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HomeMy WebLinkAbout2014-162 Contract - Accustat Sports Timing Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: f}CLLt5,T1K S , TlPAWn TAC.. ASHLAND CONTACT: EY`tc, 41A1~~nr~ ~CeS~~ 20 East Main Street C Ashland, Oregon 97520 ADDRESS: d1g N~-~ (t~~S+' ~C;~~~ Telephone: 541/488-6002 Fax: 5411488-5311 TELEPHONE: ~A3~g~3~9311 DATE AGREEMENT PREPARED: FAX: 503 -M I -I11s I BEGINNING DATE: 2 2.8 I COMPLETION DATE: -1/2.1114 COMPENSATION: $2,,jo bywp o 833 p~vhc,Nfmis lm V I+" GOODS gz 33 u AND SERVICES TO BE PROVIDED: tom" }t Cat ip (W (N~ M 4h ADDITIONAL TERMS: ,t f n Y NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONI RACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 279B.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $19,825 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 9. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City under any of the following conditions: 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 06/1312013, 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: 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 4), b. General Liabi r Ep %ajithycombined single limit, or the equivalent, of not less than Enter one: r $200 000 $500 00 000 000 ~?ti^, ? J )r Not Applicable for each occurrence for Bodily Injury and Property damage. It shall include con ractuai iaun y coverage for the indemnity provided under this contract. C. Automobile Lia suranc ombined single limit, or the equivalent, of not less than Enter one: W"E 1 00 r of Applicable for each accident for Bodily Injury and Property Damage, $200,000, $500,000, including coverage for owned, hired or non-owne 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 Rachel Dials From: Eric- Accustat [Eric@accustatsportstiming.com] Sent: Tuesday, June 17, 2014 1:55 PM To: Rachel Dials Subject: Re: FW: IMPORTANT-NEED Intial for contract Attachments: ashlandcontractl4.jpg; insurance.jpg Follow Up Flag: Follow up Flag Status: Completed Hey Rachel- My apologies, it's attached- I also added "N/A" and initialed after the Work Comp section, my crew are all independent contractors. I've also attached the auto insurance coverage. Best Eric > Eric- > Really need this from you so I can finish the contract. > Thanks > Rachel Dials > Recreation Superintendent > Ashland Parks and Recreation > rachel.dials(@ashland.or.us > www.ashlandparksandrec.org > 541-488-5340 LIKE us <http://facebook.com/ashlandparksandrec> > From: Rachel Dials [mailto:dialsr(@ashland.or.us] > Sent: Tuesday, June 10, 2014 8:36 AM > To: 'Accustat' > Subject: IMPORTANT-NEED Intial for contract > Can you please initial one of the lines for the 1,000,000 insurance > information and scan back to me as soon as possible? I accidently > circled 2,000,000. > I need this as soon as possible. 1 > > Thank you!! > Rachel Dials > Recreation Superintendent > Ashland Parks and Recreation > rachel.dials(dashland.or.us > www.ashlandparksandrec.org > 541-488-5340 > LIKE us <http://facebook.com/ashlandparksandrec> Best, Eric 2 that the services are no longer allowable or appropnate for purcnase unaer ims cunueu v, a,v 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. 1. 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. fi. 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. OblloatioNLlabllity 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-discrlmination Certificatlon: 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 ilcense. 13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor has qualified as a QRF for this agreement Institutes an action for relief In bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type Identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 16. Insurance. Contractor shall at its own expense provide the following insurance: a. Worker's Comoensation insurance in compliance with ORS 658.017, which r subject employers to provide Oregon workers' compensation coverage for all their subject workers It4/~,(~l~J :mbined single Ilmil, or the equivalent of ss than Enter one: 4)b. G I bi - . rn u Oh o i $200 000 $500.000 . ':thl r Not Applicable for each occurrence for Bodily Injury and Property ~ama~gThall include con ractua~ ndumq voverage for the indemnity provided under this conlracL g~c, garen mbined single limit or the equivalent, of not less than Enter one: $200,000, $500,000, 1 ~OOO, or of livable for each axident for Bodily Injury and Property Damage, (•r/ including coverage for owned, hired or non-own vehicles, as applicable. d. Notice of cancellation or chance. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance covers e s without 30 da s' written notice from the Contractor or its insurer(s) to Contract for Goods and Services Less than $25,000, Revised 06/1312013, 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. Contra ; City of Ashlar By INC/ By V~ L:7~" Si nature Department Head Gf~Qf?f.%U1t`ui✓!~ ! Joy,\~ac~tcL'`'~ Print ame A Print Name (3 LAGS/~t/1/k S0hI Title Date W-9 One copy of a W-9 is to be submitted with /J/OJ the signed contract. Purchase Order No. y~ AP D S oRM oafa_L~ 1 _ Ill Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: (1) 1 carry out the labor or services at a location separate from my residence or is in a /specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. Telephone listing is used for the business separate from the personal residence listing. 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 ear. (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. ryi Contra 0o /r (Date) Contract for Goods and Services Less than $25,000, Revised 06/13/2013, Page 4 of 5 Accustat Sports Timing, Inc. Service Agreement The following agreement is being offered by and between Accustat Sports Timing, Inc and_The City of Ashland, OR For the event known as The Fourth of July Run (Herein after known as "The Event") to be held on -July 4, 2014 Accustat Sports Timing, Inc will provide the following services at the rates stated below. Database Management and Chip Preparation Services • If requested by The Event AST can set up online registration through any online registration service. • The Event to provide AST with access to its online registration provider for retrieval of information necessary to prepare the database of participants. • If The Event wishes AST to enter off-line registrations to the online registration site, all mail-in entries and/or in-store entries must be sent to AST in a timely fashion. Once per week is acceptable up until the week of the event, during which greater frequency may be required. AST may perform some collection of entries, in which case The Event will provide AST with access to those collection points. • Label and prepare bib/chip packets for pre-registered participants before the start of Packet Pick-Up. Bibs are to be provided by The Event and delivered to AST no less than 2 weeks prior to the start of Packet Pick-Up/Registration. Late delivery may result in AST not being able to complete preparation of Packet Pick-Up materials and AST will not be held responsible. • AST to provide staff to assist in managing volunteers (to be provided by The Event, estimated number of volunteers based on total estimated participation for event to be determined closer to date of event) for Packet Pick-Up and Day of Race Registration. AST staff member will manage "Assistance/Changes" of pre- registered participants. AST staff member will manage volunteers to set up registration area. • Equipment for registration and packet pickup including tables, tents and chairs are to be provided by The Event. • AST to provide one copy of complete database within 5 business days after event in agreed format. • AST to send one copy of complete database within 2 days after the event in agreed format to the event photographer if requested by the event. Day of Race Registration and Chip Preparation • AST will prepare bib/chip packets for individuals who register day of race. • AST will provide kiosk laptops for registration and issue bib/chip packets to individuals who register Day of Race. Chip Timing Services • AST to provide chip timing services Chronotrack(single use) timing system for both the 2 mile and 10k events. • AST to provide staff to assist in managing volunteers (to be provided by The Event) at the Start Line as needed for timing the event. • AST to provide at least one display clock at finish line ($200.00 per clock value). Additional display clocks may be available if there are multiple events starting at different times. • AST to provide and set-up a computer for announcer or a complete list of registered participants listed numerically by BIB number depending on appropriateness. • AST to provide an accurate Gun Start time for all participants (results to be calculated using Finish time minus Gun Start time in accordance with USATF rules for scoring a road race), and Net Time calculated using Finish time minus Matstart Time. • AST to provide results as accurately and quickly as reasonable based on the variable conditions of weather, accuracy of entry forms and equipment. • AST to post complete results on Chronotrack Live during the event. • AST to send results in electronic format to agreed locations on race day. AST is not responsible when results are actually posted to these websites. • AST to make updates to results in a timely manner as appropriate. • AST to provide one paper copy of results to The Event if requested. • AST to send database in electronic format to event photographer for The Event if requested. • AST to provide results for the awards ceremony followin . e event. • AST to provide mailing labels of award winners to The Event if requested. Promotional Services • If AST timed the race previously, AST will email past participants about the upcoming event. • AST to list The Event on www.accustatsportstiming.com website with links to details about the event and online registration. Additional Services • AST will make arrangements to have the photographer of your choice take photos at the event if requested by the event. • Order Bib numbers through our preferred provider, Marathon Printing, if requested. Cost of bibs will be billed to The Event. • AST will make available to The Event One 14' inflatable Start/Finish arch, 1000 watt PA system, 3 pop up tents Add Split Points $750 per location As a condition of the proposal The Event will provide the coordination, implementation and accountability of the following: Race Directing & Management Service: The Event is understood to be completely responsible for implementation and coordination of the event and is furthermore responsible for all liabilities associated with the management of the event, financial and otherwise. The Event is understood to be completely responsible for the management and set up of all transition areas, start lines, finish lines, pre-event areas, post event areas, course marshals, police, permits and any and all areas of setup and management of the event not pertaining to the timing equipment and equipment provided by AST. Use of Foundation and/or Event Marks: The Event hereby grants Accustat Sports Timing, Inc., a royalty-free, nonexclusive, non-transferable license to use and display the logos, trademarks and trade names associated with The Event, such use is to be solely limited to the promotion(s) held in conjunction with the event. Assumption of Liability. The Event is understood to retain ownership of the event as the Event Operator and Owner and assumes all financial liabilities associated with the event. The Event will further insure the event against any losses, liabilities and damages to persons and property associated with this event in the amount no less than $1,000,000. Under terms of this agreement, The Event is responsible to financially cover: a. Permits/Insurance b. Medical, Police and Fire Services c. Advertising/Entry Form Printing d. Shirts/Giveaways e. Equipment Rental f. Race related cost (Porta-lets, Awards, shirts, equipment rentals, etc.) g. Race Bibs h. Event Budget CT system: $ 2500.00. Minimum Fee Includes Database Management, Chip Preparation Services, Chip Timing Services, Promotional Services and Additional Services as stated above for up to 833 participants. Any registered participant and/or finisher over 833 will be billed at $2.50. Transportation and lodging expenses and all necessary equipment and royalties for achieving this have been included in this quote. Terms: Deposit ef $500.00 due upen signing and must be paid a rninimurn of 30 days . to the e.,e..t with the balance or credit of all fees due 30 days after the event. If the Event uses an AST preferred online registration service the Deposit is waived. If the Event is cancelled with 7 or more days notice, the Event is responsible for the cost of the Chronotrack tags ordered. Late payments for balances outstanding will be assessed a 3% per month finance charge. For AST: Title: PiP~s~pyyr~ For The Event: Title: P.(CCS kcw~; ~lJ~~i ~3~~/~ Date: CERTIFICATE OF LIABILITY INSURANCE 4;~412oi4 ) 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 endorsement(s). PRODUCER NAM TACT Cindy Cromwell Elliott Powell Baden and Baker Inc. PHCHE . (503)227-1771 FAX .(503)274-7644 1521 S.W. Salmon Street EbMA~,L~ss.ccromwell@epbb.com INSURERS AFFORDING COVERAGE NAIC # Portland OR 97205-1783 INSURER A.-Val le Forge Insurance Co. 0508 INSURED INSURERS: ACcustat Sports Timing INSURER C: 2325 NE 3RD CT INSURER D: INSURER E : PORTLAND OR 97212 INSURER F: COVERAGES CERTIFICATE NUMBER:2014 GL 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 TYPE OF INSURANCE R POLICY NUMBER MMIDDY EFF MMIDDYIYYVY LIMITS TR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY A PREMISES Be Gff7URTNT u re rrence) S 300,000 A CLAIMS-MADE F-IOCCUR 085898531 /1/2014 /1/2015 NED EXP(Any one person) $ 10,000 PERSONAL B ACV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea amdent ANY AUTO BODILY INJURY (Per person) S ALL OAMED SCHEDULED BODILY INJURY (Per ec:dent) $ AUTOS NON TOS OMED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per awdenl S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WC STATU- DTH- ANDEMPLOYERTLIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE❑ H/A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDE07 (Mandatory In NN) E.L. DISEASE -EA EMPLOYE S If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is required) CERTIFICATE HOLDER CANCELLATION rachel.dials@ashland.or.us SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland Parks 6 Recreation Department ACCORDANCE WITH THE POLICY PROVISIONS. Rachel Dials 340 South Pioneer St AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Cindy Cromwell/CINDYC ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25nmm5tnl Tho ArnDn nnmo and Innn aro ronietoroH un=rlee nr AP.nDn Company Code: 11727 Policy Number: 71548254 Underwritten by: Progressive Universal Insurance Co Policyholder: Eric J larpemeur Page 1 01 t March 5, 2014 Customer Service 1-800-7764737 24 hours a day, 7 days a week Verification of Insurance for Eric J Larpenteur Please accept this letter as verification of insurance for the driver and vehicle listed below. Policy and driver information Policy number: 71548254 ~ Policy state: Oregon Policy period Feb 23, 2014 :Aug 23, 2014 Effect ve date: Feb 23.2014 . . ve r. Eric 1 10- ~ . en.` . eur 6n, Na in ed insured Address: 8748 Ne Glisan Si Portland, OR 97220 Vehicle information Vehicle: 2003 Ford Econc/Cfub 4V n E150 . Vehicle identifiatlon number: 1 FDRE 11 W03HB71527 Coverage information .Bodily.......In.j..u..ry......Liabili.....ty: .............................................................................9 5500,000 wmbined sin le limit Property Damage Liability: 5500,000 combined single limit . Collision: Deductible: f500deductible p-re*hens......i...ve:.................................................... D... edu.... c..t ible:.... f500..........ded..uctib...... l..e Compre Pro....t.ection: o"in*.......................................425.......,00...0 Personal Injury This verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of the policies. If you have any questions, please call Customer Service. Thank you. Farm Vol (03105) C" REC0R21 E: R Page 1 / 1 ASHLAND PARK COMMISSION 20 E MAIN ST. 1 APO NUMBER. ASHLAND, OR 97520 6/27/2014 00357 (541) 488-5300 VENDOR: 004490 SHIP TO: ACCUSTAT SPORTS TIMING INC 8748 NE GLISAN STREET PORTLAND, OR 97220 FOB Point: Req. No.: Terms: net Dept: Req. Del. Date: contact: Rachel Dials Special Inst: Confirming? NO Quanta ty - Unit- - `^"Descn Lon ` •.UnitPrice- "-ExC-Price Database management and ship 3,000.00 preparation services for 2014 - 4th of July Run. Contract for Goods and Services Beqinninq date: 02/28/2014 Completion date: 07/31/2014 SUBTOTAL 3,000-00 BILL TO: TAX J60 FREIGHT TOTAL 3Account Number Project Number .'j ;Amount ' ~AecountNumber " Projecf.Number Amount E 211.12.03.02.60695 E 000003.999 3,000.00 Authoriz d Signre VENDOR COPY FORM 93 INC,il 6~ C ITY OF A request for a Purchase Order ASHLAND Dm~ 2 REQUISITIONy Date of request:IS n Required date for delivery: Vendor Name hic-a6d ,~f)Y{SlNliyrior Address, City, State, Zip ~ I `y k. ) P.y~(ti Fl 0~ ~9~~.),17 Contact Name &Telephone Number, ~fi ~dn{r112. Pro drn7' (fi3) $D.3-IJD) Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached Isr 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 #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $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 until: Date Description of SERVICES Total Cost ,4Cb~~p GLlCl.4yTV~ •V1Cr/j~w. Imo' krxr,~~rr~ w T,. Item # Quantity Unit Description of MATERIALS Unit Price Total Cost -TTOTA!Jrbd ;h Per attached quotelproposal ~ti Ga e',i Project Number ~l~1 .Account Nurri I - IL ( -C>Z- lLt7C~~~ r, Account Number - . Account Number 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: ITDirector Date Support-Yes/No By signing this requi lion form, artily that the City's public contracting requirements have been satisfied. Employe / Im 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 YES / NO Finance Director- (Equal to orgreaterthan $5,000) Date Comments: Form #3 - Requisition