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HomeMy WebLinkAbout2014-006 Contract - Robert Saladoff Architect Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: Robert Saladoff, Archtiect ASHLAND CONTACT: Robert Saladoff 20 East Main Street Ashland, Oregon 97520 ADDRESS: 508 Clinton St. Ashland, OR 97520 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-482-3772 DATE AGREEMENT PREPARED: 1-9-2014 FAX: BEGINNING DATE: 1-13-2014 COMPLETION DATE: 05-31-2014 COMPENSATION: Not to exceed $4,000 Compensation for reimbursable expenses and additional services per the attached addendum SERVICES TO BE PROVIDED: Architectural Services and Fees, see attached addendum for included services ADDITIONAL TERMS: n/a FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of City. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is $19,825 or more, Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any Subcontractor who performs 50% or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 10. Termination: Contract for Personal Services, Revised 06/30/2013, Page 1 of 5 a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Consultant may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or ~w; } 1 delegate duties under, the Contract. 14 surance. Consultant shall at its own expense provide the following insurance: R a. Worker's Compensation insurance in compliance with ORS 656.017, which regyires subjept employers to provide Oregon workers' compensation coverage for all their subject workers See a t tQ r k e ~ B-r1a a u~~ b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to cover damages caused by error, omission or negligent acts related to the professional services to be provided under this contract. c. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contract. d. Automobile 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. Contract for Personal Services, Revised 06/30/2013, Page 2 of 5 e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 17. Nona ppropriations 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: City of As d 44 By By Signatur Department Head Print Name Print Name 17 904 ea' ARC HIECE Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. as o form Contract for Personal Services, Revised 06130/2013, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: 95 (1) I 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. Rs (2) Commercial advertising or business cards or a trade association membership are purchased for the business. RS (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) I assume financial responsibility for defective workmanship or for service not provided TT 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. W dl/ > 9/ Contrac r (Date) Contract for Personal Services, Revised 06/30/2013, Page 4 of 5 Lonny Flora From: rob@salarch.com Sent: Thursday, January 09, 2014 11:44 AM To: Rachel Dials Cc: lonny.flora@ashland.or.us; 'Bruce dickens' Subject: Re: Daniel Meyer Pool Building Hi Rachel, I just dropped off signed copies of my proposal to be used as addendum for Daniel Meyer Pool Building - Phase I, as well as my W-9, and insurance documents. I made a couple of small changes to my proposal with regard to wording, and scope of work for CA and bid documents. I also had a chance to review the contract for services from the City of Ashland, and I have just a few comments and requested additions. - Beginning Date should be adjusted - Under Compensation, please add - Compensation for reimbursable expenses and additional services per the attached addendum (or attachment) - Under Services to be provided, please add, see attached addendum for included services - Under insurance - since I am a sole practitioner, I do not carry Worker's Compensation Insurance Thank you, Rob Saladoff Robert Saladoff, Architect 508 Clinton Street Ashland, Oregon 97520 541-482-3772 office 541-601-9031 cell rob(@salarch.com CC: Lonny Flora, Bruce Dickens 1 ROBERT SALADOFF, ARCHITECT Project Proposal: Daniel Meyer Pool Building - Phase I January 7, 2014 Rachel Dials Recreation Superintendent Ashland Parks and Recreation Ashland, OR Dear Rachel, This proposal letter is for Professional Architectural Services and Fees for the Daniel Meyer Pool Building - Phase I Project. This proposal, if approved, will be attached as an addendum to the Contract For Personal Services. The overall design and construction project for the existing Daniel Meyer Pool Building includes a new entry and lobby, new roofing, and solar panel system design and installation. SCOPE OF WORK AND FEES: ARCHITECTURAL SERVICES ARCHITECTURAL FEES: Not to exceed $4,000 (Reimbursable Expenses and Additional Professional Services will be billed separately and negotiated under a separate contract) - Client collaboration, meetings and correspondence - Basic pre-design work regarding zoning and building codes (see below for additional services not included in this proposal) - Architectural design services from schematic design through construction documents (drawings set to include site plans, floor plans, lighting and electrical plans, roofing plan, exterior elevations, building sections, construction details, window/door/material/equipment schedules) - Collaboration with construction team - Collaboration with roofing, solar and electrical and lighting designers and contractors - Incorporate solar and roofing specifications into construction documents 508 Clinton Street Ashland, Oregon 97520 - 0: 541.482.3772 C: 541.601.9031 rob@salarch.com REIMBURSABLE EXPENSES: - Travel time and expenses within Jackson County are not billed-out. - Travel time outside of Jackson County is billed at 50% the hourly rate for architectural services. - All other travel expenses are billed at $ .45 per mile. - Other Reimbursable expenses are charged to the client at cost (except where noted otherwise) and include the following: Large scale plotting (B&W $3.00 per 24" x 36" sheet, Color $5.00 per 24!'x 36" sheet) In-house printing and copies .15 per 8'/z x 1 l sheet, $ .30 per 11 x 17 sheet) Blueprints Postage Fees paid on client's behalf ADDITONAL PROFESSONAL SERVICES: Architectural Fees related to the following services, activities and materials to be specified and negotiated under separate contract. - Services and activities for additional planning actions including pre-apps, planning applications and findings, variances, etc. - Services and materials regarding project bid and contract documents - Services and activities for construction administration (CA) including project observation and site visits, change orders, design changes during construction and additional project coordination. - Services and activities related to changes during construction to the final construction documents, project scope and/or schedule - includes all site visits, meetings, correspondence, changes to drawings and documentation, and addendums and change orders needed to administer and implement such changes. Ica, Ra> hei Hiafs IM (Gt~lll Rob rt Saladoff R Project Architect Ashland Parks and Recreation 508 Clinton Street Ashland, Oregon 97520 O: 541.482.3772 C: 541.601.9031 rob@salarch.com T RAV ELERSI'k Travelers 1" Choice 4 sm DESIGN PROFESSIONALS LIABILITY COVERAGE DECLARATIONS POLICY NO. 105474134 Travelers Casualty and Surety Company of America Hartford, CT 06183 (A Stock Insurance Company, herein called the Company) Important note: This is a claims-made policy. To be covered, a claim must be first made against an insured during the policy period or any applicable extended reporting period. The limit of liability available to pay settlements or judgments will be reduced by defense expenses. The deductible applies to defense expenses. This policy is composed of the Declarations, the Professional Liability Coverage, the Professional Liability Terms and Conditions, and any endorsements attached thereto. ITEM 1 NAMED INSURED: ROBERT SALADOFF, ARCHITECT Principal Address: 508 CLINTON AVENUE ASHLAND, OR 97520 ITEM 2 POLICY PERIOD: Inception Date: July 28, 2012 Expiration Date: July 28, 2014 12:01 A.M. standard time both dates at the Principal Address stated in ITEM 1. ITEM 3 ALL NOTICES PURSUANT TO THE POLICY MUST BE SENT TO THE COMPANY BY EMAIL, FACSIMILE, OR MAIL AS SET FORTH BELOW: Email: PLclaims@travelers.com FAX: 888-460-6622 Professional Liability Claims Manager Travelers Bond & Financial Products 385 Washington Street, MC 9275-NB08F St. Paul, MN 55102 ITEM 4 COVERAGE INCLUDED AS OF THE INCEPTION DATE IN ITEM 2: Design Professionals Liability Coverage 5HIPLEY & A5500ATE5 INSURANCE PrvWslomfs MMng the Inwma need, ofprofeeelonale SHIPLEY & A55OCIATE5, INC ' PO BOX 12066 3913 NE 20th Ave. Portland, Oregon 97212 Phone: (503) 282-3444 DPL-1000 Ed. 11-08 Printed in U.S.A. Page 1 of 3 ©2008 The Travelers Companies. Inc. All Rights Reserved c ITEM 5 PROFESSIONAL LIABILITY COVERAGE LIMITS Professional Services and Network and Information Security Offenses Coverage Limits: $1,000,000 for each Claim: not to exceed $2,000,000 for all Claims Deductible: $0 each Claim N/A all Claims Retroactive Date: N/A Knowledge Date: July 28, 2004 ITEM 6 ADDITIONAL BENEFITS LIMITS: Crisis Event Expenses Limits: $10,000 for each Crisis Event $30,000 for all Crisis Events Disciplinary or Regulatory Proceeding Expenses Limits: $25,000 for each Disciplinary or Regulatory Proceeding $50,000 for all Disciplinary or Regulatory Proceedings ITEM 7 PREMIUM FOR THE POLICY PERIOD: $3,600.00 Policy Premium $1,800.00 Annual Installment Premium ITEM 8 OPTIONAL EXTENDED REPORTING PERIODS: Additional Premium Percentage: Additional Months: 125% 12 185% 24 200% 36 240% 60 DPL-1000 Ed. 11-08 Printed in U.S.A. ©2008 The Travelers Companies, Inc. All Rights Reserved Page 2 of 3 t ITEM 9 FORMS AND ENDORSEMENTS ATTACHED AT ISSUANCE: DPL-1001-1108; PTC-1001-1108; PTC-3037-1108; DPL-2019-1108 The Declarations, the Professional Liability Terms and Conditions, the Professional Liability Coverage, and any endorsements attached thereto, constitute the entire agreement between the Company and the Insured. Countersigned By IN WITNESS WHEREOF, the Company has caused this policy to be signed by its authorized officers. X. A60,4& k 0 Executive Vice President Corporate Secretary DPL-1000 Ed. 11-08 Printed in U.S.A. Page 3 of 3 ' ©2008 The Travelers Companies, Inc. All Rights Reserved Billing Number: 9 8 0 3 3 7 3 • Policy Number: AM 9063952 03 FINANCIAL 40*0 BUSINESSOWNERS POLICY DECLARATIONS Ile COUNTRY Mutual Insurance Company Policy Period From: 0 7 - 01- 2 013 To: 0 7 - 01 - 2 014 12:01 A.M. Standard Time Effective Date: 07-01-2013 Named Insured: SALADOFF ROBERT 12:01 A.M., Standard Time Agent No.: 15637 Agent Name: RADEMACHER HANK DESCRIBED PREMISES: See Schedule of Locations Coverage is applicable only it an is shown in the boxes below and / or a limit of insurance is shown. Limits of Insurance POLICY COVERAGES: Blanket Loc. Bldg. if applicable Limits of Insurance No. No, Coverage Building Actual Cash Value - Building Option Automatic Increase - Building Limit % $ 50 , 000 001 001 Business Personal Property See Schedule of Mortgagees MORTGAGE HOLDER NAME AND ADDRESS: DEDUCTIBLES: 500 Property Ded: $ 500 Optional Coverage Ded: $ Property Damage Liab Ded: Earthquake: Limits of Insurance OPTIONAL COVERAGES: Per occurrence Employee Dishonesty Per occurrence outdoor Signs Inside the Premises Burglary and Robbery Outside the Premises (Named Perils only) Inside the Premises Money and Securities Outside the Premises X Coverage Extensions -Optional Higher Limits Accounts Receivable $ 25,000 Valuable Papers and Records LAdditional erages -pinal Higher Limits d Alteration come From Dependent Properties Extended No. of Days come - Extended Number of Days for Ordinary Payroll Expenses Extended No. of Days usiness Income - Extended Number of Days ) - See Businessowners Optional Coverages Schedule THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. ABP DS 02 01 10 Copyright, Insurance Services Office, Inc., 2010 ms°red Copy t- i` LIABILITY AND MEDICAL PAYMENTS Except For Damage To Premises Rented To You, each paid claim for the following liability coverages reduces the amount of insurance we provide during the applicable annual period. Please refer to Paragraph DA of the Businessowners Liability Coverage Form or Section II-Liability in the Businessowners Coverage Form and any attached endorsements. Limits of Insurance Liability and Medical Expenses / General Aggregate $ 1, 000, 000/ $ 2,000,000 Medical Expenses $ 5, 000 Per person Products / Completed Operations / Aggregate $ 2, 000, 000 Damage To Premises Rented To You $ 50, 000 Any one fire or explosion Tenants Liability $ 500, 000 Damage To Premises Rented To You (In Excess of $50,000) Self-storage Facilities Customer Goods Legal Liability Per occurrence Sale and Disposal Liability Motels Liability For Guests' Property (Subject to Base Property Deductible) Per guest Per occurrence Liability For Guests' Property in Safe Deposit Boxes Per occurrence ANNUAL PREMIUM AUDITS Policy Subject to Premium Audit: YES Liability Exposure Base: (Sales or Payroll) Subcontracted Work: (Cost) FORMS AND ENDORSEMENTS See Schedule of Forms and Endorsements BLANKET INSURANCE: Blanket # Type of Property Limit of Insurance Minimum Premium: $300.00 Total BOP Premium / Total BOP Advance Premium $342.00 ABP DS 02 01 10 Insured Coov AUTO INSURANCE DECLARATION' COUNTRY Preferred Insurance Companys F I N A N C I A L P.O. Box 14151, Salem. Oregon 97309-5069 Preferred Plan I POLICY NUMBER POLICY TERM PAYMENT PLAN INS. OFFICE /AGENT P36A4796424 6 MONTHS SEMI-ANNUAL 36003 SOREG / 15637 To report a claim or for roadside assistance any ACCOUNT NUMBER 9840556-001-00001 time day or night, call 1-866-COUNTRY(1-866-268-6879) Policy period beginning Sep 17, 2013 INSURED 12:01 a.m. standard time at your address ending Mar 17, 2014 12:00 a.m. SALADOFF ROBERT 508 CLINTON ST Declarations reason: ASHLAND OR 97520-1 21 9 POLICY CHANGE Effective Sep 17, 2013 12:01 a.m. standard time at your address. cam- , asca2*0 c ' Your policy consists of the policy booklet, applications, declarations pages and any endorsements. Please keep them together. 5637 0000 TOTAL PREMIUM $418.86 PREMIUM CHANGE NONE DO NOT PAY THIS AMOUNT. ANY BALANCE DUE WILL BE LISTED ON A SEPARATE INVOICE. VEHICLE VEHICLE, USE ME DRIVER INFCRMA`nO 1999 TOYOT 222670 TRUCK 1 TON AND UNDER, WORK UNDER 10, MALE, 30-64 POLICY COVERAGE LIMITS EACH PERSON EACH OCCURRENCE LIABILITY-BODILY INJURY 500,000 1,000,000 PROPERTY DAMAGE - 100,000 UNINSURED MOTORISTS 500,000 1,000,000 UNDERINSURED MOTORISTS 500,000 1,000,000 1999 TOYOT Intentionally Left Blank Intentionally Left Blank Intentionally Left Blank Terr 029 VEHICLE COVERAGE LIMITS PERSONAL INJURY PROTECT EACH PERSON 100,000 COLLISION - ACTUAL CASH VALUE LESS DED 500 COMPREHENSIVE - ACTUAL CASH VALUE LESS DED 250 VEHICLE RENTAL YES ENDORSEMENTS UNINSURED MOTORISTS PROPERTY DAMAGE COV YES AMENDATORY END-OR YES PREMIUMS LIABILITY-BODILY INJURY 155.49 PROPERTY DAMAGE included UNINSURED MOTORISTS 64.77 UNDERINSURED MOTORISTS included PERSONAL INJURY PROTECT 66.77 COLLISION 84.69 COMPREHENSIVE 29.14 FOR SERVICE CALL YOUR FINANCIAL REPRESENTATIVE HANK RADEMACHER AT (541)826-8900. 113020R (00-09/04) INSURED'S COPY Pagel RECORE;,ER Page 1 / 1 Ashland Park Commission DATE 'PO NUMBER 20 E MAIN ST. 1/17/2014 00318 ASHLAND, OR 97520 (54.1) 488-5300 VENDOR: 000723 SHIP TO: ROBERT M. SALADOFF, ARCHITECT 508 CLINTON STREET ASHLAND, OR 97520 FOB Point: Req. No.: Terms: net Dept.: Req. Del. Date: Contact: Rachel Dials Special Inst: Confirming? NO ' Ouanti Unit' Description Unit Price' - Ext. Price Architectural services for Daniel Meyer 4,500.00 Pool Upqrades, Not to exceed $4,000.00 Contract for Personal Services Beqinninq date: 01/13/2014 Completion date: 05/31/2014 SUBTOTAL 4.500.00 BILL TO: TAX O.00 FREIGHT 0.00 TOTAL 4,500.00 Account Number ' :Project Number Account Number°_ ~ Project Nomber,~ ' ; : Amount ' E 211.12.02.06.60410 4,500.00 Authorize ignature mil/ VENDOR COPY FORM#3 CITY OF A request for a Purchase Order ASHLAND REQUISITION Date of request: I ID'I'J Required date for delivery: Vendor Name Add Address, City, State, Zip 601 CA zy 2 1) Contact Name & Telephone Number Fax Number 1f)r yq L_ 37 Z Af / A SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on f le) ❑ 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) ❑ State of Oregon ❑ Direct Award Date.approved by Council: Contract # ❑ Verba[Mritten quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # Q. GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract ~ r A/ $5.000 to $100.000 El Written quote or proposal attached Agency p .ryi ❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # I~nA w PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5.000 to $75.000 ❑ Form #9, Request for Approval ❑ Agency Less than $35,000, by direct appointment El Written quote or proposal attached Date original contract approved by Council: 'LJ (3) Witten proposals/written solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: -(Date) I Description of SERVICES Total st R'YChtkth6JSCMLCs I'ovw" 01L -)d_ Lo%, Lb p , $ Item # Quantity Unit Description of MATERIALS Unit Price Total Cost Rrtlmkthw~Q~ 40W (Z lt'A vrSWbLL ek/U u ` 5DO`- TOTAL COST. Per attached quotelproposal $ r Project Number Account Number2(f_-(L-OL-DX}Jj2Y}JDD Account Number Account Number _ 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. `fpriG~ IT Director in collaboration with department to approve all hardware and software purchases: 6 R< ITO' Date S plA-Yes/No By signing t~ qMl form, l 11rfify that the City's public contracting requirements have been satisfied. Employee: ~J 1 &'t 6 Department Head: (Equal to or greater than $5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year: YES / NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition