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HomeMy WebLinkAbout2014-247 Contract - Childress Roofing Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: Childress Roofing, Inc. -AS H LAND CONTACT: Ted Childress 20 East Main Street Ashland, Oregon 97520 ADDRESS: 6353 Ventura Lane, Central Point, OR 97502 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-665-9889 DATE AGREEMENT PREPARED: September 2, 2014 FAX: 541-665-9900 BEGINNING DATE: September 4, 2014 COMPLETION DATE: October 17, 2014 COMPENSATION: $14,575.00 ($3,850.00 Garfield Park Restroom and $10,725.00 Hunter Park Restroom/Concession) GOODS AND SERVICES TO BE PROVIDED: Roofing projects per ITB attached as Exhibit C and bids submitted by Childress Roofing attached as Exhibit D. Locations: Hunter Park Restroom 1705 Homes Street and Garfield Park Restroom 40 Garfield Street ADDITIONAL TERMS: NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 2796.220, 27913.225, 27913.230, 27913.235, 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 $20,142.20 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: Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 1 of 5 i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or 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 b. 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. C. 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. d. Notice of cancellation or chap e. There shall be no cancellation, material change, reduction of limits or Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 2 of 5 intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to 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 refe Co ctor: City of Ashland ture Department Head ~S ~~cG~/t~~' ,Q • P~/mot Print Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. Contract for Goods and Services Less than $25,000, Revised 07/08/2014, 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. (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. Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 4 of 5 CITY OF LC~~2 ASHLAND FORM #2 INVITATION TO BID - TRADE SERVICES INTERMEDIATE PROCUREMENT Release date: 7-31-2014 Requested by: Jason Minica Central Division Tech 11 City of Ashland Parks and Recreation Department Tel: (541) 324-4112 Fax: (541) 488-6099 Email: minicaina,ashland.or.us Voluntary Pre-Bid conference: 9:00 am Wednesday, August 19, 2014 Bids are due by: 4:30 pm, Friday, August 29, 2014 Proiect name: 1.Hunter Park restroom building roofing project 2. Garfield Park restroom building roofing project Job site location: 1. 1705 Homes St, Restroom/Concession building, Hunter Park, Ashland, OR 97501 2.40 Garfield St, Restroom building, Garfield Park, Ashland, OR 97501 Protect completion required by: Friday, October 17, 2014 ***(Both buildings must be bid and itemized separately)*** Preferred method of shipment for materials/equipment (if applicable): FOB Ashland - Freight Prepaid Bids may be faxed, emailed or hand delivered. Contractors shall submit bid on their company letterhead. Informal email bids and/or late bids will not be accepted. Terms or discounts which are conditioned upon payment within a certain time will not be considered for purposes of comparison of bids. The successful contractor will be required to enter into a contract with the City for the services and provide insurance certificates in their own name for General Liability, Automobile and Workers' Compensation. Workers' Compensation insurance is mandatory. Subcontracting will not be permitted. "OR EQUAL": Any brand name listed in the specifications as "or equal" or "or equivalent" shall establish the minimum requirements for quality, utility, durability, function, purpose, etc. Other product brands may be offered that are equal to or better than the product brand name. Bidder may show cost difference, alternates and options in the space provided in the quote. This clause is not meant to be restrictive, but to set the minimum standard. THE CITY SHALL DETERMINE, IN ITS SOLE DISCRETION, WHETHER A PRODUCT OFFERED IS "EQUAL." When the designation is "or equal" or "equivalent" City shall make its decision after Bid Closing. SCOPE OF SERVICES 161ALE1 Form #2 - Intermediate Procurement, Invitation to Bid, Trade Services, Page 1 of 3, 8/21/2014 • Remove existing roofing and dispose of the debris. • The new roofing material will be Bruce & Dana's snap lock roofing (with hidden fasteners). The color will be Bruce and Dana's (Standard Brown). • Contractor will install 30 pound felt paper, 24 gauge snap-lock hidden fastening metal roofing with vented ridge system, including all trim and flashings, as per manufacturer's specifications. • Replace any damaged or rotten wood as needed after tear-off on a time and materials basis. • Sky lights will also be replaced with a recommended quality skylight or equivalent. • Contractor will be responsible to ensure safety to the public and parks staff personnel. The Hunter/Garfield restroom buildings are public facilities that will be open during the day while the roofing projects take place. Additional Information: * * * Work at this project site must be organized, safe and kept clear of debris for park patrons. The restroom building will be kept open during the time of the roofing project. * * * Other conditions for safely working around the public may be presented to potential bidders at the pre-bid conference. Please provide an official bid on your company letterhead, including the following information: 1. Total cost for materials and labor. 2. Roofing type/materials and color to be provided. 3. Timeline for completing the roofing project. 4. Completion date 5. Proof of insurance for General Liability, Automobile and Workers' Compensation (No exceptions). 6. Proof of valid contractor's license 7. Proof of valid City of Ashland business license 8. W-9 Questions/Requests for additional information: If you have any questions and/or need additional information, Jason Minica (contact information listed above) will be the primary point of contact for this solicitation. Please call or email your questions directly to Jason. Jason will then provide the questions and answers to each of the bidders. Jeff McFarland will also be available to answer questions or provide any additional information if needed. Telephone: 541-601-3926 Thank you, Jason Minica Central Division Tech II City of Ashland Parks and Recreation C:\Users\minicaj\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\0066W028\Hunter Park roofing project.doc 2 All Pricing Must Be Held Firm For 30 Days Method of Award: ORS 279B.0701ntermediate Procurements. (4) If a contract is awarded, the contracting agency shall award the contract to the offeror whose quote or proposal will best serve the interests of the contracting agency, taking into account price as well as considerations including, but not limited to, experience, expertise, product functionality, suitability for a particular purpose and contractor responsibility under ORS 279B.110. C:\Users\minicaj\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\0066W028\Hunter Park roofing project.doc 3 > Childress Roofing, INC 6353 Ventura Lane Proposal Central Point, OR 97502 CCB: 126064 childressroofing@gmail.com DATE PROPOSAL N... F Phone:541-665-9889 Fax: 541-665-9900 8/28/2014 11700 NAME/ADDRESS Job Address Garfield Park Restroom Ashland Parks and Recreation 1705 Homes Rd City of Ashland Ashland, OR 97520 345 S Poineer St Ashland, OR 97520 Phone Fax 541-488-5340 DESCRIPTION TOTAL Tear off existing roofing 3,850.00 Install Bruce & Dana Brown Standing Metal Roof System over synthetic underlayment Flash roof penetrations Replace skylights TEN YEAR WORKMANSHIP GUARANTEE Thank you for calling Childress Roofing and may God Bless you. Clean up and haul away debris created by roofing job. Clean debris from gutters and downspouts after roofing job is complete. Run magnet around grounds to pick up nails. We cannot be responsilbe for dirt infiltration through roof or ceiling. Any carpenry work to be done or any sheathing to be replaced would be in additon to this price. Any asbestos removal is not included in this price. Owner to have asbestos testing done before job can be started. If any asbestos is found, removal would need to be done by Asbestos Abatement Contractor at owner's expense. Childress Roofing is not responsible for mold due to moisture, leaking, sweating, and lack of ventilation.. Note-This proposal may be withdrawn by Childress Roofing if not accepted within 10 days. Respectifully Submitted: Payment to be made as follows: Progressive draws and/or balance due upon completion. All material is guaranteed to be as specfied, and the above work to be preformed in accardance with good workmanlike manner. Included are the Lien notices. Any alternation or deviation from above specifications involving extra cost will be upon written order and/or verbal agreement, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. The above prices, specification and conditions are satifactory and are hereby accepted. You are authorixed to do work as specified. Signature: Date: Childress Roofing, INC 6353 Ventura Lane Proposal Central Point, OR 97502 CCB: 126064 childressroofing@gmail.com DATE PROPOSAL N... F Phone, 541-665-9889 Fax: 541-665-9900 8/28/2014 11701 Job Address NAME/ADDRESS. . Hunter Park Ashland Parks and Recreation 1705 Homes St Restroom City of Ashland Ashland, OR 97520 345 S Poineer St Ashland. OR 97520 Phone Fax 541-488-5340 DESCRIPTION TOTAL Tear off existing roofing 10,725.00 Install Bruce & Dana Brown Standing Metal Roof System over synthetic underlayment Any sheeting to be replaced would be at $45 per hour and material Flash roof penetrations Replace skylights TEN YEAR WORKMANSHIP GUARANTEE Thank you for calling Childress Roofing and may God Bless you. Clean up and haul away debris created by roofing job. Clean debris from gutters and downspouts after roofing job is complete. Run magnet around grounds to pick up nails. We cannot be responsilbe for dirt infiltration through roof or ceiling. Any carpenry work to be done or any sheathing to be replaced would be in additon to this price. Any asbestos removal is not included in this price. Owner to have asbestos testing done before job can be started. If any asbestos is found, removal would need to be done by Asbestos Abatement Contractor at owner's expense. Childress Roofing is not responsible for mold due to moisture, leaking, sweating, and lack of ventilation. Note-This proposal may be withdrawn by Childress Roofing if not accepted within 10 days. Respectifully Submitted: Payment to be made as follows: Progressive draws and/or balance due upon completion. All material is guaranteed to be as specfied. and the above work to be preformed in accardance with good workmanlike manner. Included are the Lien notices. Any alternation or deviation from above specifications involving extra cost will be upon written order and/or verbal agreement, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. The above prices, specification and conditions are satifactory and are hereby accepted. You are authorixed to do work as specified. Signature: Date: • F DATE (MM/DD/YYYY) ,4~ L7► CERTIFICATE OF LIABILITY INSURANCE 02/20/14 PRODUCER ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RENARD'S INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ALLSTATE INSURANCE CO HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 405 E MCANDREWS RD MEDFORD, OR 97501 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: ALLSTATE INSURANCE CO CHILDRESS ROOFING INC INSURER B: GENERAL CONTRACTOR INSURERC: 6353 VENTURA LANE INSURER D: CENTRAL POINT, OR 97502 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN LTR NSRE TYPE OF SR DD' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS MADE X OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO 048684005 11/01/2013 11/01/2014 (Ea accident) $ 1,000, 000 X ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) i I PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN _ EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 71CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N T RY IMI ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 1997 ROAD KING TRAILER VIN 1R9FP1726WS241041; 1993 DODGE W300 TRUCK VIN 367MM33C9PM107259; 1994 DODGE DAKOTA TRUCK VIN 1 B7GL23X6RW1 09499; 1991 DODGE DAKOTA TRUCK VIN 1BFL26X5MS268411 RE: LITHIA SPRINGS CERTIFICATE HOLDER CANCELLATION ASHLAND PARKS & RECREATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) ©1988-2009 ACORD CORPOR ION. All rights reserved. The ACORD name and logo are registered marks of ACORD AUG/28/2014/THU 03:51 PM HART INSURANCE MED FAX No•541 772 3963 P,001/001 9CHILRO OP ID: KD '`kC CERTIFICATE OF LIABILITY INSURANCE 08/2812014 FO YY) THIS CEATIFICA7E 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 pollcy(las) 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 cartlflcats holder In Ileu of such endorsement(s). PRODUCER Phone: S41-779429 C,ANNNre"cT E Hart Insurance Aeve. Fax: 541.77'2-3963 WE 1123 Royal A AIC No : Medford, OR 97504 EMAIL Hart Insurance / Medford ADDRESS: INSURERS AFFORDING COVERAGE NAICM INSURER A;Cincinnati S eclat insurance 10677 INSURED Childress Roofing Inc wsuwna:SAIF Co 36196 6353 Ventura Lane Central Point, OR 97502 INSURER c : INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVI ION 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 REOUIREMENT, 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. IN Lx - SR TYPE OF INSURANCE ADO YB POLICY NUMBER M IDDffyYY MMIODlriYY LIMITS OENERALLIABILITY EACH OCCURRENCE S 1,000,00 A X COMMERCIAL GENERAL LIABIUTY OS00042690 11/01/2013 11101/2014 p~NBS Eaocw e $ 100,00 CLAIMS-MADE ❑X OCCUR MED EXP (Any One person) S exclude PERSONAL &ADV INJURY S 1,000,0 GENERAL AGGREGATE $ 2,000,0 GEN'LAGGREGATE LIMIT APPLIES PER PROOUCTS-COMPIOPAGG $ 2,000,0 POLICY PR LOC S AUTOMOBILE LIABILITY COMBINED SINOLIE LIMIT E9 accident] ANY AUTO BODILY INJURY (Par parson) S AUTO$ JED ASCHEDULED UTO$ BODILY INJURY (Per acddent) S NON.)WNED PROPERTY DA MAGE S H. I I HIRED AUTOS AUTOS Per S UMBRELLA UAB HOCCUR EACH OCCURRENCE S EXCESS LIA13 CLAIMS-TADS AGGREGATE i EO ON S WORKERO COMPENSATION WC STATU To' 10111 AND EMPLOYERS' LIABILITY B ANY PROPRIETORIPARTNERIEXECUTIVE YIN 920921 1010112013 10/01/2014 ELEACH ACCIDENT. S 500,00 OFFICER/MEMBER EXCLUDED9 NIA (MyaWRtary M NH) E.L. DISEASE - EA EMPLOYEE $ 600,00 It descrID9 under DESCRIPTION OF OPERATIONS bNOW EL DISEASE • POLICY LIMrr $ 500,00 DESCRIPnON OF OPERA110N9I LOCATIONS I VEHICLES (Athch ACORD 101, AddlUaml Rsmarlis acDeduls, It mote space is required) CERTIFICATE OLDER ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN Ashland Parks & Recreation ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRUENTATNE Hart Insurance / Medford 01988.2010 ACORD CORPORATION, All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD STATE OF OREGON • CONSTRUCTION CONTRACTORS BOARD LICENSE CERTIFICATE LICENSE NUMBER: 126064 This document certifies that: CHILDRESS ROOFING INC 6353 VENTURA LANE CENTRAL POINT OR 97502 is licensed in accordance with Oregon Law as a Residential Specialty Contractor and a Commercial Specialty Contractor Level 2. License Details: EXPIRATION DATE: 07/16/2015 ENTITY TYPE: Corporation INDEP. CONT. STATUS: NONEXEMPT PESIDENTIAL BOND: $15,000 -;OMMERCIAL BOND: $20,000 INSURANCE: $1,000,000 / $2,000,000 RMI: PAULA RAE CHILDRESS HOME INSPECTOR CERTIFIED: NO CITY OF ASHLAND TAX REGISTRATION (FOR REVENUE PURPOSES ONLY) sTREEraDDRESS BUSINESS LOCATION INFORMATION : 6353 VENTURA LN NAME: TED & PAULA CHILDRESS N!99 OWNER INFORMATION PHONE: (541) 665-9889 Barbara Christensen CITY RECORDER/TREASURER REGISTRATION EXPIRES JUNE 30. CHILDRESS ROOFING, INC. 6353 VENTURA LN CENTRAL POINT, OR 97502 TO BE POSTED IN A CONSPICUOUS PLACE. i . Y.y r Page 1 / 1 ASHLAND PARK COMMISSION 20 E MAIN ST. DATE PO NUMBER ASHLAND, OR 97520 9/4/.2014 00393 (541) 488-5300 VENDOR: 004523 SHIP TO: CHILDRESS ROOFING INC 6353 VENTURA LANE CENTRAL POINT, OR 97502 FOB Point: Req. No.: Terms: net Dept.: Req. Del. Date: contact: Jason Minica - Bruce Dickens Special Inst: Confirming? NO Quanti Unit Description Unit Price Ext. Price Roofing Proiects 14,575.00 Garfield Park Restroom $3,850.00 Hunter Park Restroom $10,725.00 Contract for Goods and Services Beginning date: September 4, 2014 Completion date: October 17, 2014 SUBTOTAL 14 575.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 14,575.00 Account Number Project Number Amount Account Number Project Number Amount E 411.12.00.00.70420 E 000038.999 14 575.00 Authoriz Signatures4x VENDOR COPY ,od FORM #3 CITY OF request for a Purchase Order ASHLAND REQUISITION Date of request: Required date for delivery: Vendor Name r CZSS i Address, City, State, Zip 635-3 I. i~4~ r.J Il !;4- Contact Name & Telephone Number W, R&L,6- 0k W.%g 5-41- 6,6'r- -9900 Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding El Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5.000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ❑ Direct Award Date approved by Council: Contract # ❑ Verbal/Written quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract $5,000 to $100.000 ❑ Written quote or proposal attached Agency M (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 [I 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 $51K to $75K Valid until: Date Description of SERVICES Total Cost F s s $ ICI, Item # Quantity Unit Description of MATERIALS Unit Price Total Cost I J TOTAL COST ❑ Per attached quotelproposal $ Project Number ; i UK,,C-~9- 9r Account Number Account Number-'M -u-) - c0, - 7U 2~T 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: IT Director Date Support -Yes / No By signing this requisition form, l certify that the City's public contracting requirements have been satisfied. Employee: l~^~ Department Head: (Equal to or greater than $5,000) Department anagerlSupervisor: M.At (y~ City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year / NO Finance Director- (Equal to or aterthan $5,000) Date Comments: Form #3 - Requisition