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2014-033 Contract - Civil West Engineering Service
Contract for PERSONAL SERVICES C I T Y OF CONSULTANT: Civil West Engineering Services, Inc. ASHLAND CONTACT: Garret Pallo, P.E. 20 East Main Street Ashland, Oregon 97520 ADDRESS: 486 'E' Street, Coos Bay, OR 97420 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-266-8601 DATE PREPARED: 2/10/2014 FAX: 541-266-8681 BEGINNING DATE: 2111/2014 COMPLETION DATE: 8/11/2014 COMPENSATION: Time and Materials; Not to Exceed - $30,842.00 SERVICES TO BE PROVIDED: Value Engineering Analysis and Evaluation; Bear Creek portion of 2012 Wastewater Master Plan PWE: Project No. 2013-14 ADDITIONAL TERMS: FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. ' 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of . City. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is $19,825 or more, Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any Subcontractor who performs 50% or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 10. Termination: a. Mutual Consent. This contract may be terminated at an time b mutual consent of both parties. G:\pub-wrks\eng\13-14 Bear Creek - Mountain Ave San SwAA Admin\Eng Vendorl\Contract Documents\Contract Development - Pre- Contract\2013-14 Civil West Contract - Value Engineering - 2-10-2014.doc b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: I. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; I L If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. I. Either City or Consultant may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 14. Insurance. Consultant shall at its own expense provide the following insurance: a. Workers Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $2,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to cover damages caused by error, omission or negligent acts related to the professional services to be provided under this contract. C. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $2,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contract. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. e. Notice of cancellation or change. There shall be no cancellation material change, reduction of limits or G:\putrwrks\eng\13-14 Bear Creek - Mountain Ave San Swr\A_Admin\Eng Vendort\Contract Documents\Contract Development - Pre- Contract\2013-14 Civil West Contract - Value Engineering - 2-10-2014.doc i. intent not to renew the insurance coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 1 15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United State's District Court for the District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further liability to Consultant. Certification. Consultan all sign the certification attached hereto as Exhibit A and herein incorporated b reference. onsult City of Ashland By Sig t Depa epartmen d • E1T ALLO m_ t cnvi-£( e. r`A.~Gr"r yO'' --cw"P/(chHer Print Name Print Name ~ES✓D6NT ~~a~~ry Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. G:\pub-wrks\eng\13-14 Bear Creek - Mountain Ave San Swr\A Admin\Eng Vendorl\Contract Documents\Contract Development - Pre- Conlract\2013-14 Civil West Contract- Value Engineering - 2-10-2014.doc 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 thel 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. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. ✓ (3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. ✓ (5) Labor or services are performed for two or more different persons within a period of one year. ✓ (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. -2 - ¢ Co u1t (Date) G:\pub-wrks\eng\13-14 Bear Creek - Mountain Ave San Swr\A_Admin\Eng Vendorl\Contract Documents\Contract Development - Pre- Contract\2013-14 Civil West Contract- Value Engineering - 2-10-2014.doc i Civil W41nc..~ 4B6'E'Street Cnoe Bay, OR 97420 Engineering Ser609 SW Hurbert Street ' Newport, i R 97366 PROPOSED SCOPE OF SERVICES Date: February 6, 2014 Work Order Number: To: Mr. Morgan Wayman, Project Manager, City of Ashland From: Garrett Pallo, PE, President, Civil West Engineering Services, Inc. RE: Wastewater Master Plan Value Engineering - Phase 1- Scope of Services Civil West Project Number: 1003-002 This document summarizes and describes the proposed scope of services for the completion of a value engineering analysis and evaluation of a portion of the City of Ashland Wastewater Master Plan. This is the first phase of review of what is anticipated to be multiple phases of review, each considering different parts of the system and different projects in the City's wastewater capital improvement plan (CIP). Background Summary The City of Ashland owns and operates a wastewater system that includes collection system piping and manholes, lift stations, force mains, a wastewater treatment facility, and an effluent elimination system (outfall). The City has invested heavily in their treatment facilities in recent years and is now preparing to undertake improvements to their collection system. With that goal in mind, the City recently completed a wastewater master plan (Keller and Associates, Inc., 2012) and is currently completing a wastewater facilities plan (Keller). The City's water master plan includes a number of recommended projects that have been organized and prioritized in a CIP. The City is now preparing to take on the highest priority projects and wishes to conduct a value engineering (VE) review of the recommendations. The purpose of the VE is not to second guess or override the recommendations in the CIP. Rather, it is to ensure that the recommendations are confirmed and to see if there are ways to reduce costs, refine the approach, or otherwise provide value to the rate payers in the community. As many of the high priority projects are of significant costs, conducting a VE is an appropriate step to being good stewards of the public funds and ensuring that the projects have been vetted and reviewed in detail before moving into final design. On the following pages, we will provide a summary of the major work tasks that will be included within this first phase VE study. This first phase of VE will focus on the projects related to the Bear Creek interceptor project. Future phases will evaluate other major CIP project areas. This VE effort will be coordinated with surveying and data collection being undertaken by the City under a separate contract. We will be responsible for coordinating the collection of the data and for the conclusions and recommendations that result from evaluation of the data that is provided. 1 City of Ashland Wastewater Master Plan Value Engineering Phase I - Scope of Services for Engineering Part A: Scope of Work The following tasks are identified to track the project's progress. An estimate of the man-hours required for each task will be provided under Part B. While there may be many subtasks included within these major task areas, only the major tasks are discussed below. Wastewater Master Plan Value Engineering Phase 1- Scope of Services 1. Task 1- Project Management and Administrative Services - This task Includes administrative and project management efforts related to the project. This shall include processing of paperwork and correspondence between Civil West and the City, coordination on financial matters, directing resources internally, meeting with staff on routine issues, and other project management activities. 2. Task 2- Review of Existing Planning, Mapping and Information- Under this task, our engineers will review existing mapping, data, as-builts, flow data, and other information that is available from the City. We will provide the City with a "wish list" of information that we will evaluate if available. From this information, we will identify additional and supplemental data to be collected by the City's survey consultant (separate contract). 3. Task 3 -Coordination with Survey Effort - Under this task, we will coordinate with the consultant gathering survey data, under a separate contract for the City. We will identify the manholes and areas that we need information gathered, the format of the information, and the level of detail we require. This coordination will occur throughout the evaluation process to ensure that the data we need is being collected by the survey consultant. We will provide the survey team with a sample manhole survey sheet that can be used for data collection at each manhole. 4. Task 4 - Updated Mapping Products - The City will provide us with a mapping product, prepared by their survey consultant under separate contract. This task will include an allowance of hours to coordinate.this effort, review the mapping product, and making any conversions or updates required to make use of it for our study purposes. 5. Task 5 -Capacity Calculations and Evaluation of CIP- Underthis task, we will utilize spreadsheet tools to calculate the physical capacity of each pipeline section in the interceptor and its subordinate systems. We will utilize the Manning's Equation and the information collected through this effort to complete capacity calculations and capacity curves for each section of piping. The curves and performance calculations will provide the full range of capacity for each section, which we will compare against the estimated existing flows and projected future flows developed in the Master Plan. From this, we will be able to confirm the relevance of the CIP projects in terms of sizing, layout, and ultimately, recommended project concepts and costs. 6. Task 6 - Phase 2 Directive - Not included in this scope of services. 7. Task 7 -Conclusions, Recommendations, and Deliverables- Under this task, we will provide a final report summarizing the work completed in this Phase 1 evaluation. The report will include the following sections: a. Introduction and Background b. Summary of Data Collection Effort c. Summary of Calculations and Capacities d. Conclusions and Recommendations 2 City of Ashland Wastewater Master Plan Value Engineering Phase I - Scope of Services for Engineering e. Phase 2 Directive Recommendations In addition to this report, we will provide digital and hardcopy prints of the sewer mapping prepared in Task 4 for the City to utilize. This information can be "plugged Into" the City's master GIS files or used by staff for engineering or operations purposes. We will provide the City with 6 draft copies of the report and 10 copies of the final along with digital submittals of all deliverables. Digital deliverables will be provided in native formats (AutoCAD, Word, Excel, etc). 