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HomeMy WebLinkAbout2014-083 Contract - Rick Stevens Painting Contract for GOODS AND SERVICES Less than $25,000 C I T Y OF CONTRACTOR: Rick Stevens Painting -ASH LAND CONTACT: Rick Stevens 20 East Main Street Ashland, Oregon 97520 ADDRESS: 107 E. Main St. Medford, OR 97501 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-772-8287 DATE AGREEMENT PREPARED: 04/23/2014 FAX: 541-734-5644 BEGINNING DATE: 04/28/2014 COMPLETION DATE: 06/01/2014 COMPENSATION: $9,225 GOODS AND SERVICES TO BE PROVIDED: Daniel Meyer Pool building exterior and interior painting/drywall repair 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 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 2798.220, 2798.225, 2798.230, 2798.235, 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. Citv's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, count or other sources is not obtained and continued at levels Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 1 of 5 sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Contractor to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. 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: L 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 ey b. General Liability insurance h a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, 2,000,0 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include contractua is i ity coverage for the indemnity provided under this contract. C. Automobile Liabilit insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, 1,000,00 or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for own , ired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurers to Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 2 of 5 the City. e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further liability to Contractor. 20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Contractor: City of Ashlan By By Signature Department Head Print Name Print Name PNeS1d, f I y I-P4 q Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. AP 'VEDA ORM J Ashland Cr Aitorne Date 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: f (1) 1 carry out the labor or services at a location separate from my residence or is in a r/ 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. t~ (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. ~I-21-/L{ Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 4 of 5 ION" PAINTING Residential & Commercial Painting Contractor Contractor License # 0119361 April 25, 2014 Ashland Parks & Recreation City of Ashland Attn: Lonny Flora Email: Lonny.tlora nashland.or.us Cc: bruce.dickens@asliland.or.us 1 propose to supply all labor and materials to prepare and paint the following interior and exterior areas on the pool building located at Hunter Park on Homes Ave, Ashland. Interior: Paint all interior doorjambs, drywall walls, ceilings and block walls with Miller Acrinamel semi-gloss. Color shall match existing ceiling color. Includes fixing drywall cracks with tape, mud and texture. Does not include T-1 1 I tan walls. Doors shall be painted with accent color. $ 4,025.00 Exterior: Preparation includes: Pressure wash. Treat mildew. Scrape loose paint. Caulk cracks and voids with elastomeric caulking. Fix drywall ceiling and texture. Mask and cover adjacent surfaces not to be painted. Painting includes: Paint exterior block with acrylic block filler. Prime bare wood exposed from scraping with acrylic stain-blocking wood primer. Apply two coats of Miller Evolution satin house paint to block and other previously painted surfaces. Doors shall be painted with semi-gloss enamel. City's choice of colors. Possible Miller color 0218 (taupe) on walls and overhangs and 0215 (cream) on trim. Primer and paint shall be worked into porous surfaces with brush or roller so as to till small cracks. $ 5,000.00 Metal hand railings: Sand. Spot prime with rust inhibitive primer and paint metal hand railings that lead down to pump room and at gate around wading pool. $ 200.00 Please call me if you have any questions. If you would like to accept this bid, please sign the acceptance and return a copy to our office. Sincerely, n Rick Stevens Acceptance: Mobile 541-621-1634 107 E. Main Street #5 • Medford, Oregon 97501 • (541) 772-8287 • Fax (541) 734-5644 Email: rickspaintingco@clearwire.net I 9STEVRI OP ID: PB CERTIFICATE OF LIABILITY INSURANCE 0 1 °A 4/29/2014 04/2912014 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 541-779.4232 CONTACT Hart Insurance NAME: 'Aic No. HONE It AC No 1123 Royal Ave. Fax: 541-772-3963 P Medford, OR 97504 E-MAIL Hart Insurance / Medford ADDRESS: INSURERS AFFORDING COVERAGE NAIC II INSURER A : Sentinal Insurance CO 22367 INSURED Rick Stevens Painting Co INSURER B: 107 E Main St #5 Medford, OR 97501 INSURER C 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. INSR BR TYPE OF INSURANCE POLICY NUMBER MMIDDY/YYEFF YY MMIDDY/ EXP R YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 52SBAZV6624 1210112013 12/01/2014 PREMISES Ea OCanence E 1,000,00 CLAIMS-MADE OCCUR NED EXP(Any one person) E 10,00 PERSONAL B ADV INJURY E 1,000,00 GENERAL AGGREGATE E 2,000,00 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO E 2,000,00 POLICY X PRO- LOC E IFCT -1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea acadent E A X ANY AUTO 52UECNK6616 1210112013 1210112014 BODILY INJURY (Per Person) E ALLOMED N SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON_OMED PROPERTY DAMAGE S HIRED AUTOS AUTOS Peracadent E UMBRELLA LU%B OCCUR EACH OCCURRENCE E EXCESS LIAB CLAIMS-MADE AGGREGATE E DED RETENTIONS $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS' LIABILITY YIN IT ANY PROPRIETORIPARTNEWEXECUTIVE E.L. EACH ACCIDENT E OFFICERIMEMSER EXCLUDED? ❑ NIA (Mandatory In NH) E L DISEASE - EA EMPLOYE E if yes, descdba under DE SCRIPT)ONOFOPFRATIONSheI. E.L. DISEASE - POLICY LIMIT E DESCRIPTION OF OPERAnONS I LOCATIONS I VEHICLES (Attach ACORD 101, AdEKional Remarks Schedule, It mom apace Is required) City of Ashland Parks S Recreation Dept are included as additional insured per form SS0008 04/05 attached. lonny.flora@ashland.or.us CERTIFICATE HOLDER CANCELLATION CITYAS7 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. Parks and Recreation Lonny Flora AUTHORIZED REPRESENTATIVE 340 S Pioneer Street Hart Insurance / Medford Ashland, OR 97520 ©1986-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED 3. Additional Insured -Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. is If listed or shown as applicable in the Declarations, amended to include as an additional insured one or more of the following Optional Additional the person(s) or organization(s) shown in the Insured Coverages also apply. When any of these Declarations as an Additional Insured - Optional Additional Insured Coverages apply, Grantor Of Franchise, but only with respect to Paragraph 6. (Additional Insureds When Required their liability as grantor of franchise to you. by Written Contract, Witten Agreement or Permit) 4. Additional Insured - Lessor Of Leased of Section C., Who Is An Insured, does not apply Equipment to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below: Insured - Lessor of Leased Equipment, 1. Additional Insured - Designated Person Or but only with respect to liability for "bodily Organization injury", "property damage" or "personal WHO IS AN INSURED under Section C. is and advertising injury" caused, in whole or amended to include as an additional insured in part, by your maintenance, operation or the person(s) or organization(s) shown in the use of equipment leased to you by such Declarations, but only with respect to liability person(s) or organization(s). for "bodily injury", "property damage" or b. With respect to the insurance afforded to "personal and advertising Injury" caused, in these additional insureds, this insurance whole or in part, by your acts or omissions or does not apply to any occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that behalf: equipment. a. In the performance of your ongoing 5. Additional Insured - Owners Or Other operations; or Interests From Whom Land Has Been b. In connection with your premises owned Leased by or rented to you. a. WHO IS AN INSURED under Section C. is 2. Additional Insured - Managers Or Lessors amended to include as an additional Of Premises insured the person(s) or organization(s) shown in the Declarations as an Additional a. WHO IS AN INSURED under Section C. is Insured - Owners Or Other Interests From amended to include as an additional insured Whom Land Has Been Leased, but only the person(s) or organization(s) shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership, maintenance or use of that part Designated Person Or Organization; but only of the land leased to you and shown in the with respect to liability arising out of the Declarations. ownership, maintenance or use of that part of the premises leased to you and shown in the b. With respect to the insurance afforded to Declarations. these additional insureds, the following b. With respect to the insurance afforded to additional exclusions apply: these additional insureds, the following This insurance does not apply to: additional exclusions apply: (1) Any "occurrence" that takes place This insurance does not apply to: after you cease to lease that land; or (1) Any "occurrence" which takes place (2) Structural alterations, new after you cease to be a tenant in that construction or demolition operations premises, or performed by or on behalf of such person or organization, (2) Structural alterations, new 6. Additional Insured - State Or Political construction or demolition ion operations performed by or on behalf of such Subdivision -Permits person or organization. a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Insured - State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the slate or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusions apply: (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, except such operations performed (1) "Bodily injury", "property damage" or at the vendor's premises in "personal and advertising injury" connection with the sale of the arising out of operations performed for product; the state or municipality; or (g) Products which, after distribution (2) "Bodily injury" or "property damage" or sale by you, have been labeled included in the "product-completed or relabeled or used as a operations" hazard. container, part or ingredient of any 