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2015-237 Contract - Aqua Technex LLC
Contract for WTP & WWTP Chemicals CITY OF CONTRACTOR: AquaTechnex, LLC -ASHLAND CONTACT: Kyle Langan, Manager/Aquatic Specialist 20 East Main Street Ashland, Oregon 97520 ADDRESS: PO Box 118, Centrailia, WA 98531 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 360-330-0152, FAX: 360-330-0174 DATE AGREEMENT PREPARED: Jul 27, 2015 EMAIL: kyle@aquatechnex.com BEGINNING DATE: Jul 27, 2015 COMPLETION DATE: June 30, 2017 COMPENSATION: WTP Chemical #5 PAK27 - $16,234.40 per order ($1.1596 per lb, 50 Ibs per bag, 280 bags per order, includes delivery charge) GOODS AND SERVICES TO BE PROVIDED: Solvay Chemicals, SePRO Corp, Product name: PAK27 (Sodium Carbonate Peroxyhydrate) to be delivered as specified for the WTP per Invitation to Bid #2015-101, Approved b Council Jul 21, 2015, A uaTechnex bid form is 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. 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, 2796.230, 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 b certified mail or in person. Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 1 of 5 C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of 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 rnodified, 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 liabilitieE. 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 $2,000,000 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 Enter one: $2,000,000 for each accident for Bodily Injury and Property e, including coverage for owned, hired or non- Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page of 5 owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to 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 noon-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: ,r City of Ashland Bye' By Sig ure Department Head Prin Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with ' the signed contract. Purchase Order No. vp:n AS TO FORM Ashlan As #t. Cit Attorney 9a Contract for Goods and Services Less than $25,000, Revised 06/02/20T3t 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 she 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: k, (1) 1 carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a Trade association membership are purchased for the business. (3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. r. e' Contr or (Date) Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 4 of 5 CITY OF ASHLAND, !OREGON EXHIBIT B City of Ashland LIVING WAGE . . per hour effective June 30, 2015 (Increases annually every June 30 by the 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- 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 x~~L WTP (Water Treatment Plant) - CHEMICAL h!5: SODIUM CARBONATE PEROXYHYDRATE, FREE FLOWING - "GREENCLEAN" OrEauivalent Granular Algaecide / Fungicide, Free Flowing must meet the following specifications: 1) Primary ingredient must be greater than or equal to 85% of product. 2) Must meet State and Federal aquatic use requirements. 3) Estimated annual usage - June through October - 420 bags, 50 Lbs per bag, (10.5 pallets). 4) Currently an order is placed for 140 bags, (4) pallets, 40 bags per pallet, 50 Lbs per bag, every 3 to 4 weeks on average in summer months. 5) Location is the City of Ashland, Service Center, 90 N. Mountain Avenue, Ashland, Oregon, 97520. Forklift can be provided by the City. 6) Deliver 40 bags per pallet, 50 Lbs per bag, on pallet jackable pallets. 7) Bids must be in the form of dollars per pound (Lb). 8) City reserves the right to not purchase the product due to lack of algae blooms. Manufacturer Solvay Chemicals, Inc. Manufactured for: SePRO Corp. Number of pounds (Lbs) per bag 50 lbs/bag Number of bags per pallet 40 bags/pallet July 2015 - June 2016 July 2016 - June 2017 Price per pound (Lb) $ 1.1596/lb $ 1.1596/lb Cost per order - 270 bags, (5) pallets $ 15,654.60 for 270 bags $ 15,654.60 for 270 bags Delivery charge $ Included $ Included Technical Report Analysis To be submitted with bid Comments' Product name: PAK27 1TR -ChPmicalg fnr WTP R WWTP Page 13 of?5 6/5/9n15 i CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ACQ)RO L8/1212015 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 endorsements . PRODUCER CONTACT NAME:___ _ HUB International, Northwest PHCNE 110 Unity Street E oless:NOW.Un.-9000 hubnternational.co(~c y60-734-8496 Bellingham WA 98225 - - m - - INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:The Travelers Indemnity Company _ 5658 - . INSURED AQ UALLC-03 INSURERB: Aquatechnex LLC INSURER C: PO Box 30824 - - - INSURER D Bellingham WA 98228 - - - " INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1192167039 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MMtDD/YYYY MMIDDIYYYY LIMITS GENERAL LIABILITY I EACH OCCURRENCE _.--1 DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY j PREMISES(Eaoccurrencej $ - CLAIMS-MADE 1:1 OCCUR II MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS COMP/OP AGG $ POLICY PE _T LOC $ A AUTOMOBILE LIABILITY Y BA3899R30A 9/12/2014 9!12/2015 COM (Ea accident LIMIT _$1,00.0,000 ANY AUTO BODILY INJURY (Per person) $ X ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ _ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ Per acc ident _ HIRED AUTOS AUTOS 1_ - - $ I UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE_ 1 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC Y OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER_ _ Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N / A EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under ! DESCRIPTION OF OPERATIONS below E 1 . DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Performs and conditions: Auto Coverage Plus Endorsement form CA T4 20 07 10. 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. 90 N Mountain Ave Ashland OR 97520 AUTHORIZ D REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage- However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC B. EMPLOYEE HIRED AUTO EQUIPMENT - INCREASED LIMIT C. EMPLOYEES AS INSURED 1. WAIVER OF DEDUCTIBLE - GLASS D. SUPPLEMENTARY PAYMENTS - INCREASED J. PERSONAL EFFECTS LIMITS K. AIRBAGS E. TRAILERS - INCREASED LOAD CAPACITY L. AUTO LOAN LEASE GAP F. HIRED AUTO PHYSICAL DAMAGE M. BLANKET WAIVER OF SUBROGATION G. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT A. BLANKET ADDITIONAL INSURED performing duties related to the conduct of The following is added to Paragraph A.1., Who Is your business- An Insured, of SECTION II - LIABILITY COV- 2. The following replaces Paragraph b. in B.5., ERAGE: Other Insurance, of SECTION IV - BUSI- Any person or organization who is required under NESS AUTO CONDITIONS: a written contract or agreement between you and b. For Hired Auto Physical Damage Cover- that person or organization, that is signed and age, the following are deemed to be cov- executed by you before the "bodily injury" or ered "autos" you own: "property damage" occurs and that is in effect (1) Any covered "auto" you lease, hire, during the policy period, to be named as an addi- rent or borrow; and tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance (2) Any covered "auto" hired or rented by applies and only to the extent that person or or- your "employee" under a contract in ganization qualifies as an "insured" under the that individual "employee's" name, Who Is An Insured provision contained in Section with your permission, while perform- II ing duties related to the conduct of B. EMPLOYEE HIRED AUTO your business. However, any "auto" that is leased, hired, 1. The following is added to Paragraph A.1., rented or borrowed with a driver is not a Who Is An Insured, of SECTION II - LI- covered "auto". ABILITY COVERAGE: An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED operating a covered "auto" hired or rented The following is added to Paragraph A.1., Who Is under a contract or agreement in that "em- An Insured, of SECTION II - LIABILITY COV- ployee's" name, with your permission, while ERAGE: CA T4 20 07 10 © 2010 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission- COMMERCIAL AUTO Any "employee" of yours is an "insured" while us- (3) If a repair or replacement results in better ing a covered "auto" you don't own, hire or borrow than like kind or quality, we will not pay for the in your business or your personal affairs. amount of betterment. D. SUPPLEMENTARY PAYMENTS - INCREASED (4) A deductible equal to the highest Physical LIMITS Damage deductible applicable to any owned 1. The following replaces Paragraph A.2.a.(2) of covered "auto". SECTION II - LIABILITY COVERAGE: (5) This Coverage Extension does not apply to: (2) Up to $3,000 for cost of bail bonds (in- (a) Any "auto" that is hired, rented or bor- cluding bonds for related traffic law viola- rowed with a driver; or tions) required because of an "accident" (b) Any "auto" that is hired, rented or bor- we cover- We do not have to furnish rowed from your "employee". these bonds. 2. The following replaces Paragraph A.2.a.(4) of G. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES -INCREASED LIMIT SECTION II - LIABILITY COVERAGE: The following replaces the first sentence in Para- (4) All reasonable expenses incurred by the graph A.4.a., Transportation Expenses, of "insured" at our request including actual SECTION III - PHYSICAL DAMAGE COVER- loss of earnings up to $500 a day be- AGE: cause of time off from work. E. TRAILERS - INCREASED LOAD CAPACITY We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- The following replaces Paragraph C.1. of SEC- curred by you because of the total theft of a cov- TION I - COVERED AUTOS: ered "auto" of the private passenger type. 1. "Trailers" with a load capacity of 3,000 H. AUDIO, VISUAL AND DATA ELECTRONIC pounds or less designed primarily for travel EQUIPMENT - INCREASED LIMIT on public roads. Paragraph C.2.. Limit Of Insurance, of SEC- F. HIRED AUTO PHYSICAL DAMAGE TION 111 - PHYSICAL DAMAGE COVERAGE is The following is added to Paragraph AA., Cover- deleted. age Extensions, of SECTION III - PHYSICAL I. WAIVER OF DEDUCTIBLE - GLASS DAMAGE COVERAGE: The following is added to Paragraph D., Deducti- Hired Auto Physical Damage Coverage ble, of SECTION III - PHYSICAL DAMAGE If hired "autos" are covered "autos" for Liability COVERAGE: Coverage but not covered "autos" for Physical No deductible for a covered "auto" will apply to Damage Coverage, and this policy also provides glass damage if the glass is repaired rather than Physical Damage Coverage for an owned "auto", replaced. then the Physical Damage Coverage is extended J. PERSONAL EFFECTS to "autos" that you hire, rent or borrow subject to the following: The following is added to Paragraph AA., Cover- (1) The most we will pay for "loss" in any one age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE- "accident" to a hired, rented or borrowed auto" is the lesser of: Personal Effects Coverage (a) $50,000; We will pay up to $400 for "loss" to wearing ap- (b) The actual cash value of the damaged or parel and other personal effects which are: stolen property as of the time of the (1) Owned by an "insured"; and "loss", or (2) In or on your covered "auto". (c) The cost of repairing or replacing the This coverage only applies in the event of a total damaged or stolen property with other theft of your covered "auto"_ property of like kind and quality. No deductibles apply to Personal Effects cover- (2) An adjustment for depreciation and physical age. condition will be made in determining actual cash value in the event of a total "loss". Page 2 of 3 © 2010 The Travelers Indemnity Company. All rights reserved. CA T4 20 07 10 Includes copyrighted material of Insurance Services Office, Inc. with its permission- COMMERCIAL AUTO K. AIRBAGS (2) Any: The following is added to Paragraph B.3., Exclu- (a) Overdue lease or loan payments at the sions, of SECTION III - PHYSICAL DAMAGE time of the "loss"; COVERAGE: (b) Financial penalties imposed under a Exclusion 3.a. does not apply to "loss" to one or lease for excessive use, abnormal wear more airbags in a covered "auto" you own that in- and tear or high mileage; flate due to a cause other than a cause of "loss" (c) Security deposits not returned by the les- set forth in Paragraphs A.1.b. and A.1.c., but sor, only: (d) Costs for extended warranties, Credit Life a. If that "auto" is a covered "auto" for Compre- Insurance, Health, Accident or Disability hensive Coverage under this policy; Insurance purchased with the loan or b. The airbags are not covered under any war- lease; and ranty; and (e) Carry-over balances from previous loans c_ The airbags were not intentionally inflated. or leases. We will pay up to a maximum of $1,000 for any M. BLANKET WAIVER OF SUBROGATION one "loss". The following replaces Paragraph A.S., Transfer L. AUTO LOAN LEASE GAP Of Rights Of Recovery Against Others To Us, The following is added to Paragraph A.4., Cover- of SECTION IV - BUSINESS AUTO CONDI- age Extensions, of SECTION III - PHYSICAL TIONS: DAMAGE COVERAGE: 5. Transfer Of Rights Of Recovery Against Auto Loan Lease Gap Coverage for Private Others To Us Passenger Type Vehicles We waive any right of recovery we may have In the event of a total "loss" to a covered "auto" of against any person or organization to the ex- the private passenger type shown in the Schedule tent required of you by a written contract exe- or Declarations for which Physical Damage Cov- cuted prior to any "accident" or "loss", pro- erage is provided, we will pay any unpaid amount vided that the "accident" or "loss" arises out of due on the lease or loan for such covered "auto" the operations contemplated by such con- less the following: tract. The waiver applies only to the person or organization designated in such contract. (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto", and CA T4 20 07 10 0 2010 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DATE (MM/DD/YYYY) ,4c"rro CERTIFICATE OF LIABILITY INSURANCE 8/12/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 11 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 endorsements . PRODUCER NAME: CONTACT Bellin ham, WA-Hub International Northwest PHONE 9 , C No Ext :360-647-9000 vc,No1:360 734-8496 110 Unity St. E-MAIL Bellingham WA 98225 ADDRESS:now.Unl info hubinter_.national,com INSURE (S) AFFORDING COVERAGE NAIC # INSURER A:Ad mi ral Insurance Company_ INSURED AQUALLC-03 INSURER B: AquaTechnex LLC INSURER C: DBA H2O TechneX INSURER D PO Box 30824 - Bellingham WA 98228 INSURERS. INSURER F : COVERAGES CERTIFICATE NUMBER: 813096320 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP 1 LIMITS INSR WVp POLICY NUMBER MM/DD/WYY MMIDDNYYY ATR GENERAL LIABILITY Y Y FEIECC1651202 7/15!2015 7/15/2016 EACH OCCURRENCE $2,000,00.0 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrences $50,000 CLAIMS-MADE OCCUR MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE _ $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $4,000,0_00_ POLICY X PECa LOC Deductible $5,000 IN L LI m person) LIABILITY 75991-NE5 ! (Ea accidents _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS - - NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident) UMBRELLA LAB OCCUR EACH OCCURRENCE 1 $ j EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ A WORKERS COMPENSATION FEIECC1651202 7/15/2015 7/15/2016 WCSTATU- X IoTH- Wa Stop Gap AND EMPLOYERS' LIABILITY Y I N TORY LIMITS ERr_ _ _ - ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED. N / A (Mandatory In NH) r E L DISEASE- EA EMPLOYE1,000, 000 - If es, tlescribe under - -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATION'S below 1 E DE A Professional FEIECC1651202 7/15/2015 7/15/2016 Aggregate 2,000,000 Pollution Y Y Each Claim 1,000,000 Deductible 5,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Performs and conditions. Automatic Additional Insured form ECC-319-0712; Additional Insured with Completed Operations form CG 20 37 07 04; Waiver of Subrogation form ECC-320-0712; Primary and Non-Contributory form ECC-548-0712; Per Project Aggregate CG 25 03 11 85. 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. 90 N Mountain Ave Ashland OR 97520 AUTHORIZ D REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Aquatechrm Inc Endorsement Number 27 w~ Asti. Amendment - Aggregate Limits of Insurance (Per Project) This endorsement, effective 7-15-2015 attaches to and forms a part of Pdtry Number FEI-ECC•16512-02 This endorsement changes the Policy Please need it carefully In consideration of an additional premium of SWi this endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIIv1ITS OF INSURANCE (SECTION M) applies separately to each of your projects away from premises owned by or rented to you. CG 25 0311 85 Copy t9hL Insurance SeNces t7Rice. Inc 1954 Aquatechnex Inc Endorsement Number 18 lrMOM - Automatic Primary and Non-Contributory Insurance Endorsement Designated Work Or Project(s) This endorsement, effective 7-15-2015 ettaclm to and forms a pert of Policy Number FEI-ECC-16512-02 This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the No ed insured agrees, in a written contract, to provide Primary andlex Non-eoNributory status of this insurance. However, this status exists only for the projed specified in that contracL In consideration of an additional prcminnn of SApplied and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreod that any other insurance which the pcoon(s) or organization(s) named in the schedule may have is excess and non- contributory to this insurance. ECC-548-0712 Aquatechnmr Inc Endorsement Number 6 YwTp Automatic Waiver of Subrogation Endorsement This endorsement, effective 7-15-2015 attaches to and forms a past of Policy Number FEI-ECC-16512-02 This endorsement changes the Policy Please read it carefully This endorsement modifies insurance provided under the following. CONOdERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name ofPerson or Organization: Any person(s) or organization(s) to whom iltc Named Insured agrees, in a written contract, to provide a twaiver of subrogation. However, this status costs only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the knired's wale done under a contract with that per son or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to ex" the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. ECC-320-0712 Aquatechnex Inc Endorsement Number 26 Additional Insured - Owners, Lessees or Contractors - Completed Operations This endorsement, effective 7-15-201$ attaches to and forms apart of Policy Number FEt-ECC-16512-02 This endorsement changes the Policy Please read it carefully In consideration of an additional premium of iplih this endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) London And Description Of Completed Or O nkolSo s): Operations Any person(s) or organization(s) whom the Named Insured Those project locations where this agrees, in a written contract, to name as an additional insured endorsement is required by contract However, this status exists only for the project specified in that contract Information required to complete this Schedule. ifnot shown above. will be shown in the Dedwadons Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of ibis endorsement performed for that additional insttrs,d and included in the "products- completed operations hazard". CG 20 37 07 04 0 ISO Properties, Inc., 2004 Aquatechrm Inc Endorsement Number 5 wasrex aese~ Automatic Additional Insured Owners, Lessees or Contractors This endorsement, effective 7 15-2015 attaches to and forms a part of Policy Number FED-ECC-16512-02 This endorsement changes the Policy Please read it carefully This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Nana of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured However, this status exists only for the protect specified in that contract. The person or organization shmvn in this Schedule is included as an insured, but only with respect to that person's or organization's vicarious liability arising out of your ongoing operations performed for that insured. ECC-319-0712 Page 1 / 1 CITY OF ® ASHLAND DATE PO NUMBER 20 E MAIN ST. 7/15/2015 12997 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 013549 SHIP TO: Ashland Water Treatment Plant AQUATECHNEX LCC (541) 488-5345 PO BOX 30824 ASHLAND, OR 97520 BELLINGHAM, WA 98228 FOB Point: Ashland, Oregon Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Greg Hunter Special Inst: Confirming? No Quantity Unit Description Unit Price Ext. Price 3.00 Ordr Invitation to Bid 2015-101 -Chemicals 16,234.40000 48,703.20 for WTP & WWTP PAK27 Sodium Carbonate Peroxvhvdrate Alqaecide (6 Full Reservoir Treatments) Location: WTP 280 Bags per order, 50 Ibs per bag, cost per pound $1.1596, deliverv charqe included SUBTOTAL 48 703.20 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 48,703.20 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 670.08.19.00.60150 48 703.20 >rPrf; - Authorized Signature VENDOR COPY FORM#3 CITY OF ASHLAND REQUISITION Date of request: 7-1-15 Required date for delivery: 7-15-15 Vendor Name AQUA TECHNEX LLC Address, City, State, Zip Contact Name & Telephone Number Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ® Invitation to Bid (Copies n file ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date p'proved by Council / ❑ Written quote or proposal attached ❑ Written quote or proposal attached Attach co of council communication -(If council approval required, attach co of CC ❑ 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) -(Attach copy of council communication) ❑ 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 - (Attach copy of council communication) Description of SERVICES Total Cost Item # Quantity Unit Description of MATERIALS Unit Price Total Cost 1 3 ORDERS 280 BAGS PAK27 SODIUM CARBONATE PEROXYHYDRATE ALGAECIDE 16,234.40 48,703.20 ( 6 FULL RESERVOIR TREATMENTS) r~ TOTAL COST ❑ Per attached quotelproposal $ 48,703.20 Project Number _ _ _ _ _ _ - _ _ _ Account Number 670.08.19.00.601500 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 certify that the City's public contracting requirements have been satisfied, Employee: Department Head: A c i t Al G (Equal to or greater than $5,000) Department Manager/Supervisor: City Administrator: 0--0( (Equal to or greatan $25,000) Funds appropriated for current fiscal year: (YES / NO Finance Director- (Equal to orgreater an $5,000) Date Comments: Form #3 - RPm iNition