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Home My WebLink About2014-258 Agrmt - Integrity Pest & Home Repair Integrity Pest & Home Repair a o I «r'est/Termite Control -Bird Control -Home Repair Randy Baldwin Owner/Operator 541-613-7311 www.medfordpest.com 548 Hogan Ave, Meford, Oregon 97504 rbaldwin03O3@gmA.com Oregon CCB License #195036 Pesticide License #AG-L 1018497cpo 541-613-7311 License # AG-L1018497CPO Pest Control Agreement Purchaser t'P First Name Last name Address c State 'Zip Code Phone E-mail Pest to be covered: Ants Mice Ticks Carpenter Ants Rats Wasp Fleas Earwigs Yellowjackets Service Frequency: Quarterly Bi-Monthly One-Time Summary of Charges: One-Time Charge Initial Charge $ Regular Charge $ Discounts $ Total Annual Amount $ Method of payment: Check Cash Integrity Pest Representative i i. r Purchaser " kT yM Page 1 / 1 ASHLAND PARK COMMISSION 20 E MAIN ST. DATE FPO NUMBER ASHLAND, OR 97520 9/18/2014 00397 (541) 488-5300 VENDOR: 004103 SHIP TO: INTEGRITY PEST & HOME REPAIR 548 HOGAN AVENUE MEDFORD, OR 97504 FOB Point: Req. No.: Terms: net Dept.: Req. Del. Date: Contact: Bruce Dickens Special Inst: Confirming? NO Quantity Unit Description Unit Price Ext. Price 1.00 Each Pest Elimination 125.00 125.00 Parks Office (jd~ 340 S.Pioneer Street Exclusion Work 1.00 Each Initial Work 125.00 125.00 4.00 QTR Quarterly service for elimination of 85.00 340.00 pests and vermin per attached agreement. At this time, only planninq to use "snap traps" due to Parks limited ability to use chemicals in the parks. SUBTOTAL 590.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 590.00 Account Number Project Number Amount Account Number Project Number Amount E 211.12.02.01.60410 590.00 Authorize(d Signature VENDOR COPY C FOFM#3 CITY OF T~ p~~6qLllesii for Purchase Order AS H LAN D REQUISITION Date of request: 9/15/14 Required date for delivery: Vendor Name RandV RAdwin' r)wnar / nperatnr Address, City, State, Zip Integrity Pest and Home Repair, wwww.medfordpest.com / rbaldwin03O3OQmail com / 541-613-7311 Contact Name & Telephone Number Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergencx ❑ 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 ❑ (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 Pest elimination at Parks and Recreation office, 340 S. Pioneer Street, Ashland Item # Quantity Unit Description of MATERIALS Unit Price Total Cost $ 1 1 each Exclusion work 2A- 2 1 each Initial work $125.00 $125.00 3 .10 - 12 a Monthly checkup for elimination of pests and vermin $85.00 0A0- ® Per attached quotelproposal TOTAL COST Project Number---------- Account Number - 211 12 - _02- 01 6041& Account Number---.--. - Account Number___-__-__-__-______ - - - - *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support -Yes /No By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. Employee: _<~D(Qt(/6 Department Head: 21/p/ / (Equal to or greater than $5,000) Department Manager/Supervisor:` v City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year: NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition