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2015-227 Contract - C&S Fire Safe Services
Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: C & S Fire Safe Services -AS H LAND CONTACT: Kaylynn Ramsey, Service Manager 20 East Main Street Ashland, Oregon 97520 ADDRESS: 4019 Hooker Road, Roseburg, OR 97470 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541 673 1337 DATE AGREEMENT PREPARED: 17 Jun 2015 FAX: 541 673 4534 BEGINNING DATE: 1 Jul 2015 COMPLETION DATE: 30 Jun 2016 COMPENSATION: Not to exceed $3000.00 GOODS AND SERVICES TO BE PROVIDED: Provide service and maintenance and related equipment of fire extinguishers for FY 15/16 to the City. Per fee schedule attached as Exhibit C. ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with the said primary City of Ashland Contract. NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 27913.220, 27913.225, 27913.230, 27913.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $20,142.20 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 9. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in art, effective upon deliver of Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 1 of 5 written notice to Contractor, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Contractor to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Contractor may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Contractor's performance of each and every obligation and duty under this contract. City by written notice to Contractor of default or breach, may at any time terminate the whole or any part of this contract if Contractor fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. 10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any requirement of ORS 279A.110 or the administrative rules implementing the Statute. 12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 16. Insurance. Contractor shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 2 of 5 including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits ointent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(the City. e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim) between the City (and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further liability to Contractor. 20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Contractor: City of Ashland Signature Department (-lead 1 'R Print Name Print Name ~ ,L ~ k y Title Date r' W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. G Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 3 of 5 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. V, (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. Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 4 of 5 CITY • ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGIE per hour effective June 30, 2015 (Increases annually every June 30 by the ILI Consumer Price Index) portion of business of their 401 K and IRS eligible employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. = For all hours worked under a business from the City of service contract between their Ashland in excess of - Note: "Employee" does not employer and the City of $20,142.20. include temporary or part-time Ashland if the contract employees hired for less than exceeds $20,142.20 or more. If their employer is the City of 1040 hours in any twelve- twelve- Ashland including the Parks month period. For more For all hours worked in a and Recreation Department. details on applicability of this month if the employee spends policy, please see Ashland employee's or more of the In calculating the living wage, Municipal Code Section employee's time in that month employers may add the value 3.12.020. working on a project or of health care, retirement, For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF -ASHLAND Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 5 of 5 C& ire-Safe Services, Since 1977 "Our Pride Is Your Security." Proposal for Fire Extinguisher Service 201512016 City of Ashland Annual Service of portabie fire extinguishers 20 E Main 5t Inspections $ 6.00 each Ashland OR 97520 Recharge of dry chemical fire extinguishers 12 year dry chemical test 2.5# $ 10.75 21/2# $ 18.75 5# $ 13.75 54 $ 21.75 10# $ 22.75 10# $ 34.75 20# $ 34.75 20# $ 46.75 ABC Powder, per # $ 2.00 0-Ring $ 2.00 Valve Stem $ 7.00 Recharge of C02 fire extinguishers 5 year hydro-test for C02 fire extinguishers 5# $ 21.00 5# $ 35.00 10# $ 24.50 10# $ 38.50 15# $ 31.50 15# $ 45.50 20# $ 37.50 20# $ 51.50 0-Ring $ 3.00 Halotron 5 year teardown Halotron hydro-test 21/2# $ 36.00 21/2# $ 48.00 5# $ 43.00 5# $ 55.00 11# $ 52.00 11# $ 64.00 15# $ 58.00 15# $ 70.00 Halotron per # $ 36.00 0-Rin0 $ 2.00 Valve Stem $ 9.00 Fire extinguisher training class $125.00 f2echarges for fire extinguisher training level three pricing *dependent upon Sizes used in the training class TIM O'SULLIVAN Sales & Service Technician _aP110hAL K1T r~4 Q e, i-I Y`. G~ ' WAK 'oil 14T A.7 4019 Hooker Road, Roseburg, OR 97470 INDUSTRIES, WC Corporate Office: 800-200-1337 • Main Line. 541-673-1337 Fax: 54 l -673-4534 www.CSFireSafe.com C&SFIRE-01 DLEONG ,acoRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/18/2015 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 NAME ACT Amanda Bray _ Medford Office PHONE FAX (541) 779 9187 PayneWest Insurance, Inc. EA1C-Noo E-t)-(541-- ~779 1- -321 C, No: -AIL 38 North Central Ave. ADDRESS;_ Medford, OR 97501 INSURER(S) AFFORDING COVERAGE - I NAIC # - INSURER A:Toklo Marine Specialty Insurance Services, Inc.I INSURED INSURER B :Western NatlOnal Assurance CO 24465 C & S Fire-Safe Services LLC INSURERC:SAIF 36196 4019 Hooker Rd INSURER D :Travelers; Casualty & Surety Co 19038 Roseburg, OR 97470 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADDLI SUBR - - POLICY EFFi POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY rDAMAGE ACH OCCURRENCE $ 1,000,000 ~I I -Y I TO RENTED STI CLAIMS-MADE I~ OCCUR X PPK1253419 10/30/2014 j 10/30/2015 REMISES LEa occurrence $ 100,000 MED XP (Any one person) S 5,000 I. - X Per Project CG2503 PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PERGENERAL AGGREGATE S 2,000,000 ECT ~J LOG _PRODUCTS COMP/OP AGG S 2,000,000 _ POLICY FRO- OTHER l p Gap p S 1,000,000 X Sto SGap AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ B ANY AUTO CPP100074805 10/30/2014 10/30/2015 BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ ALL OWNED I X SCHEDULED _ AUTOS X AUTOS i PROPERTY DAMAGE $ HIRED AUTOS X NON-OWNED AUTOS (Per accident) UMBRELLA fA6 X A S MADE EACH OCCURRENCE S 2,000x000 X rT OCCUR EXCESS LIAB 0 PUB479512 10/30/2014 10/30/2015 AGGREGATE 2,000,000 - it DED X RETENTIIs 4: WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY YI - N C ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1969337 10/01/2014 10/01/2015 sTATACCI - ER E L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBENH) E.L. DISEASE - EA R EXCLUDED? NIA S - 1,000,000 I- --(Mandatory in E $ If yes, describe under I DESCRIPTION OF OPERATIONS below E L DISEASE POLICY LIMIT $ 1,000,000 D Crime - Fidelity ,105733861 01/25/2015 01/25/2016 'Employee Dishonesty 50,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured endorsement CG2010 04/13 attached Primary and noncontributory endorsement CG2001 04/13 attached Waiver of Transfer of Rights endorsement CG2404 05/09 attached Auto Additional Insured Waiver of Transfer or Rights endorsement WNCA44 12 1- attached 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. Attn: Dale Peters 20 E. Main St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE oCVt G~~r/QOQF nV ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PPK1253419 COMMERCIAL GENERAL LIABILITY CG 20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations As where required by written All covered locations. contract prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations, Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 04 13 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: PPK1253419 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization as where required by written contract prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ WN CA 27 11 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO 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 Business Auto Coverage Form identified in this endorsement will be amended as shown below. SECTION II - LIABILITY COVERAGE f. Any "employee" of yours is an "insured" while AMENDMENTS using a covered "auto" you don't own, hire or borrow in your business or your personal A. Who Is An Insured - amended affairs. SECTION II - LIABILITY COVERAGE, Item A. g, Any "employee" of yours is an "insured" while Coverage, 1. Who Is An Insured is amended to operating a covered "auto" hired or rented add: under a contract or agreement in the d. Any legally incorporated subsidiary of yours in "employee's" name, with your permission, which you own more than 50% of the voting while performing duties related to the conduct stock on the effective date of this coverage of your business. form. B. Blanket Additional Insured However, "insured" does not include any Section II - LIABILITY COVERAGE, Item A. subsidiary of yours that is an "insured" under Coverage, 1. Who Is An Insured, paragraph c. any other automobile liability policy, or would is amended to add the following: be an "insured" under such policy but for termination of such policy or the exhaustion Any person or organization who is required under on such policy's limits of insurance. a written contract or agreement between you and that person or organization, that is signed and e. Any organization which is newly acquired or executed by you before the "bodily injury" or formed by you and over which you maintain "property damage" occurs and that is in effect majority ownership. However, coverage during the policy period, to be named as an under this provision: additional insured is an "insured" for Liability (1) is afforded only for the first 180 days after Coverage, but only for damages to which this you acquire or form the organization or insurance applies and only to the extent that until the end of the policy period, persons or organization qualifies as an "insured" whichever comes first; under the Who Is An insured provision contained in Section Il. (2) does not apply to "bodily injury" or "property damage" that results from an C. Liability Coverage Extensions - "accident" that occurred before you Supplementary Payments formed or acquired the organization; SECTION II - LIABILITY COVERAGE, Item A. (3) does not apply to any newly acquired or Coverage, 2. Coverage Extensions, a. formed organization that is a joint venture Supplementary Payments is amended by or partnership; and replacing subparagraphs (2) and (4) with the following: (4) does not apply to an "insured" under any other automobile liability policy, or would (2) Up to $5,000 for cost of bail bonds (including be an "insured" under such a policy but bonds for related traffic law violations) required for termination of such policy or the because of an "accident" we cover. We do exhaustion of such policy's limits of not have to furnish these bonds. insurance. (4) All reasonable expenses incurred by the WN CA 27 11 12 Includes copyrighted material of Insurance Services Office, with its permission page 2 of 5 WN CA 27 11 12 B. Blanket Waiver of Subrogation D. Employee Hired Auto Section IV - BUSINESS AUTO CONDITIONS, SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights of B. General Conditions, 5. Other Insurance, b. is Recovery Against Others to Us, is amended by deleted and replace by the following: adding the following exception: b. For Hired Auto Physical Damage Coverage, However, we waive any right of recovery we may the following are deemed to be a covered have against any person or organization to the "autos" you own: extent required of you by a written contract signed and executed prior to any "accident" or "loss", (1) Any covered "auto" you lease, hire, rent provided that the "accident" or "loss" arises out of or borrow. operations contemplated by such contract. The (2) Any covered "auto" hired or rented by waiver applies only to the person or organization your "employee" under a contract in that designated in such contract. individual "employee's" name, with your C. Unintentional Failure to Disclose Hazards permission, while performing duties related to the conduct of your business. SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, However, any "auto" that is leased, hired, rented Misrepresentation Or Fraud, is amended to add or borrowed with a driver is not a covered "auto". the following paragraph: If you unintentionally fail to disclose any hazards SECTION V - DEFINITIONS AMENDMENTS existing at the inception date of the policy, or A. "Bodily Injury" Redefined To Include Mental during the policy period in connection with any Anguish additional hazards, we will not deny coverage under this Coverage Part because of such failure. SECTION V - DEFINITIONS, C. "Bodily Injury" is deleted and replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. "Bodily injury" includes mental anguish or other mental injury resulting from such bodily injury. WN CA 27 11 12 Includes copyrighted material of Insurance Services Office, with its permission page 5 of 5 Page 1 / 1 . CITY OF ASHLAND DATE PO NUMBER 20 E MAIN ST. 7/28/2015 13024 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 012800 SHIP TO: Ashland Building Maintenance C & S FIRE SAFE SERVICES (541) 488-5358 4019 HOOKER ROAD 90 N MOUNTAIN AVENUE ROSEBURG, OR 97470 ASHLAND, OR 97520 FOB Point: Ashland, Oreqon Req. No.: Terms: Payable on receipt Dept.: Req. Del. Date: Contact: Dale Peters Special Inst: Confirming? No Quantity Unit Description Unit Price Ext. Price Provide service and maintenance of fire 3,000.00 extinguisher and related material for FY 2016 Contract for Goods and Services Beqinninq date: July 1, 2015 Completion date: June 30, 2016 SUBTOTAL 3,000.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 3,000.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 410.08.24.00.60240 E 000254.999 3,000.00 t"I'11 r k)u' r I~_ Authoriied'SijWature VENDOR COPY FORM #3 CITY OF SHLAN D % REQUISITION Date of request: 16 JUN 2015 Required date for delivery: Vendor Name C & S FIRE SAFE SERVICES Address, City, State, Zip 4019 HOOKER ROAD Contact Name & Telephone Number ROSEBURG OR 97470 Fax Number 541673 1337 FAX 541 673 4534 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 T4--Small Procurement Cooperative Procurement less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon H 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 $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 racyt',Dm 31F-20 ICE GNU rNfV1r4Tr-_tiie4k3zc- ©f= F,gx-- E.-t~~+ga...SNrcl2_ s1n~D 1~CLbgTt:D 1M I0 9 fErZ)l4JL, tRma- FY 3000.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST El Per attached quote/proposal ~ zs~t 9~ Project Number _ 98A990.WU- _ Account Number 410.08.24.00.602400 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 for i that the City's public contracting requirements have been satisfied. b3' Employee: i Department Head: a-7 /7 (Equal to or g"remoter-than $5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year YES / NO Finance Director- (Equalto orgreaterthan $5,000) Date Comments: Form #3 - Requisition