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HomeMy WebLinkAbout2014-092 Contract - Laurie Sager & Associates Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: Laurie Sager and Associates ASHLAND CONTACT: Laurie Sager 20 East Main Street Ashland, Oregon 97520 ADDRESS: 700 Mistletoe Road Ashland Oregon 97520 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-488-1446 DATE AGREEMENT PREPARED: 3/4/14 FAX: 541-488-0636 BEGINNING DATE: COMPLETION DATE: November 15, 2014 COMPENSATION: Not to exceed 32,208.00 SERVICES TO BE PROVIDED: Architectural and Engineering for Ashland Creek Park See Exhibit C ADDITIONAL TERMS: N/A 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, famish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of city. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is $19,825 or more, Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any Subcontractor who performs 50% or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not limited to, Consultants employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 10. Termination: a. Mutual Consent. This contract may be terminated at an time b mutual consent of both parties. Contract for Personal Services, Revised 06/30/2013, Page 1 of 1 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: L If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. L Either City or Consultant may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 14. Insurance. Consultant shall at its own expense provide the following insurance: a. 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. 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, 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 Contract for Personal Services, Revised 06/30/2013, Page 2 of 2 intent not to renew the insurance coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Consultant's services to be provided under this Contract. The consultants 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. 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. 16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City s fiscal year budget. Consultant understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further liability to gqnsultant. Certif atio o Itant shall sign the certification attached hereto as E ibit A and herein incorporated b r erence. onspI r t• City of Ashlar By By e Department Head at Print Name Print Name / Title ate W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. AP VED TO FORM Ashland City Attorney Dat ¢ Contract for Personal Services, Revised 06/30/2013, Page 3 of 3 • 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 noted 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 noted 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: V// (1) 1 carry out the labor or services at a location separate from my residence or is in a j specific portion of my residence, set aside as the location of the business. !I ✓ (2) Commercial advertising or business cards or a trade association membership are i purchased for the business. ~ //,~7✓ (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. 'k2~ C t (Date) Contract for Personal Services, Revised 06/30/2013, Page 4 of 4 ® LAU R I E SAGER AND ASSOCIATES LAND SGIE A RCHITECTS INC. 700 MISTLETOE ROAD, SUITE 201 ASHIAND, OREGON 97520 DATE: MARCH 14, 2014 PROJECT: ASHLAND CREEK PARK 27 E. HERSEY STREET ASHLAND, OREGON ASHLAND CREEK SCOPE OF WORK $16,280 THORNTON ENGINEERING: SITE ANALYSIS, CIVIL CONSTRUCTION DOCUMENTS, STRUCTURAL DESIGN FOR BUILDINGS, BID ASSISTANCE $4,000 CARLOS DELGADO ARCHITECT: CONSTRUCTION DOCUMENTS FOR BUILDINGS, BUILDING ENGINEERING REVIEW, BID ASSISTANCE, REVIEW OF INSPECTION REPORTS $9,000 LAURIE SAGER AND ASSOCIATES PLANNING PERMIT DOCUMENT PREPARATION, CONSULTANT COORDINATION AND SUBMITTAL, CLIENT AND PARKS SUBCOMMITTEE MEETINGS, LANDSCAPE CONSTRUCTION DOCUMENTS, SPECIFICATIONS, BID ASSISTANCE $29,28o TOTAL $2,928 10 % CONTINGENCY $32,208 GRAND TOTAL PHONE 541 488 1446 FAx 541 48B 0636 W .IAURIESAGER.COM t WORKERS-COMPENSATION AND EMPLOYERS LIABILITY POLICY INFORMATION PAGE 15-.2155-FA E6 POLICY NO. 97-BS-C709-3 COVERAGE IS PROVIDED BY REPLACES 1J0. 97-BQ-F886-3 STATE FARM FIRE AND CASUALTY COMPANY PO BOX 5000, DUPONT WA 98327-5000 NCCI CARRIER CODE NO. 14842 1. NAMED INSURED & MAILING ADDRESS LAURIE SAGER & ASSOCIATES FEIN 260838787 LANDSCAPE ARCHITECTS INC 700 MISTLETOE RD"STE 201 ASHLAND OR 97520-9157 WORKPLACE NOT SHOWN INSURED IS A CORPORATION COPYRIGHT 1987 NATIONAL COUNCIL ON COMPENSATION INSURANCE 2 THE POLICY PERIOD IS FROM 11/12/2013 TO 11/12/2014`12:01 A.M. STANDARD TIME AT THE INSURED'S MAILING ADDRESS. 3A. WORKERS COMPENSATION INSURANCE: PART ONE OF THE POLICY APPLIES TO THE 'WORKERS COMPENSATION LAW OF THE STATES LISTED HERE: OR B. EMPLOYERS LIABILITY INSURANCE: PART TWO OF THE POLICY APPLIES TO WORK IN EACH STATE LISTED IN ITEM 3A. THE LIMITS OF OUR LIABILITY UNDER PART TWO ARE: BODILY INJURY BY ACCIDENT $ 500,000 EACH ACCIDENT BODILY INJURY BY DISEASE $ 500,000 EACH EMPLOYEE BODILY INJURY BY DISEASE $ 500,000 POLICY LIMIT C. OTHER STATES INSURANCE: PART THREE OF THE POLICY APPLIES TO ALL STATES EXCEPT ME, MT, ND, OH, RI, WA, WV, WY AND STATES LISTED IN 3A. D. THIS POLICY INCLUDES THESE ENDORSEMENTS AND SCHEDULES: W00000008 W0000404 WC360301/0484 W0000414 WC360401 WC360601E W0000421C W0000422A WC360602 - 4. THE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUALS OF RULES, CLASSIFICATIONS, RATES AND RATING PLANS. ALL INFORMATION REQUIRED BELOW IS SUBJECT TO VERIFICATION AND CHANGE BY AUDIT. PREMIUM BASIS TO- RATE/$100 ESTIMATED CODE NOS. AND TAL ESTIMATED AN- REMUNERA- ANNUAL CLASSIFICATIONS NUAL REMUNERATION TION PREMIUM 8810 26,937 .26 70 CLERICAL OFFICE EMPLOYEES NOC EMPLOYERS LIABILITY INCREASED LIMITS 0 MERIT RATING 10.0% -7 CATASTROPHE (OTHER THAN TERRORISM) 9741 26,937 .02 5 s -TERRORISM 9740 26,937 .02 5 EXPENSE CONSTANT 140 MINIMUM PREMIUM $ 174 OREGON - TOTAL ESTIMATED ANNUAL .PREMIUM $ 213 PREMIUM ADJUSTMENT PERIOD SHALL BE ANNUAL DEPOSIT PREMIUM $ 213 m 6.20% OREGON TAX KERS COMP DEPT $ 13.21 w PREPARED 09/16/2013 COUINITERSIGNFQ _WC_00__00__0,1__A,_ ~-s 56 _202_4_1.079__B~AGE.NS VIUYIr~a CYO S WORKERS-COMPENSATION AND EMPLOYERS LIABILITY POLICY ~0~+ I INFORMATION PAGE ENDORSEMENT PAGE 01 15-2155-FAE6 THIS FORMS A PART OF COVERAGE IS PROVIDED BY