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HomeMy WebLinkAbout2015-136 Contract - Integrity Pest & Home Repair Contract for GOODS AND SERVICES Small Procurement Less than $5,000 CITY OF INDEPENDENT CONTRACTOR: Integrity Pest and Home Repair ASHLAND CONTACT: Randy Baldwin 20 East Main Street ADDRESS: 548 Hogan Ave. Ashland, Oregon 97520 Telephone: 541/488-6002 Medford, OR. 97504 Fax: 541/488-5311 TELEPHONE: 541-613-7311 FAX: BEGINNING DATE: 5/25/15 COMPLETION DATE: 6/30/15 COMPENSATION: $350 GOODS AND SERVICES TO BE PROVIDED: Rodent exclusion and trapping in NMP barn. See attached Estimate 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, 2798.225, 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 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 $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. Contract City of Ashland: By By ~/t Si atur Department He d 14« w4~~ PZritN a P rint Name r J ` Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. Revised 10-28-14 Page 1 of 2 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. t~ (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. v (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. 6tA 41~L- Contractor (Date) Revised 10-28-14 Page 2 of 2 ~to lty T1"1- ~Re a;r ° Vest 548 Hogan Ave, Medford, Oregon 97504 541-613-7311 Estimate & Work Authorization Agreement Purchaser : Ashland Parks Nature Center Telephone: 541-488-6606 Address : 620 N. Mountain Ave City : Ashland, Oregon 97520 Description of Structure Inspected : barn Areas Excluded from Agreement and Limited Warranty : Any not treated Price Rodent exclusion of any new or previous sealed holes. $175.00 Trapping for 30 days. Checking traps 2 times per week as needed $175.00 total $350.00 All work is guaranteed for one year unless otherwise stated. Warranty excludes any area not treated Purchaser Date r i Integrity Representative l I DATE (MM/DD/YYYY) ,ate ° CERTIFICATE OF LIABILITY INSURANCE 4/2/2015 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 Lina Achorn NAME: Capital Risk Underwriters, Inc. PHONE (407)540-1400 FA/C No: (407) 839-0547 P O Drawer 1793 nDORIESS:lachorn@cruins.com INSURERS AFFORDING COVERAGE NAIC # Orlando FL 32802 INSURER A:Im erium Insurance Company 35408 INSURED INSURER B : Randy Baldwin dba Integrity Pest & Home Repair INSURERC: 548 Hogan Ave INSURER D: Medford, OR 97504 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER:CL154207979 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE ❑ OCCUR IIC-GL-01807-01 08/12/201406/12/2015 MED EXP (Any one person) $ 5,000 X Prop Dmg Ded $1000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS -COMP/OP AGG $ 2,000,000 X POLICY PRO- F-1 LOC $ 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 UMBRELLALIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ X WORKERS COMPENSATION WC STATU- 770TH- AND EMPLOYERS' LIABILITY YIN 06/12/2014 06/12/2015 ANY PROPRIETOR/PARTNER/EXECUTIVE N / A IIC-WC-00255-01 E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if 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 City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Michael Schmidt/CEO ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rgnlnn5i m Tho Ar(1RIl nama anri Innn arc ranictorarl mmrlrc of Arr)pn 7 DATE JMM1DDNYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 04/0112015 ilw.- 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 poiicy(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 NAME: t'.IIr15 Wimmer Russ Wimmer Ins Agency INC PHONE 51.77.7877 FAX, No9:541-776-3299 ADDRESS: Christine.wimmer.p8a8@statefarm.com StafeFarm 2936 E Barnett Rd Su 101 E-MAIL Medford, OR 97504 INSURERS AFFORDING COVERAGE NAIC t INSURER A :State Farm Mutual Automobile Insurance Company 25178 INSURED Randy Baldwin INSURER B 548 Hogan Ave INSURER C. Medford, OR 97504 INSURERD: 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 WTH 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. ILTR I TYPEOFINSURANCE POLICYNUMBER MMiQDIYYYY MMILDD/YYXYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ AGE TO RENTED CLAIMS-MADE L l OCCUR PREQE~ Ea occurrence S MED EXP (Any one person) S PERSONAL d ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ JECT PRO ❑ LOC PRODUCTS-- COtdPfO P AGG POLICY ❑ - - - OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 9 $ Y 263-7835-A16-37A 0110612015 07106!2016 (Ea.acudent)_ ANY AUTO 145-5228-A13-37B 0111312015 0711312015 BODILY INJURY (Per person) $ 1,000,000 ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ 1,000,000 I - - - AUTOS HRED NON-OWNED PROPERTYDAMAGE $ 1,000,000 IEDAUTOS AUTOS Per accident S UMBRELLA LIAB _ OCCUR I I EACH_OCCURRENCE S EXCESS VAS CLAIMS-MADE AG_G__RE_G_ ATE $ DED ENTIONS S RET WORKERS COMPENSATION - PER 0 H- AND EMPLOYERS' LIABILITY YfNIi I STATUTE ER_ ❑ E.L. EACH ACCIDENT _ S ANY PROPRIETORIPARTNEPoEXECUTIVE N fA OFFICERMIEMBER EXCLUDED? I (Mandatory in NH) EL DISEASE - EA EMPLOYE S - If yyes, describe under DESCRIPTION OF OPERATIONS helo,. E.L. DISEASE -POLICY LIMIT S I i DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space Is required) 2003 Chevrolet C1500 pickup, 2012 Chevrolet C1500 pickup CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATI O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 Page 1 / 1 ASHLAND PARK COMS°SION 20 E MAIN ST. DATE PO NUMBER ASHLAND, OR 97520 5/27/2015 00452 (541) 488-5300 VENDOR: 004103 SHIP TO: INTEGRITY PEST & HOME REPAIR 548 HOGAN AVENUE MEDFORD, OR 97504 FOB Point: Ashland, Oreqon Req. No.: Terms: net Dept.: Req. Del. Date: contact: Susan Dyssegard Special Inst: Confirming? NO Quantity Unit Description Unit Price Ext. Price Pest Control - Nature Center Barn 350.00 Contract for Goods and Services, Small Procurement Less than $5,000 Beqinninq date: 05/25/2015 Completion date: 06/30/2015 SUBTOTAL 350.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 350.00 Account Number Project Number Amount Account Number Project Number Amount E 211.12.03.04.60211 350.00 S Z Authorized& nature VENDOR COPY FORM#3 CITY OF ASHLAND REQUISITION Date of request: 5/21/15 Required date for delivery: 6/5/15 Vendor Name Randy Edwin nwnar I npp~-~Rr Address, City, State, Zip Integrity Pest and Home Repair, www.medfordoest.com 1 rbaldwin0303~a gmail.com 1541-613-7311 Contact Name & Telephone Number 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 # ❑ VerballWritten 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 ❑ 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) I Description of SERVICES Total Cost Rodent exclusion of any new or previous sealed holes in Nature Center barn - $175.00 Trapping in barn for 30 days. Checking of traps two times per week as needed - $175.00 $ 350.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quote/proposal Project Number Account Number- 211 -12-03 -04-_602110_ $ 350.00 Account Number Account Number `Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support -Yes/ No By signing this requisition form, I mciddify 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: CXYE=,iJ NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition