HomeMy WebLinkAbout2014-167 Contract - Evergreen Job & Safety Training
Contract for Safety Training
CITY OF CONTRACTOR: Evergreen Job & Safety Training
-AS (IAN D
20 East Main Street- _ CONTACT: Jesse Langslet, President
Ashland, Oregon 97520 ADDRESS: 328 Ironwood Circle, Roseville, CA 95678
Telephone: 5411488-6002
Fax: 541/488-5311 TELEPHONE: 916-742-1811 Cell: 916-224-0395
DATE AGREEMENT PREPARED: May 7, 2013 FAX: 916-742-1852
BEGINNING DATE: April 1, 2013 COMPLETION DATE: December 31, 2014
COMPENSATION::- Public Works Electric Department
APRIL 2013 to June 2013 $2,000.78/Month $1,953.95/Month
July 2013 to June 2014 $2,080.81/Month $2,032.11/Month
Jul 2014 to December 2014' $2,164.04/Month $2,113.39/Month
SERVICES TO BE PROVIDED: Safety Training Classes and Job Observations (crew audits) per the RFP
and Evergreen's proposal attached as Exhibit C. Contract approved b Council December 18, 2012.
ADDITIONAL TERMS: Contract term is two (2) years with the option to renew the contract annually for up to
three additional years for a maximum term of five (5) years. Contract approved by Council 12/1812012.
This contract is being reassigned as of April 1, 2013 to the new owner of the company, Jesse Langslet, per
the attached confirmation letters received from Douglas Lindstrom (previous owner) and Jesse Langslet (new
owner).
Workers' Compensation insurance is being waived because Jesse Langslet does not have employees and
will be providing the services himself. ! - Initial
FINDINGS:
Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and
determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel
nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such
personal services; (4) the undersigned consultant has specialized experience, education, training and capability .
sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial
constraints provided; (5) the' consultant's proposal will best serve the needs of the City; and (6) the compensation
negotiated herein is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE
as follows:
1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated
herein by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper
performance of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service to which they will be
assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of
Oregon, are so registered, licensed and bonded.
4. Completion Date: Consultant shall start performing the service underthis 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: Ali 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 $19,494 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 b all employees.
Contract for Safety Tiaining, Page 1 of 5
G.t. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents
harrliless 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, Consultant's 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 any time by mutual consent.of both parties.
b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
written notice to Consultant, or at such later date as may be established by City under any of the following
conditions:
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.
I. Either City or Consultant may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the, breach within 15 days of the date of the.notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Consultant's performance of each and every obligation and duty
under this contract. City by written notice to Consultant of default or breach may at anytime
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
Contract for Safety Training, Page 2 of 5
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
.intent not to renew the insurance coverage(s) without 30 days' wrifteri 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 consultant's insurance is
primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant
shall furnish acceptable insurance certificates prior to commencing work under this contract. The certificate will
specify all of the parties who are Additional Insureds. Insuring companies. or entities are subject to the City's
acceptance. If requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the
City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured. retentions and/or
self-insurance.
15. 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 Consultant.
Certification. Consultant shall sign the certification attached hereto as ExhibiNA and herein incorporated b reference.
Consultant: City, f Ashland gi
By 3c~
By
Signat belpartment Head O
Uess Lc14,g51e7~- a
p~ Print Name Print Name
Title Date p ~f
1 1!i
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No.,,,'Z Q
ED
Contract for Safety Training, Page.3 of 5
EXHIB 9 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:
L/ (1) 1 carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one .
~ jyear.
(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.
tractor (Date)
Contract for Safety Training, Page 4 of 5
Evergreen job & Safety Tirami ni ig, Inc.
328 Ironwood Circle
Roseville, CA 95678
(916) 742-1811
(916) 742-1852
evergreenj obandsafe4y@gmail.com
To: City of Ashland
Attn: Kariann Olson
90 N. Mountain Ave.
Ashland, OR 97520
To Whom It May Concern,
This letter selves as confirmation that I, Jesse Langslet, have purchased the business;
Evergreen Job & Safety Training, Inc. from its previous owner Doug Lindstrom and
took ownership on April 1, 2013. Furthermore, as the "assignee," I am accepting all the
terms and conditions in the contract between the previous owner of Evergreen Job &
Safety. Training, Inc., Doug Lindstrom, and the City of Ashland for the term beginning
January 1, 2013 and expiring on December 31, 2014.
Sincerely
Jesse Langslet
4/25/2013
ENERGIRMEEN JOB & SAFr.`X`-T TRAIN P1
Douglas J. Lindstrom - President
309 Knoch Avenue, Susanville, California 96130
Office Phone: (530) 257-7812 Office Fax: (530) 257-8266 Home Phone; (530)'257-5657
Apri130, 2013
Kari Olson
Purchasing Representative
City of Ashland, Oregon
90 N. Mountain Avenue
Ashland, OR 97520
Re: Proof of Business Sold-
Dear Kari:
Jesse Langslet purchased Evergreen Job & Safety Training from Douglas Lindstrom on March
27, 2013. I hereby reassign the existing contract to Jesse Langslet, President/Owner of Evergreen Job
and Safety Training. Enclosed is a notarized copy of our Purchase Agreement. Please call if you have
any questions or require anything further.
Sincerely,
Douglas Lindstrom
Encl..
E V.4.SFtiGUE JOB & SA- Ei 3. TRL-211.VI G.
Douglas J. Lindstrom - President
309KnochAvenue, Susanville,Califomia96130
Office Phone: (530) 257-7812 Office Fax: (530) 257-8266 Cell Phone: (530)251-7743
PROPOSAL CONTENTS
Title Page/Cover Letter
To:
Kali Olson
Purchasing Representative
City of Ashland, Oregon
90 N. Mountain Avenue
Ashland, OR 97520
]From:
Evergreen Job & Safety Training-Established in January of 2000
Douglas Lindstrom, President
309 Knoch Avenue
Sus anville, CA 96130
Ph: 530-257-7812
Fx: 530-257-8266
Date: November 20, 2012
To Whom It May Concern:
Evergreen Job & Safety Training would be pleased to continue to work with the City of Ashland
Public Works and Electric departments. We have enjoyed working with you and are willing to
accommodate your needs as set forth in the RFP and as described in the attached proposal" We plan to
continue to conduct business in a straight forward, honest, and professional manner. We appreciate the
opportunity to present you with this proposal. Please call if you have any questions.
Warm Regards,
Doug Lindstrom
Table'of Contents
Qualifications and Experience p3
Public Works Safety Training Classes & Timeline p4
Fee Schedule p4
Electric Department Classes & Timeline p5
Fee Schedule P5
Safety Training Classes Offered p6
References p7
Contract Terms & Conditions p7
Exhibit A PS
Exhibit B P9
Addendum #1 pgs 10-11
2
Qualification and Experience
Evergreen Job & Safety training is committed to providing the best possible service at a reasonable
price. We provide an on-site safety training program that meets NEC, APPA, Federal and State OSHA
training'requirement& We have an extensive Video Library and many programs to offer as you will
find below. We also offer: Accident Investigation, NRECA Accreditation Observation, Pole Climbing
Training, and a Safety Programfor Office Personnel.
Evergreen Job & Safety Training uses the Medic First Aid training program to teach CPR/First Aid,
Bloodbome Pathogens and Automated External Defibrillation. We are also certified as a Train-the- .
Trainer for Medic First Aid. Other certifications we hold are: Certified Occupational Hearing
Conservationist (CAOHC), Accredited Observer Certification, 1910.269 Train-the-Trainer
Certification, Confined Space Entry Certification, and Supervisor Safety Training Certification.
Instructor: Doug Lindstrom
As an introduction, I would like to give you a little background. I have been providing Job and Safety
Training services as Evergreen Job & Safety Training since. January, 2000. Prior to that, I retired from
over 25 years as a lineman/foreman to work for Ruralite Services from November, 1996 to December,
1999. I am currently working with 15 utilities/municipalities in California and Oregon. It is this
experience, in addition to the reputation that I have developed with my other clients, that ensures me
that I can give you a quality product for your. investment.
As your Job and Safety Training Instructor, I am prepared to conduct.one safety meeting a month for
the Electric Department and one meeting a month for the Public Works Department. The safety
meetings are typically in the mornings and the observations, inspections, etc. are performed in the
afternoons. I willwork with the Supervisors to develop a course curriculum that meets the needs of
each department and law requirements..A typical meeting consists of.
1) Accidents and near misses - I bring any relevant accidents I hear of in the industry. They
are discussed with students and we draw whatever lessons may be learned from the real-life
incidents.
.2) Lecture and discussion on selected-topic (usually involves, handouts, Power Point slide,
shows and relevant videos)
3) Hands-on training (if required for selected topic)
4) Job Observations -I either drop-in on jobs already in progress or go out with the crew. I
record my observations looking for any hazards or violations in a non-threatening manner.
Discussion takes place and I try to make it a learning experience for all involved. The
observations are then typed and sent to the company with pictures.
5) Building and Grounds Inspections performed as needed or requested. I inspect the property
looking for violations, safety hazards, or anything concerning. My findings are typed and
sent to the company with pictures.
I will supply needed training materials and my curriculum is in compliance with Org/OSHA,
Fed/OSHA,.and NEC.
A "Course Tracking Form" is filled out at each class. The original is left with the company and I keep
a copy on file in my office.
3
Public Works Safety Trainine Classes and Timeline:
Thursday mornings 7-10am (length varies depending on subject matter), followed by job observations
and inspections (as required and per request):
January 2012: CPR/First Aid (AM/PM Classes)
February 2012: CPR/First Aid (AMT -M Classes)
March 2012: Hand & Portable Power Tools
April 2012: To Be Determined
May 2012: Trench Safety/Job Observation
June 2012: To Be Determined
July 2012: Personal Protective Equipment/Job Observation
August 2012: To Be Determined
September 2012: ERP/Vault Rescue
.October 2012: Confined Space
November 2012: Emergency Action Plan
December 2012: To Be Detemlined
Fee Schedule
Twelve (12) Programs presented on one day per month.
July 1, 2013
Basic Rate for up to 60 employees and twelve (12) Programs: $ 2,080.81 / Proa
ar .
Yearly Total at $2,080.81/ Program-for twelve (12) Programs: $24,969.72/Ye
Monthly Billing: $ 2,080.81 /Month
The above rates are subject to a 4% annual increase set forth as follows:
July 1, 2014
Basic Rate for up to 60 employees and twelve (12) Programs: $ 2,164.04 / Progr
Yearly Total at $2,164.04 / Program for twelve (12) Programs: $ 25,968.48 / Year
Monthly Billing: $ 2,164.04 / Month
The above rates are subject to a 4% annual increase set forth as follows:
July 1, 2015 .
-Basic Rate for up to 60 employees and twelve (12) Programs:' $ 2,250.60 / Program
Yearly Total at $2,250.60 / Program for twelve (12) Programs: $ 27,007.02 / Year
Monthly Billing: $ 2250.60 / Month
Cost of additional Employee Training Materials will be discussed and agreed to between Customer
and Evergreen prior to Evergreen supplying said materials.
4
Electric Department :lasses and Timeline:
Friday mornings 7am-12pm (length varies depending on subject matter), followed by job observations
and inspections (as required and per request):
January 2012: CPR/First Aid
February2012: Substation Training/Job.Observation
March 2012: Flagging/Job Observation
April 2012: Grounding/Job Observation
May 2012: Trench.Safety/Job Observation
June 2012: Capacitors/Job Observation
July 2012: Meter Installation/Job Observation
August 2012: Personal Protective Equipment/Job Observation.
September 2012: ERP/Pole Top & Bucket Truck Rescue
October 2012: Confined SpaceNault Rescue
November 2012` Emergency. Action Plan
December 2012: Hot Sticks & Personal Grounds Testing
Fee Schedule
Twelve (12) "Programs presented on one day per month.. .
July 1, 2013
gram
Basic Rate for 16 - 20 employees and twelve (12) Programs: $ 2,032.11/Pro
Yearly Total at $2,032.11/ Program for twelve (12) Programs: $ 24385.32 /Year
Monthly Billing: $ 2,032.11 /Month
The above rates are subject to a 4% annual increase set forth as follows:
July 1, 2014 -
Basic Rate for 16 - 20 employees and twelve (12) Programs: $ 2,113.39 / Progaam
Yearly Total at $2,113.39 /Program for. twelve (12) Programs: $ 25,360.68 / Year
Monthly Billing $ 2,113.39/Month
July 1, 2015
Basic Rate for 16- 20 employees and twelve (12) Programs: $ 2,197.93 / Pro exam
Yearly Total at $2,197.93 / Program for twelve (12) Programs: $ 26,375.16 / Year
Monthly Billing: $ 2,197.93 /Month
Cost of additional Employee Training Materials will be discussed and agreed to between Customer
and Evergreen prior to Evergreen supplying said materials.
5
Safety Training Classes/All Classes We Offer for Public Works and Electric Departments
GEN EkA L SAlN]ETY TECBMCAIL T
I Electric Power Generation, Transmission .1. Fault Current
& Distribution 1910.269 (23 subjects). 2. Voltage Regulators & Controls
2. Personal Protective Equipment (PPE) 3. Rigging
3. Electrical Bums 4. Systems Protection
& installation
I3Jolace Violence 5. Meter Setting
5. Attitude & Safety Motivation 6: Transformer Connections
6. First Aid / CPR Care Plus -Adult / Child / Infant 7. Capacitors/Application & Installation
7. -First Aid/CPR-Adult S. Underground/Grounding
8. Bloodbome Pathogens 9. Personal Grounds Testing
9. Ergonomics 10. Emergency Response Procedure (Pole Top
10. Back Safety Rescue/Bucket Track Rescue/Vault Rescue)
11, Electrical Safety (General) 11. Substation Safety
12. Job Safety Observation 11 Switching Procedures
13. Flagging 13. Bucket Tracks/Trouble Shooting
14. Confined Space Permit Required Training 14. Insulation & Grounding
15. Hand & Portable Power Tools 15. Live Line Tools & Maintenance
16. Mock OSHA Inspections. 16. Lightning Arrestor Training.
17. Loss Control 17. Excavation/Backhoe Safety
18. Safety Accreditation Assistance 18. Electrical Burns
19. Housekeeping (Trucks / Inside) 19. Boom Truck & Crane Safety
20. Rubber Gloving 20. Hot Stick & Personal Grounds Testing
21. NESC (1997 Edition) (Annual)
22. Accident Investigation
23. Chainsaw Safety
24. Powered Industrial Truck
25. Hazard Recognition
26. Hazard Assessments on Site
27. Safety & Job Briefing
28. Eye Safety
29. Dog Bite Prevention
30. Tree Trimming - (non-qualified / 7 subjects)
31. Tice Trimming- (qualified)
32. Fiber Optic-Training
33. Stretching Program
34. Automated External Defibrillation
Training
6
References
The City of Healdsburg
Contact: Todd Weismaim
Office: (707) 431-3341
City of Ukiah
Contact: Collin Murphy • .
Office: (707) 467-2971
City of Ashland Electric
Contact: Dave Tygerson
Office: (541) 552-2307.
Columbia Power Cooperative
Contact: Randy Sweek
Office: (541) 934-2311
Direct: (541) 934-2743
Midstate Electric
Contact: Steve Hess
.Office: (541) 536-7239
Contract Terms and Conditions
Evergreen Job and Safety Training accepts the contract terms and conditions except for item 14d. We
offer to sign a declaration.stating our vehicle is not used to perform work for the City of Ashland. Our
vehicle only provides transportation for the instructor to your facility. It is then parked while services
are provided. Additional automobile liability insurance is not required for the type of services that we
provide.
Evergreen Job and Safety Training also declares that it is eligible to participate in public procurement
activities. We have never been debarred, suspended, disqualified or otherwise lawfully precluded from
participating in any public procurement activity.
7
]EXID[BIT A.,
Request for Proposals
SAFETY TRAINING
Proposal Form
The undersigned proposer submits this proposal in response to the City's Request for Proposals
(RFP) for Safety Training, released on October 25, 2012. The proposer warrants that proposer has
carefully reviewed the RFP and that this proposal represents -proposer's fall response to the
requirements described in the RFP. The proposer further warrants that if this proposal is accepted,
the proposer will contract with the City, agrees to the'terms and conditions found in the attached .
contract and RFP or has submitted terms and conditions acceptable to the City, and will provide all
necessary labor, .materials, equipment, and other means required to complete the work in
accordance with the requirements of the RFP and contract documents.
The proposer hereby acknowledges the requirement to carry or indicates the ability to obtain the
insurance required in the contract. Indicate in the off -mative by initialing here: .
The proposer hereby acknowledges receipt of Addendum Nos. to this RFP.
Name of Proposer : d~ p IGtS n S +/-0 vv t
Business Address: 30 a X yt 0 G l1 R-ve -
'SO-s" V, H° CA 476 I
Getl:
Telephone Number:
Fax Number: O -~V-r -
Email Address: doG eUee-nD 5~a{e i'Y . co.m
Authorized Signature: Printed/Typed Name: p g f C L,5 L. c n S 3'~p
Title: Yfe's ~e/I +-~~v Sri~c~or
Date: /a < I
RFP - Safety Training (Onsite for Public Works & Electric Utility Departments).
Q
IE ITB
Certificate of C)mpliance.
Compliance with Oregon Tax Laws:
In compliance with OAR 137-047-0260(2)(e), I hereby attest or affirm under penalty of perjury:
That I am authorized to act on behalf of the proposer in this matter,.that I have authority and
knowledge regarding the payment of taxes, and that contractor is, to the best of my knowledge, not
.
in violation of any Oregon Tax Laws, as defined in ORS 305.3907
Compliance with Nondiscrimination Laws:
In compliance with ORS 279A.110(4), OAR 137-046-0210(2) and OAR 137-047-0260(2)(a)(E), I
hereby attest or affirm under penalty of perjury that I am authorized-to act on behalf of proposer in
this matter, and to the best of my knowledge the proposer has not discriminated and will not
discriminate, in violation of ORS 279A.110(1), against a minority, women or emerging small' business enterprise certified under ORS 200.055 or against a business
enterprise that is owned or
controlled by or that employs a disabled veteran as defined in ORS 408.225 in obtaining a required
subcontract.
Corporate Officer: B
By: oU
ignature
Print Name
Title: 1 l~5) e~~t Lh Sfi/✓~Ol
Date: l f 0 /(X
RFP - Safety Training (Onsite for Public Works & Electric Utility Depamnents)
Additional information:
Late proposals will not be considered. No exceptions. It is recommended that you request '
available delivery options for the City of Ashland and verify that your method of sbipment will
arrive prior to the due date and time.
The following Workers' Compensation extraterritorial reciprocity information man is
being provided as additional information. -If the successful proposer has employees, Workers'
' Compensation insurance will need to be. maintained during the terni of the contract.
United Staffer oho aterru ifforriap
reciprocity information maps
Last updated: 8-21-12
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http://www.cbs.state.or.us/.wcd/compliance/ecu/etmaP.htrnI
Please review, sign, and return this addendum with the RFP documents.
I acknowledge receipt of ADDENDUM #1.
Signed by: Date. 0_0
Printedname: ®Qv5 I aS
Title: pie-5jf^ ndsf~o /rl.
/_r1-r~-UC+C;Y'
Firm: CJer9te~n J a Pam} SG~e 1.f Trc~ r ; r~
RFP -Safety Training, Addendum #.I
Page
U" RECOR1DER 1 / 1
. CITY OF
ASHLAND .DATE~ ..PO NUMBER".
gLil 20 E MAIN ST. 717/2014 12341
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 017707 SHIP To: Ashland Electric Department
EVERGREEN JOB &SAFETY TRAINING (541) 488-5354
328 IRONWOOD CIRCLE 90 N MOUNTAIN
ROSEVILLE, CA 95678 ASHLAND, OR 97520
FOB Point: - Req. No.:
Terms: Net Dept:
Req. Del. Date: Contact: Mary MCClarv
Special Inst: Confirming? NO
Quantity Unit "Descri-tion -r . -Unit Price Ext. Price
6.00 Mo Safety Training - Electric Department\ 2,113.39 12,680.34
July - December, 2014, $2,113.39 per
month
Contract for Safety Training
Beginning date: April 1, 2013
Completion date: December 31, 2014
Contract can be extended annually for
up to three additional years for a
maximum term of five (5) years.
SUBTOTAL 12 680.34
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 12,680.34
ASHLAND, OR 97520
Account Number Project Number `Amount rf "AccountNumber :,Project Number Amount '
E 690:11.18.00.60640 9 510.26
E 691.02.47.00.60640 3,170.08
AuthoriZeO,~signature / VENDOR COPY
_F~ORM 43 ~ x.17 C0
CITY OF
IF I ASHLAND
REQUISITION Date of request: o7/ovt4
Required date for delivery:
Vendor Name EVERGREEN JOB & SAFETY
Address, City, State, Zip 328 IRONWOOD CIRCLE, ROSEVILLE, CA 95678
Contact Name & Telephone Number (Cell) 916-224-03~5, (0) 91
Fax Number (1) 916 742- 1862
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emeraencv
❑ 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: 12118/12 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
55.000 to 5100.000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract #
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5,000 to $75.000 ❑ Agency
❑ Form #9, Request for Approval
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3) Written proposals/written solicitafion Date approved by Council: 07120/10 (Date)
❑ Form #4, Personal Services $5K to $75K Valid until: 06130/15 Date
Description of SERVICES Total Cost
rgo22 ~sl jFr"o, - -
July 2014, through December 201k-$2A32-4tmomh Contract approved by Council July $12,680.34`.
18, 2012, Valid until December 31,2014.
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
❑ Per attached quotelproposal TOTAL COS11'
$12;686:34. '
Account Number 690.11.18.00.606400--$12,680.34.
•`~7 O 6 D ~0 5d o 4 0~ J~"/ IJ
'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support-Yes/No
By signing this quisdion fpm I certify that the City's public contracting requirements have been satisfied.
G
Employee: Department Head: aI - '/f
Department ManagerlS pervisor: City Administrator: quarto or greater than $5,000)
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year. yES / NO -7
- Finance Director- (Equal to orgreater n $5,000) Date
Comments:
Form #3 - Requisition