HomeMy WebLinkAbout2013-326 Contract - Viking Concrete Cutting Inc
Sep-30. 2013 12:07PM Ashland Parks & Rec Main Office No.2162 P. 2/8
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Viking Concrete Cutting, Inc.
ASHLAND CONTACT: Bryson
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 5235 Primrose Lane, Klamath Falls, OR. 97601
Telephone: 541/488-6002
Fax: 5411488-5311 TELEPHONE: (c)541-331-2345, Medford Office 541-773-
2420, Klamath Falls Office 541-884-1399
DATE AGREEMENT PREPARED: 9.30-2013 FAX: 541 273-1308
COMPLETION DATE: 10-4-2013 or as close to 10-4-2013 as
BEGINNING DATE: 9-30-2013 possible.
COMPENSATION: $2,932.80
GOODS AND SERVICES TO BE PROVIDED: Flat Saw & Vacuum 1128' of Concrete @ $2.60 per ft. as
marked for archaeological test-digs in the Calle Juanajuato Extension area. Work Includes: Vacuuming and
Hauling Off-Site slurry.
ADDITIONAL TERMS: Work will only be performed between the hours of 7AM -11:30AM, M-F (week days
only). Contractor will place straw-wattle booms below the sites being cut while performing the work. Ashland
Parks will provide straw wattle-booms to the contractor.
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 2798.220, 2798.225, 2799230, 2798.235, 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 frcm
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 lattendant 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 b0 terminated at an time b mutual consent of both parties.
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 1 of 6
Sep.30. 2013 12:08PM Ashland Parks & Rec Main Office No.2162 P. 3/8
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, 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.
1. 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 e
QRF if Contractor has qualified as a QRF for this agreement; institutes an action forrelief 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.W, 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, $5K000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Contract for Goods and Services Less than $26,000, Revised 06113/2013, Page 2 of 6
Sep,30, 2013 12:08PM Ashland Parks & Rec Main Office No,2162 P. 4/8
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 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; Juriadlctlon; 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. Nonapproprlatlons 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 06/13/2013, Page 3 of 0
Sep.30. 2013 12:09PM Ashland Parks & Rec Main Office No.2162 P. 5/8
Contractor: City of Ashland
13Y ~g By
(t cJ~, Jr UILWJ
Signature Department Head
k
Print Name Print Name
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 00/13/2013, Page 4 of 0
Sep-30. 2013 12:09PM Ashland Parks & Rec Main Office No.2162 P. 6/8
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 (1) 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.
1y~D (2) Commercial advertising or business. ands 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.
Jig Concre~-e~~
Contractor (Date)
Contract for Goods and Servlces Less than $25,000, Revised 06/13/2013, Page 6 of 6
kp.30. 2013 12:09PM Ashland Parks & Rec Main Office No. 2162 P. 8/E
Viking Concrete Cutting Inc. ESTIMATE
"Professional Concrete Sawing & Drilling in Southern Oregon & Northern California"
FLAT SAWING - CORING - WALL SAWING - BOBCAT - DUMP TRUCKS Date Estimate #
Main Office: 5235 Primrose Lane 9272013 727
Klamath Falls OR 97601
Klamath Office (541) 884-1399
Medford Office (541) 773-2420 TERMS., ESTIMATE VALID 90 DAYS
OR LIC #162173 - CA LIC #568236
Job
Name / Address Job: Concrete Cutting For Test Digs
Ashland Parks & Recreation Lithia Park
340 S. Pioneer Street Ashland, OR
Ashland OR 97520 Contact: Jeff McFarland
email: mofarlaj@ashland.or.us
Description Total Bid Price
Flat Saw & Vacuum l 128' of Concrete @ $2.60 per It 2,932.80
Work Includes: Flat Sawing (47) 5'x T Areas
Vacuuming and Hauling Off-Sae Slurry
*EXCLUSIONS:
1. Layout
2. Capping, Disconnecting and/or Damage to ANY Utilities
3. Permit(s)
4, Standby and/or ANY Contractor Delays .
5. Concrete Thickness Not To Exceed 6"
**NOTE: WE CAN BEGIN WORK ON PROJECT, MONDAY SEPTEMBER 30, 2013
M"aber of the Cvnu etP Scumn~fr Dr~ll~ vt~ AesocLat'ow
Viking Concrete Cutting Inc. Date
Total Bid Price $2,932.80
Accepted By Date
VIKNG CONCRETE CUTTING INC. Will not be responsible for layout or damage to utllties or any object under the surface being cut, cored
of excavated.
Due to difficult working conditions, heavy reinforced steel, wire or scattered work, VIKING CONCREM CVMNGINC. rives the right
t:o bill all Jobs on an hourly NOS.
'r
Prices may vary If the desorption of work varies Cle: depth of cut, footage, access, wa(gr, power, etc) `
AD invoices for commercial accounts are due In full 30 days after compledon of work W they are subject to 1 59~ Interest per month. NI
residential invoices are due In full upon completion.
In the event of suit to enforce collection of any sums due under ttd's urvdce, purchaser agrees to pay attorney fees and all costs of suit.
A ` °RO® CERTIFICATE OF LIABILITY INSURANCE 9/DATE 30/2013 )
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 pollcypes) 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 Ileu of such endorsement(s).
PRODUCER NcAm"EACT Kim Schnetzky _
Ward Insurance Agency Ext). (541) 687-1117 FAC (541) 342-0260
P O Box 10167
O; INSURE S AFFORDING COVERAGE NAICi
Euqeae OR 97440 INSURERA:Cincinnati Insurance Companies
INSURED INSURERS:
Viking Concrete Cutting, Inc. INSURER C:
5235 Primrose Lane INSURERD:
EKlamath Falls OR 97601-9546 !:=F
:
COVERAGES CERTIFICATE NUMBER:12/13GL/AL/UI4B-ALL DES 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
L1~ TYPEOFINSURANCE POLICY NUMBER MMLICYEFF ffDDfYYfY1 LIMrtS
GENERAL LIABILnY PP0135156 34/25/2012 34/25/2023 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY 500, 000
PREMISES ttLfre e $
A CLAIMSMPDE a OCCUR MED EXP (Any om person) $ 10,000
X $500 PD DED. - PERSONAL B ADV INJURY $ 1,000,000
PER OCCURRENCE GENERAL AGGREGATE $ 2,000,000
GENL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP ASS IF 2,000,000
POLICY X PRO LOC $
17 AUTOMOBILE LIABILITY CRA0135156 D4/25/2012 34/25/2013 E e N 1,000,000
A X ANY AUTO BODILY INJURY (Per person) $
ALL OVWED SCHEDULED BODILY NJURY IPer eu WG ) $
AUTOS AUTOS
X NON-OVdJED PRO RTY DAMAGE $
X HIRED AUTOS AUTOS P otle
Nomw dHir ARO $ 11000.000
X UMBRELLA LIAR X OCCUR PP0135156 54725T2512 M/25/2013 EACH OCCURRENCE $ 1,000,000
A EXCESS LIAR CLAIMSMADE AGGREGATE $
DED RETENTION $
WORKERS COMPENSATION 5 STATU- OTH-
AND EMPLOYERS' LIABILITY Y I N y LIMITS ER
ANY PRORRIETORRARTNER/EXECUTIVE ❑ NIA E.L. EACH ACCIDENT $
OFFICERIMEMUER EXCU[)ED'!
(MAn4rtary In NH) E. L. DISEASE - EA EMPLOYE $
If Ws, deSMN Under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ASAch ACORD 101, A&ftO ftm sSch if mms rpACA IArpulrc~
ALL OPERATIONS OF THE INSURED IN ACCORDANCE WITH POLICY TERMS AND CONDITIONS.
CERTIFICATE HOLDER CANCELLATION
mcfarlaj@ashland.or.us SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
Parks & Recreation Department
340 s. Pioneer St. AUngRIZED REPRESENTATIVE
Ashland, OR 97520
Paul Jensen/CLYNN ~~---low
ACORD 25 (2010105) O 1999-2010 ACORD CORPORATION. All rights reserved.
INS025 (201005),01 The ACORD name and logo are registered marks of ACORD
Ww .uif.com
OREGON WORKERS COMPENSATION + saiF
CERTIFICATE OF INSURANCE 0,corporation
CERTIFICATE HOLDER:
CITY OF ASHLAND
PARKS & RECREATION DEPT.
340 S PIONEER ST.
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named below for the
policy period indicated. The insurance afforded by the policy described herein is subject to
all the terms, exclusions and conditions of such policy.
POLICY NO. POLICY PERIOD ISSUE DATE
912438 10/01/2013 to 10/01/2014 09/30/2013
INSURED: BROKER OF RECORD:
VIKING CONCRETE CUTTING INC WARD INSURANCE AGENCY INC
VIKING CONCRETE CUTTING PO BOX 10167
5235 PRIMROSE LN EUGENE, OR 97440
KLAMATH FALLS, OR 97601-9546
LIMITS OF LIABILITY:
Bodily Injury by Accident $1,000,000 each accident
Bodily Injury by Disease $1,000,000 each employee
Body Injury by Disease $1,000,000 policy limit
DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS:
RE: All operations in accordance with policy terms and conditions.
IMPORTANT:
The coverage described above is in effect as of the issue date of this certificate. It is subject to change
at any time in the future.
This certificate is issued as a matter of information only and confers no rights to the certificate holder.
This certificate does not amend, extend or alter the coverage afforded by the policies above. This
certificate does not constitute a contract between the issuing insurer, authorized representative or
producer and the certificate holder.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN
ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO
PROVIDE WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE.
AUTHORIZED REPRESENTATIVE
Qsf tjef oLtboe!DFP
51 Vl ihi ITD;ff LITF
Tbxf n 4PSII: 8423
Q 1911/3969636
"14148419131
cprjrc' CDtd ' DI %i9mU Pgbl vabod
OI 1 Y RECV aari Page 1 / 1
Ashland Park Commission GATE PO NUMBER '
20 E MAIN ST. 10/3/2013 00290
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 004314 SHIP TO:
VIKING CONCRETE CUTTING INC
5235 PRIMROSE LANE
KLAMATH FALLS, OR 97601
FOB Point: Req. No.:
Terms: net Dept.:
Req. Del. Date: Contact: Bruce Dickens
Special Inst: Confirming? No
Quantity Unit Description Unit Price - Ext. Price
Flat Saw & Vacuum 1128' of Concrete 2,932.80
Calle Guanajuato Extension Area
Contract for Goods and Services
Beginning date: 09/30/2013
Completion date: 10/04/2013
SUBTOTAL 2,932.80
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 2,932.80
Aicoun£Number Project Number'. Amount Account Number Project Number Amount'.,
E 411.12.00.00.70420 E 000053.999 2-9- 32.80
O , VENDOR COPY
Authoaled Sign ure
FORM#3 CITY OF
ASHLAND
A fegUest for a Purchase Order
REQUISITION Date of request: 9730-2013
Required date for delivery:
Vendor Name Vik'nqrnnrrPtP.Quftiog In
Address, City, State, Zip 5235 Primrose Lane Klamath Falls Oregon 97601
Contact Name & Telephone Number Bryson (c) 541-331-2345, Medford Office # 541-773-2420, Klamath Falls Office # 541-884-1399
Fax Number (541) 273-1308
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 uote or no sal attached
X❑ Small Procurement Cooperative Procurement
Less than $5,000 ❑ Reguest for Proposal (Copies on file) ❑ Slate of Oregon
❑ Direct Award Date approved by Council: Contract #
X❑ 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
El (3) Written quotes and solicitation attached El Form #4, Personal Services $5K to $75K Contract # Intergovernmental Agreement
PERSONAL SERVICES ❑ Special Procurement ❑ Agency
$5,000 to 875,000 ❑ Form #9, Request for Approval Date original contract approved by Council:
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached (Date)
❑ (3) Written proposals/written solicitation Date approved by Council:
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
Lrk & Vacuum 1128' of concrete @ $2.60 per ft in Calle JuanajuatolExtension Area
des: Flat Sawing (46) 5' x 7'Areas and (1) 6' x 6' Area
g and Hauling Off-Site Slurry $ 2,932.80
only be performed between the hours of 7AM -11:30AM on week days.'
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
X❑ Per attached quotelproposal $ 2,932.80
Project Number000(2i3-yyy Account Number y/J -J,2-dY)-tK-j?yao0
Account Number Account Number
'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
ITDirector Date Support-Yes/No
By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. 11,"
Employee: Department Head: ('W
(Equal to or greater than $5,000)
Department anagerlSupervisor. ity Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year., YES / NO
Finance Director- (Equalto orgreater than $5,000) Date
-
Form #3-Requisition