HomeMy WebLinkAbout2013-237 Contract - Mountain View Paving
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Mountain View Paving
-AS H LAND CONTACT: Paul Meyer
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 2560 East Main Ashland Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-535-3840
DATE AGREEMENT PREPARED: Jul 29, 2013 FAX: 541-535-3865
BEGINNING DATE: August 5, 2013 COMPLETION DATE: August 10, 2013
COMPENSATION:
GOODS AND SERVICES TO BE PROVIDED: Asphalt Patching at Lithia Park
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 2796.220, 2796.225, 279B.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 $19,825 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:
i. If City funding from federal, state, count or other sources is not obtained and continued at levels
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 1 of 5
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.
L 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
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurers to
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 2 of 5
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
refe nce.
Ty of Ashla d
Co t t r: By
B
Signature Department Head
4 < ` ~m1~/l/try
Print Name Print Name
e 71us- e ire- cd2,11)
Title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, 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:
v
(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.
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 4 of 5
2/12/2011 06:28 541-535-3865 MOUNTAIN-VIEW PAVING,INC. #5822 P.001 /001
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stimates. for:
ASPHALT PAVING
1. EXCAVATE AND REPAIR APPROXIMATELY 45 SQ. FT. OF PATCHES
2. APPLY C-SS 1 BONDING OIL TO ALL ASPHALT EDGES
3. PAVE ABOVE AREA AT 3" COMPACTED CLASS C ASPHALT
4. PREP AN AREA APPROXIMATELY 1010 SQ. FT. OF DRIVEWAY FOR OVERLAY
5. APPLY C-SSI BONDING OIL TO ABOVE SURFACE
6. PAVE ABOVE SURFACE AT 1.5" COMPACTED CLASS C ASPHALT
WE PROPOSE hereby to furnish material and labor - complete in accordance with the above specifications, for the sum of:
dollar. fS
Payment to be made as follows:
TWO THOUSAND FOUR HUNDRED TWENTY AND 00/100 $2,420-00
AN msredel is auam%ead w bo as eoeared. All work 10 W comp'eeed'bt a pmteatiatel manna'
ocoote" , Warlord pmabes. Any alteration or deviation f abo epedlkarons unoMng
addidor.j work and ema So= will become an ama charge wer and above. the eminuSe. If Sub-
base w%Vor babe Is prepared by odtars. guarantee IS wniicd W workmare;hlp. AD agreements ern
coming= upon strikes, aocidsnts, inclement weaNer, or other delays beyond our corarol. / ri zad
Emoloyeas of contractor ere covered by mate insurance laws. Tarns: payment in full on gi4'a°°'e
cpmpktien or proles[, unl,m; omer arrangements are made in writing. A 1.5% per n q* fe a e
enarge win be added on all past due S,,,ufde (an annual pempnwgc rate of 1a%1- n Imgauon is Na0:7ha proposal may be
Inva uted arhabq diecrly out of this proposal, the pnvailing Party Shell be enfidod to fteonable wfdhdrawn by us If rkN aecepred wanin days.
anomeys roes and meta ehalrted. CCDe 59920.
/ACCEPTANCE OF PROPOSAL -The above prices, spadififations
and conditions are satisfactory and are hereby accepted. You are authorized signature
to do the work as specified. Payment will be made, as outlined above.
signature
Date of Acceptance:
DELUXE FOZ SUSiNESS 1-80"0-$"327 =etnr,o av
® CERTIFICATE OF LIABILITY INSURANCE FDA 9128(2012 (MIWDDfYTYY)
ACORO
THI` RTIFICATE 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(ies) 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(s).
PRODUCER Beecher Carlson Insurance Agency, LLC CONTACT NAME: (EUG) Site Noakes --TIAX I,
2 Eugene, OR Tennyson 97408 Ave., Suite 304 PHONE Ac Np: (AJC No. Extl- 541-284-3096
E-MAIL ADORES: suenoakes(dbeech6n;aff n.0
INSURERS AFFORDING COVERAGE NAIC it
www.beechercarlson.com INSURER A: NO 41939
INSURED INSURER B : 4
Mountain View Paving, Inc.
PO BOX 508 INSURER C:
Talent OR 97540 NsuRERD:
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 14276999 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.
ADD BR POLICY EFF POLICY EXP
ILTR TYPE OF INSURANCE I POLICY NUMBER MMNDIYYn MMIDDIYYYY LIMITS _
A GENERAL LIABILITY ✓ C11154211 912512012 9125/2013 EACH OCCURRENCE IS 1,000,000
-
✓ COMMERCIAL GENERAL LIABILITY DAMAGETORENTED 100,000
PREMISES Faocavnence $
CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000
PERSONAL B ACV INJURY $ 1,000,000
GENERALAGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000
POLICY F/ PRO- LOC $
A AUTOMOBILE LIABIUW C11154211 9/2512012 9/25/2013 COMBBIINd D SINGLE LIMIT $ 1000000
✓ ANY AUTO BODILY INJURY (Par person) $
AAUTOSLLOWNED AUTOS SCHEDULED BODILY INJURY (Per atfltleni) $
$
, an a,
NON-OWNED PROaPCEdRdI'OAMAGE
✓ HIREDAUTOS ✓ AUTOS PP
$
$
A ✓ UMBRELLA LIAR 'OCCUR C11154211 9/25/2012 9/2512013 EACH OCCURRENCE $ 1,000,000
EXCESS I. CLAIMS-MADE AGGREGATE $ 1,000,000
DED ✓ RETENTION$ 10,000 $
$
B WORKERS COMPENSATION 495478 10/112012 1011/2013 WCSTATLITS - 10&-
AND EMPLOYERS'LIABIIJTY YIN LIMI
ANY PROPRIETORIPARTNER/EXECUTIVE❑ NIA E.L. EACH ACCIDENT $ 1000000
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH) E. L. DISEASE - EA EMPLOYE $ 1000000
Ifyes, describe under
DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule. If more space is required)
Certificate holder included as additional insured as respects general liability on a primary and non contributory basis per the attached
CG8579 endorsement. Waiver of Subrogation applies b General Liability per written contract, per attached CG8579 endorsement.
CERTIFICATE HOLDER CANCELLATION
Re: Patches SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
90 N. Mountain ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland OR 97520 -
AUTHORIZED REPRESENTATIVE
EUG Sue Noakes
1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
CERT NO.: 14276999 1 EU01 Sue Noakes 9/20/2012 2:50:52 PM Pees 1 of 10
COMMERCIAL GENERAL LIABILITY
CG 85 79 05 05 .
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY
MASTER PAK PLUS@
FOR CONSTRUCTION
(OREGON)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
INDEX
SUBJECT PAGE
BLANKET ADDITIONAL INSURED (OWNERS, LESSEES OR CONTRACTORS) 2
FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT 3
NON-OWNED WATERCRAFT 4
SUPPLEMENTARY-PAYMENTS-(BAIL BONDS) 41
PERSONAL AND ADVERTISING INJURY - ELECTRONIC PUBLICATION EXTENSION 5
AGGREGATE LIMITS (PER LOCATION) 5
AGGREGATE LIMITS (PER PROJECT) 5
VOLUNTARY PROPERTY DAMAGE COVERAGE 6
OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE 6
NEWLY FORMED OR ACQUIRED ORGANIZATIONS 7
DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7
BODILY INJURY (MENTAL ANGUISH) 8
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS 8
MEDICAL PAYMENTS 8
BROAD NAMED INSURED 8
BROADENED MOBILE EQUIPMENT 8
INCIDENTAL MALPRACTICE LIABILITY 8
NON-OWNED AIRCRAFT 9
PROPERTY DAMAGE - ELEVATORS 9
CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 9
CEAT NO.: 14276999 (EUG) Sue Noakes 9/28/2012 2:50:52 PM Page 2 of 10
1. BLANKET ADDITIONAL INSURED (Owners, Lessees Or Contractors)
(Includes a Primary/Non-Contributory provision)
Section II - Who Is An Insured is amended to include as an insured any person or organization whom you are required
to name as an additional insured on this policy in a written contract or written agreement. The written contract or written
agreement must be currently in effect or becoming effective during the term of this policy and executed prior to the
"bodily injury, "'property damage" or "personal and advertising injury."
A person's or organization's status as an additional insured under this endorsement ends when your operations for that
additional insured are completed.
The insurance provided the additional insured is limited as follows:
A. The person or organization is only an additional insured with respect to liability caused by your negligence and:
1. Arising out of real property, as described in a written contract or written agreement, that you own, rent,
lease or occupy; or
2. Caused by your ongoing operations performed for the additional insured.
The insurance provided the additional insured in 1.A.2. above does not apply to:
a. Coverage A - Bodily Injury and Property Damage Liability, Coverage B - Personal and
Advertising Injury Liability or defense coverage under the Supplementary Payments arising
out of an architect's, engineer's or surveyor's rendering of or failure to render any professional
services including:
(1) The preparing, approving, or failing to prepare or approve maps, shop drawings,
opinions, reports, surveys, field orders, change orders or drawings and specifications;
and
(2) Supervisory, inspection, architectural or engineering activities.
b. "Bodily injury" or "property damage" occurring after:
(1) All work, including materials, parts or equipment furnished in connection with such work,
on the project (other than service, maintenance or repairs) that was performed by or on
behalf of the additional insured(s) at the site where the covered operations have been
completed; or
(2) That portion of "your work" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another contractor or
subcontractor engaged in performing operations for a principal as part of the same
project.
B. The limits of insurance applicable to the additional insured are those specified in a written contract or written
agreement or the limits of Insurance as stated in the Declarations of this policy and defined in Section III -
Limits Of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the
limits of insurance available under this policy.
C. The insurance provided the additional insured does not apply to the liability resulting from the negligence of the
additional insured.
CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 2 of 9
CENT NO.: 14276999 MUG) Sue Noekee 9/2812012 2:50:52 PM Page 3 of 10
D. As respects the coverage provided to the additional insured under this endorsement, Section IV- Conditions is
amended as follows:
1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim, or Suit:
An additional insured under this endorsement will as soon as practicable:
a. Give written notice of an "occurrence" or an offense, that may result in a claim or "suit"
under this insurance to us;
b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have
insurance available to the additional insured; and
C. Agree to make available any other insurance which the additional insured has for a loss
we cover under this Coverage Part.
2. The following is added to Condition 3. Legal Action Against Us:
We have no duty to defend or indemnify an additional insured under this endorsement until we receive
written notice of a claim or "suit" from the additional insured.
3. The following is added to. Paragraph a., Primary Insurance of Condition 4. Other Insurance:
If the additional insured's policy has an Other Insurance provision making its policy excess, and a
Named Insured has agreed in a written contract or written agreement to provide the additional insured
coverage on a primary and noncontributoy basis, this policy shall be primary and we will not seek
contribution from the additional insured's policy for damages we cover.
4. The following is added to Paragraph b., Excess Insurance of Condition 4. Other Insurance:
Except as provided in Paragraph 4.a. Primary Insurance as amended above, any coverage provided
hereunder shall be excess over any other valid and collectible insurance available to the additional
insured whether primary, excess, contingent or on any other basis. In the event an additional insured has
other coverage available for an "occurrence" by virtue of also being an additional insured on other
policies, this insurance is excess over those other policies.
2. FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT
If Damage To Premises Rented To You under Coverage A is not otherwise excluded from this policy, the following
applies:
A. The last paragraph of 2. Exclusions of Section I - Coverage A is replaced by the following:
If Damage To Premises Rented To You is not otherwise excluded, Exclusions c. through n. do not
apply to damage by fire, lightning, "explosion" or sprinkler leakage to premises while rented to you or
temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this
coverage as described in Section III - Limits Of Insurance:
B. Paragraph 6. of Section III - Limits Of Insurance is replaced by the following:
6. Subject to 5. above, the higher of $300,000 or the Damage To Premises Rented To You Limit
shown in the Summary of Limits and Charges section of this policy is the most we will pay under
Coverage A for damages because of "property damage" to premises rented to you or
temporarily occupied by you with the permission of the owner arising out of any one fire,
lightning, "explosion" or sprinkler leakage incident.
