HomeMy WebLinkAbout2014-067 Contract - Engineered Monitoring Solutions
Contract for PERSONAL SERVICES less than $35,000
CITY OF CONSULTANT: Engineered Monitoring Solutions
ASHLAND
CONTACT: Barry Myers, P.E.
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 617 N. Main Street, Newberg, OR 97132
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 503.537-0900
DATE AGREEMENT PREPARED: 3/13/2014 FAX: 503-537-0909
BEGINNING DATE: 3/18/2014 COMPLETION DATE: 12/31/2014
COMPENSATION: Time and materials, not to exceed $20,276
SERVICES TO BE PROVIDED: See attached Exhibit C: Hosler Dam Failure Warning System, Video Camera
Installations
ADDITIONAL TERMS: N/A
_ i
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
Stale 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 th erformance of this contract by Consultant
(including but not limited to, Consultant's employees, agents, a others designated by Consultant to perform
work or services attendant to this contract). Consultant shall n be held responsible for any losses, expenses,
claims, subrogations, actions, costs, judgments, or other da ges, directly, solely, and proximately caused by
the negligence of City.
NEGtJGE.~✓T R=TS~ oe ~~es ~iyf
Contract for Personal Services, Revised, Page 1 of 5 OA 007/SS/~t/S
10. 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 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;
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 j
iii. If any license or certificate required by law or regulation to be held by Consultant to provide the j
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 ORF 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. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to i
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, $1,000,000, $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, $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.
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,
Contract for Personal Services, Revised, Page 2 of 5
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
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 Consultants 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.
15. Conflicts and Discrepancies: In the event of conflicts or discrepancies, this City of Ashland Contract will be
primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary
provisions will be subordinate to and interpreted in a manner that will not conflict with the said primary City of Ashland
Contract.
16. 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 States 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.
17. 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.
18. 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. Consultant shall sign the certification attached hereto as Exhibit A And herein incorporated b reference,
onsultant City of Ashland
BY z : By ~_A:77f
Signatur Departure I He
A5~ wtYE25 ltiatlael ~ FAY40
Print Name Print Name
10121--51,0f-a7_ I_) I a 11 y
Title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No. <
Ap 0 ED AS M FORM
Aehla ly At m~~
Contract for Personal Services, Revised, Page 3 of 5 Data
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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:
f (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.
Contra r (Date)
Contract for Personal Services, Revised 0513 0/2 0 1 3, Page 4 of 5 -
rXt-ttStT L - Sc.aPE or- SERV,CrS
C.i 5AGeTS~
Engineered Monitoring Solutions
617 N. Main Street
Newberg, OR 97132
503-537-0900 ph
503-537-0909 fax
March 12, 2014
5004.10
City of Ashland
Public Works Department
20 East Main Street
Ashland, Oregon 97520
Attn: Mr. Pieter Smeenk, P.E.
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Re: Hosler Dam Failure Warning System
Video Camera Installations
i
Dear Pieter:
We are pleased to submit this proposal to provide assistance to the City in installing three pan,
tilt, zoom (PTZ) video cameras for surveillance at Hosler Dam and the Water Treatment Plant
(WTP). Two of the cameras will be located at the dam. One will be on the crest to view the crest,
downstream face, and downstream abutment conditions; and the other at the left abutment to
view the crest and reservoir. The third camera will be located at the WTP to view the conditions
at the entrance gate. The installation of two additional cameras at the WTP Is also included as an
optional Task 4.
SCOPE OF SERVICES
Our proposed scope of work is to configure and install three Axis Communications Model Q60-C
PTZ Dome Network Cameras. The equipment will be installed on pole mounts provided by the
City. The City will procure the camera equipment and have it shipped to our office where we will
configure it and perform bench testing in our laboratory before installation in the field. We
understand that the City will use the Microsoft Internet ExpiorerO web browser to view the
camera images and perform PTZ functions over the Internet. The City also desires the ability to
turn lights on and off from the web browser interface for night time viewing. Following installation,
operation of the cameras and lighting will be tested from a City workstation PC. Training will also
be provided for City staff on the operation of the cameras over the internet. We have assumed
that this training can be accomplished in 4 hours.
COMPENSATION
We estimate that the total cost for the scope of work outlined above would be on the order of
$20,300, which includes $4,200 for the optional Task 4. This assumes that the City will procure
all of the new video camera equipment, and will have it shipped to our office for configuration and
bench testing. We will provide a list of the camera equipment for the City to procure. We have
also assumed that the City will procure and install the poles and enclosures needed for
installation of the cameras, and will provide 110VAC power and an IP network connection in each
camera enclosure. In addition, the City will install the lighting needed for night time viewing along
with the cameralrelay interface needed to turn the lights on and off using the remote software
interface for the camera. A breakdown of the estimated labor effort and expenses Is presented
on the attached Table 1. We propose to perform this work on a time and materials basis in
accordance with the same terms and conditions as stated in our Contract for Personal Services
Agreement with the City, dated May 9, 2013. This estimate is based on the assumptions listed
herein. Should you wish to modify the scope of work prior to accepting this agreement, we would
be pleased to review this proposal and our estimated fee with you. '
i
SCHEDULE s
We are in a position to begin work on this project within three days after receiving your authoriza-
tion to proceed. We would be prepared to install the equipment within 3 weeks following receipt
of the equipment.
a
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CONCLUDING COMMENTS g
Acceptance of this proposal and attached documents is Indicated by signing and dating In the
space provided below and returning one copy of this letter to us. If more than 90 days pass
before authorizing the proposed work, we reserve the opportunity to review and modify this s
proposal where necessary.
We look forward to continuing to be of service to you on this project. Should you have any
questions regarding this proposal, or if renegotiation of the Scope of Services is considered G
advisable, we would be pleased to confer with you at your convenience. j
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Very truly yours,
Engineered Monitoring Solutions
byI_
Barry Myer , P.E. ;
President
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Encl. Table 1 Work Breakdown and Cost Estimate
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TABLE 1 WORK BREAKDOWN AND COST ESTIMATE
Rof(Cr DR.D Wslruin System - Video Canj1 rg InstnilRtion5 (City F1'OCnr(nP CIInnerN Equipment)
M4NHOUR3 RCNARGES EOIAFiAENi(S) Tobl(S)
LABOR RATE CATEGORY L.W
Sw S. Prl AhNn Lott Labo~ 1k18 S..
DESCM"ONOFTASKANDACIIVITY Pin CRY N. Toll Erynues
S188 $IQ $0 m M7
Nauro Man Um ask t -Hnelize Camera EW?pm and Inslallaft UmaOa It B 5 SB - (3,0((.00 -
. . , . SoAO u,iie.oo
Task 2-CO 09unand Bench Test Equlpmenl _ 1 10 U 52,140.00 S0,o0 #,140.00
eek3- lnmll dime Cemma Equlpmmn 38 55 (1.030.00 50.00 17,00.00
a.k4.ImWiaMTrt2AdE01ma1 umara.(Opdon) zo 20 t3,100A0 1 No swo.00 34,200.00
mk S.Rcndd Umr Tralydngr1CllyBNN ~ - 4 - 4 5140.00 _ $0.00 $740"
Prp)od AdminlsHallon _ _ _ _ 8 A 5100.DD _ SOAD $140.00
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80 ld 0 0 0 8 IN We
EaUmeWd LSOOr& Wpmmnn 51$}18A0
SO...vecton: _ _ _
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0 0 (0._00
Tra.tlNehRJ eiField SupPllesl5nlppln0 '1 $1,300 $1,300.00
COmmpW flans t. • 1. _ $380 ' $30.32
CamPw.,U 0 $ib 50.00
Repro, C.,l. SOD' wo $0.0
Rep" Maine 50 $1.00 $W.Oo
Repro. COlw
0_ $100 1000
OOC S1,TB0
SoIWel Lnnor&Ey01P !15,518
BOLapnlnclwe f0
ODC 51,180
Esdmeled TOW 520,218
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CERTIFICATE OF LIABILITY INSURANCE 12/4/2013
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 INSURERIS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain pollcies may require an endorsemont. A statement on this certificate does not confer rights to the
Certificate holder in lieu of such endorsement(s . -
PR000CER COi EAC Dee Hughes
Slater C. Associates Insurance, Inc PHONE - (503)624-0466 FA% .(503)124-084.
PO Box 1469 'AIL . dea9slaterineurance.com
Tualatin, OR 97062-1469 NSURERB AFFORDING COVERAGE NAM0
wSURE :SAIF Co 6196
INSURED INSURER 0:
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COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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. AVOL ...9 INSR TYPEOFINSURANCE POLICY NUMBER POLICY 6F POLICY "P
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CERTIFICATE HOLDER CANCELLATION
(541) 486-5320 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.
