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2014-254 Contract - National Research Center
Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: National Research Center -ASHLAND CONTACT: Damema Mann, Director National Citizen Survey 20 East Main Street Ashland, Oregon 97520 ADDRESS: 2955 Valmont Road, Suite 300, Boulder, CO Telephone: 541/488-6002 80301 Fax: 541/488-5311 TELEPHONE: 303-444-7863x118 DATE AGREEMENT PREPARED: 09/08/2014 FAX: 303-444-1145 BEGINNING DATE: 09/08/2014 COMPLETION DATE: 01/31/2015 COMPENSATION: $14,825 ($10,900 for base survey plus $3,925 for additional options including demographic subgroup comparisons, custom benchmarks, one open-ended questions, online web survey non-scientific SERVICES TO BE PROVIDED: Citizen Survey ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Personal Services will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with the said rims City of Ashland Contract. 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 under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. 6. Ownership of Documents: Documents prepared by Consultant pursuant to this contract shall be the property of City, with the exception of all materials created by Consultant prior to this Contract, for which Consultant retains all rights of authorship and ownership of copyright. 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 $20,142.20 or more, Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any Subcontractor who performs 50% or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not limited to, Consultant's employees, agents, and others designated b Consultant to perform work or services Contract for Personal Services, Revised 07/08/2014, Page 1 of 5 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: 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 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 any time terminate the whole or any part of this contract if Consultant fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; 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 $2,000,000 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 $1,000,000 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 $1,000,000 for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. Contract for Personal Services, Revised 07/08/2014, Page 2 of 5 e. Notice of cancellation or chance. 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 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 Consultant's General Liability insurance policy 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 General Liability certificate will specify the City named as Additional Insured. 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 si n h certification attached hereto as Exhibit A and herein incorporated b reference. onsultan • - City 0Ashland [ t Signature Departm nt Head 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. PP VED AS TO FORM Ash As L Attorney Data- Contract for Personal Services, 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. °1L10> 2-01q Contractor (Date) Contract for Personal Services, Revised 07/08/2014, Page 4 of 5 • ~~E~('/~~``~- l ` ~`9..G" /~JoATel~rroorrr+rn .4coRd CERTIFICATE OF LIABILITY'I~ISURANCE 09111/2014 THIS CERTIFICATE M ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER INE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERft AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the oeTtRcatS holder Is an ADOMONAL INSURED. the pollcy(ies) must be endorsed, K SUMMATION IS WA , subject to tM tams and conditkM of the policy, cortaln poBaios may requbr an endorasnmont A statement on Oft ow0flcate does not conbr r1pMs to the grtlate holder In Ieu of such ondorsomaggsj PRODUCER JEFF OGSURN, STATE FARM INSURANCE 30 530-o~2s 303 28 StateiFarm 6560 GUNPARK DRIVE, STE A BOULDER, CO 80301 AFFDRDIi9COWIErAOE NAICN INSURER A -State Farm Fire and COSUOKy Cwq)w y M47 ISURI u NATIONAL RESEARCH CENTER INC. IuSla+ses: 2955 VALMONT RD STE 300 hrSURaec: BOULDER, CO 8031-1360 Iusr(ep; MURER E INSURER IF COVERAGES CERT FICATE NUMBER: REVISION NUMWt: 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, TERRA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEW 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 TERM, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LiMIT6 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE *An PpUCY Lam A COMMERCIAL GUIPAL L ANLrrY Y Y 96-BU-M23-8 F 1111612013 littG 2014 EACH OCCURRENCE $ I, CLAIMS-WDE [X OCCUR ISf' Eaoo in = 3D0,000 HIRED AUTO LUIBILITY ASD EXP arse s 10,000 X NON-aMM AUTOS PERSONAL 6 ADV INJURY s 1.000.000 GENL AGGREGATE pLRIMpIT APPLIES PER: GENERAL AGGREGATE i 2000,400 X POLICY ❑ JECT ~ LOC PRODUCTS -COMPK)PAGCi f 2,000,000 HER- S AUTOMOBILE LIARERY a ISINGLE s ANY AUTO BODILY INAIRY ew po w S AILL OS D H CDLL® BODILY M~,iURY (Pr aoddanq i i HIRED AUTOS AUTO WNED f Mm" {!AB OCCUR EACH OCCII~NCE i EXCEIM LAB CLARd$IRADE AGGREGATE i DED RETENTION 3 WORKEFA COMPOISATM PER R AND RJKOYEOW LAMILRY YIN STATUTE ANYPROPRIETORIPAITmEROEXECUTIVE ❑N!A EL EACH ACCIDENT i OFFICERAIEMBER EXCLUDED? (yam M NN► EL DISEASE - EA EMPLOYEE S duafteurKW ?I ml g RAT NOW EL DISEASE - POLICY LHMT 3 M RR 964BU•3823-8 F 11/1l=3 11HGM14 DE000R IPTIDN OF OPERATIONS I LOCATKM I Aft 1ACORD rel. AAgMMnN AaMwka aen.ar., mq hw.utiehua r awn aP~ w n¢r.a1 RESEARCH THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE LISTED AS ADDITIONAL INSURED. CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND dIHOULD ANY OF THE At? W DESCRIBED POLICIES BE CANCELLED BEFORE 20 EAST MAIN STREET THE 170 MTION DATE THEREOF, NOTICE WILL BE DMJVERED If ASHLAND, OR 97520 ACCORDAIICE WITH THE POLICY PROVI610NG. "m"77 AT1VE 1 4 ACORD CORPORATION. All Agllts Noww4d. ACORD 25 (2014101) The ACORD name and logo are nglsovW marks of ACORD 1001486 132849.9 02-04-2014 AC CORV• DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/10/14 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 endorsements . PRODUCER CONTACT Aon Risk Services, Inc of Florida NAME: Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite #1100 PHONE FAX Miami, FL 33131-4937 A/C No Ext : 800-743-8130 A/C No :800-522-7514 EMAIL ADDRESS: ADP.COI.Center ADn.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : New Hampshire Ins Co 23841 INSURED ADP TotalSource I, Inc. INSURER B 10200 Sunset Drive INSURER C : Miami, FL 33173 ALTERNATE EMPLOYER INSURER D : National Research Center Inc INSURER E 2955 Valmont Road Suite 300 Boulder, CO 80301 INSURER F : COVERAGES CERTIFICATE NUMBER: 815669 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. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DDlYYYY (MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ -1 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP An one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PROJECT E] LOC PRODUCTS - COMP/OPAGG $ OTHER $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Peraccident $ NON-OWNED PROPERTY AMAG HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC RETENTION $ WORKERS COMPENSATION X PER OTH- A AND EMPLOYERS' LIABILITY YIN WC 094179798 CO 07/01/14 07101115 STATUTE ER ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ 2,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All worksite employees working for the above named client company, paid under ADP TOTALSOURCE, INC.'s payroll, are covered under the above stated policy. The above named dient is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ~ari ~Ls~r ~jetlvlee~, ~tse o ~~ot~a ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NAT1430 OP ID: MCI '`~~°ROA CERTIFICATE OF LIABILITY 1911 ANCE DATE(MM/DD/YYYY) 09/15/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(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 NIONT AMEACT Marilyn Cox NEISEN BORTH AGENCY www.nbinsure.com A/C O, Ec, NN EXt:303-781-6776 A/c No: 303-789-4409 333 W. Hampden Ave. Ste. 305 AE MAIL DDRESS: mcox@nbinsure.com Englewood, CO 80110 Nelsen Insurance, Inc. INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Philadelphia Insurance Company INSURED National Research Center, Inc. INSURER B: 2955 Valmont Road Ste 300 Boulder, CO 80301 INSURER C : INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LTR INSR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DA A E T RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE 1:1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ POLICY JERCoj F-] LOC $ AUTOMOBILE LIABILITY EO accident) SINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS ) NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS PERACCIDENT $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION W O STATU- OTH- AND EMPLOYERS' LIABILITY Y I N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/M EMBEREXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If Yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liab PHSD889783 01/01/2014 01/01/2015 Prof Liab 2,000,00 A Cyber Security Lia PHSD902873 01101/2014 01/01/2015 Cyber Lia 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The Professional Liability policy includes Errors & Omissions Coverage of $2,000,000 each claim,$2,000,000 annual aggregate, $5,000 deductible. CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Page 1 /I C I T Y OF DATE PO NUMBER ASHLAND 20 E MAIN ST. 9/16/2014 12494 , ASHLAND, OR 97520 1W (541) 488-5300 VENDOR: 015606 SHIP TO: City of Ashland NATIONAL RESEARCH CTR INC, NATIONAL CITIZ (541) 488-6002 2955 VALMONT ROAD 20 E MAIN STREET SUITE 300 ASHLAND, OR 97520 BOULDER, CO 80301 FOB Point: Req. No.: Terms: Net Dept.: Req. Del. Date: contact: Ann Seltzer Special Inst: Confirming? NO Quanti Unit Description Unit Price Ext. Price Citzen Survey - FY 2015 14,825.00 Base survey $10,900.00 Additional options $3,925 Additional options include demoqraphic subgroup comparisons, custom benchmarks, one open-ended questions, online web survey (non-scientific). Contract for Personal Services Beqinninq date: 09108/2014 Completion date: 01/31/2015 SUBTOTAL 14 825.00 BILL To: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 14,825.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 710.01.02.00.60410 14,825.00 Authorize ignature VENDOR COPY FORM #3 J CITY of ASHLAND REQUISITION Date of request: Required date for delivery: Vendor Name Address, City, State, Zip '2 4-4 ) lid' Contact Name & Telephone Number Fax Number `=--z / SOURCING METHOD ED-! from Competitive Bidding ❑ Emergency ❑ Reason for exemption: _ ' d ❑ 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 atfat ed`" I ❑ Small Procurement Cooperative Procurement Less than $5,000 ❑ Reguest 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{l or 8) ❑ Other government agency contract $5,000 to $100.000 ❑ Written quote or propdsal 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 #9, 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 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost 7 ❑ Per attached quotelproposal TOTAL COST Project Number _ _ _ Account Number i` Account Number___•______ Account *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, I certify that jhe City's public contracting requirements have been satisfied. • Employee• 4', ; Department Head: t Li` (Equal to or greater than $5,000) Department Manager/Supervisor: r' City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year:YE~S ! NO Finance Director- (Equal to or greater an x5,000) Date Comments: Form #3 - Requisition FORM #7 CITY OF ASHLAND SOLE-SOURCE DETERMINATION AND WRITTEN FINDINGS PERSONAL SERVICES Less than $75,000 To: Dave Kanner, City Administrator From: Ann Seltzer, Administration Date: September 15, 2014 Re: Sole Source Determination and Written Findings for Personal Services In accordance with AMC 2.50.090(F), the Department Head shall determine in writing that there is only one provider of a product or service of the quality and type required available. Estimated total value of contract: $14,825 Project name: Citizen Survey Description of project: The National Citizen Survey was developed by the National Research Center, Inc. and ICMA (International City/County Managers Association) to provide a statistically valid survey of resident opinions about their community and the services provided by local government. The National Research Center has a database of survey results from more than 500 jurisdictions throughout the country. This is the only survey administered with a database of that size and therefore our results can be compared to other jurisdictions. The City of Ashland wants to evaluate how Ashland "measures up" when compared to other communities. Background: The City conducts a citizen survey every other year using the National Citizen Survey. Form #7 - Sole Source -Personal Services - Less than $15,000, Page 1 of 2, 9/15/2014 Findings: fThe findings below must include factual information supporting the determinationj_ Market Research Overall finding: As stated above, the National Citizen Survey is the only survey administered with a database of that size and therefore our results can be compared to other jurisdictions. L n accordance with ORS 279B. 075. these are the examples oLfindings that should be addressed Select at least one of the findings and prepare the determination as it specifically relates to the good or service being procured. More than one finding can be addressed The findings are as follows. Pursuant to ORS 279B.075 (2)(a): Provide findings supporting your determination that the efficient utilization of existing goods requires the acquisition of compatible goods or services from only one source. The National Citizen Survey is the only survey administered with a database of that size and therefore our results can be compared to other jurisdictions. Pursuant to ORS 279B.075 (2)(b): Provide findings supporting your determination that the goods or services required for the exchange of software or data with other public or private agencies are available from only one source. The National Citizen Survey is the only survey administered with a database of that size and therefore our results can be compared to other jurisdictions. Pursuant to ORS 279B.075 (2)(c): Provide findings supporting your determination that the goods or services are for use in a pilot or an experimental project. N/A Pursuant to ORS 279B.075 (2)(d): Any other findings that support the conclusion that the goods or services are available from only one source. Stated above. Form #7 - Sole Source -Personal Services - Less than $75,000, Page 2 of 2, 911512014