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HomeMy WebLinkAbout2013-258 Contract - Southern OR Transportation Engineering Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: Southern Oregon Transportation Engineering ASHLAND CONTACT: Kimberly Parducci, PE PTOE Firm Principal 20 East Main Street Ashland, Oregon 97520 ADDRESS: 112 Monterey Drive, Medford, OR 97504 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-608-9923 DATE AGREEMENT PREPARED: 6/25/13 EMAIL: Kwkp1@Q.com BEGINNING DATE: COMPLETION DATE: September 30, 2013 COMPENSATION: Time and materials, not to exceed $7,815.00 as per attached proposal. SERVICES TO BE PROVIDED: Traffic impact study for a proposed new street connection (Independent Way) from Washington St. to Tolman Creek Rd. and partial build-out of 41.4 acres in the surrounding area, as per attached proposal dated June 17, 2013. ADDITIONAL TERMS: Provided consultant's insurer(s) waive(s) subrogation rights with respect to City and its insurer, notwithstanding the general insurance requirements in Section f below, Consultant's automobile insurance shall be primary (instead of both primary and non-contributory) and City shall not be named as an additional insured under Consultant's professional liability insurance. 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 $19,825 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 an losses, expenses, claims, subro ations, G:\pub-wrks\eng\05-10 Jefferson St EMension\A Admin\Eng Pre Contract\05-10 Southern OR Transportation Contract 062513.doc, Pagel of 5 actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 16. 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 Liabilit insurance with a combined single limit, or the equivalent, of not less than Enter one: G:\pub-wrks\eng\05-10 Jefferson St ExtensionW_Adnnin\Eng Pre Contract\05-10 Southern OR Transportation Contract 062513.doc, Page 2 of 5 $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. 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 I 'via(-- By S gnature Department Head 4Ms6R_L-y PWZtt,_e,-wg-u4cw, Tpv,~\r\"_t ram Print Name Print•Name -7/fs/f-3 1--x13 Title Date W-9 One copy of a W-9 is to be submitted with -,r7 4 the signed contract. Purchase Order No. ed as to form G:\pub-wrks\eng\05-10 Jefferson St E#ensionW_Admin\Eng Pre Contract\05-10 Southern OR Transportation Contract 062513.doc, 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 wo7k, (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. iZj-~ Contractor (Date) G:\pub-wrks\eng\05-10 Jefferson St Extension%_Admin\Eng Pre Contract\05-10 Southern OR Transportation Contract 062513.doc, Page 4 of 5 PROPOSAL fOUwpm gpiilwN TunfDO,RTATI11JYln jycc IN6, LLC 112 Monterey Drive -Medford, Or. 97504- Phone (541) 608-9923- Email: Kwkpl@Q.com X Contract/Proposal for Services Date: June 17, 2013 Authorization for Additional Work This agreement made this day of June, 2013 by and between the City of Ashland, hereinafter called CLIENT and Southern Oregon Transportation Engineering, LLC, hereinafter called ENGINEER. WITNESSETH: Whereas, the CLIENT agrees to employ the ENGINEER to render certain technical and/or professional services hereinafter described in connection with: The preparation of a traffic impact study (TIS) for a proposed new street connection (Independent Way) from Washington Street to Tolman Creek and partial build-out of 41.4 acres in the surrounding area. WHEREAS, the ENGINEER is qualified and agreeable to render the aforesaid technical and/or professional services; NOW, THEREFORE, in consideration of the mutual promises hereinafter expressed, the parties agree as follows: Article 1. Engagement of Engineer The CLIENT hereby agrees to engage the ENGINEER to perform the technical and/or professional services as hereinafter set forth. ENGINEER shall not be deemed an employee of the CLIENT. Article 2. Scope of Services The ENGINEER shall carry out in a satisfactory manner the services set forth in the ENGINEER'S Proposal attached hereto as "Exhibit A". With respect to the services to be performed under this contract, it is agreed that: (1) The ENGINEER is free from the CLIENT'S direction and control over the mean and manner of providing the labor and services in the preparation of the tasks listed in "Exhibit A". (2) The ENGINEER is responsible for obtaining all assumed business registrations or professional occupation licenses required by State or local government ordinances for the ENGINEER to conduct business. Article 3. Compensation (1) The CLIENT shall compensate the ENGINEER as set forth in "Exhibit A". Article 4. General Provisions A. Changes. The CLIENT may request changes in the scope of the services as set forth herein. Such changes, including any adjustments in the amount of compensation to the ENGINEER, shall be mutually agreed upon by and between the parties hereto and shall be incorporated as written amendments to this Agreement. B. Limitations of Liability. The liability of ENGINEER to the CLIENT for any cause or combination of cause is, in the aggregate, limited to an amount no greater than the fee earned under this agreement. C. Termination. The CLIENT may terminate this Agreement at any time by providing written notice to the ENGINEER of such termination and specifying the effective date thereof. If this Agreement is terminated by the CLIENT as provided herein, the ENGINEER will be paid for all expenses incurred and all services provided prior to termination. D. Interest of the ENGINEER. The ENGINEER hereby covenants that she has, at the time of the execution of this Agreement, no interest, and that she shall not acquire any interest in the future, direct, or indirect, which would conflict in any manner or degree with the performance of services required to be performed pursuant to this Agreement, except as fully disclosed in the ENGINEER'S Proposal attached hereto as "Exhibit A". This Agreement, together with "Exhibit A", constitutes the entire agreement between the CLIENT and ENGINEER and supersedes all prior written or oral agreements. This Agreement may only be amended, supplemented, modified, or canceled by duly executed written agreement. By Mike Faught, Public Works Director City of Ashland By Kimberly Parducci, PE PTOE Firm Principal Southern Oregon Transportation Engineering, LLC Traffic Impact Study Independent Way Street Connection TIS Jackson County Page 2 of 3 "Exhibit A" SCOPE OF WORK: The scope of work includes preparation of a traffic impact study (TIS) for a proposed new street connection (Independent Way) from Washington Street to Tolman Creek and partial build-out of 41.4 acres in the surrounding area. The contents and study area of the traffic impact analysis have been estimated based upon discussions with the City of Ashland Planning and Public Works staff and a preliminary look at trip distributions and potential project impacts to the surrounding area. The study area will include intersections along Tolman Creek from the proposed Independent Way to OR 66, and along OR 66 between Washington Street and Tolman Creek. The analysis shall evaluate operational and safety concerns under existing year 2013 and future year 2033 PM peak hour conditions to adequately address City requirements. This includes evaluation of level of service, sight distance, turn lanes, crash history, queuing, pedestrian and bicycle circulation and connectivity, and mitigation measures. One traffic count is required at the intersection of Washington / OR 66 and will be provided by Southern Oregon Transportation Engineering. A draft report is estimated to be provided within two weeks of obtaining all necessary counts and other applicable field data. A final report will be provided within one week of receiving comments from City staff. Six copies of the report will be provided to the City with all applicable figures and appendices. Representation at public hearings is not included in this proposal and will be billed separately in accordance with the ENGINEER'S rate schedule. There is no additional charge, however, for time spent in conference calls or meetings with the CLIENT to discuss the traffic study. PROJECT FEE: The project fee is attached to this proposal and labeled as Exhibit B. The total fee and budget is based on a time and material estimate and includes all costs associated with the preparation of the traffic impact study as outlined in the scope of work. The project fee is $7,815.00 and is due upon submittal of six copies of the study to the City. Initial (Kimberly Parducci, Southern Oregon Transportation Engineering, LLC) Initial (Mike Faught, City of Ashland Public Works Director) This proposal is valid until September 15, 2013. 1.5% interest per month is accrued on accounts payable over 30 days. Traffic Impact Study I Independent Way Street Connection TIS Jackson County Page 3 of 3 W p e p p p p p C p p p p p C C G C p p p e O oo Oe p p e b 0 Yl 10 p b m 6p p p j 00 C G 66 66 t O ~(f b N Y] N f0 O ~+l A A O O 1(I O O O O O O O O O m U f A A N N m t7 t7 LL"1 m N b b N N N N N N N N N p N 19 N N N N N N ~ N N N N N A O O W L L d d 6 6 vl O O O O b O C p O 0 0 0 0 0 0 0 0 0 0 C !q q q q q -q -q N m r ~ ~ N 0 00 O 00 C'l OPl 000000 00 00 00 00 (7 ~J U i a a w ~ w N a ~ oo °oo°oe oo°oo° oe oo ~ W q W 2 a m n a a v ) a d v ~ ~ E € m W Y 4 F « « O « O « O O ~ O a a a a a a a f o 0 0 0 0 0 0 ~y N N N N N N N w ll~C V O~ C~ c d o 1 ~ r~ ~j N E ci N O ~ d i q d a V d. ~ a ~c EoZ u_ 1F+ q E E r t0 C q _O d -6 E y d m. ~ > O 0 6 h L C = N O N ~ U d q O O d 9 ~ T _d 'O y ~ b L d d C dp a N C O7 O' N L' O N N Q U q U ~ N n d d N 2.2 d O O .Z d d U O N n t N F L O pi F a n d 'm q 0. 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ASHLAND, OR 97520 (541) 488-5300 VENDOR: 013519 SHIP TO: Ashland Public Works SOUTHERN OREGON TRANSPORTATION, ENGIP (541) 488-5587 112 MONTEREY DRIVE 51 WINBURN WAY MEDFORD, OR 97504 ASHLAND, OR 97520 FOB Point: Req. No.: Terms: Net 30 days Dept.: Req. Del. Date: Contact: Mike Fauqht Special Inst: Confirming? NO Quantity Unit Description ' Unit Price Ext. Price The preparation of a traffic impact 7,815.00 study for a proposed new street connection (Independent Way) from Washinqton Street to Tolman Creek and partial build-out of 41.4 acres in the surroundinq area. Contract for Personal Services Beginninq date: 06/25/2013 Completion date: September 30, 2013 SUBTOTAL 7 815.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 7,815.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 260.08.12.00.70420 E 201325.999 7,815.00 a~+C VENDOR Authorized Signature COPY FO #3®~ CITY OF ~ -~SH LAN D A request for a Purchase Order r /D to of request: 6125113 REQUISITION Required date for delivery: Vendor Name Southern nragnn Trang.portntinn Fnginppring. I I C Address, City, State, Zip' 112 Monterey Drive Medford OR 97504 Contact Name & Telephone Number Kimberly Parducci 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 I Dale 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 ❑ Special Procurement Intergovernmental Agreement $5,000 to $75.000 ❑ Form #0, Request for Approval ❑ Agency Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Written proposals/written solicitation Dale approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost The preparation of a traffic impact study for a proposed new street connection (Independent Way) from Washington Street to Tolman Creek and partial build-out of 41.4 acres in the surrounding area. $ 7,815.00 Written Findings: AMC 2.50.120 (A) The public works department does not have the personnel or resources required to perform the SDC consulting services under the proposed contract. Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quotelproposal $ Project Number7Q9} f) 0) 5--,zZ .5~ Account Number 260.68.12.00.704200 "Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. Employee Signature: Department Head Signature: M a Sxc S2~ J~~ (Equal to or greaterthan , DO) City Administrator: (Equal to or ater than $25,000) Funds appropriated for current fiscal year. I f / NO I { (7 ) ? LJ o t ee Director-' (Equal to orgreaterthan $5,000) DR e Form #3 - Requisition