POLICY NO. 97-BS-C709-3 STATE FARM FIRE AND CASUALTY COMPANY PO BOX 5000, DUPONT WA 98327-5000 NAMED INSURED AND MAILING ADDRESS LAURIE SAGER & ASSOCIATES LANDSCAPE ARCHITECTS INC 700 MISTLETOE RD STE 201 ASHLAND OR 97520-9157 - THE EFFECTIVE DATE IS- 11/12/2013 THE EXPIRATION DATE IS 11/12/2014 LOCATION OF THE INSURED LOCATION NUMBER 01 7.00 MISTLETOE RD STE 201 ASHLAND OR 97520-9157 ENTITY:ET01 z b1 c s a m a` 0 0 0 0 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAI,UNCHANGL~ d PREPARED 09/16/2013 COUNTERS I`GNNEED LQ-~ age Viewer Page 1 of 1 A RO' CERTIFICATE OF LIABILITY INSURANCE 03J31/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iss) 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 NCONTACT ONE: SHERRI ALTAMIRANO BRIAN LEE CONRAD STATE FARM AGENCY WCO.NO. FeF. 541482-8470 F"E Np641.482-6950 StateFdmf 1806 ASHLAND ST Ey"a ASHLAND, OR 97520 APLNr><.bt. IHSURER9 AFFORDING COVERIGE _NAICN INSURER A:S(dte Farm Fire and Ca6U3N Company 3614) INSURED DELGADO, CARLOS INSURER e: DBA CARLOS DELGADO ARCHITECT - INSURER L: _ 2174TH ST - INSURER O: -I ASHLAND OR 97520-2089 -S IxsuuRe: IHSURERF: 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 - POpCY EFF pOUCY EYP Lt TYPE OF WNW RANCE POpCY NUMBCfl MMm MM . LIMITS X COMMERCALGENERALLIASILITY 97•E5.92714 03MI12014 03101/2016 EACHOCCURRENCE _ f 2.000.000 X CWMSSA m ~J OCCUR PREMISEOF GES,Eii T I 1 300,000 MED up (my b PC.) S 5,000 PERSONAL aAW INJURY f 3,000,000 GEML AGGREGATE LIMIT APPUES PER 4,000,000 X IRO- ~I GENERAL AGGREGATE S POLICYC JECT I_ iLOC PRODUCTS-COMPIOPAGG I OTHER: I Fli COLEUMUTY COMBINEDD SINGLE UNIT 5 YAUTO 8C02YIWURYIPrpenr) 5 -OOYMEO SCHHEEDULED ( 1 BODILY1NAJRY pYemd. f NONd.EO REDAUTOS AUTOS Px eadnH I UMEIE LNB OCCUR N/A EACH CCCURPENCE s EXCESS LAB CLAIMS WOE ACOPECATE I DED RETENTIONS $ AND EM AINUT M.ERS w0EM0.°YER9'LNeIUTY YIx NIA AHYPROPRIETCRIPARTKMXECUnW ❑NIA ELEACHACCIDENT 3 CFFICERMEMSER E%GWJEOi (MAndrrdn Hn NH) E. L. DISEASE - EA EMPLOYE S 0 ESCRIP90N OF OPERATIONS CaWx ElDISEASE. POLICY LIMIS 3 °ESCMPfN)N 01OPEMTI°N91 LOCATIONS I VEHICLES (ACORn 101, AW10-M Rnm... ScM1MUH, mq W abcM1W Nrwn Wpb Is royuNd) SAME AS ABOVE Type: BUSINESS-OFFICE Coverage information B-SUSN PROP 46200 LOSS INC 12 MONTH CERTIFICATE HOLDER CANCELLATION ADDITIONAL INSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND PARKS AND ACCORDANCE WITH THE POLICY PROVISIONS. RECREATION- ARCHITECTURAL SERVICES 340 S PIONEER ST ED RFP"ESE" nvE' r\~~ co ASHLAND, OR 97520 f~ G ®1988.20 ACORD CORPORATION. All righ reaervetl ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132649.9 02-04-20' https:Hsfnet.opr.statefarm.org/im_core/jsps/pages/imageV iewer.faces 3/31/2014 VateFarm • • • . CERTIFICATE OF INSURANCE State Farm Specialty Products ISSUE DATE: April 3, 2014 Producer THIS CERTIFICATE IS ISSUED AS A MATTER OF Brian Conrad INFORMATION ONLY AND CONFERS NO RIGHTS UPON BRIAN LEE CONRAD STATE FARM AGENCY THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES 1806 Ashland St NOT AMEND, EXTEND OR ALTER THE COVERAGE, Ashland, OR 97520-2331 TERMS, EXCLUSIONS AND CONDITIONS AFFORDED BY Producer Code 372155 THE POLICIES BELOW. Producer Fax (541) 482-6956 INSURER AFFORDING COVERAGE Named Insured State Farm Fire and Casualty Company BLOOMINGTON, IL Carlos Delgado Architect, LLC 217 4th street Ashland, OR 97520 COVERAGES 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 POLICY(IES) DESCRIBED HEREIN IS SUBJECT TO ALL THE COVERAGE, TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE PS0000003746103 May 7, 2013 May 7, 2014 TYPE INSURANCE LIMIT OF LIABILITY Architects and Engineers Professional Liability Insurance $1,000,000 - Limit of Liability Each Claim Policy $3,000,000 - Total Limit of Liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE City of Ashland ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS Parks & Recreation Architectural Services WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL 340 S. Pioneer IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON Ashland, OR 97520 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESEN IVE CERT(Rev4) (08/11) :Michelle Ely FaxID:HART INSURANCE Page 1 of 3 Date 3/3112014 11:49 AM Page:1 of 3 Phone: (541) 479-5521 ext. 1008 Fax: (541) 474-1209 Fax From: Michelle Ely To: Dave Lohman Pages: 3 Fax: 5415522092 Date: 3/31/2014 11:49:30 AM Phone: ( ) - Subject: re: Thornton Engineering, Inc. Message: Following is proof of insurance for the above contractor as requested. Thank you, Michelle Ely From:Michelle Ely FaxID:HART INSURANCE Page 2 of 3 Date:3/312014 1149 AM Page:2 of 3 9THOREN OP ID: MW CERTIFICATE OF LIABILITY INSURANCE 122/171 /17/ DAT 20013 13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endomement(s . PRODUCER Phone: 541-7794232 CONTACT NAME Hart Insurance 1123 Royal Ave. Fax: 541-772-3963 PHONE No E.11, AAIXX No Medford, OR 97504 EMAIL Hart Insurance Agency ADDRESS: INSURERIS) AFFORDING COVERAGE NAIL p INSURER A: M UtUall of Enunlcl aW 14761 INSURED Thornton Engineering Inc INSURER B:Travelers Casualty & Surety PO Box 476 Jacksonville, OR 97530 INSURER C: INSURER D : INSURER E : INSURER F: I 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 POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR TYPE OF INSURANCE POLICY EFF PO CYEXP LIMITS LTR I POLICY NUMBER MMMD/YYYY MWODIYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CPP000633902 07/0112013 07101/2014 PREMISES Ea occurrence E 300,00 CLAIMS-MADE lxl OCCUR MED EXP (Any one person) $ 10,08 B X Professional E&O 105350491 1010112013 10/0112015 PERSONAL B ADV INJURY s 1,000,00 GENERAL AGGREGATE S 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AEG $ 2,000,00 X POLICY PRO LOC Prof E&O E 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Es PCCId.rA A X ANY AUTO CPP000633902 0710112013 07/0112014 BODILY INJURY (Par person) E ALL OWNED SCHEDULED BODILY IN JURY IP'He'denq S AUTOS AUTOS HIRED AUTOS NON'-OWNED PROPERTY DANIA E S AUTOS Per acciaem E UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE E DED RETENTIONS E WORKERS COMPENSATION WC STATLL TFf AND EMPLOYERS'LIABILITY YIN TORYLIMITS PER MY PROPRIETORIPARTNEWEXECUTIVE EL EACH ACCIDENT E OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE- EA EMPLOYE $ IIy desonaeunder DESCRIPTION OF OPERATIONS below EL DISEASE- POLICY LIMIT 5 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (AUach ACORD tat, Addinanal Remarks Schedule, if more apace is reauiied) City of Ashland, Oregon, its elected officials, officers and employees are included as additional insured as respects general liability per form CG3261 10/05 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Hart Insurance Agency © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD From:Michelle Ely FazID:HART INSURANCE Page 3 of 3 Date 3131/2014 1149 AM Page:3 of 3 POLICY NUMBER: CPP 0006339 02 COMMERCIAL GENERAL LIABILITY CG 32 61 10 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): CITY OF ASHLAND OREGON & ITS EMPLOYEES 20 E MAIN ST ASHLAND OR 97520 Location(s) Of Covered Operations: Information re uired to Complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to This insurance does not apply to "bodily injury" include as an additional insured the parson(s) or "property damage" occurring after: or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", - 1• All work, including materials, parts or "property damage" or "personal and advertis- equipment furnished in connection with ing injury" caused b such work, on the project (other than serv- for the additional by your ongoing operations ice, maintenance or repairs) to be insured (s) at the location(s) per- .designated above and only to the extent that formed by or on behalf of the additional in- such "bodily injury", "property damage" or sured(s) at the location of the covered op- "personal and advertising injury" is caused by erations has been completed; or your negligence or the negligence of those per- 2. That portion of "your work" out of which forming operations on your behalf, the injury or damage arises has been put to B. With respect to the insurance afforded to these its intended use by any person or organiza- additional insureds, the following additional ex- tion other than another contractor or sub- clusion applies: contractor engaged in performing opera- tions for a principal as a part of the same project. CG 32 61 10 05 Copyright, ISO Properties, Inc., 2005 Page 1 of 1 UNIFORM ® LAURIE SAGER AND ASSOCIANIS LANDSCAPE ARCHITECTS INC. 700 MISTLETOE ROAD, SUITE 201 ASNIAND, OREOON 97520 DATE: MARCH 3, 2014 PROJECT: ASHLAND CREEK PARK 27 E. HERSEY STREET ASHLAND, OREGON BRUCE, PER YOUR REQUEST, HERE IS MAT ITH A 10% CONTINGENCY FOR ASHLAND CREEK PARK FOR PROPOSED DESIGN WORK'IN ESTI ALL OUTSTANDING BILLS.) $16,280 THORNTON ENGINEERING lUi6~ m ICA ~ $4,000 CARLOS DELGADO ARCHITECT fY $9,000 LAURIE SAGER AND ASSOCIATES u'u 60- it r d f P $29,280 TOTAL $2,928 10 % CONTINGENCY r^'S $32,208 GRAND TOTAL \ yq THANKS, ~w- LAURIE SAGER /"'''"-"~~11 ~E T VlQA PHONE 541 488 1446 FAx 541 488 0636 w .IAURIESAGER.COM 02/01/2021 07:23 FAX la 001 DATE (MMMDnYYY) CERTIFICATE OF LIABILITY INSURANCE 03/04/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the polley(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 BRIAN CONRAD AGENCY N TP SHERRI ALTAMIRANO FAX FNIE -482-6479 1806 ASHLAND ST 1 Ne -MAIL StateFarm ASHLAND, OR 97520 ADDRESS, INSURER(S) AFFORDING COVERAGE NAIC r (EWs INSURER A: Slate Farm Fire and CasuaIty Company 43 INSURED LAURIE SAGER & ASSOCIATES INSURER B: LANDSCAPE ARCHITECTS INC INSURERC: 700 MISTLETOE RD STE 201 INSURERD: ASHLAND OR 97520-9157 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTFY 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 D BR POLICY EFF POLICY EX], LIMITS TYPE OF INSURANCE POLICY NUMBER MM IMM/ppNYyY) INS DENERALLIABRJTY 97-GA4836-3 0912612013 0912512014 EACH OCCURRENCE $ 2,000,000 -DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea ce$ CLAIMS-MADE a OCCUR MED EX? (Any me n) $ 6,Goo PERSONAL B ADV INJURY $ 2,000,ODD GENERAL AGGREGATE $ 4,000,000 GENL AGGREGATE LIMIT APPLES PER: PRODUCTS - COMP/OP AGO $ X POLICY FRO- LOC $ S AUTOMOBILE IIABIUTY BIN GLE LIMIT ANY AUTO ILY INJURY (Per parson) $ ;BODILY nidenl ALL OWNED SCHEDULED INJURY(Per aocklet) AUTOS NAUTOS ON-OVWED FE 5 HIRED AUTOS AUTOS accidenl $ 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 EXCESS UAB CLAIMS-MADE AGGREGATE $ OED RETENTIONS STA LL WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOP/PARTNER/EXECUNVE YIN E.L. EACH ACCIDENT $ OFFICEIMEMBER EXCLUDED? NIA (Mandd MNH) El- DISEASE - EA EMPLOYE $ If yes, desu avLre Oder E.L. DISEASE - POLICY LIMIT 5 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aexh ACORD 101, Addltlw Ramada Schedule, M mere space Is required) 30 DAY NOTICE OF CANCELLATION (10 DAY NOTICE FOR NOW PAYMENT OF PREMIUM) LOCATION AS NOTED ABOVE B-BUSN PROP 56300 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Parks and Recreation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLIC ROVISIONS. Cshra e~ 340 S Pioneer st, Ashland, OR 97520 9 RESENTATIVE UtQY~O Ls~>-S ® 1988-2010 AC RD CORPORATION. All rights reserved. ACORD 2612010105) - The ACORD name and logo are registered marks of ACORD 1001486 132849.8 01-23-201 1/04/14 03:22PM PST Farmers Insurance Bruce Dickens 5414885314 Pg 2, IRYAIID UNLESS PREMIUM IS PAID FARMER S CERTIFKATE OF UARIUTT INSURANCE - STATE OF OREGON Moodbwred hIkYWAnWr 189381789 LAURIE C SAGER 1624 LENORA DR 9fedwdice: 02.01.2014 MEDFORD OR 97504-6632 Exphmundale: 08.01-2014 NAIC number. 21636 IMRTANT: If my of #we vahkh(r) us operated by 6, pu onGl, nomad hue, mnomawle IiawIty a motor vehicle liability coverage is exduded: NOT APPLICABLE FARMERS INSURANCE COMPANY OF OREGON, HILLSBORO, OR a cAnindDrop Inwror,tenifixthat hhas 6mW a polq dtat provides no Ins tkn the mlNmum coerage nusttary for payment of die xhedala of paymews under the Oregoe Financial ResyonolbAty law, and that taid pollcv covers the insured and ap aches pertox who, with the coneem of the insured, me the dumbed veMcle(s), except for any pu m specifically exdsded ham corempe. Said isurer will give the Departmex of Tmmportatkn nonce of any wm41101kn of do polity withht 10 days after the effereve date of the mmel6tlon or termlmtion. yeeida anon R"Kwed (t-w: 2005 HONDA PILOT 4D 4WD EX-L 2HKYF18565US27302 t.AUnxz c BAask Agencrtarne: GREGORY D SCOTT Phoneno: (541) 471-7221 2$012 e12 Keep this tertERtata In yow we" of all limes. KELP WITH VEHICLE 1611911 Wool a~ e ;/04/14 03:22PM PST Farmers Insurance Bruce Dickens 5414885314 Pg 3, UNDERWRITTEN BY FARMERS INSURANCE COMPANY OF OREGON A STOCK INSURANCE COMPANY, HEREIN CALVED THE COMPANY 23175 NW Demon St. "ro, OR 97124 r Transofllon Type. OFFER OF RENEWAL allay Pop carrlalrrslmpostmrlinorn*kn Poor pRma p a NARIEA INSURED: Pol EdHlon Nnmbss: 02 LAURIE(SA6ER POLICY NUMBER: 18930-17-09 1624 UNORADR This is not a bill E"vc 12:01 A.M. on 02-01.2014 MEDFORD OR 97504.6632 Ya' OIL .iM 01 ~ iid-r,dea-wuoe„ruedxcr.uhi ERPlrafl= 12:01 A.K. on 08.01.2014 I ijmIUN1S'`Fees:; YOUR AG[Nr. GREGORVDSCOTT PahcyPremmmT ol 9 zge 7o Phone (5411471-7221 Fees' maddRaeto remmmohon Imalk gsmt149formersogeni.com - Q ( - YOUR HOUSEHOLD DRIVERS 'See Infermalbo on Addtlronul Feesonlhe reverse _ Status r LAURIE (SAGER RATED SINGLE "'"•-1969 92 a~ YOUR VEHICLE DESCRIPTIONS Year 1005, if - Me" PILOT 40 Ix.l. V.IMiOi. i..;;2RKM8565H527,302'::,i,'r kdt'q,XIF 97520 0Ilhq jr.. 91520: s ; Uspo Bashed Uaalwlda or AUTO OMF,AUTO 111VAID IN FUI~ HOMMEONNERSHI , PPING TOUR POLICY COVERAGES FEES PREMIUMS „ Beltly,h ~ y LEabilty $ 500,000 Eah Persn/$ .SOO,000;Fab Ocmrrance S 107.90 ;Propuly amoyeklaEAlly S 74.30 i S 300,000:Eaibtlcmrreme Ponaaal El luny Protmflop S 15,000 Each Perron S 39.90 Camprehaidve S 25.00 Condon....... S 51.20 TowUrgandAoodSeMde' S.. i. ISO:fudiOcdhnence :S!` 6.00 Unlowrod Motorlsl.Properly Doamge. $ 20,000 Each Ocanence 5 3.40 6iaoh'se:WoirklouBiiuflfrs: , : Plus/AcddeM Forglwtwu. S.. 21.20 Fns Per Vohldo Uabared,Rlotosiet;Be81[~ I,nlwy; ; ;S; $00,0001aih Persoq/S 500,0004060ccorrenae : A;ch0do of S :.11 AO for.thiscov0d eapphes per Poll Pop PrendumTotal• adIncluding fees $ 355.10 'See Infmwlon on Additional Fees on the reverse S69mISTLOm4E2-13 C57l 11 ffoellrraedontherevem4del 12.10-2013 ;/04/14 03:22PM PST Farmers Insurance Bruce Dickens 5414885314 Pg 4, YOUR DEDUCTIBLES AND LIMBS BY VENKLE Caoprabend" S 100 S 500 For airy coverage liadl not, shown, see app ;14 "a" "tmont. ENDORSEMENTS -THESE ARE MODIFICATIONS TO YOUR COVERAGE (OV D COVERAGE D FROM POLICY BACK I ]ST. .-,.;SAFETYGIA3S=VlANTRof DEDUCTIBLE PART iv 16,674• IA CUSTOM,UINGEQUIPMENT ENDORSEMENT ;D6688? . , TSC:.:' NOUSFNO[0 PET[OV~&E 16799 I$T AC(IDENTF,ORGIVENESS =!6934 ISI. .LOSS PAYABLE PROVIS IONS (41DORS ART. ; y . DR014 2ND END ADDING PROP ERTYDAMAGE TO.UM.COVERAGE 1 OR016 157 : st:AND AMENDINGPARTI 11.1TY;PAOIPLIM OROT7 2ND ENDORSEMENT AMENDING PIP. BENEFITS 1 i1R016 ::kr` i'2 ND;: :ENDAMEND.I.NG'OEFINUI.ONS,:PARTI LIARIUIY, j OR030A IST END ELI(LCOVERAGEFORPERSONALVENICLESHARING ) 2SI325 69.4 RIGHTS AND RESPONSIBILITIES: OREGON 254219 306 RISE ASSESSMENT INFORMATION 158590 6:12 l z. N0 (E OF:INFORMAIIOR PRACTICES - OR. .04033A., 1ST END AMENDING DEFINITIONS, PART N - DAMAGE I OTHER WORMATNTN ACCIDENT FORGIVENESS PLEASE CONTA(I YOUR FARMERS AGENT FOR A FREE FARMERS FRIENDLY REVIEW TO ENSURE THAT YOUR FAMILY IS PROPERLY PROTECTED AND THATYDU ARE RECEIVING ALIOFTHE DIS(OUNTS/CREDITS COVERAGESAND PA(RAGE POLNIESAVAILABLE VEHICLE I - DEB. WAIVAD IF GLASS REPAIRED RATHER THAN REPLACED. The-Fees stated M Ihe'Premium/Fees-toxin the front apply on a pei not on account hosis. Tho fo0ovilng additional lees also apply: A. Insldlm.al Service Charge per installment (In consideration of our agreement to aflow you to pay in imtollmeMs): For Monthly Recurring Electronic Funds Transfer (EFT) and fully enrolled online billing (peperless): S 0.00 per account Fm olher Monthly EFT plans: $ 2.00 per mcc oat -For all other payment plans: S 5.00 per account if this account Is let more them one poky, changes in these fees we not effective unto the revised fee information Is provided for each policy. B. LafeFee:S10.00per account C. Returned Payment Cborge: S25.00 per check, electronic transaaloq at other remblance which is not honored by your financiol institution for any reasaa induding but not Draped to msufRdent funds or a dosed account D. Reinstmtemomt Fee: $25.00 per poky One or more of the fees or charges dwrlbed above may be deemed a pmt of premium under applicable sate low. Count natare f45797 I;t[OmOa 213 (SM$I12 Awborned Representative i Page 1 / 1 ~ . C I T Y OF DATE - PO NUMBER ASHLAN T 20 E MAIN ST. 4/4/2014 00341 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 002745 SHIP TO: LAURIE SAGER & ASSOCIATES LANDSCAPE ARCHITECTS INC. 700 MISTLETOE ROAD, SUITE 201 ASHLAND, OR 97520 FOB Point: Req. No.: Terms: net Dept.: Req. Del. Date: - Contact: Bruce Dickens Special Inst: Confirming? NO Quanfi Unit Description Unit Price ' `Ext Price Ashland Creek Park 32,208.00 Design, Architect and Engineerin.q Services Contract for Personal Services . Beginninq date: (not on contract) Completion date: November 15, 2014 SUBTOTAL 32.208.001 BILL TO: l TAX 0.00 FREIGHT 0.00 TOTAL 32,208.00 Account Number Project Number Amount Account Number `'Project: Numbers ; :Amount E 411.12.00.00.70420 E 000054.999 32 208.00 Authorized Sitnature VENDOR COPY ~cS/L 3IF"~l~ib<f'C -~°F` o~ Gr3s~- ~ FORM IT Y OF #3 ~v ®G~J>,~~•s Cr,.,,~ O~,s5 A request for a Purchase Orderk© F,e- • H LAND REQUISITION ~z e Uat60 req~ 3` /1 ® Gi-a~rn1 aa guj~,09kydelivery: L) Vendor Name Address, City, State, Zip D Contact Name & Telephone Number Fax Number ~a•~/ _k - (,/n3~ SOURCING METHOD ❑ Exempt from Competitive Biddina ❑ 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 ❑ Wdtten quote or proposal attached Agency ❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intemovemmental Agreement 5 000 to 75 000 ❑ Agency ❑ Form #g, Request for Approval anal contrail approved than $35,000, by direct appointment ❑ Written quote or proposal attached Dale original by Council: ❑ (3) Written proposaWwritten solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost Y ..y Fl'K~ 1 ~C-C-~Gl~2C► ct,✓l1~ ~A7C-~'~e¢!~>CG A~'L ~Cvn/~ t -I~-Cx-F--Y`~r•/C-I~ ~"l~'1 ° 2 ,~ys'~.`~'i~; ,w a Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ p, Project NumberOO~ Account Number,r~l . I L-"-D -CO .7 _~2kfV 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: ITDirector Date Support-Yes/No By signing this requisition form, ) certify that the City's public contracting requirements have been satisfied. I Employee: Department Head: (Egbal,t"r greater than $5,000) Department Manager/Supervisor: City Administrator: } / (Eq al to or greater than $y5,000) Funds appropriated for current fiscal year YE / NO /,n~ / Finance Director- (Equal to or greater an $5,000) Date Comments: Form #3 - Requssi0on