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Home My WebLink About2014-317 Contract - Butterfield Originals Contract for GOODS AND SERVICES Small Procurement Less than $5,000 CITY OF INDEPENDENT CONTRACTOR: Butterfield Originals -ASHLAND 20 East Main Street CONTACT: Roger Butterfield Ashland, Oregon 97520 Telephone: 541/488-6002 ADDRESS: 215 Tolman Ck. Rd. #36 Ashland, OR 97520 Fax: 541/488-5311 TELEPHONE: 541-840-2055 FAX: BEGINNING DATE: 12-20-2014 COMPLETION DATE: 12-20-2014 COMPENSATION: $900 GOODS AND SERVICES TO BE PROVIDED: Transportation, set up, and ice sculpting performance of Kundalini Transmission during First Frost event at the Ashland Rotary Centennial In the event of conflicts or discrepancies among Contract Documents, this standard form of the City of Ashland Contract 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 this standard form 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. Ownership of Production: All documents, materials or items produced by Contractor pursuant to this contract shall be the property of City. 4. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 2798.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 5. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from those losses, expenses, or other damages resulting from injury to any person or damage to property arising out of or incident to the negligent performance of this contract by Contractor its employees, or agents. Contractor shall not be held responsible for any losses, expenses, or other damages, directly, solely, and proximately caused by the negligence of City. 6. Termination: City's Convenience. This contract may be terminated at any time by the City. 7. 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. 8. 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. 9. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 10. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work. 11. 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. 12. 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. 13. Insurance. Contractor shall at its own expense provide the following insurance: a. 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. Worker's compensation insurance is required if work is performed by employees, subcontractors, or volunteers. BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES UNDER PENA TY OF LAW THAT THE WORK REQUIRED BY THIS CONTRACT SHALL BE PERFORMED SOLELY BY THE UNDERSIGNED: ; b. General Liability insurance with a combined single limit, or the equivalent, of not less than $500,000 for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contra,~ C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $50,000 for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. 14. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon 15. 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. Certification. Co r shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Contr to City of Ashland: By By Sig ture Department Head } Print Name Print Name 0 115~i ! Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. APP - D AS TO P0RM WRIPIP3 an ZffZ~ coney A6hli?At-,i Revised 10-28-14 Page 1 of 2 Dato- t fg 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 c t 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. Con ctor (Date) Revised 10-28-14 Page 2 of 2 11/07/2014 11:25 5414884215 PAUL VOLZ INS PAGE 02/02 ® DATE(MMroDNYYY) Ac"RU CERTIFICATE OF LIABILITY INSURANCE F,1/7/2014 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 pol-Icy(ias) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conciltions of the policy, certain pollcle9 may require an endorsement. A statement an this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER TO)MM NAME; PAUL VOLZ INSURANCE AGENCY INC PHONE (541)482-8463 C Nop(541) 488-4215 450 Siskiyou Blvd Ste 5 ADDRESS;PaUl@pauJ-volzinsuranoe. Ashland, OR 97520 INSURERIB) AFFORDING COVERAGE NAICtl INSURER A : Cont:ractOFa Bonding and Ynaurancc Company INSURED Roger Butterfield INSURER B ; Butterfield Originals , Inc. INSURER C: 215 Tolman Creek Road #36 INSURER D,. Ashland, OR 97520 