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HomeMy WebLinkAbout2013-304 Contract - Discount Garage Doors Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: Discount Garage Doors ASHLAND CONTACT: Josh RI 11 20 East Main Street Ashland, Oregon 97520 ADDRESS: 5022 Table Rock Rd. Central Point Oregon Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-951-4464 DATE AGREEMENT PREPARED: FAX: BEGINNING DATE: September 9,2013 COMPLETION DATE: September 10,2013 COMPENSATION: $ 3,440.00 GOODS AND SERVICES TO BE PROVIDED: Remove old doors and haul away. Provide and install two 14x8'6" Wayne Dalton Commercial Insulated steel front steel back sectional overhead door with full seal and inside slide lock. Liftmaster chain drive motor with remote and keyless entry. ADDITIONAL TERMS: NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 279B.220, 2796.225, 27913.230, 27913.235, 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 b certified mail or in person. Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 1 of 6 C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Contractor to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Contractor may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the parry 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 Liabilit insurance with a combined single limit, or the equivalent, of not less than Enter one: Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 2 of 6 $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 insurer(s) to the City. e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further liability to Contractor. 20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Contract for Goods and Services Less than $25,000, Revised 06/1312013, Page 3 of 6 Con ctor: f City of Ashland By - l" By -T Si ature Department Head u~ l ~ It 2-) ~ /l, Print Name Print Name Gam,eral Mayaaer /;.~/rte 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 4 of 6 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: (1) 1 carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. (3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. -25-13 ntractor (Date) Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 5 of 6 Discount Garage Doors Estimate 5022 Table Rock Rd Central Point, OR 97502 Date Estimate # PH: 541-951-4464 8/12/2013 665 OR LIC # 56160 www.garagedoorweb.com Name / Address Job Address Ashland Parks & Rec 310 Granite St 340 S. Pioneer St Ashland, OR Ashland, OR 97520 Rep P.O. No. Terms Phone Josh Net 10 Days 541-951-1014 Description Qty Rate Total Remove Old Doors and Haul Away Provide and Install Two (2) 14x8'6" Wayne Dalton Commercial Insulated Steel Front Steel Back Sectional 2 1,295.00 2,590.00 Overhead Door With Full Seal and Inside Slide Lock. Option for 10' Liftmaster Chain Drive Motors With Remotes and Keyless Ent CsS425ea Discount Garage Door is not responsible for working condition of existing operator. Electrical connections and painting to be performed by others. We propose to furnish all materials and perform all labor necessary to complete this job. Any alteration or deviation from the above specifications involving extra cost of material or labor will only be executed upon written orders for same, and will become an extra charge over the sum mentioned in this contract. All agreements must be Total $2,590.00 made in writing. Price subject to change after 30 days. Electrical connections and painting to be performed by others. (Customer Signature Submitted by AMERIND-03 PHITE CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 8//28122812013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(!") 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 CONTACT NAME: Medford Office PKONE FAX Pa neWest Insurance, Inc. ac No Eae:(541) 779-1321 L,N): (541) 779.9187 38 North Central Ave. E-MAIL ADDRESS: Suite 100 Medford, , OR 97501 INSURER(S) AFFORDING COVERAGE NAICd Medf INSURERA:Westem National Mutual INSURED INSURER B:Western National Assurance Co 24465 American Industrial Door LLC; James P & Charlene A Hill INSURER C: dba: Discount Garage Doors 5022 Table Rock Rd. INSURER D: Central Point, OR 97502 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY E%P LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS INSR MD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X CPP1059502 6/2312013 6123/2014 PREMISES Ea cmunence S 100,000 CLAIMS-MADE FXIOCCUR MED UP (Any one person) $ 5,000 PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE E 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOPAGG $ 2,000,000 IECT POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident B X ANY AUTO CPP1058471-01 6123/2013 6/2312014 BODILY INJURY (Per person) $ ALL OWMED SCHEDULED BODILY INJURY (Per actldent) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS PER ACCIDENT E X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAR CLAIMS-MADE UMB1009693-01 612312013 612312014 AGGREGATE $ 2,000,000 DED X RETENTIONS 10,000 $ WORKERS COMPENSATION WC STATE- OTH- OR, LI TS F ER M AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE❑ NIA E.L. EACH ACCIDENT E OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE E If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom trace Is required) Certificate holder is additional insured when required by written contract as per attached form #WNGL52 (01109) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland Parks 8: Recreation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Bruce Dickens ACCORDANCE WITH THE POLICY PROVISIONS. 340 S. Pioneer St. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY WN GL 52 01 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU PRIMARY AND NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to a. The preparing, approving, or failing to pre- include as an additional insured any person or or- pare or approve, maps, shop drawings, ganization for whom you are performing operations opinions, reports, surveys, field orders, when you and such person or organization have change orders or drawings and specifica- agreed in writing in a contract or agreement that tions; or such person or organization be added as an addi- tional insured on your policy. Such person or or- engineering activities. ganization is an additional insured only with respect to liability for "bodily injury", "property damage" or 2. "Bodily injury" or "property damage" occurring "personal and advertising injury" caused by your after ongoing operations for the additional insured and only to the extent that such "bodily injury", "property a. All work, including materials, parts or equip- damage" or "personal and advertising injury' is ment furnished in connection with such caused by your negligence or the negligence of work, on the project (other than service, those performing operations on your behalf, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at A person's or organization's status as an additional the location of the covered operations has insured under this endorsement ends when your been completed; or operations for that additional insured are com- pleted. It. That portion of "your work" out of which the injury or damage arises has been put to Its B. The Limits of Insurance applicable to the additional intended use by any person or organization insured are those specified in the written contract other than another contractor or subcontrac- or written agreement or in the Declarations of this for engaged to performing operations for a policy, whichever is less. These Limits of Insur- principal as a part of the same project. ance are inclusive of, and not in addition to Limits of Insurance shown in the Declarations. D. As respects the coverage provided under this en- dorsement, Paragraph 4.b. of the Other Insurance C. With respect to the insurance afforded to these Condition is deleted and replaced by the following: additional insureds, the following additional exclu- sions apply: 4. Other Insurance This Insurance does not apply to: b. Excess Insurance 1. "Bodily injury", "property damage" or "personal This Insurance Is excess over any other and advertising injury" arising out of the render- insurance naming the additional insured as ing of, or the failure to render, any professional an Insured whether primary, excess, contin- architectural, engineering or surveying services, gent or on any other basis unless the written including: contract or agreement described in A. above specifically requires that this insurance be provided on either a primary basis or a pd- mary and noncontributory basis. WN GL 52 01 09 Includes copyrighted material at Insunince Sendces ORlce Inc. with its permission. Page 1 of 1 ❑ I 9AMERIN OP ID: KID D 0nr8/30 ) F (MM 113 CERTIFICATE OF LIABILITY INSURANCE 08130 13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(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 endorsements . PRODUCER 541-779-4232 CONTACT NAME HONE FAA Hart Insurance 541-7723963 P 1123 Royal Ave. _(AIC N Eat: A/C No: Medford, OR 97604 E-MAIL Hart Insurance I Medford ADDRESS: INSURERS AFFORDING COVERAGE NAICII INSURER A:SAIF Corp 36196 INSURED American Industrial Door LLC INSURER B: American Industrial Door Company INSURER C 5022 Table Rock Rd. INSURER D: Central Point, OR 97502 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSN TYPE OF INSURANCE ADDL SU POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDMYY YYY11 LIMITS GENERAL LIABILITY EACH OCCURRENCE S DAMAGETOR, COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL &ADV INJURY S GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG $ POLICY PRO, LOC E JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO BODILY INJURY (Per person) S ALLOWNEO SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) 8 11 NON-OWNED PROPERTY DAMAGE S HIRFDAUTOS AUTOS Peracddent E UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETEMION$ S WORKERS COMPENSATION X WC STATU- OTH AND EMPLOYERS' LIABILITY A ANY PROPRIETMPARTNER/EJ(ECURVE YIN 745592 10101112 10101113 E. L. EACH ACCIDENT E 500,00 OFFICE"EMBER EXCLUDED? F-] N I A (Mandatory In NHI E.L. DISEASE- EA EMPLOY $ 500,000 (DESCRdi under IPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks schedule. If more epees is re0ulmd) dickensb@ashlaad. or. us CERTIFICATE HOLDER CANCELLATION CITYOFA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland Parks & Recreation 340 S Pioneer St AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Hart Insurance / Medford ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Page 1 / 1 g-iTV Rg DAER Ashland Park Co missf DATE PO NUMBER 20 E MAIN ST. 9/3/2013. 00266 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 004301 SHIP TO: DISCOUNT GARAGE DOORS 5022 TABLEROCK ROAD CENTRAL POINT, OR 97592 FOB Point: Req. No.: ' Terms: net Dept.: Req. Del. Date: Contact: Bruce Dickens Special Inst: Confirming? No Quantity Unit 'Description _ Unit Price. - Ext. Price Remove old doors and haul away. Provide 3,440.00 and install two (2) each 14 x 8'6" commercial doors and 2-lift master chain drive motors w/remote and keyless entry. Contract for Goods and Services Beginning date: 09/09/2013 Completion date: 09/10/2013 SUBTOTAL 3,440.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 3,440.00 Account Number Project Number Amount _ 'Account Number -Project Number Amount.: E 211.12.02.06.60211 3 440.00 Authori ignature VENDOR COPY FORM #3 CITY OF A request for a Purchase Order ASHLAND REQUISITION Date of request: ZF5 J3 Required date for delivery: Vendor Name Address, City, State, Zip ~ZZ ' ^rf- P-Cek CGfI M@ 1112 IAi(J- OCO- IYI Contact Name & Telephone Number \ )[fir 14i 5q1 _G5-j ~y 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 file) ❑ Stale of Oregon ❑ Direct Award Dale approved by Council: Contract # InteVerbalNVritten quote(s) or proposal(s) ❑ Stale of Washington rmediate Procurement ❑ Sale Source Contract # GOODS & SERVICES ❑ Applicable Form (95,6, 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 proposalstwritten solicitation Date approved by Council: (Dale) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost "o-e-o 0r5hNOhPr Gait O-'-1. P 00e, PJJD/ l/et^c~IN tie~ilT~ rYM~9` IUYp~rr D►~~xNO~¢.~ 5nn g L{ ao-D Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ Project Number Account Number Account Number (-rZ^-fOW4 60V0 Account Number 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support -Yes/No By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. Employee Signature:U vtr 1~d~ Department Head Signature: (Equal to or greater than $5,000) City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year YES / NO Finance Director- (Equal toorgreaterthan s5,000) Date Comments: Form #3 - Requisition