HomeMy WebLinkAbout2014-009 Contract - Western Burner Co
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Western Burner Co.
ASHLAND CONTACT: Michael A. Griffiths
20 East Main Street
Ashland, Oregon 97520 ADDRESS: PO Box 5318
Telephone: 541/488-6002 ' Central Point, OR. 97502
Fax: 5411488-5311
TELEPHONE: (541) 482-2121
DATE AGREEMENT PREPARED: 1-232014 FAX: 541 488-1750
BEGINNING DATER-30-2014 COMPLETION DATE: April 30,2014
COMPENSATION: $14,773.00
GOODS AND SERVICES TO BE PROVIDED: Boiler Replacement Project at Daniel Meyer Pool - Labor, materials
and equipment to remove and dispose of old boiler; supply and install new boiler (not high efficiency) of same BTU
input/type and connect; obtain permits/inspections; include and install temperature controls/controller for pool H2O
temp and provide training per Western Burner's bid attached as Exhibit C.
ADDITIONAL TERMS: Work to be completed on or before April 30, 2014
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, 279B.225, 279B.230, 279B.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, indemnity and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs,
judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract may be terminated at 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
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.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the 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 a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Contract for Goods and Services Less than $25,000, Revised 06113/2013, Page 2 of 6
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; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 3 of 6
Contractor: City of Ashian
By 'AIP- By
/,Signature De artment Head
Af J oe4yr, o ltc (4
I)L L--
Print Name Print Name
Pz~s,o~r ~~2ti ~~y
Title Date
W-9 One copy of a W-9 is to be submitted with -p
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 4 of 6
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
(1) 1 carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
l`tli (2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
MG' (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.
At 6- (5) Labor or services are performed for two or more different persons within a period of one
year.
A k (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.
11;~w -27-/y
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 5 of 6
WE/TERn
BURNER CO.
BOILERS • BURNERS • CONTROLS
CODE WELDING
City of Ashland Parks & Recreation Dept. DATE: December 27, 2013
QUOTE NO: 2013104
jeffrey.mcfadand@ashiand.or.us
ATTN: Jeffrey McFarland
RE: Daniel Meyer Memorial Pool Boiler Replacement
THANK YOU FOR THE OPPORTUNITY TO PROVIDE THE FOLLOF iNG QUOTE
Western Burner Co. to supply and install (1) new RBI Dominator model number DW-0600, natural gas,
86% efficiency pool boiler with CuNi Fin tube heat exchanger. To include integral temperature control
PID controller with LCD & touch pad, State of Oregon install permit and start, test and adjustment of
boiler, and training.
TOTAL MATERIALS & LABOR: $14,773.00
Job time: 2 days
Equipment lead time: 2 weeks
Quote valid for 30 days
Terms: Net 30
F.O.BB..:, Job Site Accepted by:
Michael A G . h estem Burner Co. P.O#
westembumer@hotmail.com
PO Box 5318 9 Central Point, Oregon 97502 • (541) 482-2121 • FAX (541) 488-1750 • westernbumer@hotmail.com
Ll k
Numb 109 wuGe
u o
a~ ~ ~ 11ay ~ O m¢ R Q.6 ~
coo' .e p ~o h Q 4 moo. ¢ T
e e
® ° o
d ~ P
y~F
High Performance
Boilers and Water f {
Heaters
The Dominator® Series from RBI offers superior performance and
serviceability in a near condensing high efficiency, multi-stage
boiler. At the heart of the unit is a sealed combustion chamber poniine 52. abo awllahleMM appealing
conave''hiidlila'ithlnlers Stealladcat Ideal for outdoor and Indoor
that provides the flexibility of using outside air or mechanical imtauadoemcmosmorharshemhormremssahacurial arenamProcessing
room air for combustion. The chamber design, with fan-assist a 90flaw regmdag wuh danre.
multi-speed blowers and state-of-the-art staging control, offers
high efficiency staged firing in a compact package and virtually Easy to Install and Service
eliminates heat loss. The Dominator incorporates all the latest • Slide-Out Heat Exchanger
technological advances that engineers, contractors, and building • Side IMake,All Sizes
owners look for when specifying boilers and water heaters • Rear Intake, Sizes 750-2100
• Stackable Frame (Seismic Approval up to Zone 4)
Standard Equipment • Feld Reversible Headers
• Finned Copper Tube Heat Exchanger-Two-Pass • LowVoftage Controls
• Mounted & Wired Flow Switch • Direct Vent (up to 35' Equivalent)
• FM Compliant Gas Train
• Sealed Combustion Chamber Optional Features
• MowtedASME Relief Valve • Cupro-Nickel Finned Tubes
• Pump Delay Control • Outdoor Installation
• Factory Fired Tested • Stainless Steel Jacket
• Barometric Damper - Category 1 • Freeze Protection Package
• Thru-Wall Venting
Dependable, Efficient Performance • CSD-1Compiant Gas Train and Controls
• 85+% Efficient
• Uginox Alloy Stainless Steel Burners Load Matching Staged Firing
• Bronze Headers -Water Heaters Unlike most non-condeming units that are limited to only two-
* Cast Iron Headers - Boilers stage firing, the Dominator provides up to four-stages of firing,
• 2 or 4-Stage Firing Modes 85+56 allowing the boilerAvater heater to more closely match the heating
• Category 1 & III Venting load. The Dominator utilizes the most advanced Proportional
Integral Derivative (RI.D.) sequencing control on the market to
Iw accurately control the staging of the units. The control has six
modes of operation that can be field set with built-In standard
features that are options on most competitive units These standard
~OWNO features include outdoor reset and pump delay on temperature
'Pool heater applications available in non-U.S markets only differential between the supply and return temperatures of the unit
2
ProZons for CUm6usti i Carnevale Hodtuntaa
A6Adlmtment YAtlwut Vertical Flue conneNUn
racket Pant Removd
Air Wet Side or Gas Inlet
Rear Connection
EasyAcom N Point
LVidng center 11doWuostim Sequencing
Control. LCD Dlgday of
M, Supplymetum Ttmperamro
? EasytoReraove Heat
Eathwtger Pand
rmv r-r .
Removatde Air Wetfaer
a .
two Stage FW9 Rate
Control Valve
. Prtosary Safety
meW RevusRde Headers Shut Off Valve
. r..
Sibe•DOt Neat EscAaoqu Two Stage NOUN
for Ease of Service
ric Speed Bloomer W
P
Precisely cl M o Fuel
Air RFd lnMMm
tow f8e EmclerMes,
es
Proven Pilot Ignition System Inte mNtentspad Ig ut on
The unique pilot ignition is safer and more reliable than traditional Proven not system
hot surface systems (HSI) commonly used on other manufacturers'
equipment The system employs a birder tube as a pilot. Gas is
injected into a single bumer and ignited by spark A flame rod then Wide Variety of Venting Options
monitors the pilot tube flame. Once the pilot is proven the main The Dominator provides added flexibility and ease of installation
gas valves are powered and the remaining burlier tubes are safely with multiple venting options and configurations. The sealed
lit. This proven system offers greater dependability and Is superior combustion chamber minimizes heat loss and requires less clearance
to fragile HSI systems that can require frequent replacement. from combustible walk.
Yom,.
"Smart Service" Design f,
st4
Ease of installation and service are trademarks of all RBI water
heaters and boilers. Critical components are fully accessible to -
make short work of service and maintenance calls The Dominator
is the only sealed combustion chamber boiledwater heater with r
time-saving service features including a slide-out control cabinet
M w,"
for easy access to wiring and a slide-out heat exchanger for less dtd.= OutslrA
time-consuming service and repair. And the Dominator is only
29.5 ° wide to fit easily through standard doorways
Quality Construction for
Dependable Performance
The Dominator features a robust, compact design using the best i>~Ts ooF
materials for more dependable performance. Quality components e r a . ' ~z
include stainless steel burner tubes and solid bronze headers on
water heaters. The Dominator's design requires fewer blowers
and gas valves to achieve staged firing. Fewer components mean
reduces complexity, easier maintenance and service, and reduced x-~` j r
likelihood of breakdown.
Rack and Stack f Note: Dimensions
The Dominator offers greater a ®.0 are approximate and
fleldbil ty and ease of installation should not be used to
in a space saving design that ° ° 'rough-in' equipment.
leaves more elbowroom in the
mechanical room.A rugged frame
CD C:l
and stackable design allow you
to invall two units in the space of O
are small footprint
nIa
O e W4{
Dominator Series - Dimensions and Ratings
Overall Length Shipping
Input Output D'on.A Hue Vellt Dia. DuctedAir Sire Weight
Model MBH kW MBH kW kr. mm In. mm In mm its, k
DBIDW 300 300 88 255 75 22.118 561 6 152 6 152 325 148
DB/DW 400 400 117 340 99 28-5/8 727 6 152 6 152 430 195
DRIOW 600 600 176 511 150 35.1/8 892 7 178 8 203 580 263
DB/DW 750 750 220 638 187 41.518 1,057 8 203 8 203 725 329
DBfOw 900 900 264 766 225 48.118 1,222 10 254 10 254 80S 365
DBIDW 1050, 1,050 308 894 262 58-318 1,483 10 254 10 2S4 87S 397
DBIDW 1350 1,350 396 1,149 337 71-318 1,813 12 305 12 305 1,110 504
DBIDW 1500 1,500 440 1,277 374 77-78 11978 14• 3S6 12 305 1,130 513
DBIDW 19SO 1,950 571 1,659 487 97.3/8 2,473 14' 3S6 12 305 1,375 624
DSIDW 2100 2,100 616 1,789 524 103-78 2,638 14' 356 12 305 1,435 651
14' oval to round transition piece. -
Dominator Model 40'F 22'C 60•F 33•C Hourly 80'F 44°C 10VF 56•C 120•F 671C 140•F 76•C
DBIDW 300 765 2,.900 511 1,934 383 1,450 306 1,160 255 961 219 829
DBIDW 40D 11019 3858 679 2.572 510 1,929 408 7,543 340 1,286 291 1,102
DBIDW 600 1,532 5801 1,022 3867 766 1,900 613 2,320 511 1,934 43B 1,657
DBIDW 750 1,916 7,251 1,277 4,834 958 3626 766 1,900 639 2,417 547 2,072
DBIDW 900 2.299 8701 1.532 5,801 1,149 4,351 919 3,480 766 3900 657 2,486
DBIDW1050 2,682 101151 1,788 6,768 1,341 5076 1,073 4,061 894 3,384 766 2,900
DBIOW 1350 3,448 13052 2,299 8701 1,724 6,516 1,379 5,22t 1,149 4351 985 3729
DB/DW 1500 3,831 14,501 2,554 9668 11916 7,251 1,532 5801 1.277 4834 1,095 4,143
9111W 1950 4,980 18,853 3,320 11,568 2,490 9,426 IA92 7,541 1,660 G284 1,423 5386
DB/DW 2100 5,363 20,303 3,576 13,535 2,682 10,151 2,145 8111 1,788
8'768 1,532 5801
Dominator Series - Temperature Rise/Pressure Drop
15•F 831C 20'F 11.tY 25'F 139Y 30•F 16.7•C 35'F 19.4•C
6 20 eeom rterm n D= ne.m ae aa.rm a.1 rbwm I wow me ' norm m Iievm ae a»m meeicy illvm I,ee4
Model GPM Ft Ws We GPM Ft AM We GPM Ft ,1115 kPa GPM Ft ALls kPa GPM Ft A1h kPa
DB/DW 300 34.0 0.22 21 0.6 25.5 0.13 1.6 0.4 20A 0.09 1.3 0.3 - - - - - -
DBIDW400 45A 0.49 29 1.5 34.0 0.29 2.1 0.9 27.2 0.19 1.7 0.6 - - - - - -
DBIDW 600 68.1 130 43 3.8 51.1 0.76 3.1 2.3 409 0.51 26 1.5 34.0 036 2.1 1.1 - - -
DB/DW 750 85.1 235 5.4 6.9 639 138 4.0 4.1 51,0 0.91 3.2 2.7 42.6 Ob5 2.7 1.9 36.5 0.49 23 1.4
DR43W 900 102.1 3.84 64 11.3 76.6 2.25 4.8 6.6 613 1.49 39 4.4 51.1 1.06 3.2 31 439 090 2.8 2.4
DBIDW 1050 119.1' 623 7.5 184 89.4 3.66 5.6 10.8 71.5 2A2 45 7.1 59.6 1.73 3.8 51 51.1 130 3.2 3.8
OWDW 1350 - - - - 114.9' 7.17 72 21.1 919 4.74 5.8 14.0 76.6 338 4.8 10.0 65.6 2.54 4.1 7.5
DB/DW 1500 - 102.1 631 6.4 18,15 85.1 4.50 5.4 13.3 72.9 338 46 10.0
DBIDW 1950 - - - 110.6` 9.20 7.0 27.1 94.8 691 6.0 10.4
DB/0W 2100 - - - - 119.1' 11.2) 7S 332 102.1 8.47 6.4 25.0
*Flow erceads recommended mmdmum use a greater temperature rise or consult manufacturer. Cupro-nickel Leatetxhanger should be caaidered
260 North Elm Street, Westfield, MA 01085
. Tel. (413) 568-9571 Fax (413) 568.9613
. 7655 Trawnere Drive, Mississauga, Ontario LSS iL4
Tel. (905) 670.5888 Fax (905) 670.5782
www.rbiwaterheaters.com A MESTEK COMPANY
In the interest of product improvement RBI reserves the right to makedwm3es without notice.
www.salf.com
OREGON WORKERS COMPENSATION r saiF
CERTIFICATE OF INSURANCE ,corporation
CERTIFICATE HOLDER:
CITY OF ASHLAND
20 EAST MAIN ST
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
908060 01/01/2014 to 01/01/2015 01/27/2014
INSURED: BROKER OF RECORD:
WESTERN BURNER COMPANY ASHLAND INSURANCE INC
PO BOX 5318 PO BOX 880
CENTRAL POINT, OR 97502-0052 ASHLAND, OR 97520
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:
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.
AUTHORIZED REPRESENTATIVE
2rg~.IP
President and CEO
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9812
Polity Certificates_CertlfcateOflnsurance
.ac no v° CERTIFICATE OF LIABILITY INSURANCE /27/2014 "
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 polley(iea) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endoreeme s .
PRODUCER C Susan Rendsland
Commercial Lines-541-685-5300 PHMeE 54"85-5343 FAS .866-9684007
Wells Fargo Insurance Services USA, Inc EaeML Susan.rendsland Ilsfa o.com
875 Oak Street, Suite 900
INSURERS) AFFORDING COVERAGE NAICp
Eugene, OR 97401 IMSURERA: Houston Specialty Insurance Company 12936
INSURED IMIRIER B- Ohio Security Insurance Company 24082
Wastem Burner Company INSURER C:
5851 Peace Lane
INSURER D:
INSURER E:
Central Point, OR 97502 INSVRERF:
COVERAGES CERTIFICATE NUMBER: 7216543 REVISION NUMBER: See below
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 TERNS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
AUDI. UBR p CY NUMB POUCYEFF 1(
IN TYPEOFNSUMNCE
UNITS
X COMMERCUILGENERALUABRITY 1,000,000
A TEN12349 3/24/2013 3124/2014 EACH OCCURRENCE s
CLAIMS,MADE Q OCCUR S SaA00 PREMSEsma~non X S1,000 DFannelF MED EXP (AM v S 5.000 Pasort) X Par Olomwl0a PERSOW&ADVINAIRY f
1.00000
GENLAOORSOATELIMIT .APPLIES PER GENERALAGGREGOTE S 2.000.000
X POLICY ❑,IppE RRCT ❑LOC PRODUCTS-COMPAIPAGG f 2.000,000
OTHER: S
CONSA[EDSINGLEUMIT
B AUTOMOBILE LIABILITY BAS1455002181 3/24/2013 3/2412014
R S L000.o0o ~Nfl AWAUTO BODLY[NMtr(Po TIM" s
MRS X SOB ~DLV INJUO'(Poraciamlq S
X HIRED AUTOS X NO D RIY DAIMGE f
f
UMBRELLAUAB OCCUR EACH OCCURRENCE S
EXCESS LIAR CWMS-MADE AGGnECWTE S
D ON s
WORM" COMPENSATION
MDENPLOYERS-LMBIUTY YIN
MY PROPRIETORIPARTNERIDEDmVE ELEACHACCIDENT S
ODEIBER EXCLUDED? El NIA
1Mr00M y in NHt EL DSEASE- EA EMPLOYEE S
If 0embuger
EMT EMOV EL DISEASE -POLICY UNIT S
DESCRIPTION OF OPEMT BILOCATIOMS I VEHICLES IACORD 101, AEmlleml RFmMFa ScIrErM, mry M W+dl~tl M nan Al,wA N,polrp0
Certificate Holder is an Additional Insured under General Liability per Form CO 2037 07104 attached.
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97620
AUTHORIZED REPRESENranve
9Y
The ACORD name and iogo are registered marks of ACORD ®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 26 (2014101)
POLICY NUMBER: TEN12349 COMMERCIAL GENERAL LIABILITY
CG 20 37 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or 0 nizatio s : Location And Descillptlon Of Completed Operations
'Any person or organization for whom you are perform-
ing operations when you and such person or organize-
bon have agreed in writing In a contract or agreement
that such person or organization be added as an addi-
tional Insured on your policy,'
Information required to complete this Schedule if not shown above will be shown in the Declarations.
Section 11 - Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only with
respect to liability for "bodily injury" or "property dam-
age" caused, In whole or in part, by "your work" at
the location designated and described in the sche-
dule of this endorsement performed for that addi-
tional insured and included in the "products-
completed operations hazard".
CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 7 of 1 13
CITY RECOR.,~Et~ Page 1
Ashland Park Commission DATE PO NUMBER
20 E MAIN ST. 1/29/2014 00321
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 000871 SHIP TO:
WESTERN BURNER COMPANY, INC.
P.O. BOX 878
ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: net Dept.:
Req. Del. Date: Contact: Bruce Dickens - Jeff McFarland
Special Inst: Confirming? NO
Quanti Unit Description Unit Price Ext. Price
Boiler Replacement Project 14,773.00
Location: Daniel Meyer Pool
Contract for Goods and Services
Beginning date: 01/30/2014
Completion date: 04/30/2014
SUBTOTAL 14 773.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 14,773.00
Account Number Project Number Amount Account Number Project Number Amount
'E 411.12.00.00.70420 E 000042.999 14 773.00
vErvDOR
Authoriz Signatu a COPY
FORM #3 CITY OF
A request for a Purchase Order ASHLAND
REQUISITION Date of request: >-z3-zold
Required date for delivery:
Vendor Name Wae}om R vnpr cn
Address, City, State, Zip PO nnx 531 Central Pnint, Oregon 97502
Contact Name & Telephone Number
Fax Number Michael A Gdffiths. 541482-2121
541-48&1750
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
x❑ Written quote or proposal attached
❑ Small Procurement Cooperative Procurement
Less than $5.000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon
❑ Direct Award Date approved by Council: Contract #
❑ Verbal Wdtten 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
006£0 100 000 ❑ Written quote or proposal attached Agency
x (3) Wntten quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract #
PERSONAL SERVICES ❑ Special Procurement Interooveromental Agreement
$5.000 to $75,000 ❑ Form #g, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Wdtten quote or proposal attached Date original contract approved by Council:
❑ (3) Widen proposals/wdtten solicitation Date approved byCouncil: (Date)
E] Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
Labor, materials, and equipment to:
Remove and dispose of old boiler; Supply and install new boiler as per quote (not high efficiency)
of same BTU input/type and connect; Obtain permitsfinspections; Supply/install new integrated $14,773.00
temperature controlslcontrolier for pool H2O temperature and provide training as per quote.
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
x❑ Per attached quotelproposal $14,773.00 "
Project Number - - - - -Account Number
Account Number y~~•~?LL?00_70 /ZC-accountNumber___-__-__-
'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support -Yes/ No
By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. .
Employee: Department Head:
(Equal to or greater than $5,000)
Departme anagerlSupervisor: 4r1,1 City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year., / NO
Finance Director- (Equal to orgre er than $5,000) Date
Comments:
Forth #3 - Requisition