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 70 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. r~TR TYPE OF INSURANCE Ne0 WVD POLICY NUMBER MM F MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 CLAIMS-MADE I I OCCUR PREMISES Ea occurrence $ 300,000 -7 D12PO7668 11/4/2014 11/4/2015 MEDEXP Any ono person) S 5,000 A PERSONAL aADVINJURY $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE S 500,000 POLICY CI JET CI LOC PRODUCTS- COMP/OP AGG $ 500 , 000 OTHER: $ AUTOMOBILE LIABILITY O accident $ ANYAUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ AMA E $ PROPER HIRED AUTOS NON-OWNED AUTOS Per accldant UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB GLAIMS-MADE AGGREGATE $ DED RETENTION $ is WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETORMARTNMEXECUnVP E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ N/A (Mgnaato,y In NH) E.L. DISEASE - EA EMPLOYE , $ If yyeasunder DtGRIPT10N OF OPERATIONS bylaw E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional RameMs Schedule, may be ottached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Parka and Rees Dept. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED' IN ACCORDANCE WITH THE POLICY PROVISIONS. 340 Pioneer St:. Ashland, OR 97520 AUTHORIZED RESENT ®1888-2014 ACORD C ION. All rights re 'erved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD From: Ashland Office #1 Fax: To: +15414885314 Fax: +15414885314 Page 3 of s5 121111712001I 14/2:14` Ashland Insurance, Inc. AR99RLIM PO BOX 880 0RIIIE%nsurance ASHLAND, OR 97520 NA(C Company Code: 42994 Policy Number: 71734350 Underwritten by: Progressive Classic Insurance Co Policyholder: Roger Butterfield Page 1 of 1 December 17, 2014 Ashland Insurance, Inc. 1-541-482-0831 Contactyour agentfor personalized service. Customer Service 1-800-876-5581 Verification of Insurance for 24 hours a day, 7 days a week Roger Butterfield This verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contractor other document with respect to which this verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of the policies. Please accept this letter as verification of insurance for this policy. Policy and driver information Policy number: 71734350 Policy state: Oregon Policy period: Jul 16, 2014 - Jan 16, 2015 There was no lapse in coverage during this policy period. Effective date: Dec 8, 2014 Drivers: Roger Butterfield Insured Driver Address: 215 Tolman Creek Rd #36 Ashland, OR 97520 Vehicle information Vehicle: 1989 Chevrolet C1500/K1500 Vehicle identification number: 1 GCDC1 4K5KZ1 770 54 Coverage information Bodily Injury Liability: $50,000 each person/$100,000 each accident Property Damage Liability: $50,000 each accident Collision: Deductible: No Coverage Comprehensive: Deductible: No Coverage Personal Injury Protection: $25,000 Form VC3 (07/13) From: Ashland Office #1 Fax: To: +15414885314 Fax: +15414885314 Page 4 of 5 1211712014 2:14 Ashland Insurance, Inc. PROME1 MAE~ PO BOX 880 OR/YE /nsuiance ASHLAND, OR 97520 NAZ Company Code: 42994 Policy Number: 71734350 Underwritten by: Progressive Classic Insurance Co Policyholder: Roger Butterfield Page 1 of 1 December 17, 2014 Ashland Insurance, Inc. 1-541-482-0831 Contactyour agentfor personalized service. Customer Service 1-800-876-5581 Verification of Insurance for 24 hours a day, 7 days a week Roger Butterfield This verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of the policies. Please accept this letter as verification of insurance for this policy. Policy and driver information Policy number: 71734350 Policy state: Oregon Policy period: Jul 16, 2014 - Jan 16, 2015 There was no lapse in coverage during this policy period. Effective date: Dec 8, 2014 Drivers: Roger Butterfield Insured Driver Address: 215 Tolman Creek Rd #36 Ashland, OR 97520 Vehicle information Vehicle: 1999 Ford Explorer Vehicle identification number: 1 FMZU34X5XUB99386 Coverage information Bodily Injury Liability: $50,000 each persorA100,000 each accident Property Damage Liability: $50,000 each accident Collision: Deductible: $500 deductible Comprehensive: Deductible: $250 deductible Personal Injury Protection: $25,000 Form V01 (07/13) From: Ashland Office #1 Fax: To: +15414885314 Fax: +15414885314 Page 5 of 5 12/1712014 2:14 Ashland Insurance, Inc. PROIsREMIME" PO BOX 880 ORIYE 11MA9nce ASHLAND, OR 97520 NAZ Company Code: 42994 Policy Number: 71734350 Underwritten by: Progressive Classic Insurance Co Policyholder: Roger Butterfield Page 1 of 1 December 17, 2014 Ashland Insurance, Inc. 1-541-482-0831 Contactyour agentfor personalized service. Customer Service 1-800-876-5581 Verification of Insurance for 24 hours a day, 7 days a week Roger Butterfield This verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of the policies. Please accept this letter as verification of insurance for this policy. Policy and driver information Policy number: 71734350 Policy state: Oregon Policy period: Jul 16, 2014 - Jan 16, 2015 There was no lapse in coverage during this policy period. Effective date: Dec 8, 2014 Drivers: Roger Butterfield Insured Driver Address: 215 Tolman Creek Rd #36 Ashland, OR 97520 Vehicle information Vehicle: 2001 Isuzu Trooper Vehicle identification number: JACDJ58XX17JO308 Coverage information Bodily Injury Liability: $50,000 each perso0100,000 each accident Property Damage Liability: $50,000 each accident Collision: Deductible: $500 deductible Comprehensive: Deductible: $250 deductible Personal Injury Protection: $25,000 Form V01 (07/13) PROPOSAL. NO. CR, Q SHEET NO. Llaao DATE ~Q (~f PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT. I T ~ a ADDRESS t .NAME r ADDRESS ~~qq DATE OF PLANS PHONE NO. Masao ARGWEff I We hereby propose to furnish the materials and perform the labor necessary for the completion of er etLCI~ ~ V A i~S N1 l SSIO ~ ~ A c t c,J r All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum o 2j000- with payments to be made as follows. Dollars Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge Respectfully over and above the estimate. All agreements contingent upon strikes, submitted accidents, or delays beyond our control. Per Note - this proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications, and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Signature Date Signature fee ed w D8118 3-12 f~ ti t ; 1 r f ti yh ti~ IN ~i i ca ~;,►i Page 1 / 1 ASHLAND PARK COMMISSION 20 E MAIN ST. DATE PO NUMBER ASHLAND, OR 97520 12/23/2014 00420 (541) 488-5300 VENDOR: 004327 SHIP TO: BUTTERFIELD, ROGER 215 TOLMAN CREEK ROAD #36 ASHLAND, OR 97520 FOB Point: Ashland, Oreqon Req. No.: Terms: net Dept.: Req. Del. Date: contact: Rachel Dials - Lonny Flora Special Inst: Confirming? No Quantity Unit Description Unit Price Ext. Price Ice Sculptinq Performance for Special 900.00 Event Contract for Goods and Services Small Procurement Less than $5,000 Beqinninq date: 12/20/2014 Completion date: 12/20/2014 SUBTOTAL 900.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 900.00 Account Number Project Number Amount Account Number Project Number Amount E 211.12.03.02.60691 E 000007.999 900.00 ~L VENDOR Authoriz Signa ure/S~ COPY 6~ FORM #3 CITY OF ASHLAND _1T f la L' REQUISITION Date of request: `12 Ate''"/tf Required date for delivery: Vendor Name t' _ Address, City, State, Zip 27$ 5 ! /"f f r, 0 C_ A" ) CT 47-, t, A,,f k Br_s7 Contact Name & Telephone Number Fax Number v 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 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 El Special Procurement Intergovernmental Agreement $5.000 to $75.000 ❑ Agency ❑ Form #g, Request for Approval ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Written proposals/written solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost ,e'8 c~ V65 $ 00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ Project Number 676.Z - q q_q Account Number s - t2 -t> -C12- - TJ1_9B. _ " 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, / certify that the City's public contracting requirements have been satisfied. Employee: Department Head: ~yI- / j` p~ (Equal to or greater than $5,000) Department ManagerlSupervisor: IA/rf~•ll/"a.~a,$''' City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year YES / NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition