HomeMy WebLinkAbout2015-047 Contract - Don Ferguson
CITY OF I
-ASH LAND INDEPENDENT CONTRACTOR: DOdv F~4i~S O /O
20 East Main Street CONTACT: Dori -ice 4 SON
Ashland, Oregon 97520 ADDRESS: q- 1v NHM ST
~Sk l,,,y/C! 0Q X ?76 2_6
Department: Fire Department
Telephone: 541/482-2770 TELEPHONE:5 qt 778 )6?9 FAX:
PROJECT CAPTION: Facilitation Services: Wildfire Mitigation Commission Meeting
BEGINNING DATE: 2/17/2015 COMPLETION DATE: March 5'" 2015
COMPENSATION: $50.00 per hour not to exceed a total of $500
GOODS OR SERVICES TO BE PROVIDED: Contractor will facilitate a four hour meeting on March 4th preceded by one or two planning sessions
with City staff to establish the meeting agenda, background information, expectations, and roles. Purpose is to establish a timeline and outline for an
update of the City's Community Wildfire Protection Plan, or CWPP.
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, 27913.230, 27913.235, 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. Contractor certifies the accuracy of the representations in attached Exhibit A.
8. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license.
9. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work.
10. 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.
11. Workers' Compensation Insurance: BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES THAT THE WORK REQUIRED
BY THIS CONTRACT WILL BE PERFORMED SOLELY BY THE UNDERSIGNED AND NOT BY ANY EMPLOYEES,
SUBCONTRACTORS OR VOLUNTEERS SUBJECT TO WORKERS' COMPENSATION COVERAGE UNDER ORS 656.017:
12. Liability Insurance. Contractor shall at its own expense provide the following insurance:
a. General Liability insurance with a combined single limit, or the equivalent, of not less than $_NA for each occurrence for
Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
b. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $ 3 Sy, 000. 60 for each accident for
Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable.
13. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon.
14. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO
WAIVER, CONSENT OR MODIFICATION OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND
SIGNED BY BOTH PARTIES. IN THE EVENT OF CONFLICTS OR DISCREPANCIES AMONG CONTRACT DOCUMENTS, THIS
STANDARD FORM 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 SIGNED DOCUMENT.
Contracto : City of Ashland:
By +G V By
Signature Signature ~ uS or~1 (Y+v ~;-'S
Print Name Print Name
SOLE ~~0(t - -IT-
Title Date
W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. w2
APP 1/ED S TO ORM
11
lAshIMM1W ttomey
Dart- 2 -'-7- 1 S~
Page 1 of 2 Contract for Goods and Services - Small Procurement Less than $5,000 - LR Revised 2-13-15
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 noted 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.
I~ (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.
1
Contractor (Da of )
Page 2 of 2 Contract for Goods and Services - Small Procurement Less than $6,000 - LR Revised 2-13-15
Community Wildfire Protection Plan (CWPP) Development Facilitation
Contract Proposal
I propose to act as meeting facilitator for a four-hour workshop hosted by the City on
March 4, 2015 to establish a timeline and outline for an update of the City's Community
Wildfire Protection Plan.
I estimate that there will be approximately two meetings with Ashland Fire and Rescue
and the Wildfire Mitigation Commission in advance of the workshop to establish the
meeting agenda, background information, expectations, and roles, also requiring my
services as facilitator.
The maximum time I will bill under this proposal is eight hours. My fee for this service
would be $50.00/hour, for a maximum cost to the City of $500.00.
Thank you for considering this proposal.
Don Ferguson
Page 1 / 1
CITY i/OAF T Ll"1.1~1 ~ r >o ~ PO NUMBER
ASHLAND 20 E MAIN ST. 3/3/2015 12750
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 019276 SHIP To: Ashland Fire Department
FERGUSON, DON (541) 482-2770
440 HELMAN STREET 455 SISKIYOU BLVD
ASHLAND, OR 97520 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net Dept.:
Req. Del. Date: contact: Chris Chambers
Special Inst: Confirming? No
Quantity Unit Description Unit Price Ext. Price
Contractor to facilitate 4-hour meetinq 500.00
on March 4th preceded by one or two
planning sessions with City staff to
establish the meetinq aqenda,
expectations and roles.Purpose is to
establish a timeline and outline for an
update of the City's Community Wildfire
Protection Plan or CWPP.
Contract for Goods and Services - Small
Procurement Less than $5,000
Bepinninq date: 02/17/2015
Completion date: 03/05/2015
SUBTOTAL 500.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 500.00
ASHLAND, OR 97520
Account Number Project Number Amount Account Number Project Number Amount
E 670.07.29.00.60416 E 000442.400 500.00
AV,
Authoriz@YSignature VENDOR COPY
FORM #3 CITY OF
raque.~'l for a Purchase Order ASHLAND
REQUISITION Date of request: 2/24/2015
Required date for delivery: 3/3/2015
Vendor Name Don Ferguson
Address, City, State, Zip 440 Helman St. Ashland, OR 97520
Contact Name & Telephone Number Don Ferguson, (541) 778-2679
Fax Number
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 Inter-governmental 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
Contractor will facilitate a four hour meeting on March 4th preceded by one or two planning
sessions with City staff to establish the meeting agenda, background information, expectations, not to exceed $500
and roles. Purpose is to establish a timeline and outline for an update of the City's Community
Wildfire Protection Plan, or CWPP.
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
Ji ytiJL o~~o S TOTAL COST
❑ Per attached quotelproposal $500.00
Project Number 000442.400 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 Director Date Support -Yes /No
By signing this requisition form, 1 certify that the City's public contracting requirements have been satisfied.
Employee: Department Head:
(Equal to or greater than $5,000)
Department Manager/Supervisor: City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year. ES NO
Finance Director- Equal to or greater than $5,000) Date
~ivc /l!C ~-~/`"R~7L
Comments:
Form #3 - Requisition