Ati n: 'Rob Morris
20 E Main St - AUTHORIZED REPRESENTATIVE
Ashland, OR 97520
Dee Hughes/DMNI
ACORD 25 (2010105) - ®1988.2010 ACORD CORPORATION. All rights resomad.
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Ac ez® ® CERTIFICATE OF LIABILITY INSURANCE °A° awawv n
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THIS CERTIFICATE 13 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(fes) most be endorsed. H SUBROGATION 18 WAIVED, Subject to
the terns and eandillonS of the Polley, eenaln paUclea may Gguire an endorsement. A Statement on this eerUOCats does riot Confer rights to the
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COVERAGES CERTIFICATE NUMBER: 57719 REVISION NUMBER:
THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED OELOW 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
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CLAIMSMADE CKJOCCUR MED. E" (Airy dW paem) E 5,000
PERSON AL OYURY 1 1,000,000
GENERALAGGREGATE a 2,000,000
GENLAGGREGATE UMR APPLIES PER PRODUCTS -COMPWP AGO 6 2.000,000
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AND EUFLOYMS' LIABILITY YIN
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OESCRRTwN OF OPERATIONS I LOCATIONS I VEHICLES IAMch ACORD 101, MdNlenel RMMG aelOdela. N mdn Space is 9gPDed)
CITY OF ASHLAND IS INCLUDED AS AN ADO ITIONAL INSURED PER GLS-1506 (07-06).
CERTIFICATE HOLDER CANCELLATION
CITY OF ASH LAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 8EFORE
20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ASHLAND OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS.
ANMOPoZED REPREEGMATNe
MID VAU EYGENERAL AGENCY LLO
Attention:
Herman R Dales
ACORD 25 (20101051 ®1966.2010 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
'Terra Insurance Company TERRA
(A Risk Retention Group) INSURANCE COMPANY
Two Fifer Avenue, Suite 100
Corte Madera, CA 94925
CERTIFICATE OF INSURANCE
DATE
01/01/14
NAME AND ADDRESS OF INSURED
Engineered Monitoring Solutions
617 M Main Street
Newberg, OR 97132
This certifies that the "claims made" insurance policy (described below by policy number) written on forms in
use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as a
matter of information only, and confers no rights upon the certificate holder. This certificate does not alter,
amend or extend the coverage afforded by this policy.
The policy of insurance listed below has 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 policy described herein is
subject to all the terms, exclusions and conditions of such policy. Aggregate limits shown may have been
reduced by paid claims.
TYPE OF INSURANCE Professional Liability
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
214187 01/01/14 12/31/14
LIMITS OF LIABILITY $1,000,000 EACH CLAIM
$1,000,000 ANNUAL AGGREGATE
PROJECT DESCRIPTION
No Project Specified
CANCELLATION: If the described policy is cancelled by the Company before its expiration date,
the Company will mail written notice to the certificate holder thirty (30) days in advance, or ten
(10) days in advance for non-payment of premium. If the described policy is cancelled by the
insured before its expiration date, the Company will mail written notice to the certificate holder
within thirty (30) days of the notice to the Company from the insured.
CERTIFICATE HOLDER ISSUING COMPANY:
TERRA INSURANCE COMPANY
City of Ashland (A Risk Retention Group)
Attn: Rob Morris
20 East Main Street
Ashland, OR 97250
President
CERTIFICATE OF LIABILITY INSURANCE 1no 01w4°°°YYYYi`
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(in) 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 endonsemen s .
PRODUCER ROME: 0
R.I.S. Insurance Services P" E ve Ne 9-7800 P. O. Box 1059 +wt
acortes WA 98221
INSURE 9 AFFORDING COVERAGE NAIC0
INSURER A.
INSURED ENGIN-1 INSURER a:
ENGINEERED MONITORING INSURER C:
SOLUTIONS, LLC
617 N Main St. IxwRERO:
Newberg OR 97132 "H'rRERE'
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1330199807 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.
INS LTR TYPE OF INSURANCE POLICYNUMBER M DoYEFF MU M%
GENERILL Wtmt EACH OCCURRENCE f
COYMERCAL GENERAL UABRITY e S
CUUMSlMDE O OCCUR MED EXP (Arry o S
PERSONU-AADVINJURV $
GENERALAGGREGATE S
GENL AGGREGATELIMITAPPUESPER PRODUCTS -COMPIOP AGO $
POLICY Pno LOC f
OUT01gBRE LA®.1TY CPPI00443705 2/32013 2/3201
E . Mn 1000000
ANY AUTO BODUYINJURY(Pe Pews) S
ALL OWNED SCHEDULED
BODILY INJURY (Pe eelOelG S
AUTOS AUTOS
X1 0=10MI) HREDAUrO$ X AUTOS D PROPERTY DAMAGE S
i
UMBRELLALAB OCCUR EACH OCCURRENCE S
EXCESS LAB CLAIM34AADE AGGREGATE $
DED RETENTIONS is
IMORKERS COMPEILVLTIOx NCSTATU- OTH-
me E YERffi (ABILITY YIN
ANY PRCPRIETORNARTNERIEXECLM ELEACHACGDENT S
NIA
OFFCERIMEMSER EXCLUDED?
(Mw wry In NH) E.L DISEASE-EA EMPLOY $
p p.OAelb
DESCRIPTIONOF
OF OPERATIONS OeIOw E.L DISEASE - POLICY UMR S
PPIOO"3705 2=013 2WO14
DESC CNOFOPERAnONS/LOCATIONSIVERCLES(AtbchACOPD/01,ACCmonMRmurbetle/WgelronapwMrequ"M RECEIVED
JAN 2 9 2014
City of Ashland
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.
PUBLIC WORKS
20 EAST MAIN STREET AUTHORIZED REPRESENTATIVE
ASHLAND OR 97520
0 1 988-201 0 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
/
r/+°~' r~--qf t/~, Page 1 1
CITY O F C I t 1 v ° °E 0RE), ER
ASHLAND DATE - PO NUMBER
20 E MAIN ST. 4/4/2014 12178
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 009478
ENGINEERED MONITORING SOLUTION, LLC SHIP TO: Ashland PUbIIC Works
488-5587 ST (541) 617 N MAIN 51 WINBURN WAY
NEWBERG, O OR 97132 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net Dept:
Req. Del. Date: Contact: Rob Morris
Special Inst: Confirming? No
Quantity-' Unit .Descri Lon -
. ;:Unit Price- Ext.PriceInstallation and inteqration of video 2Price 00
camera system at Hosler Dam and Water
Treatment Plant. Time and materials,
not to exceed $20,276.00.
Note: City will procure video camera
equipment per list of camera equipment
provided bV contractor.
Contract for Personal Services
Beqinninq date: 03/18/2014
Completion date: 12/31/2014
BILL To: Account Payable SUBTOTAL 206.00
TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 20,276.00
ASHLAND, OR 97520
Account Number `a^ Project Number, Amount ";Account Number . Project Number - Amount
E 670.08.15.00.70420 E 200526.999 11 526.00
E 670.08.38.00.70420 E 200526.999 8,750.00
Authorize ignature~/r VENDOR COPY
FORM#3 CITY OF
A request for a Purchase Order ASHLAND
REQUISITION Date of request: 04/02/14
Required date for delivery: ASAP
Vendor Name Eog'nooroA,Unn'tnring.Rnl t'nnc
Address, City, State, Zip 617 N. Main Street. Newbero OR 97132
Contact Name & Telephone Number Barry Myers, P.E. (503) 537-0900
Fax Number
(503) 537-0909
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 quote or pro osal 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 #
❑ VerbalMritten 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 $75.000 ❑ Agency
❑ Form #9, Request for Approval
® 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)
❑ Form 44, Personal Services $5K to $75K Valid until: (Date) I
Description of SERVICES Total Cost
Installation and integration of video camera system at Hosler Dam and Water Treatment X20,276 00
Plant _
Item'# Quantity Unit Description of MATERIALS Unit Price Total Cost
p TOTAL.COST
® Per attached quote/proposal J1,
Project Number 2005.7 3 v Account Number 670.08 -15 - 00.704200 ($11,526.00)
ount Number 670.08 - 38.00.704200 ($8,750.00)
'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support -Yes /No
By signing this requisition form, I certify that the City's public contracting requirements have been satisfied.
Employee: Department Head: N \Alk m LLA
(Equal to r greater than $5,000)
Department anager/Supervisor: City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year: (~R/ NO `'r///
Finance Director- (Equal to orgreat ,an $5,000) Date
Comments:
Form #3-Requisition