03 10
2) Investigation; This insurance does not apply to:
3) Supervision; a. "Loss" to the covered "auto'e contents,
4) Reporting to the proper authorities, except equipment usual to trucks or pri-
or failure to so report; or vale passenger "autos'.
5) Retention; b. "Loss" to TV antennas, awnings or ca-
of a person for whom any "insured" is or banas.
ever was legally responsible and whose c. "Loss" to equipment designed to create
conduct would be excluded by Para- added living facilities,
graph a. above. However, these exclusions do not apply if
Abuse means an act which is committed Miscellaneous Personal Property Coverage
with the Intent to cause harm. Is provided by endorsement to this policy.
Explosives G. ACCIDENTAL AIRBAG DISCHARGE
"Bodily injury" or "property damage" caused COVERAGE '
by the explosion of explosives you make, Under Paragraph B.3.a. of the PHYSICAL
sell or transport. DAMAGE SECTION, the following is added:
Rolling Stores Mechanical breakdown does not include the ac-
If a covered "auto" Is a rolling store, "bodily cidenlal discharge of an airbag.
Injury" or "property damage" resulting from H. PHYSICAL DAMAGE LIMIT OF INSURANCE
the handling, use or condition of any item Under PHYSICAL DAMAGE COVERAGE
the "Insured" makes, sells or distributes if SECTION, Paragraph C., Limit of Insurance is
the injury or damage occurs after the "in- replaced by the following:
sured" has given up possession of the item. C. Limit Of Insurance
Wrong Delivery of Liquid Products 1. The most we will pay for 'lose In any
"Bodily Injury" or "property damage" result- one "accident" is the lesser of:
ing from the delivery of any liquid Into the a. The actual cash value of the damaged
wrong receptacle or to the wrong address, or stolen property as of the time of the
or from the delivery of one liquid for another, "loss", or
if the "bodily Injury" or "property damage"
occurs after the delivery has been com- b. The cost of repairing or replacing the
pleted. damaged or stolen property.
Delivery Is considered completed even if fur- 2. $1,000 is the most we will pay for "loss" in
ther service or maintenance work, or correc- any one "accident' to all electronic equip-
tlon, repair or replacement is required be- ment that reproduces, receives or transmits
cause of wrong delivery. audio, visual or data signals which, at the
Professional Services time of 'loss'. is:
a. Permanently Installed in or upon the
"Bodily injury : covered "auto' In a housing, opening or
a. Resulting from the providing or the fail- other location that is not normally used
ure to provide any medical or other pro- by the "auto" manufacturer for the instal.
fessional 'services. latlon of such equipment.
b. Resulting from food or drink furnished b. Removable from a permanently installed
with these services, housing unit as described In Paragraph
"Bodily injury" or "property damage" result- 2.a. above or is an Integral part of that
ing from the handling of corpses. equipment; or
F, MOTOR HOME CONTENTS COVERAGE c. An Integral part of such equipment.
1. For a covered "auto" that Is a motor home 3. An adjustment for depreciation and physical
the following exclusions are. added to the condition will be made in determining actual
PHYSICAL DAMAGE COVERAGE cash value in the event of a total 'loss'.
SECTION:
Motor Home Contents
Page 2 of 4 Includes copyrighted material of Insurance Services Office, Inc., AC 01 02 0310
with Its permission.
AC 01 02 03 10
4. The cost of repairing or replacing may: 4. A member, if you are a limited liability com-
a. Be based on an estimate which includes pany.
parts furnished by the original equip. K. UNINTENTIONAL FAILURE TO DISCLOSE
ment manufacturer or other sources in- HAZARDS
cluding non-original equipment manu- The BUSINESS AUTO CONDITIONS SECTION
facturers and and MOTOR CARRIER CONDITIONS
b. Include a deduction for betterment for a SECTION- B.2. are amended by the addition of
pafi or parts that are normally subject to the following:
repair or replacement during the useful If you unintentionally fall to disclose any hazards
life of the "auto", such as, but not limited existing at the inception date of your policy, we
to tires and batteries. will not deny coverage under this Coverage
Betterment means the difference be- Form because of such failure. However, this
tween the actual cash value of a part provision does not affect our right to collect addl-
Immediately before the "loss" and the lional premium or exercise our right of cancella-
cost to replace that part with a new part. tion or nonrenewal.
5. If we offer to pay the actual cash value of L. AUTOS HIRED OR RENTED BY
the damaged or stolen propa EMPLOYEES
rty, we will val-
ue auto advertising wraps, paint customize- If hired or rented 'autos" are covered 'autos' on
don, and similar business related advertising this policy, the following provisions apply:
modifications, in addition to the actual cash A. Changes In Liability Coverage
value of the property. Auto advertising The following is added to the Who Is An In-
wraps, paint customizatlon, and similar sured Provision in the LIABILITY
business related advertising modifications COVERAGE SECTION:
will be valued at the cost to replace them
with an adjustment made for depreciation An "employee" of yours is an "insured" while
and physical condition, operating an "auto" hired or rented under a
1. GLASS REPAIR-WAIVER OF DEDUCTIBLE contract or agreement in that "employee's"
Under Paragraph D. Deductible of the name, with your permission, while performing
PHYSICAL DAMAGE COVERAGE SECTION, dudes related to the conduct pf your busl-
the following is added: ness.
No deductible applies to glass damage If the B. Changes In General Conditions
glass Is repaired rather than replaced. Paragraph 5.b. of the Other Insurance
J. AMENDED DUTIES IN EVENT OF ACCIDENT, Condition in the Business Auto Coverage
CLAIM, SUIT, OR LOSS Form and Paragraph 5.f.of the Other Insur•
ance Condition in the Motor Carder Cover-
The requirement in Loss Condition 2.a. Duties In age Form are replaced by the following:
the Event Of Accident, Claim, Suit Or Loss - of For Hired Auto Physical Damage Coverage,
the BUSINESS AUTO CONDITIONS SECTION
and the MOTOR CARRIER CONDITIONS the following are deemed to be covered "au-
SECTION that you must notify us of an "acd- toe" you own:
dent", "claim", 'sulr, or "loss" applies only when 1. Any covered "auto" you lease, hire, rent
the "accident, 'claim', "suit", or "loss" is known or borrow; and
to: 2. Any covered "auto" hired or rented by
1. You, If you are an individual your "employee" under a contract in that
2. A partner, If you are a partnership; Individual "employee's" name, with your
3. An executive officer or the employee desig- permission, while performing duties re-
g- to the conduct of your business.
nated by you to give such notice if you area However, any' "auto" that Is leased, hired,
corporation; or rented or borrowed with a driver is not a
covered "auto".
AC 01 02 0310 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 4
with its permission.
AC 01 02 03 10
. ,
M. EMERGENCY LOCKOUT - PRIVATE 3. Original copies of receipts for services of a
PASSENGER VEHICLES locksmith must be provided before relm-
We will reimburse you up to $50 for reasonable burse ment is payable.
expense Incurred for the services of a locksmith N. LIBERALIZATION
to gain entry Into your covered "auto° of the pri- Paragraph 3, of the General Conditions is re-
vale passenger type subject to these provisions: placed by the following:
1. Your door key or key entry pad has been If we adopt any revision that would broaden the
lost, stolen or locked in your covered "auto' coverage under this policy without additional
and you are unable to enter such 'auto' , or premium within 60 days prior to or during the
2. Your key or key entry pad has been lost or policy period, the broadened coverage will Im-
stolen and you have changed the. lock to mediately apply to this policy.
prevent an unauthorized entry; and
f
All terms and conditions of this policy apply unless modified by this endorsement.
Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc., AC 01 02 0310
with its permission.
Page 1 / 1
Ashland Park Commission DATE PO NUMBER
20 E MAIN ST. 6/14/2013 00227
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 000291 SHIP TO:
ECONOMY PLUMBING, INC.
309 KENT STREET
ASHLAND, OR 97520
FOB Point: Req. No.:
i
Terms: Net 30 days Dept:
Req. Del. Date: contact: Bruce Dickens
Special Inst: Confirming? No
- Quantity. :Unit Description > Unit Price Ext Price
Repair shower controls at Daniel Meyer 4,525.00
Pool
Contract for Goods and Services
Beqinninq date: 05/2812013
Completion date: 06/14/2013
SUBTOTAL 4,525.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 4,525.00
- Account Number Project Number Amount - Account Number Project Number.'AmounP
E 211.12.02.06.60416 4,525.00
VENDOR
Authorized Signature COPY
V+0 jtj~1#3 CITY OF
A request for a Purchase Order S H LAN D
REQUISITION Date of request: 5~~ ~I3
q Required date for delivery:
Vendor Name / 3 1 L / t I
Address, City, State, Zip ~r>~i ~~F lll'I 81511"t) (~261 ~'t/l) 4 7 ~5~a
Contact Name & Telephone Number
Fax Number 1 _ _ f UGC!
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emeroencv
❑ 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
$5.000 to $100.000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes and solicitation attached ❑ Form 94, Personal Services $5K to $75K Contract #
PERSONAL SERVICES E] Special Procurement Interoavemmental Agreement
$5,000 to $75,000 ❑ Form #g, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date o ginal contract approved by Council:
❑ (3) Written proposals/written solicitation Date approved by Council: (Date)
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
I~e~7s ,eu-- rscz3
~j tl2 5(1101kMX- 00)1~2olS al 1~nUte4
:
h1v ~ E'er ! C 1- $ o~~5. At 750
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
❑ Per attached quotelproposal $
Project Number Account Number
Account Number0lJ2 Cp-=CYO-GUyIbO 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 requi . io/n/ form, I certify that the City's public contracting requirements have oe~ , s fisfied.
Employee Signatur Department Head Signature:
(Equal to or greater than $5,000)
City Administrator:
6 \ (Equal to or greater than $25,000)
Funds appropriated for current fiscal year., YES NO l lvl&. ti k d LAL Al c 1 7 f/-13
Fine Director- (Equal to or greater than $5,000) Date
Comments:
Form #3 - Requisition