HomeMy WebLinkAbout2013-149 Contract - Terrasurvey
Contract for PERSONAL SERVICES less than $35,000
CITY OF CONSULTANT: Terrasurvey Inc.
-4S H LAND CONTACT: Stuart Osumus P.L.S.
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 274 Fourth St.
Telephone: 541/488-6002 Ashland OR. 97520
Fax: 541/488-5311
TELEPHONE: 541/482-6474
DATE AGREEMENT PREPARED: 5/30/2013 FAX: 541/552-0292
BEGINNING DATE: 10/24/2012 COMPLETION DATE: 6/30/2013
COMPENSATION: Not To Exceed $9,500
SERVICES TO BE PROVIDED: Survey, prepare, submit and record all necessary survey and Jackson County
Planning documents for the property line adjustment with regards to the City of Ashland and Mr. Miller land
exchange agreement approved b the City Council on September 18, 2012.
ADDITIONAL TERMS: None
FINDINGS:
Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and
determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor
resources to perform the services; (3) the statement of work represents the department's plan for utilization of such
personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient
to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints
provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein
is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service 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.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service 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.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $19,494 or more, Consultant 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 service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Consultant 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 Consultant (including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations,
actions, costs, judgments, or other damages, directly, solely, and proximately caused b the negligence of City.
Contract for Personal Services, Revised 06/30/2012, Page 1 of 5
10. 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 Consultant, 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 Consultant 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 Consultant 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 Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant 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, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Consultant 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 Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant 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. Consultant 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.
13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant 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.
14. Insurance. Consultant 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. Professional 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 claim, incident or occurrence. This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
C. 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.
d. 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,
Contract for Personal Services, Revised 06/30/2012, Page 2 of 5
including coverage for owned, hired or non-owned vehicles, as applicable.
'e. 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 Consultant or its insurer(s) to
the City.
f. Additional Insured/Certificates of Insurance. Consultant 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 Consultant's services to be provided under this Contract. The consultant's insurance is primary and
non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish
acceptable insurance certificates prior to commencing work under this contract. 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
Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
15. 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 Consultant 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. Consultant, 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.
16. 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.
CONSULTANT, 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.
17. 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. Consultant
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 Consultant, with no further
liability to Consultant.
Certification. Consultant shall sign the certification attached hereto as Exhibit A and herein incorporated b reference.
onsultant City of Ashland \
By 't: 'C. By
I Signature Department Head
Print Name/0 Print Name
Vict ~PES~p~e..f (pI4I13
Title Date
W-9 One copy of a is to be submitted with /
the signed contract. Purchase Order No.
RROV D TO FORM
Signature
(a-'II-(?
Date
Contract for Personal Services, Revised 06/30/2012, Page 3 of 5
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
J (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.
J (2) Commercial advertising or business cards or a trade association membership are
r purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
J (4) Labor or services are performed only pursuant to written contracts.
J (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.
G
Contractor (Date)
Contract for Personal Services, Revised 06/3012012, Page 4 of 5
gN L:, . .ata tGY tn~umER PRICER Ee ACCOUNT mAatt nvDrr raerdD
'D• PAS•43357319 02218248 M014893S 17-001-00001 NONE
'BRANCH ST BRANCH TED - NC RENEWAL EFF 05/10/2013
ZURICH
ASSURANCE COMPANY OF AMERICA
COMMON POLICY DECLARATIONS
PRECISION AMERICA
`OFFICE PROGRAM'
Y
This policy consists of the declarationts as well as the coverage forms and endorsements
listed on the Forms and Endorsements Applicable List.
NAMED INSURED AND MAILING ADDRESS AGENCY NAME AND SERVICING ADDRESS
TERRASURVEY, INC ASHLAND INSURANCE, INC.
274 4TH STREET PO BOX 880
ASHLAND OR 97520-2044 ASHLAND OR 97520-0030
(541) 482-0831
a BRANCH NAME AND SERVICING ADDRESS I POLICY PERIOD
"d BRANCH TBD - NC FROM TO
PO Box 2248 05/10/2013 05/10/2014
Grand Rapids, MI 49501-2248 12:01 AM 1201 AM
(800) 800-3907
L Standard Time At.Your Mailing Address Shown Above
U I E ENTIT : CORPORATION
BUSINESS DESCRIPTION: ENGINEERS OR ARCHITECTS- ONSULTING-NOT ENGAGED IN CONSTRUCTION SUPERVISION
POLICY PREMIUMS
In return for the payment of the premium, and subject to all the terms of this policy, we agree
with you to provide the insurance as stated in this policy.
This policy consists of the following coverage parts for which a premium is indicated. This
f premium may be subject to,adjustment.
1t PREMIUM
COMMERCIAL PROPERTY AND GENERAL LIABILITY $
,a EMPLOYMENT PRACTICES LIABILITY COVERAGE S #0
c
i
TERRORISM PREMIUM S JIM
TOTAL ANNUAL PREMIUM f 400Mlt
Countersigned by 0
u oriWd Representative Date
l.dud.a ..,,ight.d m.t.,W .1150 Proprttin, Inc., with io p.rmimim.
C.,,i,ht, ISO Pr,wi.e, Inc., 2001 04/04/2013
COMMON INSURED'S COPY U-CL-D- 1 Do-A Cw (06-04)
$7,
Liberty
Northwest. PO Box 5048
M m.„ Portland, OR 97208-5048
INSURANCE IS PROVIDED BY NORTH PACIFIC INSURANCE COMPANY
POLICY C12 15-17-49
RENEWALOF C11 151749
COMMON POLICY DECLARATIONS
YOUR AGENT: ASHLAND INSURANCE, INC. AGENT CODE: 1090-30
NAMED INSURED AND MAILING ADDRESS: POLICY PERIOD:
TERRASURVEY INC From 10/30/12 to 10/30/13
274 4TH ST 1201A.M. STANDARDTIME AT YOUR MAILING ADDRESS SHOWN ABOVE.
ASHLAND, OR 97520
BUSINESS DESCRIPTION: LAND SURVEYOR
FORM OF BUSINESS: CORPORATION
In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as staled in this policy. This
policy consists of the following Coverage Parts for which a premium is indicated. This premium may be subject to adjustment.
COVERAGE PARTS PREMIUM
COMMERCIAL PROPERTY COVERAGE PART $
COMMERCIAL GENERAL LIABILITY COVERAGE PART $
COMMERCIAL AUTO COVERAGE PART $
COMMERCIAL CRIME COVERAGE PART $
COMMERCIAL INLAND MARINE COVERAGE PART $
FARM COVERAGE PART $
$
TOTAL POLICY PREMIUM $ i.
TERRORISM PREMIUM OF $ 0.
INCLUDED IN TOTAL POLICY PREMIUM
FORMS AND ENDORSEMENTS APPLICABLE TO ALL COVERAGE PARTS:
PER FORMS SCHEDULE ATTACHED
Countersignature, if required by law c Authorized Representative
These declarations together with the common policy conditions, coverage part form(s) and forms and endorsements, if any, issued to form a part thereof, complete the above
numbered policy. ORIGINAL 10/02/12
LML 8009 (06-03)
C 0102
i I l REMIT PAYMENT TO:
PO BOX 1804
MEDFORD OR 97501
Am'h'
INVOICE#0035694
ACCOUNT NUMBER : 749200 INVOICE DATE : 11/07/22
ATTN:
Terra Survey TITLE NUMBER : 799458
274 4th Street CUSTOMER REF : Miller-Ashland
Ashland, OR 97520 ESCROW NUMBER :
ESCROW OFFICER :
Quea[lona~ Pleaao call 541-779-7660
DESCRIPTION LIABILITY AMOUNT
Subdivision Guarantee 150..0
Additional Chain Search 150.0
Attn: Fred Frantz
M
0
0
TOTAL 300.00
W
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TERRASURVEY, INC. STATEMENT
PROFESSIONAL LAND SURVEYORS
274 FOURTHSTREET
ASHLAND, OREGON 97520
TELEPHONE: (541) 481-6474 JOB NAME GUN CLUB
FACSIMILE.' (541) 552-0292 rerrain@bisp.net
JOB: O. A 261-12
JOB DESCRIPTION: INVOICE NO. A261-12.2
CITY OF ASHLAND
ASHLAND GUN CLUB TAX NO. 93-1262036
PROPERTY LINE ADJUSTMENT
DATE May 30, 2013
BILL TO:
DIRECTOR OF PUBLIC WORKS
CITY OF ASHLAND
20 EAST MAIN STREET
ASHLAND, OREGON 97520
DATE DESCRIPTION HOURS RATE AMOUNT
1-09-13 TO 5-30-13
1128/13 REVISE MAPS AND APPLICATIONS TO CREATE 2 7 65.00 455.00
SEPARATE APPLICATIONS
2/6/13 DELIVER APPLICATIONS TO CITY, MILLER AND 2 45.00 90.00
COUNTY
2/13/13 (FIELD) SET PINS ON MILLER SIDE OF CREEK 3 120.00 360.00
4/1/13 PREPARE SURVEY NARRATIVE 2 80.00 160.00
4/10/13 FINAL REVISIONS TO LEGAL DESCRIPTIONS 1 80.00 80.00
4/10/13 DELIVER PACKAGE TO COUNTY PLANNER 2 45.00 90.00
4/10/13 JACKSON COUNTY SURVEYOR FILING FEE (PAID 1 248.00. 248.00
CHECK. No. 5778)
4/10/13 JACKSON COUNTY DEVELOPMENT SERVICES FINAL 1 74.00 74.00
PLAT FEE (PAID CHECK NO. 5779)
0
$1557.00
TOTAL
DUE
DUE AND
PAYABLE
UPON
RECEIPT
MAKE CHECKS PAYABLE TO:
TERRASURVEY, INC.
TERRASURVEY, INC. STATEMENT
PROFESSIONAL LAND SURVEYORS
274 FOURTH STREET
ASHLAND, OREGON 97520
TELEPHONE: (541) 482-6474 JOB NAME GUN CLUB
FACSIMILE: (541) 532-0292 terrain@bisp.net
JOB NO. A 261-12
JOB DESCRIPTION: INVOICE NO. A 261-12.1
CITY OF ASHLAND
ASHLAND GUN CLUB TAX NO. 93-1262036
PROPERTY LINE ADJUSTMENT
DATE May 30, 2013
BILL TO:
DIRECTOR OF PUBLIC WORKS
CITY OF ASHLAND
20 EAST MAIN STREET
ASHLAND, OREGON 97520
DATE DESCRIPTION HOURS RATE AMOUNT
10-24-12 TO 1-09-13
10/24/12 MEETING ON SITE WITH CITY, MILLER, GUN CLUB 1 45.00 45.00
10/24/12 RESEARCH, CALCULATIONS FROM EXIST. SURVEYS 3 80.00 240.00
10/30/12 FIELD - EXTEND EXISTING CONTROL TO SITE 3 120.00 360.00
10/31/12 FIELD - SET CONTROL ON SITE, TIE IMPROVEMENTS 2 120.00 240.00
11/5/12 PREPARE APPLICATIONS 6 80.00 480.00
11/12/12 TITLE REPORT RECEIVED, REVIEW, PLOT EASEMENTS 4 80.00 320.00
11/26/12 FIELD - LOCATE EASEMENTS ON MILLER PARCELS 2 120.00 240.00
11129/12 PREPARE PLOT PLAN, LETTERS TO OWNERS 4.5 80.00 360.00
12/3/12 PREPARE ADJUSTED LEGAL DESCRIPTIONS 4 80.00 320.00
12/4/12 PREPARE ADJUSTED LEGAL DESCRIPTIONS 3 80.00 240.00
12/5/12 FIELD - LOCATE AND SURVEY EXISTING MONUMENTS 7.5 120.00 900.00
12/6/12 FIELD - LOCATE CREEK BANKS 7 120.00 840.00
12/7112 OFFICE - CALCULATE NEW PARCEL BOUNDARIES 4 80.00 320.00
12/10/12 COMPLETE PARCEL LEGAL DESCRIPTIONS 7 80.00 560.00
12/11/12 PREPARE PRELA4INARY MAP OF SURVEY 7.5 65.00 487.50
12/12/12 CHECK LEGAL DESCRIPTIONS, DELIVER TO CITY 2.5 80.00 200.00
1/8/13 FIELD - SET PINS ON CITY SIDE OF CREEK 5.5 120.00 660.00
1/9/13 FIELD - SET PINS ON CITY SIDE OF CREEK 3 120.00 360.00
11/12J12 TITLE REPORT - PAID CHECK NO. 5653 1 300.00 300.00
$72472.50
TOTAL
DUE
DUE AND
PAYABLE
UPON
RECEIPT
MAKE CHECKS PAYABLE TO:
TERRASURVEY, INC.
