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HomeMy WebLinkAbout2014-065 Contract - Key Manufacturing & Rentals Contract for 1aOODS AND SERVICES Lefs than $25,000 C I T Y OF CONTRACTOR: Key Manufacturing and Rentals, Inc ASHLAND CONTACT: Annie Chisholm 20 East Main Street Ashland, Oregon 97520 ADDRESS: 18179 Boones Ferry Rd. Portland, OR 97224 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: (503) 597-2023 DATE AGREEMENT PREPARED: FAX: (503) 597-2040 BEGINNING DATE: March 31, 2014 COMPLETION DATE: June 30, 2014 COMPENSATION: Not to exceed $10,940 see attached quote GOODS AND SERVICES TO BE PROVIDED: tear down, cleaning and storage of the Ice Rink Tent and Frame for the summer season. ADDITIONAL TERMS: NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless. otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or borided 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 tfie standards and specifications, no later than the date indicated above and start performing the work unde this centract by the beginning date indicated above and complete the work by the completion date indicated al ::ve. 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 2796.220, 2798.225, 2796.230, 2796.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $19,825 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 9. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City under any of the following conditions: Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 1 of 5 i. If City fun from federal, state, county or other sou s 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: $20030003 $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, 81.000.000. or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or Contract for Goods and Services Less than $25,000, Revised 06/132013, Page 2 of 5 intent not to renew the insurance coverage(s) without 30 days' written n 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 noncontributory. 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: /j p ~C I n nI City of Ashla By &]AU By Signature De artment lead rw sholm /\I~r fl- Print Name Pri t Name Sal6 b Title bate W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. AP OVE AS FORM 411 Ash an ty ttornay Da 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. (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. A C, ,1~~ 3n~li~ Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 4 of 5 The Key Companies • AID YL\T - W Side Re talc OFFER TO SUPPLY TO: Ashland Packs 8 ReC CLIENT PHONE: 541-5S2-2252 FAX: ATTN: Bruce Dickens 20 East Main Street KNIR would be pleased to supply the following Ashland, Oregon 97520 goodsiservlees according to the quantities and terms outlined below. Please Indicate arry changes andfor approval and return to Updated As Of 3/20/14 Key Manufacturing and Rental, Inc. RE: Removal of Entire Structure KEY REP: Annie Chisholm QUANTITY UNIT TOTAL Trans ortation $ 500.00 2 Key men travel 9 hrs $ 1,440.00 2 K men on site 10 hrs $ 1,600.00 5 Temporary Labor on site 10 hrs $ 1,440.00 Lod in /Per Diem $ 250.00 Seasonal Storage of Fabric at Key Salem $ 500.00 $ Sub-Total $ $ Quote does not Include fabric cleaning or repairs $ Cleaning $401hour - estimated at 90-100 hours $ Repairs $701hour - estimated at 16-20 hours $ $ Quote based on client providing lull forklift all terrains $ If Key provides forklift - add $800 $ Re-Install Fall of 2014 - not included in this OTS $ Estimate same numbers as above $ y~ DUE $ 6,730.00 ALL MERCHANDISE F.O.B. I I / \ 57Y.1 by 14 OFFER VALID 30 DAYS ~,balanee due at comDletlon of cleaningfrepahs THANK YOU FOR THE OPPORTUNITY TO SERVE YOU 2 ftlAlAlA . ~ l 3~I1~ FOR KEY MANUFACTURING a RENTALS, INC DATE OFF ACCEPMED BY DATE A Complete Concept in Event Services 18179 SW Boones Ferry Rd. Ph (800) 345-8368 Portland, OR 97224 www.keymanufacturing.com Fax (503) 597-2040 The=KeysCoerpanies } Invoice Number 21450 REMITTO: ( = Imroce'Date:, Mar,21,:2014 KEY. MANUFACTURING 8c RENTALS Customer ID , I9179'SWJBOdNE5.FERRY RD.; ;Page 1 Voice: :PORTLAND` Fax OR 97724'?: Duplaate TAX ID. 93-1009110 ` PLEASE NOTE INVOICE # ON PAYMENT CITYOFASHLAND 20 EAST MAIN STREET ASHLAND, ORE 97520 ~Customer~P~O~y~, a~i'! ~a P,~aYme4t~TemLs . 'r-?~ Due Date Sales [te ID RENTAL NET DUE 4/3114 ACH e~Quant~,." ten IT Descn tiori °°""3, r.~'du UnrtlPnce'"^w' ` Amount'±F,,' INITIAL DEPOSIT FOR REMOVAL OF 2,865.00 CLIENT STRUCUTURE- PER TERMS OF OFFER TO SUPPLY Subtotal 2,665.00 Sales Tax Total Invoice Amount 2,865.00 Check/Credit Memo No: PaymentlCredit Applied (TOTAL uk I"t P4iEr ii, t bk sn i A p'" 865!00' fi t...,•.~ik~r. rte A Complete Concept in Event Services 18179 SW Boones Ferry Rd. Ph (503) 639-3344 Portland, OR 97224 www.keymanufacturing.com Fax (503) 597-2040 POLICY NUMBER: CPP 0010970 01 COMMERCIAL GENERAL LIABILITY CO 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or O zation(s) AS REQUIRED BY WRITTEN CONTRACT, SEE ME8802 18179 SW BOONES FERRY RD PORTLAND OR 97224 Information required to complete this Schedule if not shown above will be shown in the Declarations. Section 11 - Who Is An Insured is amended to in- sions or the acts or omissions of those acting on clude as an additional insured the person(s) or or- your behalf: ganization(s) shown in the Schedule, but only with A. In the performance of your ongoing operations; respect to liability'for "bodily injury", "property or damage" or "personal and advertising injury ' caused, in whole or in part, by your acts or omis- B. In connection with your premises owned by or rented to you. CG 20 26 07 04 Copyright, ISO Properties, Inc., 2004 Page 1 of 1 UNIFORM KEEYFA01C OP W: SHJ ,+-1't CERTIFICATE , a~ ii `7 r,H']]ma4i~ y[Lq w,p+ Dar IMMIDDhYYY) 1 . ii twx , h,,:t , {L r d11tl tl\F!1NCt, - Oa/~5/2tf1 y' ~I"li'p', Hl'IFICATF• !`i 13ilUED 6,s A:t1Ad,i rER OF INFO, L al l4r R r/I r.:t T14 RI HTS•UPON THE CFRT{FICKfE HOLDEt2THIS ( CkRI INCATE %)ES ?{0T.AFft)MTIVELY OR NEOA111, I.X IC.t I r_TE•'H 14F COVERAGE, AFF6R[iED BY THE POLICIES S 9Ll ON THis ERTIRdATE 6F INSURANCE pD!'S k I , 1. • I IU'r. A BFT*EFN Tiik ISSUING INSYRER(S) AUTHOR!4E0 REPty65EtdTAI*' OR PROQUCER, ANU THE'1-T RTU IC L I:J ;Z1 1 - : - - - IFAPO; TANT, I1 S g ceRificato ikder is an ACDITIONAI Iti JnE,. 1117 puI'rrf{~, ai i st ^dB Jr11 Gd : 11 SUBROGATIOWIIS WAIVED sugfect:to 1 0 io fmr and condltlom;.oi tho 60111, certain po)ic n • , r• ,u'r n , n r,tan ant. A at 1 s tan thto Ca t tlcdte dons rioitonlor rlghtsYr the cel'0`2stiiIt1 hegar in llau of sadhY ndorsemem(s)'y`T =Roc.,)^~.1 I I~hahD o:'~%:4ui?iirtiPU" ~r r i DenBll Ilnif~ pink Sbl;AlOns Inc - , ~'{Teevr . - FAX POHTx936 ?9u44124.9r1q, In,rt sl .i 45Y1i1 ~Ne•5412451142 h) - FSedforU,OR 97504-OOU7 1 TeA!. ~,a a 6 I cuss ti s~W drisk.co n { NSU TR~SiyFFD9MN000116I.AGC 1 "gip + L.BV_ r r a 'rAmr_al of L'nunxh9v _ 14761' + ' I ISSIIRCD Key Manufacturing & Rentals Inc. " 18179 SW Boones Ferry Rd. INSURERC: „Portland,OR97224-7672 INSURER D: - INSURER 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. wSR TYPE OF INSURANCE ADDI. sum PO POLICY NUMBER MLICY EFF POLICY EXP : LIMRS fMMIVDIYYYY) GENEMLLIIIBILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL UABIUTY X PP001097I1e12 04/0112014 0410112015 PREMISES Ea orwrrence $ 1,000,00 CLAIMS-MADE FXIOCCUR MED EXP(Arri are person) f 10,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS -COMPIOP AGG f 2,000,00 X POLICY PRO- LOC f AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea x 1,000,00 de $ A X ANY AUTO CPPOO1097002 0410112014 0410112015 BODILY INJURY (Per person) $ A O SCHEDULED BODILY INJURY (Per ac dent) $ UTOS AUTOS S HIREDAUTOS NN-OWNED - PROPERTY DAMAGE., $ AUTOS Per xtidaM f UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,00 A X 1 EXCESS UAB CLAIMSWADE UM0000211201 0410112014 0410112015 AGGREGATE s 1,000,00 DED X RETENTIONS 1U'Op0 It WORKERS COMPENSATION WC STATU- OTH. AND EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNERIEXECUTIVE❑ NIA E.L. EACH ACCIDENT f OFRCERIMEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe =Ier DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Inland Marine CPPOO1097002 0410112014 0410112015 Ded. 2,50 Equipment RenULeas 100,00 DESCRIPTION OF OPEMTIONS I LOCATIONS I VEHICLES (AtbeN aCORD tat, Addllbnel Remarks Scbadub, N mon epaee b egolrM) City of Ashland, Oregon and its elected officials, officers and employee are additional insured with primary and non-contributory coverage per forma CG20206 07/04 and NESS02 12/01. CERTIFICATE HOLDER CANCELLATION CITAS03 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 97520.1814 AUTHORED REPRESENTATIVE ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD W urlc.PrS (,um p KEYM0IW OP ID: KCF ACORO' DAOM MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 04/08/2014 THIS.CEPTIFICATE 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 Ileu of such endorsement(s). PRODUCER Phone: 541-245-1111 CONTACT NAME: KC Ferguson United Risk Solutions, Inc. PO Box 936 Fax: 541-245-1112 P"o"E y.541-494-7752 - CNq:541-245.1112 Medford, OR 97501.0067 nuoa Cindi L. Jayubo, CIC, CRM ess: kc.ferguson@unitedrisk.com INSURER(S) AFFORDING COVERAGE NAIC P INSURER A ; Oregon Employers Trust INSURED Key Manufacturing INSURER B:(Self Insured Group) &Rentals, Inc. N¢w York MadneBGeneral ins 18179 SW BOones Ferry Rd. INSURER C: Portland, OR 97224-7672 INSURER D: (Excess Insurance Company Wo INSURER E: Empire Pacific Risk MM Inc.) 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. INBR POLICYEFF POLICYEXP L TYPE OF INSURANCE POLICY NUMBER MMIDrYTY MMIDDIYYYY LIMITS wvr~ GENERAL LIABWTY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES Ea occurt¢nce $ CLAIMS-MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL BADV INJURY $ GENERALAGGREGATE S GENT AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMPIOPAGG S POLICY PRO- 71 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acadent $ ANY AUTO BODILY INJURY (Per person) S ALLOWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE s DED RETENTIONS $ WORKERS COMPENSATION X WC STATEOTH- AND EMPLOYERS LIABILITY TORY LIMITS A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 088WC130136 1010112013 1010112014 E.L. EACH ACCIDENT $ 2,000,00 OFFICERNEMBER EXCLUDED? N I A (Mandatory In NH) E.L. DISEASE - EA EMPLOYE S 2,000,00 I( yes, describe under DESCRIPTION OF OPERATIONS tool. E.L. DISEASE. POLICY LIMIT S 2,000,00 1 F I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AMach ACORD 101, Additional Remarks Schedule, if more space Is required) RE: All Operations of the Named Insured CERTIFICATE HOLDER CANCELLATION ASHAS08 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ashland Parks and Recreation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 340 S Pioneer St Ashland, OR 97520 Atm-IO(RIZE/EDD RR(E,PRRESENTATWE `~II~'""-'7- Aa- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 6TY ~EV03?sER Page 1 / 1 CITY OF ASHLAND DATE ~r ~ a t ~ PO NUMBER' 20 E MAIN ST. 4/8/2014 00342 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 004401 SHIP TO: KEY MANUFACTURING R RENTALS 18179 SW BOONES FERRY ROAD PORTLAND, OR 97224 FOB Point: Req. No.: . Terms: net Dept.: Req. Del. Date: Contact: Rachel Dials Special Inst: Confirming? No , Quanti >`Umt nit Price .,r "EitiPrice Ice Rink Cover - Take down, cleaning 10,940.00 and storage of the ice rink tent and frame for the summer season Contract for Goods and Services Beginning date: March 31, 2014 Completion date: June 30, 2014 SUBTOTAL 10940.00i BILL TO: TAX 0FREIGHT TOTAL 1- Achouht Numtier SProleet Num er - Amount - :Account Number Pao ect Number. Amount E 211.12.02.06.60211 10,940.00 e Author 6c! Signature VENDOR COPY T + O R M #3 C I T Y LAND /OAF T p~ A request for a Purchase Utter?I' ~SH REQU OSOTB ®N Date of request: Required date for delivery: Vendor Name ~n D ~f icyc Address, City, State, Zip Contact Name & Telephone Number Fax Number SOURCING METHOD ❑ Exempt from CompattliveBidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC Z60 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5.000 ❑ Request far Proposal (Copies on file) ❑ Slate of Oregon ❑ DlrectAward Dale approved byCouncil:_ Contract# ❑ VerbaUWdllen quote(s) or proposal(s) ❑ Stale of Washington Intermediate Procurement Sole Source Contract # 1 L4 GOODS & SERVICES. Applicable Form #5,6, 7 or 8 ❑ Other government agency contract -$5,0090 51001000 ( ) Agency r"( ❑Wrillen quote or proposal attached Contract # J'(3) Written quotes and so icl ation attached ❑ Form A, Personal Services $5K to $75K PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5.000 to $75.000 ❑ Form 49, Request for Approval ❑ Agency ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Dale original contract approved by Council: ❑ (3) Written proposaishvritten solicitation Dale approved by Council: (Dale) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES . / / Total Cost G~r~~ v Qa-ui~.~c.~•~.~ 4C ~~o-r<r~ $ .~111~ c/_'4~0 °t' Item # quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST Perattachedquotelproposal $ Project Number r':'~-l Account Number Account Number 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware andsoftware purchases: IT Director Date Support -yes I NO By signing thisregquisdtnform, I dilythat theCity's public contracting requirements have been satlsfied. Employee:~('r a Department Head: (Equal to or greater than $5.000) Department Manager/Supervisor: City Administrator: (Equal to or greater the $25000) Funds appropriated for current fiscal year., (q/NO Finance Director- (Equattoorgreat0an$5,000) Date t Comments: Form #3-Requisition FORM #3 CITY OF A request for a Purchase Order ASHLAND REQUISITION Date of request: Required date for delivery: r1 Vendor Name Address, City, State, Zip U Contact Name & Telephone Number Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written uote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5,000 ❑ Reguest for Proposal (Copies on file) . ❑ State of Oregon ❑ Direct Award Date approved by Council: Contract # ❑ Verbal(Written quote(s) or proposal(s) n ❑ State of Washington Intermediate Procurement / © Sole Source Contract # GOODS & SERVICES ' /6G~~s~ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract 55.00"0 5100.000 VVV u E- ❑ Written quote or proposal attached Agency ❑~'(3) Written quotes and so iG ation attached ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Soecial Procurement Interaovemmental Agreement $5,000 to $75.000 ❑ Agency El Form #g, Request for Approval ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Wdtten proposalslwdtten solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost Item # Quantity Unit Description of MATERIALS Unit Price Total Cost . ~ ''TOTALCOST © Per attached quotelproposal r t Project Number _ Account Number2l l - J_L-0L{k• WJ(Q 'Account Number Account Number `Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing thMo n form, l dify that the Oly's public contracting requirements have been satisfied. Employ( e:,lL~~r'I(G 0,/-) Department Head: (Equal to or greater than $5,000) Department Manager/Supervisor: City Administrator: (Equalt griaterr/" " 00) Funds appropriated for current fiscal year: YES / NO f/ Finance Director-(Equaito orgreaterthan$5,000) Dat Comments: I Form #3 - Requisition