HomeMy WebLinkAbout2014-044 Contract - Stampede Fence
Contract for GOODS AND SERVICES Less than $25,000
i
C I T Y OF CONTRACTOR: Stampede Fence
ASHLAND CONTACT: Jordan Stevens, Kody Stevens
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 2798 Coker Butte Road, Medford, OR 97504
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-890-2430
DATE AGREEMENT PREPARED: March 13, 2014 FAX:
BEGINNING DATE: March 17, 2014 COMPLETION DATE: April 15, 2014
COMPENSATION: $6,845.00 per bid attached as Exhibit C.
GOODS AND SERVICES TO BE PROVIDED: Fencing projects per attached ITB and bid submitted by
Stampede Fence. Locations: #1 North Mountain Parking Area Chain Link Fence Enclosure with Gates
@ south end of North Mountain Park Shop Parking Log, near the wash station; #2 Lisa Lane TID Trail/David
Lewis Fence Project @ along TID trail adjacent to 800 Lisa Lane; #3 North Mountain Park Varsity Baseball
Fence Repair North Mountain Park Athletic Fields 620 North Mountain Ave
ADDITIONAL TERMS: Workers' Compensation is being wain because the two owner operators have no
employees and will be performing the work themselves. ~iV (contractors initials) (Contractor's initials)
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual c enants 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, 2796.225, 279B.230, 27913.235, 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 art, effective upon delivery of
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 1 of 5
written notice to Contractor, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract, or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach, may at any time terminate
the whole or any part of this contract if Contractor fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City.
Contractor shall have the complete responsibility for the performance of this contract.
11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.110 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
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 In6ury and Property Damage,
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 2 of 5
including coverage for owned, hired or non-owned vehicles, as applicable.
d. Notice of cancellation or chance. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the
parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The
Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Contractor. City of Ashla
By By
Sig ature \ Department Head
Jordan Stevens l /F`
tint ame Print Name
Signature Date
Kody Stevens
Print Name Purchase Order No.
W-9 One copy of a W-9 is to be submitted with
the signed contract.
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, 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:
(1) 1 carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
l~S (2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
~1S (3) Telephone listing is used for the business separate from the personal residence listing.
1~S (4) Labor or services are performed only pursuant to written contracts.
I<S (5) Labor or services are performed for two or more different persons within a period of one
year.
I~5 (6) 1 assume financial responsibility for defective workmanship or for serv
ice 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.
( q
Contractor V S~- (Date)
Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 4 of 5
Estimate
e ~"dlJ1bs F Date Estimate No.
® a 3/10/2014 89
Name/Address
ANI
90-243 Ashland Parks and Recreation Department
340. Pioneer Street
Ashland, OR 97520
STAMPEDE FENCE COMPANY
2798 Coker Butte Rd.
Medford, OR
97504
Description ` Total
#1 TID Trail/David Lewis Project.. 6,845.00
Install 120' of 6' high Shadowbox Style cedar fencing..Chamfered 44 pressure
treated posts set in concrete..3- rail 2x4 construction with 2x4 top cap..Standard and
better #2 DF 2x4's..SD 24 2x4 brackets.. Premium grade 1x6 cedar fence boards..
#2 North Mountain Parking Area Chain Link Fence Enclosure with Gates Project.
Installation of 114' of 6' high 9 gauge chain link fencing-Footage includes (1) 4' wide
walk gate with HD malleable hardware..(1) 11' wide single swing drive gate..(1) 17
wide double swing drive gate..(4) 2 7/8 terminal posts..(3) 4" SS40 hinge posts..1 5/8
top rail..gates to be 15/8 frame with 9 gauge chain link attached..bulldog hinges and
ind. drop latch assembly-all posts set in concrete..9 gauge tension wire..
#3 North Mountain Park Varsity Baseball Fence Repair Project
Remove and dispose of 123' of existing 10' high chain link and replace with 123' of
new 10' high 9 gauge chain link..lncludes removing and disposing of existing bottom
rail-weld in (2) 15/8 SS40 bottom rails approx. 12 inches apart to existing 4"
posts-Includes new 9 gauge steel ties
Total : $ 6845.00
Note : Work can be completed in any order desired by the City of Ashland..Stampede
Fence can begin work on March 17th and be completed on all projects by March
28th..
Payment due upon completion Total $6,845.00
Signature
Customer Copy - JORDAN A STEVENS Page 1 of 1
Customer name:JORDAN A STEVENS Company: SF Mutual
KEW J STEVENS Servicing Agent: MANNY SAENZ
Address: 2798 COKER BUTTE RD Eff date: 03.132014 to 09-13-2014
MEDFORD, OR 975049711 Description: 1986 TOYOTA XTRA CAB PICKUP
Policy: 165 2735-Cl3-37 VIN: JT4RN67P5G5027951
Status: PAID ON SFPP SFPP 0403832015
Coverage Details
The premium amounts shown reflect a six-month policy rrrCode Description _ Amount
A P2 Combined Premium 112.91
A Liability Coverage
Bodily Injury Limits
Each Person, Each Accident
$100,000 $3=000
Property Damage Limit
Each Accident
$50,000
P2 Personal Injury Protection Coverage
(See Policy Schedule for Limits.)
D Comprehensive Coverage - $100 Deductible - 11.46
H Emergency Road Service Coverage 4.80
U Uninsured Motor Vehicle Coverage 21.20
Bodily Injury Limits
Each Person, Each Accident
$100,000 $300,000
Total: 150.37
The information on this document is presented for general inforrnationat
purposes only and is not intended to serve as a declaration page or policy.
State Farts Mutual Automobile Insurance Company, Bloomington, Illinois
https://sfiietopr.statefarm.org/sysapv/PrintOptionsAction.do 3/6/2014
Customer Copy - JORDAN A STEVENS Page 1 of 2
Customer name:JORDAN A STEVENS Company: SF Mutual
KELLI J STEVENS Servicing Agent: MANNY SAENZ
Address: 2798 COKER BUTTE RD Eff date: 12-01-2013 to 06-01-2014
MEDFORD, OR 975049711 Description: 1986 GMC K2500 PICKUP!
Policy: 054 2415-F01-37B VIN: 2GTGK24J5G1537971
Status: PAID ON SFPP SFPP 0403832015
Premium/Billing Information
Amount Due: ON SFPP
Total premium: 128.23
Last amount paid: 0.00
Previous premium: 127.11
Premium refund: 0.00
Dividend amount: 12.60
Dividend date: 06-01-2007
Additional Policy Details
Policy forth: 98376
Coverage Details
The premium amounts shown reflect a six-month policy term.
Code Description Amount
A Pt Combined Premium 104,88
A Liability Coverage
Bodily Injury Limits
Each Person, Each Accident
$50,000 $100,000
Property Damage Limit
Each Accident
$50,000
P1 Personal Injury Protection Coverage
(See Policy Schedule for Limits.)
H Emergency Road Service Coverage 4.80
Ut Uninsured Motor Vehicle Coverage 18.55
Bodily Injury Limits
Each Person, Each Accident
$50,000 $100,000
Property Damage Limit
Each Accident
$20,000
Total: 128.23
https:Hsfiiet.opr.statefann.org/sysapv/printOptionsAction.do 3/6/2014
STATE OF OREGON
CON.S'k UCTION CONTRACTORS BOARQ: \y;
LICENSE CERT/FICATE
LICENSE NUMBER72652
This document certifies that
JORDAN ALLEN&STEVENS,
2798 COKER BUTTE: RD:
r MEDFORD'OR 97504 '
is licensed m accgrdance with Oregon Law as a Residential Specialty Contractor
k
Business Names License Details
n STAMPEDE ENTERPRISES EXPIRATION DATE: 10/1§1201-4
ENTITY TYPE Sole P.ropnetor
INDEP.CONT. STATUS EXEMPT
RESIDENTIAL BOND .$15 000'
C; L
.am w
COMMERCIAL BOND: NONE ,x
. 1NSURANCE..$300,600 / $300;000 '
RMI JORDAN ALLEN STEVENS
HOME INSPECTOR CERTIFLED: NO
116 -Vh,
St.*Fa OREGON
INSURANCE CARD
INSURED STEVENS, JORDAN A A HEW J MUT
VOL
_ POUCYNUMBER 165935-)1337 ERECTIVE
YR 1586 MAKE TOYOTA MAR137014TO SEP132014
MODEL RTRACAB VIN JTININSTP50509951
AGENT MANMYSAHR 2245-AN
PHONE (541)770,28M NAIC 25178 .
A BODILY INJURYIPROPERTY DAMAGE LIABILITY
D 00 DEDDUUCTL CJOYPPREE"ENSWEE
KU
SUREVM SME RIR AODBOMLL COYBMBHMDRYMION
OF ID DR 4
A`Q CERTIFICATE OF LIABILITY INSURANCE 'A'0216/1` 118/1Y,
THIS CERTIFICATE IS ISSUED AS AMATTER 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 older Is an ADDITIONAL INSURED, the po icy(lee must be en orsed. H S BR I IS WAIVED, subject to
the terms and conditions of the po0ey, certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER NAME,
-Insurance marketplace, Inc. A/C, N0:
1998 Skypark Dr Suite '100 Medford OR 97504 AMP-1
c:FAX 772-8235 NSUNAICs
Phone: 541-779-0177 Fa3
INSURED CO/DICO Gro
St de Este rises Jordan Allen S evens
2798 Coker Butte Rd Medford OR 97504 INSURER():
UfS11RBt E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POUGES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
DEDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITONOF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR ANY PERTADI. THE MSURANCEAFFOROED SYTHE POLICIES DESCRIBED HEREIN IS SUBIECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONSS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE INSR POLICY NUMBER OD (ABAIOOIYYYY) LIMITS
. GENERAL LABILITY EACH OCClR2RENLE 5300000
A X COMMERcALGENEPALLABILITY BIS00016480-01 07/2S/2a 07/25/11 PREMISES 6oeartLmim IS 100000
CLAIMS-MADE ® OCCUR MEDEXPyulyane mon) $ 5000
PERSONALa ADV INJURY 5300000
GENERAL AGGREGATE s300000
GEN'LAGGREGATE LINITAPPUES PER: PRODUCTS -COMPIOP AG(; 530()000
POLICY PST LOC $
AUTOMOBILE LABILITY COMBINED SINGLE LIMIT S
(Ea ecddem)
ANY AUTO BODILY INJURY (Wm wn) $
ALL OWNED AUTOS BODILY DUURY(Par ft=M ) $
SCHEDULEDAUI'OS PROPERTY DAMAGE $
HIREDAUTOS (Pera[gtlent)
NON-OWNED AUTOS
5
H UMBRELLA LAB OCCUR EACH OCCURRENCE S
EXCESS LAB CLAIMS-MADE AGGREGATE $
H DEDUCTIBLE $
RETENTION S S
WORKERS COMPENSATON TWC STA ITS Efy ORY AND EMPLOYERS` LABILITY YIN
pO E.L. EACH ACCIDENT S
ANY PRDPRIET0! TA
OrFF"CERIMNEREXCLUDED7 EL DISEASE-EAEMPLO S
II Wa desc0be under EL DISEASE-POLICY LIMIT S
DESCRIPTION OF OPERATIONS Delm+r
DESCRUnMNOFOPERATIONSILOCATIONSIVEHICLES(AUAehACORD101,AddiB R.m ScheftCUmmRipi km*&Um
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DEED POLICIES BE CANCELI W BEFORE
THE EVIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland Parks and Rea AUTHORED REPRESENTATIVE
340 S Pioneer St
Ashland OR 97520 Insurance Marketplace Inc.
®1988.2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
41 we
STATE OF OREGON sY z 3cI
i
CONSTRUtT~ION CONTRACTORS BOARD
L CENS,E CERTIFJCA.TE F
r LICENSE NUMBER~202066
This document certifies that
a
KODY RYAN STEVENS Y
230ALDERST a >s `
)CENTRAL POINT OR 97502
is licensed in accordance with Oregon Law as a Residential Specialty Contractor a W
s s'
License Details:
EXPIRATION DATE 02/19/2016 r
n c ENTITY TYPE Sole P:ropnetor
INDEP.CONT STATUS EXEMPT w
01
RESIDENTIAL BOND:$15 000
COMMERCIAL BOND: NONE a 'w
. x'`
NSURANCE: $300,000 / $300;000'
I
RMI KODY RYAN, STEVENS
s HOME INSPECTOR CERTIFIED NO
in : F ~3 s '.'e :T .e
W ~ .
RO® CERTIFICATE OF LIABILITY INSURANCE OP ID DR 1 DATE(MMIDUYYYY)
02/21/14
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.
OR the certificate holder is an ADDITIONAL INSURED, the po I les must endorsed. WAIVED, su eet 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 endorsement(s).
PRODUCER
NAPE:
Insurance Marketplace, Inc. A/C No Eat, ac, NO:
1998 Skypark Dr Suite 100 ADDRESS:
Medford OR 97504 CUSTOMERmr. STEKO-1
Phone:541-779-0177 Fax:FAX 772-8235 NSURER(S) AFFORDING COVERAGE NAIC9
INSURED pp NSURERA: CBIC
290yAl er Stevens INSURER B:
Central Point OR 97502 NSURERC:
INSURER D :
USURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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.
LTR TYPE OF INSURANCE NSR W VD POLICY NUMBER (MMIDINYYY') "WONYYY) LIMITS
GENERAL LIABILRY EACH OCCURRENCE 5300000
MAIURGEIVREITTED-
A X COMMERCIAL GENERAL LIABILITY Dl IP17751 02/14/14 02/14/15 PR
EMISES Eaa Ienee $
CLAIMSMADE F_X] OCCUR MED EXP (Any one person) 5
PERSONAL S ADV INJURY $300000
GENERAL AGGREGATE s300000
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $300000
'POLICY PRO-
JECT LAC E
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO (Eaaccident) $
BODILY INJURY (Per person) $
ALLOW NED AUTOS
BODILY INJURY fear accident) $
SCHEDULED AUTOS
PROPERTY MADE $
HIRED AUTOS (Perao5dern) 0enQ
NON-OWNED AUTOS E
E
UNSRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LMB CLAIMS-MADE AGGREGATE $
DEDUCTIBLE
S
RETENTION S E
WORKERS COMPENSATION
AND EMPLOYERS, UABRITY YIN TORY UMRS ER
ANY PROPRIETORPARTNERVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?~ /A
(Mandatory In NH) EL DISEASE- EA EMPLOYEE S
yes OesaiOe unOn
If
DESCRIPTION OF OPERATIONS be]" ELDISEASE-POUCYIJMR $
DESORPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atmch ACORD 101, AddIUOrol Remarks StJUM04, 11 more aWOe g mgWnrD
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ASHLAPA THEEUnRATION DATE THEREOF, NOTICE WILL BE DELWEREON
ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland Parks S Recreation AUTHORGED REPRESENTATWE
340.5. Pioneer Street
Ashland OR 97520 Insurance Marketplace Inc.
®1988.2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
'Customer Copy - JORDAN A STEVENS Page 1 of 1
Customer name:JORDAN A STEVENS Company: SF Mutual
KELLI J STEVENS Servicing Agent: MANNY SAENZ
Address: 2798 COKER BUTTE RD Eff date: 03-13-2014 to 09-13-2014
MEDFORD, OR 975049711 Description: 1986 TOYOTA XTRA CAB PICKUP
Policy: 165 2735-C13-37 VIN: JT4RN67P5G5027951
Status: PAID ON SFP15 SFPP 0403832015
Coverage Details
The premium amounts shown reflect a six-month policy term.
Code Description Amount
A P2 Combined Premium 112.91
A Liability Coverage
Bodily Injury Limits
Each Person, Each Accident
$100,000 $300,000
Property Damage Limit
Each Accident
$50,000
P2 Personal Injury Protection Coverage
(See Policy Schedule for Limits.)
D Comprehensive Coverage - $100 Deductible 11.46
H Emergency Road Service Coverage 4.80
U Uninsured Motor Vehicle Coverage 21.20
Bodily Injury Limits
Each Person, Each Accident
$100,000 $300,000
Total: 150.37
The information on this document is presented for general informstional
purposes only and is not intended to serve as a declaration page or policy.
State Farm Mutual Automobile Insurance Company, Bloomington, Illinois
https://sfnet.opr.statefarm.org/sysapv/printOptionsAction.do 316/2014
Customer Copy - JORDAN A STEVENS Page 1 of 2
Customer name:JORDAN A STEVENS Company: SF Mutual
KELLI J STEVENS Servicing Agent: MANNY SAENZ
Address: 2798 COKER BUTTE RD Eff date: 12-01-2013 to 06-01-2014
MEDFORD, OR 975049711 Description: 1986 GMC K2500 PICKUP
Policy: 054 2415-F01-378 VIN: 2GTGK24J5G1537971
Status: PAID ON SFPP SFPP k 0403832015
Premium/Billing Information
Amount Due: ON SFPP
Total premium: 128.23
Last amount paid: 0.00
Previous premium: 127.11
Premium refund: 0.00
Dividend amount: 12.60
Dividend date: 06-01-2007
Additional Policy Details
Policy form: 98378
Coverage Details
The premium amounts shown reflect a six-month policy term.
Code Description Amount
A P1 Combined Premium 104.88
A Liability Coverage
Bodily Injury Limits
Each Person, Each Accident
$50,000 $100,000
Property Damage Limit
Each Accident
$50,000
P1 Personal Injury Protection Coverage
(See Policy Schedule for Limits.)
H Emergency Road Service Coverage 4.80
U1 Uninsured Motor Vehicle Coverage 18.55
Bodily Injury Limits
Each Person, Each Accident
$50,000 $100,000
Property Damage Limit
Each Accident
$20,000
Total: 128.23
https://sfoet.opr.statefann.org/sysapv/printOptionsAction.do 3/6/2014
CITY OF ASHLAND TAX REGISTRATION
(FOR REVENUE PURPOSES ONLY)
BUSINESS LOCATION INFORMATION REGISTRATION NO.
STREET ADDRESS: 2798 COKER BUTTE RD BL-008446
PHONE: (541) 890-2430
OWNER INFORMATION
NAME: JORDAN STEVENS
Barbara Christensen
Cm RECORDER/TREASURER
REGISTRATION EXPIRES JUNE 30.
STAMPEDE FENCE COMPANY
2798 COKER BUTTE RD
MEDFORD, OR 97504 2014
TO BE POSTED IN A CONSPICUOUS PLACE.
CITY OF CITY RECO;?DER Page 1 / 1
;i~-:.~,.~tt,. -,,Po NUMBER
ASHLAND .~...:~r:DATE
20 E MAIN ST. 3/20/2014 00336
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 004399 SHIP TO:
STAMPEDE FENCE COMPANY
2798 COKER BUTTE ROAD
MEDFORD, OR 97504
FOB Point: Req. No.:
Terms: net Dept:
Req. Del. Date: Contact: Bruce Dickens - Jeff McFarland
Special Inst: Confirming? No
quantity'- 2und .,r.. Desori hon.-F?<r w `Unit Price ."y. EA Price
Fencinq Projects 6,845.00
#1 North Mtn Parkinq Area Chain Link
#2 Lisa Lane TID Trail/David Lewis
#3 North Mtn Park Baseball Fence
Contract for Goods and Services
Beqinninq date: March 17, 2014
Completion date: April 15, 2014
SUBTOTAL 6 845.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 6,845.00
Account Numher :ProjectNumher ,-Amount -,-AccountNumber... `ProjeotNumber -,..,Amount
-
E 211.12.02.06.70400 E 000057.999 6,845.00
Authorized tSignature VENDOR COPY
CITY OF
ASHLAND
A mc)best ?ar a "Purchase Order
REQUISITION Date of request: 3-17-2014
Required date for delivery:
Vendor Name Stampede Feem rompnny
Address, City, State, Zip 2798 Coker Butte Road. Medford Oregon 97504
Contact Name & Telephone Number Jordan Stevens, Kody Stevens, 541-890-2430
Fax Number No Fax email: stam edeo on
p reg @gmail.cem
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emeroencv
❑ Reason for exempfion: ❑ 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
❑ DirectAward Date approved by Council: Contract #
❑ Verba[AAldtten 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
X❑ (3) Written quotes attached ❑ Form #4, 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 attached Date approved by Council: (Date)
❑ Form #4, Personal Services $5K to $75K Valid unfil: (Date) I
Description of SERVICES Total Cost
GOODS AND SERVICES TO BE PROVIDED: Fencing Projects Per ITB and attached bid `zt y k+x^ + ,
submitted by Stampede Fence. Location: #1 North Mountain Parking Area Chain Link Fence
CIS i e s rM1d 4 'p z ,r' yra ,w , it
Enclosure with Gates @ south end of North Mountain Park Shop Parking Lot, near the wash @@ c pp~~'~~ L < r
station; #2 Lisa Lane In
Lane; #3 North Mount Park arsity Baseball Fence Repair along @ North Mountain Park Athletic Fields 620 North Mountain Ave.
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
3'`TOTAL COST
X❑ Per attached quotelproposal s
y$ 6,845 w~ , i=~ y r
Y
~ A(~e hY fi ~N'r >3 ~rdwk' Ty 0
57- ProjectNumber_6Polo ~ Account Number $ *Yr~ ~~~r~° zs
AccountNumber2//-j9-G20b-10yQ01 AccountNumber___-_ -
`Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expend#ures.
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support -Yes / No
By signing this requisition form, I certify that the Citys public contracting requirements have On atisfied.
Employee Signature: = Department Head Signature:
(Equal to or greater than $5,000)
City Administrator:
(Equal to or grater than $25,000)
Funds appropriated for current fiscal year YES / NO
Finance Director- (Equal to orgreater than 55,000) Date
Comments:
Form #3 - Requisition