1 8. Task 8 - Reimbursables/Direct Costs - This item will cover direct reimbursable expenses anticipated for the project. These include travel and per diem costs, reproduction and office expenses, and other reimbursable costs. Part B: Project Fee Proposal We have prepared a detailed worksheet summarizing the tasks described above, key sub tasks, and anticipated hours that will be required for the completion of all tasks. We have totaled up the individual tasks to arrive at a proposed fee for the completion of this project for the City of Ashland for this scope of services. The detailed spreadsheet used to develop our proposed budget is provided on the attached Exhibit A. A summary of the proposed fee schedule is provided below: Task Summary of Proposed Engineering Budget: Budget 1 Project Management & Coordination $1,120 2 Review of Existing Planning, Mapping and Information $5,680 3 Coordination with Survey Effort $1,474 4 Updated Mapping Products $706 5 Capacity Calculations and Evaluation of CIP $12,416 6 Phase 2 Directives - NIC $0 7 Conclusions, Recommendations, and Deliverables $8,796 8 Reimbursables $650 Total Proposed Budget $30,842 The proposed fee is based on a time-and-materials to a maximum for the scope of services proposed herein. No additional costs or fees are anticipated unless the City requests a change to the scope of work. Part C: Proiect Schedule While we are flexible and will meet the time constraints of the City, it is useful to discuss a potential project schedule for the project as a basis for moving forward. The following tentative schedule is proposed for your consideration: 1. Authorization to begin work- By mid-February 2014 (assuming the City contract process Is completed) 2. Work begins - Late February 2014 3. Data reviewed and request for survey information provided to survey consultant - by early March 2014 4. Capacity calculations for pipe sections- by February 28a' 5. Draft report submitted - by March 14, 2014 (allow for 1 week review) 6. Final report submitted - by March 28, 2014 3 City of Ashland Wastewater.Master Plan Value Engineering Phase 1 - Scope of Services for Engineering The above schedule is approximate and may vary depending on a number of issues. If desired, the schedule can be accelerated to meet the City's timing requirements. Currently, the schedule is based around a roughly 60-day contract window. I We are prepared to begin this work on this project as soon as we are authorized to do so. Please let Ime know if you have any questions or if you wish to see any alterations to our proposed approach. If this proposed scope of services is acceptable, please sign below and return a copy to our office for our records. Sincerely, Civil West Engineering Services, Inc. 5 J. Garrett Pallo, PE President Authorized Representative Signature Accepting Swpe of Services Date 4 i Ri i3 i3 ffi m yN_~ yN~ ia-' nun u yy e $ $ e y~ 26 ~~.j 1V e LL N tV A A N ~ A A M N~ A A N N E N~ N A w N N N ^ ~e mm m ,@,$ aaaa mm y,~ m$S opo om$~ c { r e ~Q„ s a s s m b 1 ~ ` 0 6 ti° o 0 0 0 0 o mm u g $ A s L U LI a R` 3 0 IMP e e o 0 o e e o N N t p, _c m U _ n S &s t L'o e n a n n m m m$ o f a $ c c n a x e ~y w, Q.e •j o o 0 0 0 o e o c 1WN a $ Q a a O 7 Ca O O e O O O O O L w w W y`umg F am e m r$ n a fa f a 'p 'p m~fy$ o $fmA Q' q N 1..E N s• p v~ 1.4 O Eh' 4 C O a Y": O m N N a O N N N N m O m f ~ y Y C a` aw'• m Al 14 n n a 92 m ~.~2a' EGE a ~ • .5 U 5W ~ ~ c4 dl {p7 C 6 C d 4 g4g 6 a • 16 5 fi fl °e o f L' 16 mE@o"p .ga rc°~€~ cS b c~ ~~u~$o~ 6rc~ ~ah~~ ~F rc o Q 3 m a n N ^ .9i~ a B N$ Q 3~ 5i $ $ ^ n n n e$ U 3 W2 f ® DATE (M.IDDfYYYY) ,4coao CERTIFICATE OF LIABILITY INSURANCE 2/12/2014 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 policy(ies) 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 endorsements . PRODUCER A T NAME: Michael J Hall & Company PHONE ac No: N,. EMI-360-598-37 0 Hall & Company AE-MAIL DDRESS: 19660 10th Ave NE Poulsbo WA 98370 INSURERS AFFORDING COVERAGE NAICk INSURER ARLI Insurance Company 13056 INSURED INSURER BAlterra Excess , Sun2lLja I Civil West Engineering Services Inc INSURER C 486 E Street INSURER D: Coos Bay OR 97420 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 896854656 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR I POLICY EFF POLICY EXP LIMITS LTR IN SR WV POLICY NUMBER MM/DD/YYYY M1141 YYY A GENERAL LIABILITY SB0003294 11/2013 /1/2014 EACH OCCURRENCE $2,000,000 DAMAGE X COMMERCIAL GENERAL LIABILITY PREMISE TE T R NDn a $1000,000 CLAIMS-MADE 15F] OCCUR MED EXP An one person) $10,000 X OCP/XCU/BFPD PERSONALS ADV INJURY $ X Separation losds GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $4,000,000 POLICY PRO- F LOC $ -1 JECT A AUTOMOBILE LIABILITY PSA0001542 /112013 11/2014 Ea accident 1,000000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS 'NAUTOS ON-OWNED PROPERTY DAMAGE $ X HIREDAUTOS X AUTOS Per accident A UMBRELLA UAB OCCUR PSE0003058 11/2013 /1/2014 EACH OCCURRENCE $2,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WCSTATU- OTH-TORY I IMITA FIR AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE❑ N/A E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatoryin NH) E.L. DISEASE -EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ B Professional Liab:Claims Made AX7PL0000881 /1/2013 /1/2014 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is faquirad) Certificate Holder(s) is/are an Additional Insured on the Commercial General Liability and Auto Liability when required by written contract or agreement regarding activities by or on behalf of the Named Insured. The Commercial General Liability insurance is primary insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance. A waiver of subrogation applies to the Commercial General Liability, Auto Liability & Umbrella / Excess Liability in favor of the Additional Insured. PWE: Project No. 2013-2014 The City of Ashland, Oregon and its elected officials , officers and employees are Additional Insureds on the Commercial General Liability See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland OR 97520 AUTHORIZED REPRESENTATIVE >)l _ ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: _ LOC A ADDITIONAL REMARKS SCHEDULE Pagel of 1 AGENCY NAMED INSURED Michael J Hall & Company Civil West Engineering Services Inc 486 E Street POLICY NUMBER Coos Bay OR 97420 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS ! THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE and Auto Liability when required by written contract or agreement regarding activities by or on behalf of the Named Insured. This insurance is primary insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance. A waiver of subrogation applies to the Commercial General Liability, Auto Liability & Umbrella / Excess Liability in favor of the Additional Insured. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II - LIABILITY AND SECTION III AS IT PERTAINS TO LIABILITY ONLY A. First Aid And Good Samaritan Services a. Expected or Intended Injury 1. The following is added to Section II A.1. 'Bodily Injury' or "property damage" Business Liability Coverages expected or intended from the standpoint of We will pay those sums that the insured the insured. This exclusion does not apply becomes legally obligated to pay as damages to "bodily injury' or "property damage" because of "bodily injury" arising out of either the resulting from the use of reasonable force to rendering of or failure to render, "First Aid" or protect persons or property. "Good Samaritan Services" to any person. For D. Non-Owned Watercraft the purposes of this coverage grant, "First Aid° "Good Samaritan Services" will be deemed to 1. Section II 6.1.g. Exclusions, Aircraft, Auto Or meet the definition of "occurrence". For the Watercraft Subparagraph (2) is deleted and purposes of determining the applicable limits of replaced by the following: insurance, any act or omission together with all (2) A watercraft you do not own that is: related acts or omissions in the rendering of "First Aid" or "Good Samaritan Services" to any (a) Up to seventy-five (75) feet long; and one person will be deemed one "occurrence" . (b) Not being used to carry persons or a. "First Aid" means initial care for medical property for a charge; attention Immediately following a "bodily 2. Only as respects to the insurance provided by injury" this provision C. Who Is An Insured is b. "Good Samaritan Services" means medical amended to include as an insured any person attention provided in an emergency and for who, with your express consent uses the which no remuneration is demanded or watercraft. received. 3. The insurance provided by this provision shall be 2. The Insurance provided by this provision shall excess over any valid and collectible other be excess over any valid and collectible other insurance available to the insured, whether insurance available to any insured whether primary, excess, contingent or on any other primary, excess, contingent or any other basis, basis, except for the insurance purchased except for insurance purchased specifically by specifically by you to apply In excess of the you to apply in excess of the limits of Insurance Limits of Insurance shown in the declarations for shown in the declarations for Business Liability. this Coverage Part. B. Supplementary Payments E. Canoes Or Rowboats Section II A.11 Coverage Extension - The following is added to the exceptions contained Supplementary Payments Paragraphs 1.(b) and In Section II B.1.g. Exclusions, Aircraft, Auto Or 1.(d) are deleted and replaced with the following: Watercraft: (b) Up to $2,500 for the cost of bail bonds required (6) Any non-motorized canoe or rowboat owned by because of accidents or traffic violations arising the insured. Only as respects to the insurance out of any vehicle to which Business Liabllity provided by this provision C. Who Is An Coverage for "bodily injury' applies. We do not Insured is amended to include as an insured have to furnish these bonds. any person who, with your express consent, uses any such canoe or rowboat. (d) All reasonable expenses incurred by the insured at our request to assist in the investigation or F. Damage to Premises Rented to You defense of the claim or "suil°, including actual 1. The last paragraph of Section 11 B.I. loss of earnings up to $500 a day because of Exclusions - Applicable To Business time off work. Liability Coverage is deleted and replaced by C. Reasonable Force - Bodily Injury Or Property the following: Damage Section II B.1.a. Exclusions, Expected Or Intended Injury, is deleted and replaced by the following: PPB 316 02 11 Page 2 of 7 Exclusions and o. in "Electronic data" means