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HomeMy WebLinkAbout2013-403 Contract - Karin Onkka Enterprises Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: VWV'1 Q1 K.&, GAT%PcILSt LLC, ASHLAND CONTACT: IC MA on K ILr~ 20 East Main Street Ashland, Oregon 97520 ADDRESS: 17,1 W r&Itic. S~. Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: ~~{I~Ngz-gZ3Z DATE AGREEMENT PREPARED: I ZI FAX. BEGINNING DATE: COMPLETION DATE: ~t COMPENSATION: 5 SERVICES TO BE PROVIDED: C, _f _ d~X 17~Unus7 s~-~ l~~" ADDITIONAL TERMS: ~J / A FINDINGS: I 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 I 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 any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 10. Termination: a. Mutual Consent. This contract may be terminated at an time b mutual consent of both parties. Contract for Personal Services, Revised 06/3012013, Page 1 of 5 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 co ined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or of Applicable r each claim, incident or occurrence. This is to cover damages caused by error, omission or negligen ac s re ated to the professional services to be provided under this contract. C. General Liability insurance with a combi a limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or of Applicable or each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage o ndemnity provided under this contract. Automobile Liabilit 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, inc u ing coverage for owned, hired or non-owned vehicles, as applicable. e. Notice of cancellation or chan e. There shall be no cancellation, material change, reduction of limits or Contract for Personal Services, Revised 06/30/2013, Page 2 of 5 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. Consultant: 4-e- City of Ashland By IC . ~n By Signature Department Head I/I . Print Name Print Name q f-D I ML 0u~s 1,gnzi-- l L (r 10 Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. 9-K; eF RM APP OVE=Ae Ash al Data ► ~ - t v- t3 Contract for Personal Services, Revised 06/30/2013, 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 Pas 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. oil LtP - Contractor (Date) Contract for Personal Services, Revised 06/30/2013, Page 4 of 5 KARIN ONKKA Contract Proposal with Estimated Hours - R1 ENTERPRISES, LLC The following tables represent tasks identified by North Mountain Park 125 Wimer Street staff which require the need for interpretive design work during the current fiscal year. The task numbers relate to a master sheet of interpretive tasks created by the Nature Center Manager. The tasks are listed in the order in Ashland, OR 97520 which she would like them completed. 541.482.9232 On Monday, November 18, 2013, 1 met with the park staff to review the tasks and receive input on the details regarding each task. Specifics were karinonkkadesign@gmail.com discussed and agreed upon for many of the tasks. Some tasks require contacting third parties in order to be able to determine how to proceed. Other tasks are hinging upon budget decisions. As a result, the estimated hours for each of the tasks is based on current information, as of today's date. Interpretive Design Work for North Mountain Park A schedule was established for completing the work. Once the contract is signed, I will begin work in December 2013 and will aim to complete the Begin date: July 1, 2013 work by the end of March 2014. End date: June 30, 2014 1 plan to be working at the Nature Center or from my office on Tuesdays and Thursdays from 12 noon to 4 pm on the following dates with an un- derstanding that these hours and dates may be adjusted as needed: December 3 and 5 February 4 and 6 December 10 and 12 February 11 and 13 December 17 February 18 and 20 February 25 and 27 January 7 and 9 January 14 and 16 March 4 and 6 January 21 and 23 March 11 and 13 January 28 and 30 March 18 and 20 March 25 and 27 Karin Cnkka Enterprises, LLC - North Mountain Park Contract- 1. Task tt: Task Estimated Notes Location Hours 1-2: Layout and design of the wall, 5 Includes creating design of wall, shopping for a Kitchen Wall tech pieces and sighting board magnetic white board, and setting up a sketch kit on etc. the table. 1-3: Hook up and mount TV and flex 4 Once Task 1-2 is completed above, we may choose Kitchen Wall camera to have Jim install the TV and flex camera if there are any technical/advanced handyman skills required. Flex cam also needs stabilizing base-Jim? 1-5: Create a sample "closer look" 10 Includes learning more about the flex camera to see Kitchen Wall kit, with seasonally themed about which objects may harm the lens. Create kit items labeled in a kit. with laminated objects, shadow box objects and 3-D objects. 2-3: Order the vinyl appliques for 6 Either consulting with Commercial Sign and Design Weather Wall weather graphic OR oversee on application of vinyl weather graphic OR consult- artist ing with artist in painting a version of the weather graphic. 6-1: Modify weather station poster, 2 Poster can mount directly on wall-no need for Weather reprint and mount. mounting device. Station 4-2: Get the new version of stream 8 Matte laminate printout. I need to modify the size/ Stream Wall channel produced as interp shape of the file I have from Renie to have it fit to board and change out the origi- what is currently on the wall. Research adhesives to nal painting attach laminated,and printed piece directly to the wall. 4-4: Create a sample of interactive 10 Develop two sample card sets: one for mural critters; Stream Wall cards with info and questions one for aquariums. Use two different colors. Cards about aquariums and the mural. will hang below aquariums. 5-2: Finalize Fish Interpretive Cards 6 Work with staff and illustrator to create remaining fish Front Lobby illustrations. Incorporate artwork into final cards. Supervise volunteer on finalizing any needed information. 2-6: Design the Weather panel for 10 NMP staff to author text. Weather Wall cabinet face, produce and mount it 7-2: Restoration Panel: Design a 20 May include looking at the vinyl lettering in the room. Stream Wall large (vertical) interpretive sign, For example "Welcome to the Discovery Room" and produce and mount "Investigate" higher up on this wall, "Look closer" on Kitchen Wall, and "Identify, compare" on cabinet wall. Also bird wall lettering. 8-1: Brainstorm riparian interpreta- 4 Includes participating in brainstorming meetings and Plant & tion to enhance and enlarge typing up notes. Animal Wall what we already have Karin Onkka Enterprises, LLC- North Mountain Park Contract - 2 Task Task Estimated Notes Location Hours 9-1: Brainstorm salmon life history 4 May incorporate research or brainstorming that has Native addition to NA exhibit already taken place. American Wall 9-3: Design, produce and mount 5 Follow examples already on wall. Native salmon life history addition American Wall 10-1: Design and make animal tracks 10 Includes researching possible materials and how to Exhibit Room to be used on the exhibit room adhere tracks to floor. Floor floor 10-1: Create a few track-stories as 8 "Who dunnit?" track stories and/or relating exhibits Exhibit Room examples of how to lay out the based on individual animals. Create a few examples. Floor animal tracks 13-2: Plant Interpretive Cards 4 See if Kara needs input. Train NMP staff on Front Lobby downloading, saving and modifying historic plant illustrations available on web that no longer have copyrights. Also train on cropping NMP-owned illustrations. TOTAL ESTIMATED HOURS: 116 Karin Onkka Enterprises, LLC- North Mountain Park Contract - 3 Form W-9 Request for Taxpayer Give Form to the (Rev. December. 2011) Identification Number and Certification requester. Do not Department mf the Treasury send to the IRS. Internal Revenue Service Name shown on your income tax return) ~h tout 1! ks-- ni Business name/disregarded entity name, if different from above r LLL Check appropriate box for federal tax classification: c Ip ❑ S Corporation ❑ Partnership ❑ TmsVestate 9-Individual/sole proprietor E] C Corporation _ m c no v [ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ► ❑ Exempt payee `o c ❑ Other (see instructions) ► ' !E Address (number, street, and apt. or suite no.) Requester's name and address (optional) 2S WIC- m City, state, and ZIP code N Q I ~ 1- 2.0 List account number( here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line Social security number to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. Far other 5 6 - © - A_ L1 g entities, it is your employer identification number (EIN). If you do not have a number, see How to get a `C TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number number to enter. M - Certification I Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have tailed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Sign Signature of Here D.S. person► R On c-,- Date► General Instructions Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar Section references are to the Internal Revenue Code unless otherwise to this Form W-9. noted. Definition of a U.S. person. For federal tax purposes, you are Purpose of Form considered a U.S. person if you are: A person who is required to file an information return with the IRS must • An individual who is a U.S. citizen or U.S. resident alien, obtain your correct taxpayer identification number (TIN) to report, for • A partnership, corporation, company, or association created or example, income paid to you, real estate transactions, mortgage interest organized in the United States or under the laws of the United States, you paid, acquisition or abandonment of secured property, cancellation • An estate (other than a foreign estate), or of debt, or contributions you made to an IRA Use Form W-9 only if you are a U.S. person (including a resident • A domestic trust (as defined in Regulations section 301.7701-7). alien), to provide your correct TIN to the person requesting it (the , Special rules for partnerships. Partnerships that conduct a trade or requester) and, when applicable, to: business in the United•States are generally required to pay a withholding 1. Certify that the TIN you are giving is cored (or you are waiting fora tax on any foreign partners' share of Income from such business. number of be issued), Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, 2. Certify that you are not subject to backup withholding, or and pay the withholding tax. Therefore, if you are a U.S. person that is a 3. Claim exemption from backup withholding if you are a U.S. exempt partner in a partnership conducting a trade or business in the United payee. If applicable, you are also certifying that as a U.S. person, your States, provide Form W-9 to the partnership to establish your U.S. allocable share of any partnership income from a U.S. trade or business status and avoid withholding on your share of partnership income. is not subject to the withholding tax on foreign partners' share of effectively connected income. Cat. No. 10231X Form W-g (Rev. 12-2011) FROM :BUCKMISTERS-RLLSTRTE FAX NO. :5414821219 Dec. 03 2013 01:27PM P2 Q)Allstate. Allstate Insurance Company You're in good hands. RENEWAL Auto Policy Declarations Summary NAMED INSURED($) YOUR ALLSTATE AGENT 18 YOUR BILL Karin Onkka Robert N Buckmister lists your payment options. 125 Wlmer St (541) 488-2518 Ashland OR 97520.1647 1908 Ashland St I'C Ashland OR 97520 POLICY NUMBER POLICY PERIOD 0 87 851554 03/10 Sep. 10, 2013 to Mar. 10, 2014 at 12:01 a.m. standard time DRIVER(S) LISTED DRIVER($) EXCLUDED Karin None VEHICLES COVERED VEHICLE ID NUMBER LIENHOLDER 1. 87 Subaru Impreza Jr1GF4855VG013245 None 2. 07 Subaru Impreza JF16661617GB18831 Td Auto Finance Total Premium Premium for 97 Subaru Impreza Premium for 07 Subaru Impreza TOTAL ✓ vour tala/pramlum retleMesmmM/redd/aeouetollPlAY9 See the Important Payment and Coverage Information section for details about Installment fees. Your Polley Effective Date is Sep. 10, 2913 auto•at003"IMMOSO MUZ• . 1~11~119~IlIIIIII~II~p~0~~nIaII~IIII~IIIIBa0lellllllll9~llelgl~ ~;mu~ Pagp, r.SZ.g . FROM :BLICKMISTERS-RLLSTRTE FAX NO. :5414821219 Dec. 03 2013 01:28PM P3 Q)Allstate- Allstate Insurance Company You're in good hands. Policy Number: 0 87 661661 03110 Year Agent Ronan a aockmister (641(488-2516 Policy Effective gate: Sep. to, 2013 COVERAGE FOR VEHICLE 61 1997 Subaru Impreza COVERAGE UMITS DEDUCTIBLE PREMBIM Automobile Liability Insurance Not Applicable • Bodily Injury $100,000 each person $300,000 each occurrence • Property Damage $50,000 each occurrence Basic Personal Injury Protectlon (Please see the attached Supplement to Policy Declarations for complete coverage, limits and deductible.) Uninsured Motorlats Insurance " . • Bodily Injury $100,000 each person Not Applicable $300,000 each accident • Property Damage $20,000 each accident As Stated In Policy _ Total Premium for 97 Subaru Impreza DISCOUNTS Your premium for this vehicle reflects the following discounts: Passive Rectralnt $9,86 Andlock Bmkae $13.45 Framer $25.78 Multiple Policy $7.53 eaogva. rq Page 2 AYpYq aM11 MCIIAfO 01M r.$1-j FROM :BUCKMISTERS-ALLSTRTE FAX NO. :5414821219 Dec. 03 2013 01:28PM P4 Q)Allstate,, Allstate Insurance Company You're in good hands. Polley Number: 0 87 851554 03/10 Your Agent. Resort N eucumtslef 1541148&2516 Policy FJlocllve Date: Sop. 10, 2013 Supplement to Policy Declarations This document forms a part of your Palley Declarations. ADDITIONAL LIENHOLDERS AND INTERESTED PARTIES Llenholders interested Parties 97 Subaru Impreza JF1GF4855VG813245 City of Ashland 07 Subaru Impreza JF1GG8181711818831 Gdot Page 5 'hm10. Y01i OPOIOFBe 87M G52 's Page 1 / 1 )]TV REG®^DER Ashland Park Commission DATE PO NUMBER . 20 E MAIN ST. 12/12/2013 00308 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 000596 SHIP TO: ONKKA, KARIN 125 WIMER STREET ASHLAND, OR 97520 FOB Point: Req. No.: Terms: net Dept.: Req. Del. Date: Contact: Rachel Dials Special Inst: Confirming? NO . ~.Quantity Unit Description Unit Price Ext. Price. Graphic Designer - Interpretive Design 5,000.00 Work for North Mountain Park per attached proposal and estimated hours. Contract for Personal Services Beginning date: December 16, 2013 Completion date: June 30, 2014 SUBTOTAL - 5 000.00 BILL TO: - TAX 0.00 FREIGHT 0.00 TOTAL 5,000.00 :Account Number Project Number - Amount Account Number Project Number Amount, E 211.12.03.04.60410 5,000.00 i L"" Authorized Signature 3/~-~ VENDOR COPY FORM #3 clrY of A reque i for a Purchase Order ASHLAND REQUISITION Date of request: I 13 Required date for delivery: Vendor Name VWtA GAILU,-; Address, City, State, Zip `2,~ l 0;}. gSKVvl 001 Z0 Contact Name & Telephone Number C1 Fax Number 2 Z 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 p Small Procurement Cooperative Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon 'VL Direct Award Dale approved by Council: Contract # erbal/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 #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5,000 to $75,00 0 ❑ Form 99, Request for Approval ❑ Agency ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Dale 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 jA1)'e(~ VI,Q,h K~qU vvlc i 111 urbtn M lw Item At Quantity Unit Description of MATERIAL. Unit Price Total Cost r I TOTAL COST Per attached quote/proposal $ ~T D Iroject Number - - - - - - - - -Account Number 21 -1Z-03-JA-SJ-01JI00 Account Number Account Number 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: ITDirector Date Support-Yes/No By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. Employee: Department Head: f I (Equal to or greater than $5,000) Department Manager/Supervisor: I City Administrator: (Equal to or greater than 25,000) Funds appropriated for current fiscal year. / NOw / y 3 Finance Director- (equal to orgrea than $5,000) Date Comments: Form #3 - Requisition -