7. Additional Insured-Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. is the vendor, or amended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (t) The exceptions contained in business and only if this Coverage Part Subparagraphs (d) or (f); or provides coverage for "bodily injury" or {Ii) Such inspections, "property damage" included within the "products-completed operations hazard". adjustments, tests or servicing as the 6. The insurance afforded to the vendor is vendor has agreed to subject to the following additional exclusions: make or normally undertakes to make in the usual course of (1) This insurance does not apply to: business, in connection with (a) "Bodily Injury" or "properly the distribution or sale of the damage" for which the vendor is products. obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contractor agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contractor agreement; products. (b) Any express warranty 8. Additional Insured -Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor, Declarations as an Additional Insured - (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of: demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container; Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM Insured - State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusions apply: (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, (1) "Bodily injury, "property damage" or except such operations performed "personal and advertising injury" at the vendors premises in connection with the sale of the arising out of operations performed for product; the state or municipality; or (2) "Bodily injury" or "property damage" {g) Products which, after distribution or sale by you, have been labeled included in the "product-completed or relabeled or used as a operations" hazard. container, part or ingredient of any 7. Additional Insured -Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. is the vendor, or amended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (I) The exceptions contained in business and only if this Coverage Part provides coverage for "bodily injury' or Subparagraphs {d} or (f); or "property damage" included within the (ii) Such inspections, "products-completed operators hazard". adjustments, tests or servicing b. The insurance afforded to the vendor is as the vendor has agreed to subject to the following additional exclusions: make or normally undertakes to make in the usual course of (1) This insurance does not apply to: business, in connection with (a) "Bodily injury" or "property the distribution or sale of the damage" for which the vendor is products. obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contractor agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products. (b) Any express warranty 8. Additional Insured -Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor, Declarations as an Additional Insured - (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of: demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container, Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural The limits of insurance that apply to additional alterations, new construction and demolition insureds are described in Section D. - Limits Of operations performed by or for that person or Insurance. organization. How this insurance applies when other insurance 9. Additional Insured - Owners, Lessees Or is available to an additional insured is described in Contractors - Scheduled Person Or the Other Insurance Condition in Section E. - Organization Liability And Medical Expenses General a. WHO IS AN INSURED under Section C. is Conditions. amended to include as an additional G. LIABILITY AND MEDICAL EXPENSES insured the person(s) or organization(s) DEFINITIONS shown in the Declarations as an Additional Insured - Owner, Lessees Or Contractors, 1. "Advertisement" means the widespread public but only with respect to liability for "bodily dissemination of information or images that injury", "property damage" or "personal has the purpose of inducing the sale of goods, and advertising injury" caused, in whole or products or services through: in part, by your acts or omissions or the a. (1) Radio; acts or omissions of those acting on your (2) Television; behalf: (3) Billboard; (1) In the performance of your ongoing operations for the additional (4) Magazine; insured(s); or (5) Newspaper, (2) In connection with "your work" b. The Internet, but only that part of a web performed for that additional insured site that is about goods, products or and included within the "products- services for the purposes of inducing the completed operations hazard", but sale of goods, products or services; or only if this Coverage Part provides c. Any other publication that is given coverage for "bodily injury" or widespread public distribution. "property damage" included within the However, "advertisement" does not include: "products-completed operations hazard". a. The design, printed material, information or images contained in, on or upon the b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products; or does not apply to "bodily injury", "property damage" or "personal an advertising b. An interactive conversation between or injury" arising