information, facts or SECTION 11 - LIABILITY do not apply to programs stored as or on, created or used on, or damage by water, fire, explosion, lightning, or transmitted to or from computer software smoke resulting from fire to premises while (including systems and applications software), rented to you, or temporarily occupied by you hard or floppy disks, CD-ROMS, tapes, drives, with permission by the owner. A separate cells, data processing devices or any other Damage To Premises Rented To You Limit of media which are used with electronically Insurance applies to this coverage as described controlled equipment. in paragraph D. Liability And Medical 3. For the purposes of the coverage provided by Expenses Limits of Insurance in SECTION 11- this endorsement, Section II F. Liability And LIABILITY. Medical Expenses Definitions, Paragraph 17. 2. Section II F.9.a. Liability And Medical is deleted and replaced by the following: Expenses Definitions, is deleted and replaced by the following: 17. "Property damage" means: a. A contract for a lease of premises. However, a. Physical Injury to tangible property, that portion of the contract for a lease of including all resulting loss of use of that premises that indemnifies any person or property. All such loss of use shall be organization for damage by water, fire, deemed to occur at the time of the explosion, lightning, or smoke resulting from physical Injury that caused it; fire to premises while rented to you or b. Loss of use of tangible temporarily occupied by you with permission property that is not physically Injured. All such loss of of the owner is not an "insured contract"; use shall be deemed to occur at the 3. This provision does not apply if coverage for time of the "occurrence" that caused it; Damage To Premises Rented To You is or excluded by another endorsement to this policy. c. Loss of, loss of use of, damage to, G. Aircraft Chartered With Crew corruption of, inability to access, or in- t. The following is added to the exceptions ability to properly manipulate "electronic data contained in Section 11 B.11.9. Exclusions, ; resulting from physical Injury to Aircraft, Auto or Watercraft: tangible property. All such loss of "electronic data" shall be deemed to (6) Any non-owned aircraft chartered to you occur at the time of the "occurrence" with a crew including a pilot. that caused it. 2. The insurance provided by this provision shall For the purposes of this insurance, be excess over any valid and collectible other "electronic data" is not tangible property. insurance available to the insured whether primary I. Who Is An Insured -Newly Acquired Or Formed , excess, contingent or on any other basis, except for insurance purchased Organizations specifically by you to apply in excess of the The following is added to Section II C. Who Is An Limits of Insurance shown in Declarations. insured: H. Electronic Data Liability Any organization you newly acquire or form, other 1. Section ii B.1.q. Exclusions is deleted and than a partnership, joint venture or limited liability replaced by the following: company, over which you maintain ownership or majority interest, will qualify as a Named Insured if q. Electronic Data there is no other similar Insurance available to that Damages arising out of the loss of, loss of organization. However: use of, damage to, corruption of, inability to 1. Coverage under this provision is afforded only access, or inability to manipulate "electronic until the one hundred eightieth (180"') day after data" that does not result from physical you acquire or form the organization or the end injury to tangible property. of the policy period, whichever is earlier; 2. The following definition is added to Section II F. 2. Coverage does not apply for "bodily injury" or Liability And Medical Expenses Definitions: "property damage' that occurred before you acquired or formed the organization. PPB 316 02 11 Page 3 of 7 3. Coverage does not apply for "personal and (1) Only if the "bodily injury", -property dam- advertising injury" arising out of an offense age" or "personal and advertising injury committed before you acquired or formed the " is caused, In whole or iri part, by you or organization. any person or organization performing 4. This provision does not apply to any operations on your behalf, and arises organization for which coverage is excluded by out of the ownership, maintenance or another endorsement to this policy. use of that part of any premises leased to you under that contract or agreement; J. Who Is An Insured - Unnamed Partnership Or or Joint Venture (2) The "bodily injury", "property damage" or 1. The last paragraph of Section II C. Who Is An "personal and advertising injury " is Insured: is deleted and replaced by the caused, in. whole or in part, by you or following: any person or organization performing No person or organization is an insured with operations on your behalf, and arises respect to the conduct of any current or past out the maintenance, operation or use partnership, joint venture or limited liability of equipment leased to you by such company that is not shown as a Named Insured additional insured. in the Declarations. However this limitation does 2. The insurance provided to such additional in- not apply to your liability with respect to your sured under this provision is subject to the conduct of the business of any current or past following: partnership or joint venture: a. The limits of insurance afforded to such a. That is not shown as a Named Insured in additional insured shall be the limits which the Declarations, and you agreed to provide in the contract or in the b. which you are a member or partner but agreement, Declarations, or the whichever limits are less; shown and only if o (i) Each and every member or partner in b. The insurance afforded to such additional that joint venture or partnership is not a insured does not apply: construction contractor, and (1) To any "bodily injury" or "property dam- (ii) The joint venture or partnership is not age" that occurs, or "personal and providing construction contracting advertising injury" caused a offense services. committed, after you cease t to be a tenant in that premises; 2. This provision does not apply to any person or (2) To any structural alterations, construc- organization for which coverage is excluded by tion or demolition operations performed another endorsement to this policy. by or on behalf of such additional 3. The insurance provided by this provision shall insured; be excess over any valid and collectible other (3) To any premises for which coverage is insurance, whether primary, excess, contingent or on any other basis, which is available excluded by another endorsement to covering your liability with respect to your this Coverage Part; conduct of the business of any current or past (4) To any "bodily injury" or "property dam- partnership or joint venture that is not shown as age" that occurs, or "personal and a Named Insured in the Declarations and which advertising injury caused by an offense is issued to such partnership or joint venture. committed, after the equipment lease K. Additional Insured - Owner, Manager Or Lessor expires; or Of Premises Or Leased Equipment (5) If the equipment is leased with an Section II C. Who Is An Insured is amended to operator. include as an insured: 3. This provision does not apply on any basis to any person or organization for which coverage 1. Any person or organization that you have as an additional insured specifically is added by agreed in a contract or agreement to include as another endorsement to this policy. an additional insured on this policy, but: a. Only with respect to liability for "bodily injury" or "property damage" that occurs, or "personal and advertising injury" caused by an offense committed, after you have entered into that contract or agreement; and PPB 316 02 11 Page 4 of 7 L. Additional Insured - State Or Political is twice the Liability and Medical Expenses Subdivisions - Permits Related To Premises Or limit. Operations The aggregate limit for all "bodily injury" and Section II C. Who Is An Insured is amended to "property damage", medical expenses and include as an insured: "personal and advertising injury" other than 1. Any state or politicsl subdivision that has issued "bodily injury" or "property damage" included in the products-completed operations hazard" a permit in connection with premises owned or applies separately to each of your "projects" occupied by, or rented or loaned to, you, but away from premises owned by or occupied by only with respect to "bodily injury", "property you or to each of your "locations" owned by or damage", personal and advertising injury ' occupied by you. arising out of the existence, ownership, use, maintenance, repair, construction, erection or "Projects" mean an area away from premises removal of advertising signs, awnings, canopies, owned by or rented to you at which you are cellar entrances, coal holes, driveways, performing operations pursuant to a contract or manholes, marquees, hoist away openings, agreement. For the purposes of determining the sidewalk vaults,. elevators, street banners or applicable aggregate limit of insurance, each decorations for which that state or political "project" at the same 'location" shall be subdivision has issued such permit. considered a single "project". 2. Any state or political subdivision that has issued For the purposes of this provision, "location" a permit, but only with respect to "bodily injury", means "property damage", "personal and advertising injury" arising out of operations performed by 1. Premises involving the same or connecting you or on your behalf for which that state or lots; political subdivision has issued such permit. 2. premises where connection is interrupted However, no such state or political subdivision is only by a street, roadway, waterway or right- an insured for: of-way of a railroad; or a. "Bodily injury", "property damage", "personal 3. premises where operations are performed In and advertising injury" arising out of op- sections, stages or phases as a continuation erations performed for that state or political of the same contract or agreement, even if subdivision; or the premises do not involve connecting lots. b. "Bodily injury" or "property damage" Subject to Paragraph a. or b. above, whichever included within the "products-completed applies, the Damage To Premises Rented To operations hazard". You Limit is the most we will pay for damages M. General Aggregate Limit - Per Project Or Per because of "property damage" to any one Location premises, while rented to you, or in the case of fire; explosion; lightning; smoke resulting from Section II D. Liability And Medical Expenses such fire, explosion or lightning; or water while Limits of Insurance, Paragraph 4. Aggregate rented to you or temporarily occupied by you Limits. is deleted and replaced by the following: with permission of the owner. 4. Aggregate Limits The Limits, of Insurance of SECTION II - LIABILITY apply separately to each consecutive The most we will pay for: annual period and to any remaining period of a. All "bodily Injury" and "property damage" less than twelve (12) months, starting with the that is included in the "products-completed beginning of the policy period shown in the operations hazard" is twice the Liability and Declarations, unless the policy period is Medical Expenses limit. extended after issuance for an additional period of less than twelve (12) months. In that case, the b. All' additional period will be deemed part of the last (1) "Bodily injury" and "property damage" preceding period for purposes of determining the except damages because of "bodily in- Limits of Insurance. jury" or 'property damage" included in N. Knowledge And Notice Of Occurrence Or the "products-completed operations Offense hazard"; (2) Plus medical expenses; The following is added to Section II E. 2. Liability and Medical Expenses General Conditions, (3) Pius all "personal and advertising injury" Duties In The Event of Occurrence, Offense, caused by offenses committed; Claim Or Suit: PPB 316 02 11 Page 5 of 7 Notice of an "occurrence" or of an offense which 3. The insurance provided by this provision shall may result in a claim must be given as soon as be excess over any valid and collectible Railroad practicable after knowledge of the "occurrence" or Protective Liability insurance available to an offense has been reported to you, one of your insured , whether primary, excess, contingent or "executive officers" (if you are a corporation), one of on any other basis, except for the insurance your partners who is an individual (if you are a purchased specifically by you to apply in excess partnership), one of your managers (If you are a of the Limits of Insurance shown in the limited liability company), one of your trustees who is declarations for this Coverage Part. an individual (if you are a trust), or an "employee" Q. Amended Personal And Advertising Injury (such as an insurance, loss control or risk manager Definition -Electronic Material or administrator) designated by you to give such notice. 1. The definition of "personal and advertising Knowledge by any other "employee" of an "occur- injury" in Section 11 F.14.d. Liability And rence" or offense does not imply that you also have Medical Expenses Definitions is deleted and such knowledge, replaced by the following: Notice of an "occurrence" or of an offense which d. Oral, written or electronic publication, in any may result in a claim will be deemed to be given as manner, of material that slanders or libels a soon as practicable to us if it is given in good faith as person or organization or disparages a soon as practicable to your workers' compensation, person's or organization's goods, products accident, or health insurer. This applies only if you or services; subsequently give notice of the "occurrence" or 2. The definition of "personal and advertising offense to us as soon as practicable after you, one injury" in Section II F.14.e. Liability And of your "executive officers" (if you are a corporation), Medical Expenses Definitions is deleted and one of your partners who is an individual (if you are replaced by the following: a partnership), one of your managers (if you area e. Orel, written or electronic publication, in any limited liability company), one of your trustees who is an individual (if you are a trust), or an "employee" manner, of material that violates a person's (such as an insurance, loss control or risk manager right of privacy; or administrator) designated by you to give such 3. Section II B.1.p.(2) Exclusions for Personal notice discovers that the "occurrence" or offense And Advertising Injury is deleted and replaced may involve this policy. by the following: 0. Amended Bodily Injury Definition (2) Arising out of oral, written or electronic The definition of "bodily injury" in Section II F.3. publication of material if done by or at the Liability And Medical Expenses Definitions is direction of the insured with knowledge of its falsity; deleted and replaced by the following: "Bodily injury" means injury to the body, sickness, 4. Section 11 B.1.p.(2) Exclusions for Personal disease, or death. "Bodily injury" also means mental And Advertising Injury is deleted and replaced injury, mental anguish, emotional distress, pain and by the following: suffering, or shock resulting from injury to the body, (3) Arising out of oral, written or electronic sickness, disease or death of any person. publication of material whose first P. Amended Insured Contract Definition - publication took place before the beginning Construction Or Demolition Operations Within of the policy period; 50' Of Railroad R. Unintentional Omission 1. The definition of "insured contract" in Section II The following is added to SECTION III - COMMON F.9.c. Liability And Medical Expenses POLICY CONDITIONS Paragraph C. Concealment, Definitions is deleted and replaced by the Misrepresentation Or Fraud (BUT APPLICABLE following: ONLY TO SECTION II - LIABILITY) c. Any easement or license agreement However as it pertains to Business Liability 2. The definition of "insured contract" in Section II Coverage only, the unintentional omission of, or F.91(1) Liability And Medical Expenses unintentional error in, any information provided by Definitions is deleted. you which we relied upon in issuing this policy shall not prejudice your rights under this insurance. This provision does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. PPB 316 02 11 Page 6 of 7 S. Waiver Of Transfer Of Rights Of Recovery b. Ongoing and completed operations Against Others To Us performed by you, or on your behalf, under a SECTION III - COMMON POLICY CONDITIONS contract or agreement with that person or Paragraph K.2. Transfer of Rights of Recovery organization; Against Others to Us (BUT APPLICABLE ONLY c. Your "work"; or TO SECTION II - LIABILITY) is deleted and d. "Your products". replaced by the following: 2. Applicable to Business Liability Coverage: We waive these rights only where you have agreed to do so as part of a contract or. agree- We waive any rights of recovery we may have ment entered into by you before the "bodily against any person or organization because of injury" or "property damage" occurs or the payments we make for "bodily injury", "property "personal and advertising injury' offense is damage", "personal injury and advertising injury" committed. arising out of. a. Premises owned by you, temporarily occu- pied by you with permission of the owner, or leased or rented to you; ALL OTHER TERMS AND CONDITIQNS OF THIS POLICY REMAIN UNCHANGED. PPB 316 02 11 Page 7 of 7 1 ~ - w .salfxom OREGON WORKERS COMPENSATION rsaiF CERTIFICATE OF INSURANCE iro 0 ration 1 1 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 1 all the terms, exclusions and conditions of such policy. POLICY NO. POLICY PERIOD ISSUE DATE 736954 09/01/2013 to 09/01/2014 10/03/2013 INSURED: BROKER OF RECORD: l CIVIL WEST ENGINEERING INC HUGGINS INS OF COOS BAY INC 466 E ST PO BOX 1019 COOS BAY, OR 97420-4340 COOS BAY, OR 97420 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: I 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. 1 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 President and CEO 400 High Street SE Salem, OR 97312 P: 800.285.8525 - F: 503.373.8020 Poliry_Babch_certifimteoflnwrance / CITY RECORDER Page 1 1 CITY OF DATE „nk+ .PO.NUMBER`. ` ASHLAND 20 E MAIN ST. 3/6/2014 12129 ASHLAND, OR 97520 (541)488-5300 VENDOR: 018505 SHIP To: Ashland Public Works CIVIL WEST ENGINEERING SERVICE (541) 488-5587 486 E STREET 51 WINBURN WAY COOS BAY, OR 97420 ASHLAND, OR 97520 FOB Point: Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Morgan Wavman Special Inst: Confirming? No ,'Desc~'bon Value Engineering Analysis and 30,842.00 Evaluation Bear Creek Trunkline Sewer Portion of 2012 Wastewater Master Plan, Project #2013-14 Contract for Personal Services Beginning date: 02/11/2014 Completion date: 08/11/2014 SUBTOTAL 30 842.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0,00 541-552-2010 TOTAL 30,842.00 ASHLAND, OR 97520 s: /lccounf Numtier~'~ «Prolect'Numtier ;,,,,r a ' " ' ^'rY . s,. Amount,.._. ~..:AbcounY,NUmberx,~ „_~,?;,~pro~ect~Number ;,,,_,;.!,Amount„ E 675.08.38.00.70420 E 201314.100 30 842.00 i Aut rized Signature VENDOR COPY F0 RM#3 CITY OF A request for a Purchase Order ASHLAND REQUISITION Date of request: ?/25/2014 Required date for delivery: 3/6/2014 Vendor Name Civil West Engineering Services, Inc. Address, City, State, Zip 486'E' Street, Coos Bav OR 97420 I Contact Name & Telephone Number Garrett Pallo, P.E.; 541-266-8601 Fax Number 541-266-8681 SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Ememencv ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ 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/Written quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract $5.000 to $100.000 ❑ Written quote or proposal attached Agency ❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5.000 to 575.000 ❑ 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 solicitation Date approved by Council: (Date) ❑ Fo m #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost Value Engineering Analysis and Evaluation; Bear Creek Trunkline Sewer portion of 2012" , + ra ~r1 Wastewater Master Plan. PWE: Project #2013-14 $30,842 00'~ a~ y Item # Quantity Unit Description of MATERIALS Unit Price Total Cost ® Per attached quotelproposal 10 r TOTAL COST Project Number: 2013.14 Account Number: 675.118.17.0 704200; WW Collections - $528,138.00 Account M ber: 675.08.38.00.704200; SD C - $1,035,822.00 'Expenditure must be charged to the appropriate account nu F-the financials-toaccu4tely reflect the actual expenditures. By signing this requisiti n form, /certify t e City's public contracting requirements have been satisfied. Employee: Department Head: (6q aI Department Mana erlSupervisor. Administrator: l~ igreater ran$5,000) ` qual to or greater than $25,000) t'om' f( Funds appropriated for current fiscal year.' NO Finance Director- (Equal to org aterthan $s,ooo) Date Comments: Form #3 -Requisition