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HomeMy WebLinkAbout2015-107 Contract - Gage-it Construction 78Contract for GOODS AND SERVICES Small Procurement Less than $5,000 CITY OF INDEPENDENT CONTRACTOR: Gage-it -ASHLAND 20 East Main Street CONTACT: Brian Bowman Ashland, Oregon 97520 ADDRESS: 4887 Airway Dr, Central Point, OR 97502 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: (541) 779-7007 FAX: BEGINNING DATE: 4/28/2015 COMPLETION DATE: 6/12/2015 COMPENSATION: $3069.00 SCOPE OF WORK: Price for 2 guardrail Anchors, 25 feet of 2A guardrail, AC removal for face of posts, includes vacuum excavation, traffic control 1 shift through flagging Intersection of Grandview Dr. and Wri hts Cr. GOODS AND SERVICES TO BE PROVIDED: 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, 279B.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 PENALTY ?F LAW THAT THE WORK REQUIRED BY THIS CONTRACT SHALL BE PERFORMED SOLELY BY THE UNDERSIGNED: f b. 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. C. 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. 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. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Contractor: City of Ashland: r i w} By Departure H r -Print,Name Pri t Na re r Title Date W-9 One copy of a W-9 is to be submitted ith the signed contract. Purchase Order No. Revised 10-28-14 Page 1 of 2 EXHIBIT A CERTIFICATIONWREPRESENTATIONS: 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. O 4 Labor or services are performed onl -~-=Lry pursuant to written contracts. t: b (5) Labor or services are performed for two or more different persons within a period of one year. E (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. Contr ctor (Date) Revised 10-28-14 Page 2 of 2 -+os'e"N GAGE01C OP ID: CDS i4'CI~,,,,,°.=RD~ CERTIFICATE OF LIABILITY INSURANCE ou15" 2 ' 015 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 endorsemen s . PRODUCER NAANT Cindy Sorensen United Risk Solutions, Inc. PHONE W- MW 541-245-1111 I FAX. Box 938 No 541-245-1112 Medford, OR 97501-0087 ADDRESS: cindy.sorensert@unitedrisk.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Western National Assurance Co 24465 INSURED Gage It Construction LLC INSURER B : SAIF Corporation P.O. Box 3483 Central Point, OR 97502-0018 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. LTR TYPE OF INSURANCE POLICY NUMBER N DVY`/YYY ExP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ _ 1,000,0001 A X COMMERCIAL GENERAL LIABILITY X CPP103830004 03!09/2015 03/09/2016 PREMISES Ea ommence_) $ 300,00 CLAIMS-MADE a OCCUR MED EXP (Any one person) $ 10, PERSONAL & ADV INJURY $ 1,000,0 GENERAL AGGREGATE $ 2,000,0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,0 -1 F-1 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMB I ED SINGLE LIMIT 1,000000 a accdent , A ANY AUTO CPP103829904 03/09/2015 03109/2016 BODILY INJURY (Per person) $ X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X AU OS NED P RAC is DAMAENT) GE $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00-0 A EXCESS LIAB CLAIMS-MADE UMB100639007 03/09/2015 03/0912016 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,060 $ WORKERS COMPENSATION WC STATU- X OTH- AND EMPLOYERS' LIABILITY LIMITS B ANY PROPRIETOR/PARTNER/EXECUTIVEY/N 756250 05101/2014 05/01/2015 E.L. EACH ACCIDENT $ 1,000,0 OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ 1,000,0 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,0 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, M more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C"'4- 19W.aA 4 - ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1• WNGL390310 COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Bodily Injury And Property Damage Liability • Non Owned Watercraft Up To 50 Feet 2 Property Damage Liability Elevators ............................................................................................................................3 Fire, Lightning, Explosion Or Sprinkler Leakage Exception ..................................................3 Borrowed Equipment ($25,000 Per Occurrence, $50,000 Aggregate, $2,500 Deductible Per Occurrence 3 Supplementary Payments -Amended Bail Bonds Up To $5,000 3 Loss of Earnings Up To $500/Day .........3 Who Is An Insured Amendments • Employee Bodily Injury To A Co-Employee 4 • Newly Formed Or Acquired Organizations For Up To 180 Days 4 Blanket Additional Insured - Vendors - As Required By Contract 4 • Blanket Additional Insured - Lessor Of Leased Equipment .................................................5 Blanket Additional Insured - Managers Or Lessors Of Premises .........................................5 Blanket Additional Insured - State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations 5 • Blanket Additional Insured - State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises .......................5 o Damage To Premises Rented To You - $300,000 5 N N O Medical Payments Increased Limit - $10,000 Or Amount Shown on Declarations 6 Conditions o • Knowledge of Accident, Claim, Suit Or Loss Amended ........................................................6 • Unintentional Failure To Disclose Hazards 6 Waiver of Subrogation .........................................................................................................6 Bodily Injury Redefined To Include Mental Anguish ..........................................................................6 Insured Contract Amended ..............................................................................................................6 Personal And Advertising Injury Redefined • Televised, Videotaped Or Electronic Publication ..................................................................6 WN GL 39 03 10 Includes copyrighted material of Insurance Services Office, with its permission Page 1 of 6 WNGL390310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. SECTION I - COVERAGES AMENDMENTS (5) "Bodily injury" or "property damage" arising out of COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY (a) The operation of machinery or equipment that is attached to, or part of, A. Non Owned Aircraft Or Watercraft a land vehicle that would qualify under Item 2. Exclusions, Paragraph g. is replaced by the the definition of "mobile equipment" if it following: were not subject to a compulsory or g: financial responsibility law or other g. Aircraft, Auto Or Watercraft motor vehicle insurance law in the state where it is licensed or principally "Bodily injury" or "property damage" arising out garaged; or of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or (b) The operation of any of the machinery watercraft owned or operated by or rented or or equipment listed in Paragraph f. (2) loaned to any insured. Use includes operation or f. (3) of the definition of "mobile and "loading or unloading". equipment". This exclusion applies even if the claims against B. Damage To Property Coverage Extensions any insured allege negligence or other wrongdoing in the supervision, hiring, Item 2. Exclusions, Paragraph j. is replaced by the employment, training or monitoring of others by following: that insured, if the "occurrence" which caused j. Damage To Property the "bodily injury" or "property damage" involved in the ownership, maintenance, use or "Property damage" to: entrustment to others of any aircraft, "auto" or (1) Property you own, rent, or occupy, including watercraft that is owned or operated by or any costs or expenses incurred by you, or rented or loaned to any insured. any other person, organization or entity, for This exclusion does not apply to: repair, replacement, enhancement, restoration or maintenance of such property (1) A watercraft while ashore on premises you for any reason, including prevention of injury own or rent; to a person or damage to another's (2) A watercraft you do not own that is: property; (a) Less than 50 feet long; and (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part (b) Not being used to carry persons or of those premises; property for a charge; This Subparagraph (2) applies to any (3) Property loaned to you; person, who with your expressed or implied (4) Personal property in the care, custody or consent, either uses or is responsible for the control of the insured; use of the watercraft; (5) That particular part of real property on which (3) Parking an "auto" on, or on the ways next to, you or any contractors or subcontractors premises you own or rent, provided the working directly or indirectly on your behalf "auto" is not owned by or rented or loaned to are performing operations, if the "property you or the insured; damage" arises out of those operations; or (4) Liability assumed under any "insured (6) That particular part of any property that contract" for the ownership, maintenance or must be restored, repaired or replaced use of aircraft or watercraft; or because "your work" was incorrectly performed on it. WN GL 39 03 10 Includes copyrighted material of Insurance Services Office, with its permission Page 2 of 6 WN GL 39 03 10 Paragraphs (1), (3) and (4) of this exclusion do not C. Damage To Premises Rented To You apply to "property damage" (other than damage by fire, lightning, explosion or sprinkler leakage) to Item 2. Exclusions, the last paragraph is replaced premises, including the contents of such premises, by the following: rented to you for a period of 7 or fewer consecutive Exclusions c. through n. do not apply to damage by days. A separate limit of insurance applies to fire, lightning, explosion or sprinkler leakage to Damage To Premises Rented To You as described premises while rented to you or temporarily in SECTION III - LIMITS OF INSURANCE. occupied by you with permission of the owner. A However, the provisions of this paragraph do not separate limit of insurance applies to this coverage apply if coverage for Damage To Premises Rented as described in Paragraph 6. of SECTION III - To You is excluded by endorsement. LIMITS OF INSURANCE. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, COVERAGE B - PERSONAL AND ADVERTISING rented or held for rental by you. INJURY LIABILITY Paragraphs (3) and (4) of this exclusion do not apply D. Personal And Advertising Injury to the use of elevators. Item 2. Exclusions is amended by replacing Paragraphs (3), (4), (5) and (6) of this exclusion do Sub-paragraphs b. and c. with the following: not apply to liability assumed under a sidetrack agreement. b. Material Published With Knowledge Of Falsity Paragraph (4) of this exclusion does not apply to "property damage" to borrowed equipment while not "Personal and advertising injury" arising out of being used to perform operations at the jobsite. oral, written, televised, videotaped or electronic Subject to Paragraph 2. of SECTION III -LIMITS publication of material, if done by or at the OF INSURANCE, the rules below fix the most we direction of the insured with knowledge of its will pay for "property damage" under this provision: falsity. (1) $25,000 any one "occurrence", regardless of the c. Material Published Prior To Policy Period number of persons or organizations who sustain "Personal and advertising injury" arising out of damages because of that "occurrence"; oral, written, televised, videotaped or electronic (2) $50,000 annual aggregate; and publication of material whose first publication took place before the beginning of the policy (3) We will pay only for damages in excess of period. $2,500 as a result of any one "occurrence", regardless of the number of persons or SUPPLEMENTARY PAYMENTS - COVERAGES A organizations who sustain damages because of AND B that "occurrence". We may, or if required by N law, pay all or any part of any deductible E. Supplementary Payments - Coverages A and B S amount, if applicable, to effect settlement of any Item 1. is amended by replacing Subparagraphs b. claim or "suit". Upon notice of our payment of a and d. with the following: deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. b. Up to $5,000 for cost of bail bonds required because Paragraph (6) of this exclusion does not apply to of accidents or traffic law violations arising out of the use of any vehicle to which the "property damage" included in the Bodily Injury Liability Coverage applies. We do "products-completed operations hazard". not have to furnish these bonds. ° The insurance provided for "property damage" from d. All reasonable expenses incurred by the insured the use of elevators and for "property damage" to at our request to assist us in the investigation or borrowed equipment is excess over any other valid defense of the claim or "suit", including actual and collectible property insurance (including any loss of earnings up to $500 a day because of deductible portion thereof) available to the insured time off from work. whether primary, excess, contingent or on any other basis. WN GL 39 03 10 Includes copyrighted material of Insurance Services Office, with its permission Page 3 of 6 WNGL390310 SECTION 11- WHO IS AN INSURED AMENDMENTS d. Repackaging, except when unpacked solely for the purpose of inspection, A. Employee Bodily Injury To A Co-Employee demonstration, testing, or the substitution of Paragraph 2. a. (1) is replaced by the following: parts under instructions from the manufacturer, and then repackaged in the (1) "Bodily injury" or "personal and advertising original container; injury": e. Any failure to make such inspections, (a) To you, to your partners or members (if you adjustments, tests or servicing as the are a partnership or joint venture), to your vendor has agreed to make or normally members (if you are a limited liability undertakes to make in the usual course of company), or to your other "volunteer business, in connection with the distribution workers" while performing duties related to or sale of the products; the conduct of your business; f. Demonstration, installation, servicing or (b) For which there is any obligation to share repair operations, except such operations damages with or repay someone else who performed at the vendor's premises in must pay damages because of the injury connection with the sale of the product; described in Paragraph (1) (a) above; or g. Products which, after distribution or sale by (c) Arising out of his or her providing or failing you, have been labeled or relabeled or used to provide professional health care services. as a container, part or ingredient of any B. Newly Acquired Organizations other thing or substance by or for the vendor; or Paragraph 3. a. is replaced by the following: h. "Bodily injury or "property damage" arising a. Coverage under this provision is afforded only out of the sole negligence of the vendor for until the 180th day after you acquire or form the its own acts or omissions or those of its organization or the end of the policy period, employees or anyone else acting on its whichever is earlier; behalf. However, this exclusion does not apply to: The following are added: (1) The exceptions contained in C. Blanket Additional Insured - Vendors - As Subparagraphs d. or f.; or Required By Contract (2) Such inspections, adjustments, tests or Section II - Who Is An Insured is amended to servicing as the vendor has agreed to include as an additional insured any person(s) or make or normally undertakes to make in organization(s) (referred to below as vendor) with the usual course of business, in whom you have agreed in a written contract, connection with the distribution or sale executed prior to loss, to name as an additional of the products. insured, but only with respect to "bodily injury" or "property damage" arising out . of "your products" 2. This Provision C. does not apply: which are distributed or sold in the regular course of a. To any insured person or organization from the vendor's business, subject to the following whom you have acquired such products, or additional exclusions: any ingredient, part or container, entering 1. The insurance afforded the vendor does not into, accompanying or containing such apply to: products; a. "Bodily injury" or "property damage" for b. To any vendor for which coverage as an which the vendor is obligated to pay additional insured specifically is scheduled damages by reason of the assumption of by endorsement; or liability in a contract or agreement. This c. When liability included within the exclusion does not apply to liability for "products-completed operations hazard" has damages that the vendor would have in the been excluded for such product either by the absence of the contract or agreement; provisions of the coverage part or by b. Any express warranty unauthorized by you; endorsement. c. Any physical or chemical change in the product made intentionally by the vendor; WN GL 39 03 10 Includes copyrighted material of Insurance Services office, with its permission Page 4 of 6 WNGL390310 D. Blanket Additional Insured - Lessor Of Leased 2. This insurance does not apply to: Equipment a. "Bodily injury", "property damage" or 1. Section II - Who Is An Insured is amended to "personal and advertising injury" arising out include as an additional insured any person or of operations performed for the federal organization from whom you lease equipment government, state or municipality; or AX. when you and such person or organization have b. "Bodily injury" or "property damage" agreed in writing in a contract or agreement, included within the "products-completed executed prior to loss, that such person or operations hazard". organization be added as an additional insured on your policy. Such person or organization is G. Blanket Additional Insured - State Or an insured only with respect to liability for "bodily Governmental Agency Or Subdivision Or injury", "property damage" or "personal and Political Subdivision - Permits Or Authorizations advertising injury" caused, in whole or in part, by Relating To Premises your maintenance, operation or use of Section II - Who Is An Insured is amended to equipment leased to you by such person or include as an insured any state or governmental organization. agency or subdivision or political subdivision with A person's or organization's status as an whom you have agreed in a written contract, additional insured under this endorsement ends executed prior to loss, to name as an additional when their contract or agreement with you for insured, subject to the following provision: such leased equipment ends. This insurance applies only with respect to the 2. With respect to the insurance afforded to these following hazards for which the state or additional insureds, this insurance does not governmental agency or subdivision or political apply to any ~,occurrence which takes place subdivision has issued a permit or authorization in connection with premises you own, rent or control after the equipment lease expires. and to which this insurance applies: E. Blanket Additional Insured - Managers Or 1. The existence, maintenance, repair, Lessors Of Premises construction, erection or removal of advertising Section II - Who Is An insured is amended to signs, awnings, canopies, cellar entrances, coal include as an insured any person or organization holes, driveways, manholes, marquees, hoist with whom you have agreed in a written contract, away openings, sidewalk vaults, street banners executed prior to loss, to name as an additional or decorations and similar exposures; or insured, but only with respect to liability arising out of 2. The construction, erection or removal of the ownership, maintenance or use of that part of elevators; or the premises leased to you, subject to the following 3. The ownership, maintenance or use of any additional exclusions: elevators covered by this insurance. This insurance does not apply to: S 1. Any "occurrence" which takes place after you SECTION III - LIMITS OF INSURANCE cease to be a tenant in that premises. AMENDMENTS 2. Structural alterations, new construction or demolition operations performed by or on behalf A. Damage To Premises Rented To You of such additional insured. Paragraph 6. is replaced by the following: F. Blanket Additional Insured - State Or 6. Subject to Paragraph 5. above, the most we will Governmental Agency Or Subdivision Or pay under Coverage A for damages because of Political Subdivision - Permits Or Authorizations "property damage" to any one premises, while Section 11 - Who Is An Insured is amended to rented to you, or in the case of damage by fire, include as an insured any state or governmental lightning, explosion or sprinkler leakage, while agency or subdivision or political subdivision with rented to you or temporarily occupied by you whom you have agreed in a written contract, with permission of the owner is the greater of: executed prior to loss, to name as an additional a. $300,000; or insured, subject to the following provisions: b. The amount shown next to the Damage To 1. This insurance applies only with respect to Premises Rented To You Limit in the operations performed by you or on your behalf Declarations. for which the state or governmental agency or However, the provisions of this paragraph do not subdivision or political subdivision has issued a apply if Damage To Premises Rented To You permit or authorization. Coverage is excluded by endorsement. WN GL 39 03 10 Includes copyrighted material of insurance Services office, with its permission Page 5 of 6 WN GL 39 03 10 your policy, we will not deny coverage under B. Medical Expense Limit this Coverage Part because of such failure. Paragraph 7. is replaced with the following: However, this provision does not affect our right to collect additional premium or 7. Subject to Paragraph 5. above, the most we will exercise our right of cancellation or pay under Coverage C for all medical expenses non-renewal. because of "bodily injury" sustained by any one person is the greater of: D. Waiver of Subrogation a. $10,000; or SECTION IV - COMMERCIAL GENERAL b. The amount shown next to the Medical LIABILITY CONDITIONS, 8. Transfer of Rights of Expense Limit in the Declarations. Recovery Against Others to Us is hereby amended by the addition of the following: This insurance does not apply if coverage for Medical Expenses is excluded either by the We waive any right of recovery we may have provisions of the coverage part or by because of payments we make for injury or damage endorsement. arising out of your ongoing operations or "your work" done under a written contract, executed prior to loss, SECTION IV - COMMERCIAL GENERAL LIABILITY requiring such waiver with that person or CONDITIONS AMENDMENTS organization and included in the A. Knowledge Of Occurrence "products-completed operations hazard". However, our rights may only be waived prior to the Item 2. Duties In The Event Of Occurrence, "occurrence" giving rise to the injury or damage for Offense, Claim or Suit is amended by adding the which we make payment under this Coverage Part. following: The insured must do nothing after a loss to impair e, You must give us or our authorized our rights. At our request, the insured will bring 'suit or transfer those rights to us and help us representative prompt notice of an "occurrence", enforce those rights. claim or loss only when the "occurrence", claim or loss is known to: (1) You, if you are an individual; SECTION V - DEFINITIONS AMENDMENTS (2) A partner, if you are a partnership; A. Bodily Injury Redefined (3) An executive officer or insurance manager, Paragraph 3. "Bodily injury" is replaced by the if you are a corporation; or following: (4) A member or manager, if you are a limited 3. "Bodily injury" means bodily injury, sickness or liability company. disease sustained by a person, including death B. Other Insurance resulting from any of these at any time. "Bodily injury" includes mental anguish or other mental Item 4. Other Insurance, b. Excess Insurance (1) injury resulting from such bodily injury. (a) (ii) is replaced by the following: B. Insured Contract Amended (ii) That is fire, lightning, explosion or sprinkler Paragraph 9. a. is replaced b the following: leakage insurance for premises rented to you or P Y g: temporarily occupied by you with permission of a. A contract for a lease of premises. However, the owner; that portion of the contract for a lease of C. Unintentional Failure To Disclose Hazards premises that indemnifies any person or organization for damage by fire, lightning, Paragraph 6. Representations is replaced by the explosion or sprinkler leakage to premises while following: rented to you or temporarily occupied by you 6. Representations And Unintentional Failure with permission of the owner is not an "insured To Disclose Hazards contract ; a. By accepting this policy, you agree: C. Personal And Advertising Injury Redefined (1) The statements in the Declarations are Paragraph 14. d. and e. are replaced by the accurate and complete; following: (2) Those statements are based upon d. Oral, written, televised, videotaped or electronic representations you made to us; and publication of material that slanders or libels a person or organization or disparages a person's (3) We have issued this policy in reliance or organization's goods, products or service; upon your representations. e. Oral, written, televised, videotaped or electronic b. If you unintentionally fail to disclose any publication of material that violates a person's hazards existing at the inception date of right of privacy; WN GL 39 03 10 Includes copyrighted material of Insurance Services Office, with its permission Page 6 of 6 IL 02 79 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraph 2. of the Cancellation Common in violation of the insurance laws of Policy Condition is replaced by the following: Oregon or any other state; or 2. If this policy has been in effect for: (7) Loss or decrease in reinsurance a. Fewer than 60 days and is not a re- covering the risk. newal policy, we may cancel for any c. 60 days or more or is a renewal policy, reason. we may cancel for any other reason b. 60 days or more or is a renewal policy, approved by the commissioner by rule, we may cancel only for one or more of but only with respect to insurance pro- the following reasons: vided under the following: (1) Nonpayment of premium; (1) A package policy that includes (2) Fraud or material misrepresentation commercial property and commer- cial liability insurance; N made by you or with your know- 8 ledge in obtaining the policy, con- (2) Commercial Automobile Coverage tinning the policy or in presenting a Part; claim under the policy; (3) Commercial General Liability (3) Substantial increase in the risk of Coverage Part; loss after insurance coverage has (4) Commercial Property Coverage Part 0> been issued or renewed, including - Legal Liability Coverage Form; 8 but not limited to an increase in ex- (5) Commercial Property Coverage Part posure due to rules, legislation or -Mortgageholders Errors And Omis- ° court decision; sions Coverage Form; (4) Failure to comply with reasonable (6) Employment-related Practices Liabil- loss control recommendations; ity Coverage Part; (5) Substantial breach of contractual (7) Farm Coverage Part - Farm Liability duties, conditions or warranties; Coverage Form; (6) Determination by the commissioner (8) Liquor Liability Coverage Part; that the continuation of a line of insurance or class of business to (9) Products/Completed Operations which the policy belongs will jeop- Liability Coverage Part; or ardize our solvency or will place us (10)Medical Professional Liability Cov- erage Part. IL 02 79 09 08 ° ISO Properties, Inc., 2007 Page 1 of 2 B. Paragraph 3. of the Cancellation Common than one year or without a fixed Policy Condition is amended by the addition of expiration date. the following: However, if this policy is issued for a term 3. We will mail or deliver to the first Named of more than one year and for additional Insured written notice of cancellation, stat- consideration the premium is guaranteed, ing the reason for cancellation. we may not refuse to renew the policy at C. The following is added to the Cancellation its anniversary date. Common Policy Condition: Nonrenewal will not be effective until at 7. Number Of Days' Notice Of Cancellation: least 45 days after the first Named Insured receives a. With respect to insurance provided our notice. under 2.c.(1) through (10) above, can- cellation will not be effective until at a. If notice of cancellation or nonrenewai least 10 working days after the first is mailed, a post office certificate of Named Insured receives our notice. mailing will be conclusive proof that the b. With respect to insurance other than first Named Insured received the notice that provided under 2.c.(1) through on the third calendar day after the date (10) above, cancellation will not be of the certificate of mailing. effective until at least: b. The following provision applies with (1) 10 days after the first Named respect to coverage provided under the Insured receives our notice, if we Farm Coverage Part: cancel for nonpayment of premium; If the first Named Insured has affir- or matively consented to our use of an (2) 30 days after the first Named electronic record to deliver notice of Insured receives our notice, if we cancellation or nonrenewal and has not cancel for any other reason. withdrawn such consent, then the elec- tronic record delivering notice of can- D. Paragraph 6. of the Cancellation Common cellation or nonrenewal satisfies the Policy Condition does not apply. requirement that the notice of E. The following are added and supersede any cancellation or nonrenewal be provided, provision to the contrary: or made available, to the first Named 1. Nonrenewal Insured in writing if we send the first Named Insured the electronic record We may elect not to renew this policy by with a request for a return receipt and mailing or delivering to the first Named we receive the return receipt. If we do Insured, at the last mailing address known not receive the return receipt, we may to us, written notice of nonrenewal before cancel or nonrenew the policy only the: after providing or delivering the notice a. Expiration date of the policy; or of cancellation or nonrenewal to the b. Anniversary date of the policy if the first Named Insured in writing, subject policy is written for a term of more to Paragraph 2.a. above. Page 2 of 2 ® ISO Properties, Inc., 2007 IL 02 79 09 08 IL 00 17 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation b. Give you reports on the conditions we 1. The first Named Insured shown in the Dec- find; and larations may cancel this policy by mailing c. Recommend changes. or delivering to us advance written notice of 2. We are not obligated to make any inspec- cancellation. tions, surveys, reports or recommendations 2. We may cancel this policy by mailing or and any such actions we do undertake delivering to the first Named Insured written relate only to insurability and the premiums notice of cancellation at least: to be charged. We do not make safety a. 10 days before the effective date of can- inspections. We do not undertake to cellation if we cancel for nonpayment of perform the duty of any person or premium; or organization to provide for the health or safety b. 30 days before the effective date of can- of workers or the public. And we do not warrant that conditions: cellation if we cancel for any other a. Are safe or healthful; or reason. 3. We will mail or deliver our notice to the first b. Comply with laws, regulations, codes or Named Insured's last mailing address known standards. to us. 3. Paragraphs 1. and 2. of this condition apply 4. Notice of cancellation will state the effective not only to us, but also to any rating, date of cancellation. The policy period will advisory, rate service or similar organization end on that date. which makes insurance inspections, 5. If this policy is cancelled, we will send the surveys, reports or recommendations. first Named Insured any premium refund 4. Paragraph 2. of this condition does not due. If we cancel, the refund will be pro apply to any inspections, surveys, reports or rata. If the first Named Insured cancels, the recommendations we may make relative to refund may be less than pro rata. The certification, under state or municipal cancellation will be effective even if we statutes, ordinances or regulations, of have not made or offered a refund. boilers, pressure vessels or elevators. 6. If notice is mailed, proof of mailing will be E. Premiums s sufficient proof of notice. The first Named Insured shown in the Declar- N B. Changes ations: This policy contains all the agreements 1. Is responsible for the payment of all pre- between you and us concerning the insurance miums; and afforded. The first Named Insured shown in 2. Will be the payee for any return premiums the Declarations is authorized to make changes we pay. in the terms of this policy with our consent. F. Transfer Of Your Rights And Duties Under This This policy's terms can be amended or waived Policy only by endorsement issued by us and made a g part of this policy. Your rights and duties under this policy may not be transferred without our written consent C. Examination Of Your Books And Records except in the case of death of an individual We may examine and audit your books and rec- named insured. ords as they relate to this policy at any time If you die, your rights and duties will be during the policy period and up to three years transferred to your legal representative but only afterward. while acting within the scope of duties as your D. Inspections And Surveys legal representative. Until your legal 1. We have the right to: representative is appointed, anyone having proper temporary custody of your property will a. Make inspections and surveys at any have your rights and duties but only with time; respect to that property. IL 00 17 11 98 Page 1 of 1 Copyright, Insurance Services Office, Inc., 1998 Price for 2 Guardrail Anchors 550.00 EA 1,100.00 25 feet of 2A guardrail 035.00 per foot = $875.00 AC removal for face of posts = $ 350.00 Includes vacuum excavation Traffic control 1 shift through flagging $ 744.00 Total $3069.00 Revised On Mon, Apr 27, 2015 at 2:22 PM, Brian Bowman <brianb@gageit.org> wrote: Please call me 541-601-8666 e Page 1 / 1 CITY OF ASHLAND DATE PO NUMBER 20 E MAIN ST. 4/30/2015 12848 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 005867 SHIP To: Ashland Wastewater Department GAGE IT CONSTRUCTION, LLC (541) 488-5354 P O BOX 3483 90 N MOUNTAIN CENTRAL POINT, OR 97502 ASHLAND, OR 97520 FOB Point: Ashland, Oreqon Req. No.: Terms: Net Dept.: Req. Del. Date: contact: Jason RObustelli Special Inst: Confirming? No Quantity Unit Description Unit Price Ext. Price Install 25 feet of quard rail at 3,069.00 Grandview Dump station Contract for Goods and Services, Small Procurement Less than $5,000 Beqinninq date: 04/28/2015 Completion date: 06/12/2014 SUBTOTAL 3,069.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 3,069.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number, Project Number Amount E 675.08.17.00.70420 3,069.00 Aut rized Signature VENDOR COPY FORM #3 CITY OF ASHLAND REQUISITION Date of request: 4/28/2015 Required date for delivery: Vendor Name Gage-it Address, City, State, Zip 4887 Airway Dr. Central Point OR 97502 Contact Name & Telephone Number Brian Bowman - 541-779-7007 Fax Number SOURCING METHOD ❑ Exempt from Competitive Biddinq ❑ 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 ❑ Special Procurement Intergovernmental Agreement $55,000 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 proposalslwritten solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: -(Date) I Description of SERVICES Total Cost Install of 25 feet of guard rail at Grandview pump station. $3069.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ Project Number _ _ _ _ _ _ - _ _ _ Account Number 675.08.17.00.704200 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 ate Support -Yes /No By signing this requisifi form, I certify t Ci 's public contracting requirements have been satisfied. Employee: Department Head: o~..~ / (Equal to or great "I'M) Depart~ efnt/NanageriSupervisor: a8 S City Administrator: V (Equal to or greater than $25,000) Funds appropriated for current fiscal year. YES / NO Finance Director- (Equal to orgreater than S5,000) Date Comments: Form #3 - Requisition