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C. Paragraph b.(1)(b) of Condition 4. Other Insurance (Section IV - Conditions) is replaced by the
following:
(1) That is Fire, Lightning, Explosion or Sprinkler Leakage insurance for premises rented to you or
temporarily occupied by you with the permission of the owner;
D. Paragraph. 9.a. of the definition of "insured contract" in Section V- Definitions is replaced by the
following:
9. "Insured contract" means:
a. A contract for the lease of premises. However, that portion of the contract for a lease of
premises that indemnifies any person or organization for damages by fire, lightning,
"explosion" or sprinkler leakage to premises while rented to you or temporarily occupied
by you with the permission of the owner is not an "insured contract";
E. The following definition is added to Section V - Definitions:
"Explosion" means a sudden release of expanding pressure accompanied by a noise, a bursting forth of
material and evidence of the scattering of debris to locations further than would have resulted by gravity
alone.
"Explosion" does not include any of the following:
1. Artificially generated electrical current including electrical arcing that disturbs electrical
devices, appliances or wires;
2. Rupture or bursting of water pipes;
3. Explosion of steam boilers, steam pipes, steam engines or steam turbines owned or
leased by you, or operated under your control; or
4. Rupture or bursting caused by centrifugal force.
3. NON-OWNED WATERCRAFT
Subparagraph g.(2) of Paragraph 2., Exclusions of Section I - Coverage A is replaced by the following:
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons or property for a charge;
4. SUPPLEMENTARY PAYMENTS
In the Supplementary Payments - Coverages A and B provision:
The limit for the cost of bail bonds in Paragraph 1.b. is changed from $250 to $1000.
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5. PERSONAL AND ADVERTISING INJURY - ELECTRONIC PUBLICATION EXTENSION
Paragraphs 14.b., d. and e. of Section V - Definitions are replaced by the following:
b. Malicious prosecution or abuse of process;
d. Oral, written, televised, videotaped or electronic publication of material that slanders or libels a person or
organization or disparages a person's or organization's goods, products or services;
e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of
privacy;
The following is added to Paragraph 14. "Personal and Advertising Injury" of Section V - Definitions:
h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but
only if such discrimination or humiliation is:
(1) Not done intentionally by or at the direction of:
(a) An insured; or
(b) Any "executive officer" director, stockholder, partner or member of the insured; and
(2) Not directly or indirectly related to the employment, prospective employment or termination of
employment of any person or persons by any insured.
Subparagraphs b. and c. of 2., Exclusions of Section I -.Coverage B - Personal And Advertising Injury Liability are
replaced by the following:
b. Material Published With Knowledge Of Falsity
"Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic
publication of material, if done by or at the direction of the insured with knowledge of its falsity;
C. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic
publication of material whose first publication took place before the beginning of the policy period;
6. AGGREGATE LIMITS OF INSURANCE (PER LOCATION)
The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your "locations"
owned by or rented to you or temporarily occupied by you with the permission of the owner.
"Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a
street, roadway, waterway or right-of-way of a railroad.
7. AGGREGATE LIMITS OF INSURANCE (PER PROJECT)
The General Aggregate Limit under Section III Limits Of Insurance applies separately to, each of your projects away
from premises owned by or rented to you.
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8. VOLUNTARY PROPERTY DAMAGE COVERAGE
At your request, we will pay for "loss" to property of others caused by your business operations. The most we will pay for
this coverage is $500 each "occurrence." The "loss" must occur during the policy period. The "occurrence" must take
place in the "coverage territory". "Loss" means unintended damage or destruction. "Loss" does not mean disappearance, abstraction or theft.
This coverage does not apply to:
1. Damage arising out of the use of any "auto";
2. Property you own, occupy, rent or lease from others; or
3. Property on your premises for sale, service, repair or storage.
None of the other policy exclusions apply to this coverage.
If the policy to which this endorsement is attached is written with a property damage liability deductible, the deductible
shall apply to Voluntary Property Damage. The limit of coverage stated above shall not be reduced by the amount of this
deductible.
9. OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE
A. We will pay those sums that you become legally obligated to pay as damages because. of "property damage" to
personal property of others while in your or your "employees" care, custody or control or real property of others
over which you or your "employees" are exercising physical control if the "property damage" arises out of your
business operations. This Coverage is subject to sections B., C.,.D. and E. below_
B. Exclusions
This insurance shall not apply to:
1. "Property damage" of property at premises owned, rented, leased, operated or used by you;
2. "Property damage" of property while in transit;
3. The cost of repairing or replacing:
(a) Any of your work defectively or incorrectly done by you or by others on your behalf; or
(b) Any product manufactured, sold or supplied by you, unless the "property damage" is caused
directly by you after delivery of the product or completion of the work and resulting from a
subsequent undertaking; or
4. "Property damage" of property caused by or arising out of the "products-completed operations hazard".
C. Limits Of Insurance - The most we will pay for "property damage" under this Section 9. is $25,000 for each
"occurrence". The most we will pay.for the sum of all damages covered under this Section 9. because of
"property damage" is an annual aggregate limit of $25,000.
The Limits Of Insurance provided under this Section 9. are inclusive of and not in addition to any other limits provided
in the policy or endorsements attached to it.
D. Deductible - We will not pay for "property damage" in any one "occurrence" until the amount of "property
damage" exceeds $250. If the policy to which this endorsement is attached contains a "property damage"
deductible, that deductible shall apply if it is greater than $250.
E. In the event of "property damage" covered by this endorsement, you shall, if requested by us, replace the
property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or
overhead charges.
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10. NEWLY FORMED OR ACQUIRED ORGANIZATIONS
A. Paragraph 4. of Section II - Who Is An Insured is deleted and replaced by the following:
4. Any business entity acquired by you or incorporated or organized by you under the laws of any individual
state of the United States of America over which you maintain majority ownership interest exceeding fifty
percent. Such acquired or newly formed organization will qualify as a Named Insured if there is no
similar insurance available to that entity. However:
a. Coverage under this provision applies only until the expiration of the policy period in which the
entity was acquired or incorporated or organized by you.
b. Coverage A does not apply to '.bodily injury" or "property damage" that occurred before the entity
was acquired or incorporated or organized by you.
C. Coverage B does not apply to "personal and advertising injury" arising out of an offense
committed before the entity was acquired or incorporated or organized by you.
d. Records and descriptions of operations must be maintained by the first Named Insured.
B. This Section 10. does not apply to newly formed or acquired organizations if coverage is excluded either by
provisions of the Coverage Part or by other endorsement(s) attached to it.
11. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
A. The requirements in Section IV - Conditions, Paragraph 2.a., that you.must.see to it that we are notified of an
"occurrence" applies only when the "occurrence" is known to,
1. You, if you are an individual;
2. A partner, if you are a partnership;
3. A member or manager, if you are a limited liability company;
4. An executive officer or designee, if you are a corporation;
5. A trustee, if you are a trust; or
6. A designee, if you are any other type of organization.
B. The requirements in Section IV - Conditions Paragraph 2.b, that you must see to it that we receive written
notice of a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is
known to:
1. You, if you are an individual;
2. A partner, if you are a partnership;
3. A member or manager if you.are a limited liability company;
4. An executive officer or designee, if you are a corporation;
5. A trustee, if you are a trust, or
6. A designee, if you are any other type of organization.
Knowledge of an "occurrence," claim or "suit" by the agent, servant or "employee" of any insured shall not in itself
constitute knowledge of the insured unless an officer or designee shall have received notice from its agent, servant or
"employee".
12. BODILY INJURY
Paragraph 3. of the definition of "bodily injury" in the Section V - Definitions is replaced by the following:
3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish
or death resulting from any of these at any time.
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13. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against any person or organization for whom you perform work under a written contract that requires you to
obtain this agreement from us..
This agreement shall not operate directly or indirectly to benefit anyone not named in the agreement.
14. MEDICAL PAYMENTS
If Coverage C Medical Payments is not otherwise excluded, the Medical Expense Limit provided by this policy shall be
the greater of:
A. $10,000; or
B. The amount shown in the Declarations.
15. BROAD NAMED INSURED
Paragraph 2.a.(1)(d) of Section II - Who Is An Insured is replaced by the following:
(d) Arising out of his or her providing or failing to provide professional health care services. However, this
exclusion does not apply to nurses, emergency medical technicians or paramedics who are employed by
you to provide medical or paramedical services to your employees.
16. BROADENED MOBILE EQUIPMENT
Paragraph 12.f.(1) of Section V - Definitions is replaced by the following:
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or
(c) Street cleaning provided that vehicles have a Gross Vehicle Weight of 1,000 pounds or greater;
17. INCIDENTAL MALPRACTICE LIABILITY
Paragraph 3. of Section V - Definitions is replaced by the following:
3. "Bodily injury" means bodily injury, sickness, disease or "incidental medical malpractice" sustained by a
person, including mental anguish or death resulting from any of these at any time.
The following is added to Section V - Definitions:
23. "Incidental medical malpractice" means injury arising out of the negligent rendering or failure to render
medical or paramedical services to persons by any physician, dentist, nurse, emergency medical
technician or paramedic who is employed by you to provide such services to your employees, provided
you are not engaged in the business or occupation of providing any services referred to in this definition.
18. NON-OWNED AIRCRAFT
The following is added to Subparagraph g. of 2., Exclusions of Section I - Coverage A Bodily Injury And Property
Damage Liability:
(6) An aircraft with a paid crew, that is hired, chartered or loaned but is not owned by any insured.
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19. PROPERTY DAMAGE - ELEVATORS
The following is added to Subparagraph j. of 2., Exclusions of Section I - Coverage A Bodily Injury And Property
Damage Liability:
Paragraphs (3) and (4) of this exclusion do not apply to damages that result from the use of elevators.
All other terms and conditions of your policy remain unchanged.
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CITY RECCRLE)ER Page 1 / 1
Ashland Park Commission DATE PONUMBER-
20 E MAIN ST. 8/6/2013 00247
ASHLAND, OR 97520
(541) 488-5300 _
VENDOR: 000559 SHIP TO:
MOUNTAIN VIEW PAVING, INC.
PO BOX 508
TALENT, OR 97540
FOB Point: Req. No.:
Terms: net Dept.:
Req. Del. Date: Contact: Bruce Dickens
Special Inst: Confirming? NO
Quanti Unit. Description - Unit Price Ext. Price
Asphalt Patchinq/Paving Co Lithia Park 2,420.00
Per attached proposal
Contract for Goods & Services
Beqinninq date: Auqust 5, 2013
Completion date: Auqust 10, 2013
c
SUBTOTAL 2,420.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 2,420.00
'Account Number Project Number. Amount Account Number' Project Number.' Amount
E 211.12.02.06.60410 2,420.00
a <
AuthO orized Signature VENDOR COPY
FOiM#3 G> DA CITY OF
G ASHLAND
a-ecILteSt for a Purchase Order
REQUISITION ¢ 2teofrequest: 7~z`~ 13
C C' Required date for delivery:
Vendor Name O/ bDum n~))Iy 1) w chyW& Iii
Address, City, State, Zip 0, 0 ~O T I O(ZC ( Q7~7~d
Contact Name & Telephone Number ph'( L., fo H &e- I - S - ~39'0 O
Fax Number -~~.1,~✓ 3S
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
e Small Procurement Cooperative Procurement
ss than $5,000, ❑ Reauest for Proposal (Copies on file) ❑ State of Oregon
❑ Direct Award- Dale approved by Council: Contract #
VerbaliWritten 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 Dale original contract approved by Council:
❑ (3) Written proposalstwritten solicitation Dale approved by Council: (Dale)
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
1~5Phaf.7- p~v/11~j2e, t12UIG~i r -
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
❑ Per attached quotelproposal $
Project Number . Account Number
Account Number Zll -JL02-D6-kk1li 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:' OL-L-L~L'C0ti4-~~ Department Head Signature:
(Equal to or greater than $5,000)
City_ Administrator:
1 (Equal to orgrealer tb n.$25,000)
Funds appropriated for current fiscal year. rYES:/ NO h ; u}~~ 1' I1"l
Finance IreCtOr- (Equal to or greater than $5,000) Date
Comments:
Form #3 - Requisition