out of the rendering of, or among persons through a computer network. the failure to render, any professional 2. "Advertising idea" means any idea for an architectural, engineering or surveying "advertisement". services, including: 3. "Asbestos hazard" means an exposure or (1) The preparing, approving, or failure to threat of exposure to the actual or alleged prepare or approve, maps, shop properties of asbestos and includes the mere drawings, opinions, reports, surveys, presence of asbestos in any form, field orders, change orders, designs or 4. "Auto" means a land motor vehicle, trailer or drawings and specifications; or semi-trailer designed for travel on public (2) Supervisory, inspection, architectural roads, including any attached machinery or or engineering activities, equipment. But "auto" does not include "mobile equipment". 10. Additional Insured - Co-Owner Of Insured Premises S. "Bodily injury" means physical: WHO IS AN INSURED under Section C. is a. Injury; amended to include as an additional insured b. Sickness; or the person(s) or Organization(s) shown in the c. Disease Declarations as an Additional Insured - Co- Owner Of Insured Premises, but only with sustained by a person and, if arising out of the respect to their liability as co-owner of the above, mental anguish or death at anytime. premises shown in the Declarations. 6. "Coverage territory" means: Page 20 of 24 Form SS 00 08 04 05 SAIF Corporation 4/29/2014 10:20:10 AM PAGE 1/001 Fax Server www.salf.mm OREGON WORKERS COMPENSATION Paif CERTIFICATE OF INSURANCE poration CERTIFICATE HOLDER: CITY OF ASHLAND 340 5 PIONEER ST ASHLAND, OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. POLICY NO. POLICY PERIOD ISSUE DATE 499826 10/01/2013 to 10/01/2014 04/29/2014 INSURED: BROKER OF RECORD: RICK STEVENS PAINTING CO 107 E MAIN ST STE 5 MEDFORD, OR 97501-6022 - - - - LIMITS OF LIABILITY: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Body Injury by Disease $500,000 policy limit DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: Daniel Meyer Pool painting IMPORTANT: The coverage described above is in effect as of the issue date of this certificate. It is subject to change at any time In the future. This certificate is issued as a matter of Information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. /AUTHORIZED REPRESENTATIVE V John C. Plotkin President and CEO 400 High Street SE Salem, OR 97312 P: 800.285.8525 F: 503.373.8020 Pollcy_Ba lc h_Cert Iflcaleoflnsu rance CITY RECORDER Page 1 / 1 Pr . ~J~ CITY OF '7-~S H LAN D PO NUMBER ~ 20 E MAIN ST. 5/1/2014 00344 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 004409 SHIP TO: RICK STEVENS PAINTING 107 E MAIN STREET #5 MEDFORD, OR 97501 FOB Point: Req. No.: Terms: net Dept: Req. Del. Date: Contact: Rachel Dials - Lonny Flora Special Inst: Confirming? No Quantity -,-Unit 'Description' F:+Unitprice- Ext Price. Paintinq and Drywall Repair 9rice 0 Location: Daniel Mever Pool Building Contract for Goods and Services Beginninq date: 04/28/2014 Completion date: 06/01/2014 SUBTOTAL 9225.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 9,225.00 Account Number -zPFojeet.Number • %-Amount - , Account Number r" ProjecfNumberv . Amount, E 411.12.00.00.70420 E 000042.999 9.225.00 AUtho ei S Ignature VENDOR COPY I FORM #3 CITY OF A request for a Purchase Order ASHLAND REQUISITION Date of request: Required date for delivery: LEI Vendor Name f -rJ 5 n ~;7n Address, City, State, Zip yam( yl S me A C/75 Contact Name & Telephone Number ^ S t~VP~ Fax Number S O . -5 7 7~- 8-JF~ 7 {asc : S `!1 73 SAN , SOURCING METHOD ❑ Exempt from Competitive Biddinq ❑ 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 proposal attached ❑ Small Procurement Cooperative Procurement Less than $5.000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ❑ Direct Award Date approved by Council: Contract# ❑ Verbal/Written quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract 5 000 to 100 000 ❑ Written quote or proposal attached Agency (3) Written quotes and solicitation attached ❑ Form K Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovernmental Aareement $5,000 to $75.000 ❑ Form #g, Request for Approval ❑ Agency ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Written proposals/written solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid unfit: Date Description of SERVICES 1 Total Cost 1, v11 ifrlof .S ~X CY)09-p +/~C(.-IY{/)~~ l✓7C/L( l "~o9,~K ~zElk u41 it r4~l~ !I rb 7~ Enr`'t ~ ~Qfa ~ 1 >7 G2.✓a rrl GSrY LUGL r Q ~cc , i u r , K ~ 1 ~ a 'I~o d n ,i a R g+iy~~ i,r 'l if ~ 1 ~r i tl 1F~2 ! i 1 iHl Wf E~LII i~ Item # Quantity Unit Description of MATERIALS Unit Price Total es`bFa ,pTOTA L COS ❑ Per attached quotelproposal Project Number P -0PQffAccount Number ?a{',,,,, Account Number gII-l2-0O.OQ-?Oy2DD Account Number 'Expend'iture 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: TDirector Date Support-Yes/No By signing this requisition form, l certify that the City's public contracting requirements have been satisfied. Employee: GFr-ee Department Head: (Equal to or greater than $5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year., Y(9 / NO zl~p< - S/ Finance Director- (Equal to orggma rrhan $5,000) Date Comments: Form #3 - Requisition