PLEASE REMIT PAYMENT UPON RECEIPT OF THIS STATEMENT. LEGAL INTEREST AT THE RATE OF
1.5% PER MONTH (18% PER YEAR) WILL BE ADDED FOR EACH 30 DAYS OVERDUE.
L_
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T
s.:
SURVEYOR'S OFFICE
Jackson County Courthouse i
10 S. Oakdale
MEDFORD, OREGON 97501
Phone (541) 774.6191
CUSTOMER'S ORDER NO. PHONE DAT ,
10 - Y3
NAME - i;,-A.l.
lerv4 Suvvev
ADDRESS
CASH O.O.D. CHARGE ON ADCI. MDSE REM PAID OUT
II~~ 7->
~Zrc;71~ 1
t:
t 1`4.577d
TAX
SCLO BY gEDE.VED SY
TOTAL
C PRODLI T eos All claims and returned goods MUST be accompanied by this hill.
4766 `AankWou
i.
s
15201300000000001339
JACKSON COUNTY DEVELOPMENT SERVICES 4/10/2013
3:10:05PM
JACKSON RECEIPT OF PAYNIENT
COUNTY
Receipt 9: IS201300000000001339 Receipt Date: 04110/2013
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SUB2012-00069 PLA Final Plat Fee 3701040000.45105.4500 74.00
Line Item Total: $74.00
Payments: -
Method Payer Bank No Account No Confirm No How Received Amount Paid
Check TERRASURVEY WC 5779 to In Person 74.00
Payment Total: $74.00
Balance
Payment Received By:
(staff signature)
Page I of I cRecci
W Tt
Ul ` Y htU DEfj
Page 1 / 1
CITY OF . ASHLAND TE - - PO NUMBER
20 E MAIN ST, 6/14/2013 11639
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 003354 SHIP TO: Ashland Public Works
TERRASURVEY INC (541) 488-5587
274 FOURTH STREET 51 WINBURN WAY
ASHLAND, OR 97520 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net Dept.:
Req. Del. Date: Contact: Brad Barber
Special Inst: Confirming? No
- " - Description - ' `Unit Price: - , Ext. Price
-QuanH Unit.' - -
Property Line Adjustment 9,500.00
Ashland Gun Club
Contract for Personal Services
Beqinninq date: 10/24/2012
Completion date: 06/30/2013
SUBTOTAL 9 500.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 9,500.00
ASHLAND, OR 97520
Account Number Project Number Amount AccountNumber Project Number Amount
E 410.08.24.00.70420 E 200907.999 9 500.00
b~nM 4L~ "t r 1 VENDOR COPY -
Authonzeu Signature
FORM #3 CITY OF
A request for a Purchase Order ASHLAND
REQUISITION Date of request: 6-04-2013
Required date for delivery: 6-14-2013
Vendor Name Tpaa y lnr.
Address, City, State, Zip 274 Fourth St Ashland Oregon 5175,20
Contact Name & Telephone Number StuArtOgumus 941-487R474
Fax Number
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergency
❑ 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 f le) ❑ State of Oregon
❑ Direct Award Date approved by Council: Contract #
❑ VerbalMdtten 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 #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 proposalsMritten solicitation Date approved by Council: (Date)
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
Survey, prepare, submit and record all necessary survey and Jackson County Planning documents
for the property line adjustment with regard to the City of Ashland and Mr. Miller land exchange $9500.00
agreement approved b the City Council on September 18, 2012.
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
❑ Per attached quote/proposal $9500.00
Project Number 200907.999_ Account Number 410 -08-24 -00 -704200
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:
ITDirector Date Support -Yes/No
By signing this requisition form, I certify that the City's public contracting requirements have been satisfied
Employee Signature: ~~~>~~7i. ~1 - Department Head Signature: Wr-fk.lz2-~Ya-
(Equaltoorgreater th n$5,000)
City Administrator:
r (Eual to or greater than $25,000)
Funds appropriated for current fiscal year., ES / NO CAOA l ,h L({ut ,4- ( A' (G,1 1" / I4 r_
Financb~ Director-(Equal to orgreater than $5,000) Date
Comments:
Forth #3 - Requisition