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HomeMy WebLinkAbout2014-291 Contract - Pacific Mobile Structures Inc Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: Pacific Mobile Structures -AS H LAND CONTACT: Ron Young 20 East Main Street Ashland, Oregon 97520 ADDRESS: 13970 Fir St. Oregon City, OR 97045 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 503-722-2998 DATE AGREEMENT PREPARED: 10-28-2014 FAX: 503-722-2988 BEGINNING DATE: 11-3-2014 COMPLETION DATE: 03-17-2015 COMPENSATION: Not to exceed $6,500 GOODS AND SERVICES TO BE PROVIDED: 8'x20' and 8'x30' mobile office rental including delivery, setup, tear down, pickup, and PPT ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and 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 primary City of Ashland Contract. 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 27913.220, 2796.225, 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 b City under an of the following Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 1 of 5 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 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: NA 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. Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 2 of 5 d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its 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 reference. Contractor: City of Ashlan By By Signature Department Head Print Name Print Name CFO d-e) Title ate W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. AFB V~5D AS ITO FORM ty Attorney Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 3 of 5 D8 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. ,ruJurts -ac, 10 J.-)'q Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 4 of 5 CITY OF ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGE • . • per hour effective June 30, 2014 (Increases annually every June 30 by the ~r Consumer Price Index) portion of business of their 401 K and IRS eligible employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. ➢ For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: "Employee" does not employer and the City of $20,142.20. include temporary or part-time Ashland if the contract employees hired for less than exceeds $20,142.20 or more. ➢ If their employer is the City of 1040 hours in any twelve- Ashland including the Parks month period. For more ➢ For all hours worked in a and Recreation Department. details on applicability of this month if the employee spends policy, please see Ashland employee's or more of the ➢ In calculating the living wage, Municipal Code Section employee's time in that month employers may add the value 3.12.020. working on a project or of health care, retirement, For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 5 of 5 n- Ron Young RENTAL QUOTE: 94664 PACIFiC Portland SalespersoonBranch : Ro Email: ron@pacificmobile.com Date: 1012312014 • ' ' Phone: (503) 722-2998 Renter: City of Ashland Location: Address: 20 East Main Street Address: 95 Winburn Way Ashland, OR 97520 Ashland, OR 97520 Name: Lonny Flora Contact: Lonny Flora County: Jackson Phone: 541-552-2250 Fax: Phone: 541-562-2250 Tax Rate 0.00% Email: floral@ashland.or.us PO: Phone 2: Check if Exempt ❑ Rental info: * Check Desired Units and Items) 38662 38762 38670 "l if e Wit UNIT 1 ❑ 97074 ❑ 05032 Lease Term: 6 months Bldg Size: 8x24 08x20 08x30 1 i 3 - ~47 1 7/,,>~Addt1I Info: c ,tip. 11-3 - /A/ (IUI - Monthly, 1 pe or divided in half' r , S = tartup, E = End of Term) Term i:'' /5 Rental Rate 6 months of rent M $:1,134.00 $990.00 $1,260.00 OSHA Steps Included M $0.00 $0.00 $0.00 Delivery Freight S $895.00 $895.00 $895.00 Return Freight ;E $895.00 $895;00 $895.00 Std, Setup S $60.00 $60.00 $65.00 Std. Breakdown E $60.00 $60.00 $65.00 Additional Items.:.* ( c~Check Desired Options) Term Amount Qty A urt -ft ou NW FAMILY OWNED ❑ ❑ ❑ Calendar Month Billing, not every 4 weeks- ❑ ❑ ❑ Returns after lease period prorated to the day ❑ ❑ Dead Bolts S ❑ 1 $0.00 1 $0.00 19 2 $0.00 Sec Bars - Window M' ❑ 3 $0.00 3 $0.00 ❑ 4 $0.00 Plan Table(s) M ❑ 1 0.00 ❑ 1 $0.00 ❑ 1 $0.00 Counter File M ❑ 1 A0 IZI 1 $0.00 2 $0.00 Personal Property Taxes M ❑ 6 $48\00 ❑ '6 $33.00 ❑ 6 $54.00 File Cabinets - 2 Dwr Letter M ❑ 1 $0.~Q 21 1 $0.00 2 $0.00 Full maintenance except cleaning ❑ Ell I ❑ HVAC filters & light biubs ❑ 1 IN ❑ 1101 ❑ o 101 1 Property Damage Waiver Option (per month) 11131 $103.00, ❑ $90.00 ❑ $114.00 Property Damage Waiver Option (see above). Helps you control costs by limiting your property damage liability. See Terms and Conditions on following page. Electing this option DOES NOT relieve Customer of general liability protection requirements set forth in the "insurance" paragraph on the following page: Customers who fail to produce the required property insurance coverage certificate are automatically opted into the Property Damage Waiver Program until proof is presented. 'Pricing does not include applicable sales tax, personal property tax, pilot cars and special permits if required. Quote is good for 30 days and Limited to availability of stock on hand. Quote #94664 Acceptance: Si ned b Signed by: Pack Mobile structures, Inc. Omso Customer Authorized Representative Date:......... Date: By signing above, customer is authorizing Pacific Mobile to process the order for the selected equipment and services upon approval of credit. This authorization will convert quotation into an Operating Lease Agreement bound by"the Terms and Condition on Page Two (2) of this quotation. An Order Confirmation will be sent to the designated e-mail address on file. Page 1 of 2 Client#: 704959 PACIFMOB DATE (MM/DD/YYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 10/30/2014 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 CONTACT NAME: USI Northwest CL1 PHONE 503 224-8390 FAx 610 362-8130 700 NE Multnomah, Suite 1300 -MANo, Ext : AIC, No ADDRESS: angela.christiansen@usi.biz Portland, OR 97232 INSURER(S) AFFORDING COVERAGE NAIC # 503 224-8390 INSURER A : American Economy Insurance Comp 19690 INSURED INSURER B: American Insurance Company 21857 Pacific Mobile Structures Inc INSURER C: Liberty Northwest Insurance Cor 41939 P.O. Box 1404 INSURER D : 1554 Bishop Rd. Chehalis, WA 98532 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, EXCLUSION'S AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DDIYYW MMIDD/YYYY A GENERAL LIABILITY OIC13183905 1/31/2014 01/311201 EACH OCCURRENCE $110001000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $200,000 CLAIMS-MADE I-XI OCCUR MED EXP (Any one person) $10,000 X WA Stop Gap $1 MM PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO X LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident B X UMBRELLA LIAB X OCCUR SU048773568 1/31/2014 01/311201 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED RETENTION $ $ JOTH- FIR C WORKERS COMPENSATION WC41NCO18531 1/31/2014 01/31/201 X WCSTATU- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N E.L. EACH ACCIDENT $1,000,000 OFFICERWEMBER EXCLUDED? LN N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1$19000,000 A Installation 01C13183905 1131/2014 01/31/201 $1,000,000 $1,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Ashland, Oregon, and its elected officials, officers and employees are additional insured as respects the operations of the named insured. CERTIFICATE HOLDER CANCELLATION Lilt of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S13630138/M11649285 ADCJT PACIF35 OP ID: RS ACOROS CERTIFICATE OF LIABILITY INSURANCE 01/ /14/214/2 DATE10114 4 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 . CONTACT PRODUCER Phone: 360-736-7601 NAME: Nicholson & Associates Fax: 360-330-0970 PHONE FAX 118 W. Pine Street A/C No E:t : A/c No): Centralia, WA 98531-4290 E-MAIL Todd Working ADDRESS: INSURER(S) AFFORDING COVERAGE _ NAIC # INSURER A: American States Insurance Co. 19704_ INSURED Pacific Mobile Structures, Inc INSURER B: Attn: Nick Ververis P.O. Box 1404 INSURER C : Chehalis, WA 98532 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 DDL UBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ DAMA E TO 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 PRO- LOC- $ AUTOMOBILE LIABILITY EOa BIKED SINGLE LIMIT $ 1,000,00 A JX ANY AUTO X 01C13162925 01/31/2014 01/31/2015 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS NAUTOS ON-OVvNED PROPERTY DAMAGE $ 1,000,00 HIRED AUTOS AUTOS Per accident $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Ashland, Oregon, and its elected officials, officers and employees as additional insured with respects to auto liability. Coverage is primary and non contributory. Job located at 95 Winburn Way Ashland, OR 97520 CERTIFICATE HOLDER CANCELLATION CITY069 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD A ~ ~ mni: Page 1 / 1 ASHLAND PARK COMMISSION 20 E MAIN ST. DATE PO NUMBER ASHLAND, OR 97520 10/30/2014 00406 (541) 488-5300 VENDOR: 004545 SHIP TO: PACIFIC MOBILE STRUCTURES INC PO BOX 1404 CHEHALIS, WA 98532 FOB Point: Req. No.: Terms: net Dept.: Req. Del. Date: contact: Rachel Dials - Lonny Flora Special Inst: Confirming? NO Quantity Unit Description Unit Price Ext. Price Mobile Structure Rentals - (4) Months 6,500.00 Not to exceed $6,500.00 Total cost PER EMAIL dated 09/2612014 Unit 08x20 - $2,600.00 (4 months) Unit 08x30 - $2,786.00 (4 months) Note: Attached quote is for 6-MONTH rental. Contract for Goods and Services Beginninq date: 11103/2014 Completion date: 03/17/2015 SUBTOTAL 6.500.00, BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 6,500.00 Account Number Project Number Amount Account Number Project Number Amount E 211.12.03.02.60691 6,500.00 /U 3( / r Auth zed Signature VENDOR COPY FORM #3 C I T Y OF foi' a Pu>a't:;hzt~o Ol`de'i' ASHLAND REQUISITION Date of request: /D - Required date for delivery: Per I L M r 1 P Sfft~ r..cr(' c Vendor Name Address, City, State, Zip f 3'77a f i 5 2 e9r-eqra Contact Name & Telephone Number f-~C, r1 yb anrR IV n 1t ,11 yy/ c'r r 5 ay- ? Fax Number J 7 _ S"S SOURCING METHOD Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement COOAeratiye 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 S5.000 to S1100,000 ❑ Written quote or proposal attached Agency (3) Written quotes and solicitation attached C1 Form #4, Personal Services $5K to $75K Contract # PE SONAL 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 proposalsAvditen solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost ,c ~G`i' 8"x 30' 20b~%Z° O r c~ 1 r^i'n ~qd !f/C2 fv axe Pr' rnGfr.<~i r1 GilFl f~rY, r~i'lt~tr tPar'cx4tcr~2 ~iC, rC Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal Project Number Account Number - 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 Direct Oate S p -Yes /No By signing this requisition form,) certify that the City's public contracting requirements have been satisfied. Employee; tJ`~ Department Head: (Equal to or greater than $5,000) Department Manager/Supervisor. U City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year: YES / NO Finance Director- (Equal to orgreater than $5,000) Date Comments: Form #3 - Requlsition ' Kari Olson From: Rachel Dials [dialsr@ashland.or.us] Sent: Thursday, October 30, 2014 1:31 PM To: 'Karl Olson' Subject: Ice Rlnk Trailer Account Code Account Code 21i.12.'53.02.606918 Ice Rink Thank you Rachel Dials Recreation Superintendent Ashland Parks and Recreation rachel.dialsnashland.or.us www.ashlandparksandrec.org 541-488-5340 LIKE us 91 1 Lonny Flora From: Amy Hartnell [Amyj@pacificmobile.com] Sent: Friday, September 26, 2014 12:52 PM To: Ionny.flora@ashland.or. us Cc: Ron Young Subject: Mobile Office Quotes from Pacific Mobile Hi Lonny, As requested I have listed the entire cost for the two mobile offices you are looking at renting from us. 8x20 Mobile 8x30 Mobile Ashland Parks & Recreation Office Office Total Cost for 4 month Rental $2,600.00 $2,786.00 Should you have any questions or concerns please let us know. Thank you, Amy Hartnell /Senior Leasing Coordinator Pacific Mobile Structures, Inc. -13970 Fir Street Oregon City, OR 97045 P 503.722.2998 D 971.233.0226 F 503.722.2988 W pacificmobile.com PACIFIC :MOBILE STRUC PAGE 07/07 10/29/2014 15:01 5037222988 f PACIFi o a allesespnderson;.Bta Ro o n Young RENTAL QUOTE: 94664 Email: rdn@pacttiomobite.com date; 10123/2014 ' • Phone,- (503) 722-2998 Renter. City of Ashland Location: Addneaw 20 East!ulain•Street Address: 95 :Winburn Way- Ashland,. OR 97520 ,Ash iind,:Ok 9.7`5;20 Name: Lonny 51ora opmet: Lonny Fiara, county: Jackson ' Phon* ; 641,452:2290 Fax: Pholia: 841-M2460 TeX Rate 0.00%, Etnali;°t7QfAR- 019nd.-O to F?Q:. eh6na,z.. , -:Ctr'eck'Yeemftt n. ROn- --al-1010 * (OCheck Drifted Untie and !tents) 38662 36762 38670 UNIT 9 97074 05032 Lease Term: 8 months Bldg Size: 8x24 0:3x20 0840 # J o >~17 /,5Aadt'i Info: '-fcr:4 it r.. M Monthly; S= taltup, S= End of Term)jp= . Pe or dlvlydPd in halt r Rental.Rate 6months ofmnt M $'1,134,0.0 $490.00 $1,260,OQ. OSHA Steps i m 0.00 $0.00 $0.00 Delivery Freight 5 $695.00 $895,00 MUD Retutn Freight $895,00 3895400 $895:00 Std, Setup S $00.00' $60.00 $65,00 $1d. Rrettkdown R 1 $60.00 $60.00 $65.00 dditignelAj s'.!(elCheak Desired Opitons) erm Oty A t ~y[t Amount Q,W A,~rio„~ NW FAMILY OWNED Ell I--\ 12 1 t3alendar Month 8111ing, not every 4 weeks Ell 0 Returns after lease period prorated to the day 0 [IT- I Dead Bolts 8- 1 1 $0.00• 1 $0.00 2 $0,00 Sea Bars -Window m 3 s0.00 3 $0:00 4 $0.00 Plan Table(s) M 1 0.00 1 $0,©0 1 $0.0.0 .Counter Fite M Ell 1 ,00 1 $0.06 2 $0,00 Pet§onal Property Taxes m ❑ 6 $4 00 Q' 6 $33,00 6 $$54.00 File Cabinets - 2 Dwr Letter M 1 $0. 0 1 $0,00 19 2 $0,00 Full maintenance except cleaning HVAC fffters & light blubs Ell Pte erty D) mage Waivor Option (per month) $103,OQ $90.0'Q Il $114,0Q Proporty'Damapo Walver Option (sea above). Helps you control costa-by limiting your property damn9e:lability, See Terms and Condiilons on following page. Elating this option ODES Nor rollava custemor of ganomi lipbrtty prnteovo;% mqulremonts set forth in iho `insurance psraaraph on the rollow)ng page; Cusiamets who felt to produce the mqu(md property lnsurance•coverage mrlllicatwore automatically opted Into the Proporty Damage Walver Pragram until proof is presented. Tddng does nol rrsduds appoabta Wox tax, personal pmpaeq uur, plot =2 end sperlot parmlis if ocipired. duoto to good WOO days and Fri ad to availibrltyat stark on hens. -le #94664 ACCepiarlce; Sfgned,by: Signed by: PacKc MD611o Strictures, Inc. (PA4SI) CustamerAuthatized•Rtpt~s W WOi Date; . Date: By s?gntng above, austamcr to aulhotizing Paattic M1tot)Ae fi proceas'Ihe olcar for the ~oleeted equipment and f4rvlcaa upon approves of er&dii, 7h)s authorlml!on wtl convert quomGon Inks an Operating leoso Agleermnl tmund by the Temr,, and Condition Dn Pegb Two (2) of hits quolAtion. M Order CWiirmatlon will ba sort to tho dosignaled amali address an fig, Page 1 of 2