HomeMy WebLinkAbout2014-031 Contract - Liquivision Technology
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Liquivision Technology Inc.
ASHLAND CONTACT: Sherri Trigg
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 711 Market Street, Klamath Falls, Oregon.97601
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE:1-800-229-6959
DATE AGREEMENT PREPARED: 2-18-14 FAX: 541-883-1361
BEGINNING DATE: 3-1-14 COMPLETION DATE: 6-30-14
COMPENSATION: $4,995.00 per scope of work/quote from Liquivision Technology attached as exhibit C
GOODS AND SERVICES TO BE PROVIDED: Clean all vertical and horizontal surfaces in Granite Street
reservoir b certified potable water divers as described in scope of work/ quote attached as exhibit C
ADDITIONAL TERMS: Liquivision to dispose of effluent in city sanitary sewer approximately 400' from base of
tank, hoses to be supplied b li uivision. City of Ashland will provide lift to access hatch at time of cleaning.
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel
assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned
in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are
so registered, licensed and bonded. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated, payments will be made for work completed and accepted to date of termination.
Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 2796.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $19,825 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a
living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor
who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached
hereto as Exhibit B predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs,
judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered 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, count or other sources is not obtained and continued at levels
Contract for Goods and Services Less than $25,000, Revised 0611312013, Page 1 of 5
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
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, Contractoror Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
C. Automobile 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 insurers to
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 2 of 5
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.
Contractor: City of Ashland
By By AN\ ~c 1 0- ioat
Sign Department H cl
l2 - dV\,\.cAAM ( 1 , ~AirUG
Print Name Print Name
Title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No. 6
Contract for Goods and Services Less than $25,000, Revised 06113/2013, 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:
li (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.
t~ (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) I 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.
(~r~n ~,VISG~'~Of
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 4 of 5
E Yh i 6 PT
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LiQuivisim TiCHNOLOGY
DIVING SERVICES
015aalMailing Address Phom: (800) 229$959 Fax: (541) 883-1301 Westem Opemtiorts
711 Mallet Street liquhision@dningseniaes.mm 835 Mallet Street
Klamath Falls, OR 97801 rvmv.divirv emiaes.mm Klamath Falls, OR 97001
Steve Walker 12/27/2013
Ashland, City of Wk: 541-552-2326
90 N. Mountain Ave. Fx: 541-552-2329
Ashland, OR 97520 'OR8219313R1T_
We are pleased to provide you the following firm quotation and outline of the conditions of our services.
I
Tank Type Dia. Hgt. Maximum Surface Price for Price for Price for
or (Feet) Calculated Area Diver Diver Additional
LxW Capacity (S.F.) Wall Cleaning & Sediment
Feet Gallons Cleaning Inspection Per inch
Mobilization Charge - Flat charge to mobilize and demobilize to your location. $450
1. Granite St. Tank OG Concrete 134 26 2,500,000 14,095 $2,270 $2,275 $3,480
Subtotal $2,270 $2,725
Total 'Plus sales tax if applicable $4,995
Scope of Work:
Removal of accumulated sediment from the floor of the tank. The effluent will be disposed of at the districts direction. A
final and comprehensive inspection will be performed documenting the condition of the entire structure and recorded on
DVD. Written documentation with digital pictures, descriptions of the images and any recommendations will be provided to
the district on a USB flash drive.
Our bids are based on a variety of factors that pertain to the length of time it takes to accomplish our work. The main
consideration is the amount of sediment that has to be removed, 4" of normal sediment is included in this bid.
Initials Please Initial the line Items below to verity that you have reviewed them.
Entry hatch on top of the tank is at least 18" diameter.
The water level is kept within ten (10) feet of the top of the tank.
Tank dimensions are correct.
Scope of work is correct.
1. Placement and disposal of effluent removed from the tank is done at the direction of the Customer.
2. Quotes for cleaning assume that the sediment is normal material (such as silt, flocculated material, insects,
manganese, rust, etc.) found in potable water tanks that is easily removed by our vacuum system. If the sediment is
difficult to remove such as large amounts of concrete chips, gravel, sand, rocks, detached coating debris, etc., then
our hourly rate shall apply for each hour (over the first hour) for removing this material.
711 Market Street
L iQUIVISION TECHNOLOGY Fax: (541)883-64673
Fax: (541) 883-1361
3. Unless specified in quote detail we clean all submerged horizontal and angled berms or sloped surfaces 35 degrees
or less. Surfaces exceeding this angle such as the walls can be cleaned but must be listed separately in the quote
detail or estimated by the divers upon inspection. We do not clean surfaces that are out of the water.
4. If any information provided to us is incorrect or if any problems exist that inhibit our ability to complete the job on a
timely schedule, then we will notify you of the problem and reserve the right to add on to the quote based on our
estimate of the additional time it will take to complete the work. Charges for time delays are $200 per hour. This
paragraph only applies to any problems that are your responsibility (i.e. rescheduling with less than 2 business days
notice, set up and start of work before cancelation, etc.) Charge for going remote (if required and not addressed in
5. For coating repair in steel tanks we use a two part underwater epoxy. Each rust nodule or area of coating defect is
wire brushed to bare metal and epoxy is applied over the area. The epoxy chemically bonds to the steel, displaces
water, and remains intact with a greater bond than the original coating. All of our repair, sealing and coating materials
meet or exceed NSF 60 & 61 standards. Repairs are done at the districts direction for the rate of $375 per hour and
$35 per tube of Manus or epoxy.
6. If dechlorination is required it will be charged at $15.00 per hour. If filtration is required then the filter bags will be
charged at $200.00 per bag. Unless specified LVT does not remove the bags they become the districts responsibility
to dispose of.
7. If payment is not made within sixty days of the date of the invoice, an interest charge of 3% shall begin to accrue each
month on the unpaid balance. This interest will continue to accrue each month until the balance is paid in full. To
avoid any interest charges, payment must be received or postmarked within the sixty days following the date of the
invoice. Statements will be sent each month to reflect the new balance.
Our cleaning procedure is accomplished utilizing our proprietary vacuum cleaner, the "LiquiVacT " (Patented). The
LiquiVacT pumps an average of 200 gallons per minute. It has a rotating soft bristle brush that scrubs the floor clean and
removes all sediment without creating turbidity in your tank. This is the only way to ensure that all biofilm is removed from
the interior surfaces without getting any of it mixed into the water column. This system also enables us to clean walls.
In a conscious effort to preserve our nations natural resources -VT will provide our reports to the district on USB flash
drives. If you require a printed and bound copy of the reports please notify our office staff. There will be an additional fee of
$125 per copy.
In over 20 years of providing diving services we continue to treat every customer as if they were our only customer. We
are dedicated to accomplishing every job with the utmost professionalism, safety and efficiency.
Please sign this quote and FAX both pages back to us with an approximate time frame of when you would like the work
done. If you have any questions please give us a call. We look forward to working with you.
Quote is valid for 90 days. Upon signature the work shall be accomplished at a mutually acceptable date within one year.
Sincerely, I find the above and preceding page of contingencies and procedures
acceptable.
Accepted by: Date:
Bill Surber
V.P./ General Manager Signature: Title:
711 Market Street
i Klamath Falls, OR 97601
LdQUIVISION TECHNOLOGY PhFone: (541)
;;;3=6363
Billing/Change Order/Estimate Form
Steve Walker 12/27/2013
Ashland, City of Wk: 541-552-2326
90 N. Mountain Ave. Fx: 541-552-2329
Ashland, OR 97520 'OR8219313R1T
Team Leader: Diver #1:
Diver #2: Diver #3:
Tank Type Dia. Hgt. Maximum Surface Price for Price for Date
or (Feet) Calculated Area Diver Diver Work
LxW Capacity (S.F.) Wall Cleaning & Done
Feet Gallons Cleaning Inspection
Mobilization Charge - Flat charge to mobilize and demobilize to your location. $450
1. Granite St. Tank OG Concrete 134 26 2,500,000 14,095 $2,270 $2,275
Subtotal $2,270 $2,725
Total -Plus sales tax if a Iicable $4,995
Itemize work: Time or Quantity: Extended:
Sales Tax if an :
Total
Authorization Signature:
Estimation of cost for recommendations that LVT can perform.
Recommendations: Estimated Labor Total Estimate
Total
UQU14 OP ID: JS
`°RO CERTIFICATE OF LIABILITY INSURANCE OATEIMtl~"
02/2612014
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(SL AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: H the Certificate holder Is an ADDITIONAL INSURED, the polley(les) 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 .
PRODUCED c..0"TLACT Janice Sharp
Greatain
Basin St eEUrellee E 641X825807
828 Main Sliest
P. 0. Box 69 . anice.she rObasin.com
Klamath Falls, OR 97601
MOU Hurley IN AFFORDING COVERAGE NNC4
INSURERA:American States Insurance Co. 19704
INSURED Uqu(vision Technology Inc. INSUREREI:Ube Mutual 039800
Arrow Manufacturing Inc. INsuReae:Unlted Specialty Insurance Co. 12837
PO Box 8277
Klamath Falls, OR 87801 EEDRMD:
DIwRm or
I RER
COVERAGES CERTIFICATE NUMBER: RIEVISIONNUMBER:
THIS IS TO CERTIFY TWIT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTVIATHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EMI! TYPEOF04URANC@ LIMITS
Fca L LIABILITY EACH OCCURRENCE f 1100010111
A O@IXOALG ENERALLMBILITY X 01C11`111675110 06/01/2013 0810112014 f 200,00
CLAmsarAOE ❑X OCCUR MEDEXP mrlmmn) a 10,00
PERSONAL A ADV ULARY a 1,000,00
GENERAL AGGREGATE f 2,000.00(
OWL PRODUCTS .COMPIOPAGO A 2,000,00
X POLICY 29 F-1 OC a
AUTOMOBILE UUMMILIT' CMBINEDSINGLELUArr 1,000,0
WNMIINN A X ANY AUTO X DIC171167510 08/01/2013 0810112014 BoBILYDMURY(Pupe ) s
ALLY D PSCHEDULED SCIALY PYURY(Pe ammm) s AUTOS
HWEDAUTOS NOWOMED ER f
AUTOS
f
UMBNELLAUAB X OCCUR EACH OCCURRENCE a 6,000,00
C X excess LIAR CLAAS ADE X USA4022M 08!01/2013 D8/01/m/4 AGGREGATE f 6,000,00
s
WORKERS COMPENSATION X STA OTH-
ANDEMPLOYERa'LIABNUTY
B ANY PRoPRIToRvAmNERiEZECurrvE1-I NIA 9S319M.On 10/01IM13 IOMIPA14 E.L. EACH ACCIDENT f 1,000,00
OFFICERAEMBER EXCLUOEW LLJJ
(Wyp~nA~nlPry In NN) E.L. DISEASE- EA EMPLOYEE f 1,000,
OESCRft M)N ERATIONUI 0,91w G.L. DISEASE a 1110801
UMCMPnONGPOPmtI=MILOTAIMMIVENCLea (AUx ACCRDICI.AC MPntlftMUUadIWWIN.Nmuanpn lamgwrom
City of Ashland Oregon is on additional insured per the attached policy
endorsement form".
CERTIFICATE HOLDER CANCELLATION
ASHLAND
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CRY of Ashland THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
80 N. Mountain Ave. ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97620 AUTHORED REPRemNrA1TLn
//U~ /~G6~
®1888-2010 ACORD CORPORATION. All rights reserved.
ACORD 26 (2010!06) The ACORD name and logo are registered marks of ACORD
insurance COMMERCIAL GENERAL LIABILITY
CO 78 35 02 07
s
Policy #01C171167510
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LIABILITY PLUS ENDORSEMENT
This endorsement modifies Insurance provided under the fallowing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or OrgantwU*n:
City of Ashland
ADDITIONAL INSURED - BY WRITTEN lease or oowpy, subject to the following
CONTRACT, AGREEMENT OR PERMIT, OR additional provisions:
SCHEDULE (a) This insurance does not apply to
The following paragraph Is added to WHO IS AN any goocu ence' which takes place
INSURED (Section IQ: after y to be a tenant In
any premtses lensed to or rarded to
4. Any person or orgaNZaton shown In the Sdred• yaq
ule or for whom you are required by written con- (b) This Insurance does not apply to
tract, agreement or permit to provide Insurance any structural alterations, now coo-
Is an Insured, subject to the following additional strudlon or demolition operations
provisions: performed by or on behalf of ft
IL The contract, agreement or pemhit must be person or organization added as an
In effect during the policy period shown in insured
the Dedarellomh and must have been axe- (2) Your ongoing operations for that lo-
cured pear to the bodily Injury'. 'property cured, whether the work Is pedo . d
damages, or Personal and advertising by you or for you;
tnjury°.
b. The arson or o antratlon added as an ins (3) The maintenance, operation or use by
u of leased to you by such
sured by this andarsement Is an limured only ppeersoneor iorganization, subject to the
to the Want you are hold gable due to: following additional provisions:
(1) The ownership, maintenance or use of (a) This Insurance does not apply to
that pan of premleas you own, rent, artybearrence-which takes place
after the equipment lease empires;
Includes Copyrighted Material of Insurance SeMeas Office, Inc., with Its parmtaston.
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er n w9h reaped to opwasmm nams, use or entrusbnent to otluors of any
paWnred by you or on yaw bring draat lobe or wowareft set Is orated
mod to se fafW t adMWW pro- by or rented or Waned to s y hu-
owed hmmnae does not apply b Worthy This exclusion does not apply IN
bW, mproperly d~, or aduer 11161m (1) A watercraft while ashore on pmdm
Vanics I and ift "W you own out rasonepwfornedfortleebts
ormudeipaub. pwa roraRyrorrdorofamsotis
L The breurium vM respect to any ardOwL (a) Lm am 52 feet lorry no
wWbw, or ewveyw added as an bond (b) Not behm used to my persons or
Ibodlly horjr Voperty dwMo*, or Vw PmPMV Tor a charge:
somi and act"a g bdwy° arwq out of !sl Pwph g an %W am or an the ways
the a pm Irrg of or se bttum b randat any neld too p I I YOU "n or 1011% Pro.
prohaetorel amvioea by our for you, brdrod rented or Wined to yon or 11%kwAv4
(f) The preps" fig. or f b (4) IJebBy assumed order any Insured
prepare or approve amps, dmabpe, raw or use of lmni t sera or
daai9 or epees ~ angbeeft a" (s) qbftdie auf of or R) emv SupmWo, Inepedlon our (a) opaason wpmpwV d~
dam nwS
maddrrery d. This hm mane does ad apply b 'f* e** part that Is atbd drat b, our
of a dvahlobf Would
IrW or 'properly damage' bided wilt quft under to deffAm of
se 'prodVsCompbted opereHwm hm ' aMe ems' g R were not
ard'. mdr)eot b a compulsory or tunabl
remponeuk taw or of er motor ve-
A person's of agpkasor I stabs as an braced urn We Insurance law in se state,
der fhb errclornment ends wfen your opcrasorr far whme R Is licensed or pdnaO*
tint tnaured are oorapbted garaged or
No coumege ale be pmAded l In do absence of ft (b) the opmallon of any of the nmddm
wabramna t no ffaft would be taiposed by law an Mar aq%Waned hoed In PamMh
you. Or Amp dolt be Wna to the axles of your or L(3) of the dathimr of
negfIllwree our hull aooom1bg to are appppbis pdnd. 'mobile aquipmwa'. m
fate? of cormparame fmrE An vkcn* you by any bbmead it to
qxnjed MON.OWNED WATERCRAPT AND KON43WHED
ABtCRAFT LIABILITY TENANTS, PROPERTY DAMAGE UABLITY
Bxtadon g of COVERAGE A (tkploa q It replaced sham In die To Prowdess Remind To You Lfrdt Is
6rdusbn J. of Coverage followIng: by ~ A. Section i b replaced by tlm fdlowbrgr
S. VOW 4W or Vol" d~ aft" out of t on or I. DsmaP TO Property
eMnmhoant to odors of any akcm% 'woo' .pr y dam" to
or waler raft owned or operated by or rented
or loaned to any taaaed. Um bmhdee open (T)
aeon and ~oedtag or umt. mew ends or mcpamn Irmned by W& or
POP ado
-earmsmasawawmrmwe-
ON cliter gganftallon or mdlpr, for WHO M AN INSURED - MANAGERS wdmmml% don or MPI&. maintenance such ~ ~ The MbWbV Ill aided 10 ftMWaph 2A. Of WHO 16
rwea4 try to a AN WSURE D (Baction OX
psear or demo a to mmarm's prapew. des not apply to eooaaNve otOoma, or
R) ftMWU you goo, gm gM or Aeaden, ad O tognatdosupwAooiylevel m&am al wV part of grow p SUPPLEMENTARY PAYMENTS - COVERAGES A
(E) Propmy bared by= AND a - BAIL BONDS - TIME OFF FROM
(4) Personal PMPMV In the am% Mad* or YORK
carrI of the kw rG4 Paregreph 1.b. of GARY PAYMBn -
(5) That particular pad of tad prapedy an wdddu COIIERAM A ANQ B Is mpkW by the foamft
you or any cordradors or mmoamaclars b. Up to SUN for coat of ball bands mqu l d
wmft dm* or ' an your bow
bewuaa of aoddergs or balEo mar vloldbrs
m pwbndMp cut d Omm,se O en yroprtY addr6 Out of the use of any voldds to wdddu
damage' adwe ad of opmatlors or 5s Badly Nay LlebOly tbverage applies
t5) That P nY PAN teat We do not lave to tumbh two bands.
be restated, npaksd or replomd beam ss
avow view was I mareody pedcaved on IL 4.d. of SUPPLEIMMARY PAYMENTS
Paragapts (1)y (5) and (4) of Ids m iuslar do A AND B Is replaced by tle tHatebw
rrd apply b wpqmb damage' (ether Orerr d. AO naemabb m bwarmed by Bs tri-
g amae by ore) to pnrwu% krdudkua do coo- sured at our request to assist us In the lo-
tsrle of matt pnmlon, noted b you. AA aepmate vasdpthn or dearrw of to dabs or %uIr,
out of lam arms appilos to To Preto- bt kpft aduah kw of eandnps up to SSm
loss Rattled To You as desc d Sodon M a day be= of dome off from wmrk
- Lbb Of kwurarIM
Pmaaaph W of ft moduelon don not apply O S1PLOYEES AS INSUREDS - HEALTH CARE
the txsnI on low wak' and were now 1 8
ooa*b4 rmded or held for rental by you. pummon 2AOXCD of WHO M AN pi mm (Seadar
Par GM* Pb (4), (5) and M of this mcdudon 10 Is deleted, wdne excluded by separate andaee•
do not apply b I sift amounted under a side. rest
track aweentom
FwaWapFr M of this axcluslon don not q* to EXnR = COVERAGE FOR NEWLY ACQUIRED
avrap of y d=id k aded N Sat Vmdwts- ORGANIZATIONS
P vAdar La. of VDIO IS AN INSURED owdan 11) le
Paagaph & of LUM OF INSUMN E (Sedlon OQ mooned by Qm Mow hV
tded
IS replaced by the fallmwkv a. Owam a under this pfwAdm Is m 1,
Subjedt a m L above, the Damage To Premlees Only Urdu the WA of do ploy pmlod.
Retied To You Wn9 le 5s mast we. w M pay sr• EXTENDED ,PROPERTY DAMASE°
der Covmage A for I gw bemuse cd
Vnpmgy dwsW to any am pimrdwo, vadie Bmbjdm a. of 00V91AaE A (SedOn Q M replaced
ended to you, or In Its ace at damage by Ire,
wddia ranted to you or OnVwa* aoaipted by
you vMh pmrrdedaa of the owner, a 'Batt KW or wpmpwV domeger' empoded
jDamage To Pnmlon Rsrdad To You Ibdl lo the or bdmuded from the standpoint of the Inmuad.
-
mr of et Esdr OOOraimma Walt alarm 6r Se. DT s *mlan don not apply to %edg y kW
eeeaarre ar tls easwrt Hawn bt the Oeolora5am or VmparW damage" rmsulft from tko use of
as Deaege To Prerdses Rooted To You 4hdt. iweamdta bas to prow Pwagns or properly.
mAaaa nave Oars SP
-Imo®a~nawwmamar-
EVENDED DEFREfION OF BODILY INJURY k~a* by a street madaary. walanaw. or
of a railroad.
PatapWu ti, of DDS (Soctim V) Is replaced
by the ftbwhv. INCREASED MEDWAL EXMI8E LOW
a. llodly IrW mom bodily d*mse at ft Medical 8ponee Umit Is end to $1UM
disease eumlatrmd by a pereau, hrrdtding nrautel
at** of death rewltinp from arty of 0mm at WMLEDOE OF OCCilRRENCE
arty time.
TRANSFER OF RIGHTS OF RECOVERY The toQowMtp b added to Pace~ph i Dullm bt The
&sM Of Omo arse. ORwroe. Balm Or 80 of
ooNmnDNS
The IcIt A 9 Is added to Paragraph R Tramfer Of (99ogmidAl OBSDIAL UABOlTY
It" Of Recovery Against Ollum To Us of ODMF
MERCK mom um m ODNDm m ow ftwbfge of an bomnmtce•, debn or %ult• by
your speed, smvard or omployes shell not In bd
We wdm eery dghm of mcovmy we may hws egehral olf , of ft r bl0trod molusd Bush ►ro0m ,
aryr parson Of otganfaae0mu boom" of pgmw to In byte the agw4 served or otog"m
main for It" of daampsaftV out of your agft
11 or yar awdt° dmte wader a oonbad %M UNpJTBi OWL FAILURE TO DISCLOSE ALL
that I I " or mgattrallm and buchrded In the HAZARDS
appbs orc onforvdmaa
i Is added to ftmgmph At B
me retpr6ad by vrrtuen trtsttram, a~nled or PermO
to walla these dahm of recovery. Tim (fin 10 Qqm& tfABpJfY t~NDI
A8GItEGATE LDDT8 OF INSURANCE - PER I you unbbdmt * tap to dledoee etry hatede a*
LOCATWN Is" at to I , 111aa data of your Policy, we vm not
Form tape vfift to maraud becomes Wg* m- such fallum H r. ft ptaAe►ma~doom trot ltd
gated mp as co ftnqn lamed n a cur atht locollect addBa mtpremdma a eooen Nee our
fthl: of oaroaAodm or nomanaaal.
mtpeutrtderauees causes cmd ASE by A aodcl dd ateale Q. wider and W for for all all COVERAGE B c C
(Bacum
at 4' whWh ~ be dWbftd a* to qmadm LMRRALIZATION CLAUSE
Paragraplm ?a sad = of Umb of lrmwmm (goo- The Mbwbg -1 b added (Sawa W
Oat pp appyt sspwd* to each of your 4ocetlorre•
mid by or rented to you 10. M a redden to ft Cmmage Part Wft wmdd
n• mesa Pmdm brilltg the sane at n*m ' nee eeeo n l ft m adffjonw w prey
Wad
cauteol~ bis, or premiew whoa ownpo0on N In the eteto Naown in the Deladlorus~your pol.
by Will aubmw*dN Provide 96 additional cov-
arage an the affao0ve date of the mvlalort.
Rp/d4
--REPRU OFROMTHEARCHfiEwROtlCM/LTgNq~CxgMwrxuu~omxwxwwxw'"
COMMERCIAL AUTO
Policy #01C171167510 CA 71 10 03 07
?HIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTO PLUS ENDORSEMENT
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by tints endorsemem, the provisions of the Coverage Form apply umiess
modified by the endorsement.
EXTENDED CANCELLATION CONDITION BLANKET ADDITIONAL INSURED
Paragraph 2.b. of the CANCELLATION Common SECTION ff - LIABILITY COVERAGE - A.I. WHO
Poky Condition Is replaced by the following: IS AN INSURED provision Is amended by the addition
of the following:
b. Bo days balm the effective date of cancellation N we cancel for any other reason. s. Any person or organization for whom you are re-
quired by an inured eons act• to provide Iasur-
TEMPORARY SUBSTITUTE AUTO - PHYSICAL amore Is an insured', subject to the following
DAMAGE COVERAGE additional provisions
The Insured contract must be In effM
Under paragraph C. - CERTAIN TRAILERS. MO- (1) during the policy period'showm the Decla-
BILE EQUIPMENT AND TEMPORARY SUBSTITUTE rations, and must have been executed prior
AUTOS of SECTION 1 - COVERED AUTOS, the to the 'bodily injury" or *property damage".
following Is added:
(2) This person or organization is an insured'
If physical Damage coverage is provided by this Cov- only to the extent you are liable due to your
erage Form. t= you have coverage for. ongoing operations for that Insured, whether
the work is performed by you or for you. and
Any 'auto' you do not own while used with the per- only to the extent you are hold liable for an
mission of is owner as a temporary substitute for a 'accident' occurring while a covered 'auto'
covered eatdo. you own that Is out of service be. Is being driven by you or one of your am-
cause of its breakdown, repair. servicing, lose' or P"ses-
destruction. (3) There is no coverage provided to Otis person
or organization for bodly Irdury' to is am,.
BROAD FORM NAMED INSURED ptoyeas, nor for 'properly damage' to its
SECTION U - LIABILITY COVERAGE - A.1. WHO Properly.
IS AN INSURED provision Is amended by the addition (4) ~ Coverage for is r oth0 ire_ extant of rgyour en B
01 lire following: genes or fault according to the applicable
d. Any business emlty newly acquired or formed by principles of comparable negligence or taut.
you do more pof the oky business perio entity d wed s you ow (5) The defense of any claim or 'suit' must be
business ently Is not separately booed for tendered by this person or organization as
Business Auto Coverage. Coverage is extended soon as practicable to all other Insurers
mgr to a maximum of 180 days following aeguiol- which potentially provide insurance for such
tlon or formation of the business emiy. Coverage claim or 'suit".
under ids provision is afforded only until the and
of the policy period.
Includes copyrighted material of Insurance Services Office, Inc., with Us permission.
Copyright. Insurance Sexvlow Office. Inc.. 19g7
Qw n 10 03 W Rpr 1 de
-REN@rtFOFRm1i141MfJw6. rlaOleliCW rpNOACnONWrOInUOEeLORWMet raaW -
(6) The coverage provided will not exceed the PERSONAL EFFECTS COVERAGE
teaser oF. A. SECTION M - PHYSICAL DAMAGE COVER-
(a) The coveMe amVOr ORM of this policy, AGE. AA. COVERAGE EXTENSIONS, is
or amended by adding the following:
(b) The coverage and/or limits required by c. Personal Effects Coverage
the Insured contracts. For any Owned 'auto' that Is involved In a
M A person's or organitattaya status as an covered Iosas, we will pay up to SM for
Insured' under ads subparagraph d ends personal effects' that are lost or damaged
when your operations for that Insured' are as a result of the covered Ioess, without
completed. applying a deductible.
EMPLOYEE AS INSURED EXTRA EXPENSE - BROADENED COVERAGE
Under Paragraph A. of Section U - LIABILITY COV- Paragraph A. - COVERAGE of SECTION UI -
ERAGE hem I. Is added as follows: PHYSICAL DAMAGE COVERAGE is amended to
add:
Yout "employees while using his owned saulo', or an
%ulo° owned by a member of hie or her household. S. We will pay for the expense of returning a stolen
In your business or your personal affairs, provided you covered lauto' to you.
do not own, hire or borrow that 'auto'. This coverage
Is excess to any ocher collectible insurance coverage. AIRBAG COVERAGE
FELLOW EMPLOYEE COVERAGE Under paragraph B. - EXCLUSIONS of SECTION III
- PHYSICAL DAMAGE COVERAGE, the following is
Enatuelon S. FELLOW EMPLOYEE of SECTION U - added:
LIABILITY COVERAGE - B. EXCLUSIONS Is
amended by the addition of the following: The exclusion relating to mechanical breakdown does
not apply to the accidents[ discharge of an airbag.
However. Oft exclusion does not apply U the 'tiod0y
kfury' resuUs from the use of a covered We you NEW VEHICLE REPLACEMENT COST
own or hire. and provided 90 any coverage under
this provision only applies In excess over any other Under Paragraph C - LIMIT OF INSURANCE of
trotieetibl0 Insurance. Section III - PHYSICAL DAMAGE COVERAGE seo-
don 2 Is amended as follows:
BLANKET WAIVER OF SUBROGATION 2. An adjustment for depreciation and physical cod
We waive the right of recovery we may have for pay- dhion will be made M determining actual cash
Monte made for 'bodtiy Injury' or 'properly damage value In the event of a total toes. However, in ft
on behalf of the persons or organlrsllorns added as event of a total lose to your 'new veAk9e' to
Insuretls" under Section II - LIABILITY COVERAGE which this coverage applies. as shown In the
- A.I.D. BROAD FORM NAMED INSURED and declarations, we will pay at your option:
AAAL BLANKET ADDITIONAL INSURED. a. The verifiable anew vehide' purchase price
DAMAGE - ADDITIONAL TRANS- you paid for your damaged vehicle. not In.
PHYSICAL ur.
hndIng any Inauranxxr or wartaedes pun
PORTATION EXPENSE COVERAGE chased;
The first sentence of paragraph AA. of SECTION M b. The purchase price, as negotiated by us, of
- PHYSICAL DAMAGE COVERAGE Is amended as a new vehicle of the acme make, model and
follows: equipmerd, not Including any furnishings.
parts or equipment no Installed by the
We wN Pay up to 00 per day to a maximum of nmmdWhzw or manufachner'e dealership.
SIAW for temporary trersportalfon expense Incurred It the same model is not avellabte pay the
by you because of the total lot of a covered "auto' purchase price of the wheat sbntiar model
of the private passenger type. available;
Peas 2416
-111~II®NIOYlM6MOM iN6olOWLrgy~p~,WYO(0.W611001r10M,LFWw6
c. The market value of your damaged vehicle, e. Actual cash value of the damaged or stolen
not Including any furnishings, pads or equip- property as of the time of the loss', less an
ment not Installed by the manufacturer or adjustment for depreciation and physical
manufacturer's dealership. condition; or
This coverage applies only to a covered 'auto' b. Balance due under the terms of the ban or
of the private passenger, fight tuck or medlum lease that the damaged covered 'auto- is
tuck We (2D,000 We or lees gross vehicle subject to at the time of the lose', less any
vratght) and does not apply to Initiation or set up one or all of the frllladng adjustments:
coats associated with bans or leases. (1) Overdue payment and Mendel
TWO OR MORE DEDUCTIBLES penalties associated with those
payments as of the date of the
lose'.
Under SECTION BI - PHYSICAL DAMAGE COV-
ERAGE, if two or more 'company' poldea or carer- (Z) Financial penalties Imposed under a
age forme apply to the some accident, the following lease dim to high mileage, exces-
applies to paragraph D. Deductible: elve use or abnormal wear and tear.
a. B the applicable Business Auto deduct- (s) Coate for extended warranties. Cre
able is the smaller (or smallest) deduct- dh Ufa Insurance. Health. Accident
ible it will be waived; or or Disability Insurance purchased
b. If the applicable Business Auto deduct- with the loan or lease.
Ible Is not the smaller (or smaflesQ do- (4) Transfer or rollover balances from
ducdble it will be reduced by the amount previous loans or leases.
of the smeller (or smallest) deductible: (S) Final payment due under a Samx n
Low«
or
C. N the IM Involves two or more Bust.
tress Auto Coverage forks policies (S) urn The dolrepalredor damage amount that of any
occurred
waived. smaller (or smepast) deductible will prior to the 'total loss' of a covered
be b the
.auto..
For the purpose of this endorsement
wconpanymeans: (7) Security deposits not rshaded by a
lessor.
a. Sefeco Insurance Company of Amelia (S) All refunds payable or paid to you
b. American States Insurance Company as a resut of the early terminstim
C. General Insurance Company of America of a lease agreement or any war-
" or extended service agree-
d. American Economy insurance company ment on a covered .auto'.
e. Fast Nadonal Insurance Company of (9) Any amount representing taxes.
Amadca (10) Loan or lease termination fees
f. American States Insunma Company of
Texee GLASS REPAIR - WAIVER OF DEDUCTIBLE
g oa Stelae Preferred insurance
Cop Under paragraph D. - DEDUCTIBLE of SECTION Ili
- PHYSICAL DAMAGE COVERAGE, the following is
h. Safeco Insurance Company of annois added:
LOANILEASE GAP COVERAGE No deductible applies to glass damage B the glees is
repaired rather than replaced.
Under paragraph C - LIMIT OF INSURANCE of
SECTION M - PHYSICAL DAMAGE COVERAGE. AMENDED DUTIES IN THE EVENT OF ACCT.
the following Is added: DENT, CLAIM, SUIT OR LOSS
4. The most we will pay for a total loseo in any one The requirement In LOSS CONDITION 2a. -
%eddent• Is the greater of me following, subject DUTIES IN THE EVENT OF ACCIDENT. CLAIM,
to a $1.500 maximum emit SUIT OR LOSS - of SECTION IV - BUSINESS
AUTO CONDITIONS that you must noW us of an
Cr, 71 10 03 07 twat 3 d 6
-RVW=Ferns THEA rw6 Ta0xaMNIRaMSaCrxIMWr WRletarOaxplK r010O""
ant" applies only when the 9acddent° Is (mown deductible and excess provisions. WS will provide
coverage equal to the broadest coverage applicable
to: to any covered 'auto' you own.
(1) You It you are an incividual;
HUM AUTO PHYSICAL DAMAGE COVERAGE
(2) A partner, If you are a partnership: or -
LOSS OF USE
(9) arAn executive officer e a rpaatlo or insurance manager, lt you
S=ON BI - PHYSICAL DAMAGE AA.b, Form
does not appy.
UNINTENTIONAL FAILURE TO DISCLOSE Subject to a maximum o15/000 per accident. we will
HAZARDS cover loss of use of a hired 'auto' 0 it results from
SECTION IV - BUSINESS AUTO CONDITIONS - an acddimt, you are tegaly liable and the lessor tn..
B.2. Is amended by the addition of the following: ours an actual financial loss.
lt you unimentlanely, fag to clWase any hazards ex- RENTAL REIMBURSEMENT COVERAGE
Isling at the inception date of your policy, we will not A. We will Day for rental raimbursamem expenses
deny omrerege under ids Coverage Form because of incurred by you for the rental of an 'auto' be-
stain falbrre. However. this provision does not affect cam of a covered 9osa' to a covered auto'.
our right to collect additional premium or exercise our Payment applies In addition to the otherwise ap-
right of cancel n or non-renewal. p0cable amount of each coverage you have on a
HIRED AUTO - LIMITED WORLD MODE COVER' covered auto No deductibles apply to this
AGE Coverage.
B. We will pay only for those expanses Incurred
Under Section IV - Business Conditions, Paragraph during the policy period beg nhV 24 hours after
B.T.b e(1) is replaced by the following: the 'loss' and ending, regardless of the polcy's
(1) The aeciderd" or 'bas' results expiration, with the lesser of the following number
from the use of an auto' hired for of days:
30 days or less. 1. The number of days reasonably required to
repots or replace the covered solo'. N
RESULTANT MENTAL ANGUISH COVERAGE toss- is caused by theft, ads slumber of
days Is added to the number of days it takes
SECTION V - DERNMONS - C. M replaced by Cre to beats the covered 'au n and return It to
following: you.
'qty Injury' means bodily injury, ddmese or dis- 2. 30 days.
asse suslalned by a person Incuding mental anguish C. Our payment is limited to th newer of the fct.
or death resulting from any of Creae. lowing amounts:
HIRED AUTO PHYSICAL DAMAGE COVERAGE 1. Necessary and actual expenses Incurred.
If hired 'autos are cowered 'autos" for Uabmy cov. 2. $50 per day.
erage and C Oomprehertstve, Specified Causes of 0. This ooverage dose not apply while there are
Loss or Collision coverages are provided under this spare or reserve 'autos' avallableto you for your
Coverage Form br Only sub' you own, then the operations.
Phy&111 Damage Coverages provided are extended
to 'autos' you hire or borrow. E. C toss- results from the total theft of a covered
'auto' of the private passenger type, we will pay
The most we will pay for lose to any hired 'auto- Is under this coverage only that amount of your,
St OX0 Or Actual Cash Value or Cost of Repelr. rental reimbursement expenses which Is not at.
whichever Is OnSI MBi minus a deductible. The do- reedy provided for under the PHYSICAL DAM.
duclible will be equal to the largest deductible appg• AGE COVERAGE Coverage Extension.
cable to any owned auto" of the private passenger F. The Rental Reimbursement Coverage described
or light dkal Damage truck type for drat coverage. Hired A other Got. above does not apply to a covered auto" that is
'edible insurance. coverage Subjbect to excess o the ver any
above c grog, , described of designated as a covered -auto- on
e
pop 4 al e
• -RUM00moMnaAROwcnaoRmwmuwAcrowwrwaw ADDnmiwwrtw-
Rental Relnbu mment Coverage Form the manufacturer for the hhsta0alton of a
CA 99 23. radio'
AUDIO, VISUAL AND DATA ELECTRONIC C. Limit of Insurance
EQUIPMENT COVERAGE With respect to this coverage. the LIMIT OF IN-
SURANCE provision of PHYSICAL DAMAGE
A Coverage COVERAGE Is replaced by the following:
1. We will pay with reaped to a covered 'auto' 1. The most we will pay for loss" to audio, A.
for loss' to any emdrordc equipment that wal or dam electronic equipment and any
or transmits receives
nabs and ml Is Is of audio, visual or data ads used with title equipment as a
applies thees result of any one oaoddeM" la the lesser at
sound. This designed solely coverage age to
reproduction and ion th of e, not
any N the equipment Is permanently Installed a. The actual cash value of the damaged
in Me covered "auto' at the time of the or stolen property as of the time of the
loss" or the equipment Is removable from a loss": or
housing unit which is permanently Irmadled b. The coat of repairing or replacing the
in the covered 'equip at the line the damaged or stolen property with other
property of Mce Idnd and quality.
be boas', solely and opsucherated by equipment
use of pment the designn power ed from m
the 'auto's' electrical system. In or upon the c $1,000.
covered lauto'. 2. An adjustment for depredation and physical
2. We will pay with respect to a covered 'auto' 0oditon will be made in determining actual
for nOW to any accessortes used with the cash value at the time of the loss".
electronic equipment described In paragraph g N a repair or replacement results In hater
A.1. above. than Ore Idnd or quality. we will not pay for
However, this does not Ihdude tapes, the amount of the betterment.
records or discs.
3 N Audio, Visual and Dam Electronic Equip- D. Deductible
mach Coverage form CA 99 80 or CA 99 94 1. If loss" to the audio, visual or date eloo•
18 attached to this policy, then the Audio. W tronle equipment or axeeaodes used with
wal and Date Electronic Equipment Cover. Ws equipment lu the result of a lose" to the
age described above does not apply. covered "auto" under the Business Auto
Coverage Form's Comprehensive or CoAF
& Exclusions slon Coverage. then for each covered 'auto'
The exdudons that apply to PHYSICAL DAM' our obligation to pay for, repair, return or re-
AGE COVERAGE. swept for the exciuslon retell- Pie damaged or stolen property will be re-
11V to Audio. Visual and Data Electronic duped by the applicable deducible shown in
Equipment, also apply to this coverage. In addb the Dedeattona. Any Comprehensive Coy-
lion, the following exclusions apply: cage deductible shown In the Declared=
does not apply to 9088" to audio, visual or
We will not pay for offer any electronic equip. data electronic equipment caused by tire or
mach or 800088011e11 used with such electronic lightning.
equipment that Is: 2. 0 lasso to the audio. visual or data else.
I. Necessary for the normal operation of the M& equipment or accessories used with
covered "auto" for the monitoring of the this squiprtreM Is the result of a loss" to the
covered 'euto's• operating system; or covered 'auto' under the Business Auto
2. Both: Coverage Form's Specified Causes of Lose
Coverage. 1111011 for each covered %tW our
a. an Integral part of the same unit housing obligation to pay for. repair. return or replace
any sound reproducing equipment de- damaged or stolen property will be reduced
signed ad* for the reproduction of by a 5100 dad .
sound If the sound reproducing 3. N loss' occurs achy to the audio, visual or
equipment le permanently Installed to dam electronic equipment or accessories
the covered 'auto": and used with this equipment, them for each cow
b. permenen,y Installed In the opening of Bred 'auto" our obligation to pay for. repair.
. the dash or console normally used by
CA 711003 07 Pepe 5 de er
' -16PI~IIa7YRW iNr NKMYE. ngp~W7pplyl(:r10MWY0f41NEMdri7M~lf01eN
retum or replace damaged or stolen property SECTION V - DEFINITIONS Is amended by adding
witi be reduced by a $100 deductible. the following:
4. In the event that there is -Mrs than one ap• O. 'Personal elfectaw means your tangible
by you. ex-
jewelry. o carried! monnel, or
plicable apply. In deductible. no eve only i t the will highest more than one pt fo property tothat ola. Is worn
Ible securities.
deductible apply. It aWm vehicle' means any 'auto' of which
you are the original owner and the 'auto'
has not been previously titled and Is lees
than 965 days past the purchase date.
r68r 8 a 6
Page 1 / 1
CITY OF CI RECORD
ASHLAND NUMBER`.".
20 E MAIN ST. 3/6/2014 12132
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 003671 SHIP To: Ashland Water Department
LIQUIVISION TECHNOLOGY (541) 488-5354
711 MARKET STREET 90 N MOUNTAIN
KLAMATH FALLS, OR 97601 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net Dept.:
Req. Del. Date: Contact: Steve Walker
Special Inst: Confirming? NO
e'QUantl nIY
Divinq Services - Granite Street 4,995.00
Reservoir
All internal vertical and horizontal
surfaces to be cleaned by certified
divers per attached scope of work.
Contract for Goods and Services
Beginninq date: 03/01/2014
Completion date: 06/30/2014
SUBTOTAL 4,995-00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 4,995.00
ASHLAND, OR 97520
..r.,
":.Account Numtier, _
„,?.:;P,rgecENumber , x.; Amount CCOUnfNumb er,„ Amount
E 670.08.18.00.60240 4,995.00
Authorized Signature VENDORCOPY
FORM #3
CITY OF
LI:J_;", u,;'L,9cr, ~xrc?er ASHLAND
REQUISITION Date of request: 3-5-14
Required date for delivery: ASAP
Vendor Name Llo ,ivis on To hn I , i
Address, City, State, Zip 711 Market Stret.Klamath Falls Oregon 97601
Contact Name & Telephone Number
Fax Number Sherri Trigg 1-800-229-6959
541-883-1361
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergency
❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ AMC 2.50 El Form #13, Written findings and Authorization
El Written noteor rosalattached Date approved by Council: ❑ Written quote or proposal attached
X Small Procurement Cooperative Procurement
Less than
X ❑ Request for Proposal (Copies on file) ❑ State of Oregon
X Veba l/W Award Date approved by Council: Contract #
erb ritten 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
55.000 to $100.000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes and solicitation attached Form A, Personal Services $5K to $75K Contract
#
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5,000 to $75.000 ❑ Form #9, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3) Written proposals/written solictafion Date approved by Council: (Date)
❑ Form #4, Personal Serv ices $5K to $75K Valid until: Date
Description of SERVICES Total Cost
Clean all internal vertical and horizontal surfaces at Granite Street Reservoir using certified
potable water divers. $4,995
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
X Per attached quotelproposal TOTAL COST
.E-
Project Number Account Number 670.08.18.00.602400
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:
By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. IT Director Date Support -Yes l No
Employee: -,/o~..,0 Department Head: ilk
a/5-//q
LI
Department Manager/Supervisor: (Equal to or greater than $5,000)
City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year: YES / NO
Comments: Finance Director- (Equal to orgreaterthan $5,000) Date
Forth #3 - Requisition -