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HomeMy WebLinkAbout2015-317 Contract - Terrasurvey Inc Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: Terrasurvey Inc. ASHLAND CONTACT: Richard F. Alspach P.L.S 20 East Main Street Ashland, Oregon 97520 ADDRESS: 274 Fourth St. Telephone: 541/488-6002 Ashland OR 97520 Fax: 541/488-5311 TELEPHONE: 541-482-6474 DATE AGREEMENT PREPARED: 7/1/2015 FAX: BEGINNING DATE: 7/1/2015 COMPLETION DATE: 6/30/2017 COMPENSATION: Not to Exceed (NTE) $30,000 SERVICES TO BE PROVIDED: Miscellaneous on call surveying services on a time and materials basis. Reference exhibit C, Terra Surveying fee schedule. ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Personal 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. FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service 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. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service 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. 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of City. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is $20,142.20 or more, Consultant 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 service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant 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 Consultant (including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused b the negligence of City. Contract for Personal Services, Revised 06/02/2015, Page 1 of 5 10. 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 part, effective upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: L 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 Consultant 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 Consultant 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 Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant 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, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant 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 Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant 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. Consultant 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. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant 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. 14. Insurance. Consultant 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. Professional 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 claim, incident or occurrence. This is to cover damages caused by error, omission or negligent acts related to the professional services to be provided under this contract. C. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000,$500,000,$1,000,000,$2,000,60 0 or Not Applicable for each occurrence for Bodily Injury and Property Damage. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, 11&90_,000, or Not Applicable for each accident for Bodily Injury and Property e, Contract for Personal Services, Revised 06/02/2015, Page 2 of 5 including coverage for owned, hired or non-owned vehicles, as applicable. e. 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 Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant 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 Consultant's services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. 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 Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 15. 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 Consultant 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. Consultant, 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. 16. 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. CONSULTANT, 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. 17. 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. Consultant 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 Consultant, with no further liability to Consultant. Certification. Consultant shall sign the certification attached hereto as Exhibit A and herein incorporated b reference. Consultant: City-of-Ashland By By Sig)1naature Department Head Print Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order N10. ~AP OVEP~~SITO FORM Ashl City Attorney Date ~C'~ - 1 '5-_ Contract for Personal Services, 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: v (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. Contractor (Date) Contract for Personal Services, Revised 06/02/2015, Page 4 of 5 CITY • ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGE • • 1 per hour effective June 30, 2015 (Increases annually every June 30 by the /r Consumer Price Index) • - 1 - • . 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, additional 'For 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 O F ASHLAND Contract for Personal Services, Revised 06/02/2015, Page 5 of 5 EXHIBIT C TERRASURVEY, INC. TELEPHONE (541) 4826474 PROFESSIONAL LAND SURVEYORS terrain@Uispmet 274 FOURTH STREET irmr.terrasimeyinc.com ASHLAND, OREGON 97520 TERRASURVEY, INC. FEE SCHEDULE 2015 ~Ecca~L'~tT LSURVEY CREW: $160.00/HR PROFESSIONAL: $100.00/HR SURVEY TECHNICIAN: $80.00/HR DRAFT PERSON: $80.00/HR CLERICAL: $65.00/HR THERE IS NO ADDITIONAL CHARGE FOR COMPUTER TIME, MILEAGE, IN- HOUSE PRINTS, MAIL, COPIES, FAXES, PHONE CALLS, OR NORMAL SURVEYING SUPPLIES SUCH AS LATH OR STAKES. THESE ITEMS ARE CONSIDERED TO BE INCLUDED IN THE HOURLY RATE. If you have any questions please feel free to call me. Regards, Richar F. Alspach, PLS ® F DATE(MMIDDIYYYY) coRO CERTIFICATE OF LIABILITY INSURANCE 7/13/2015 PHIS 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. :MPORTANT: 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). ODUCER CONTAGT NAME Julie Asher shland Insurance Inc PHONE (541) 482-0831 I FAX (541) 488-5851 -1kc._Na _Exdc (AIC. Not: 35 A Street Suite 1 E-MAIL 7asher@ashlandinsurance.com ADDRESS: 0. Box 880 INSURERS AFFORDING COVERAGE NAIC# shland OR 97520 INSURERA:Foremost Insurance Cc 11185 iURED INSURERa -.North Pacific 23892 :RRASURVEY, INC INSURER C- 74 4TH STREET INSURER D: INSURER E : 4 3HLAND OR 97520-2044 INSURER F: OVERAGES CERTIFICATE NUMBER:CL1551105451 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. ~R TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY IXP LIMITS POLICYNUMBER MMIDDVYYYY MMIO I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE Is 1,000,000 CLAIMS-MADE OCCUR l PREMMI ES Es occurrence) 5 1,000,00D PAS043357319 5/1012015 5/10/2015 MED EXP (Any one person) is 10 , 000 PERSONAL BADVINJURY IS 1, 000, DOD GEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE Is 2,000,000 X I POLICY PRO JECT ~ LOC PRODUCTS - COMPIOPAGG IS 2,000,000 7 OTHER: HIREA Is 1,000,000 AUOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea accldent I ANY AUTO BODILY INJURY (Par person) is ALL OWNED X SCHEDULED C14151749 10/30/2014 10/30/2015 BODILY INJURY (Peraccfdent) S AUTOS AUTOS H NON-OWNED PROPERTY DAMAGE s HIRED AUTOS AUTOS (Par accldent ``Unfnsuradmoloristcombined Is 1,000,000 Pill' UMBRELLA LIAR J OCCUR i EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION I PER I IOTH- AND EMPLOYERS' LIABILITY YIN STATUTE IER ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT s OFFICERIMEMBER EXCLUDED7 N/A (Mandatory In NH) EL DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If morn space Is required) ERTIFICATE HOLDER CANCELLATION 541) 488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn : Bradley Barber ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main St. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE / Julia Asher © ACORD CORPORAT N. All rights reserved. ,CORD 25 (2014/01) The ACORD name and logo are registered m tB.-,10/4 CORD 95025 (201401) (MM/DD ACC> Ii CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) 7/13/2015 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 endorsements . PRODUCER CONTACT NAME: Michael J Hall & Company F~Axc No: Michael J Hall & Company PHONE Exti,360-598-3700 Hall & Company E-MAIL 19660 10th Ave NE ADDRESs:C ifi h II n m n m Poulsbo WA 98370 INSURERS AFFORDING COVERAGE NAIC # INSURER A: I INSURANCE UNDERWRITERS INC 19917 INSURED 1073 INSURER B : Terrasurvey, Inc INSURER C: 274 Fourth Street INSURER D : Ashland OR 97520 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 620612736 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 LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYW MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE F7 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY F7.IF(.T F7 PRO LOC $ AUTOMOBILE LIABILITY COMBINED IN LE 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 Peraccident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y I N I ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F-] N / A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liab: Claims Made AEA1023690001 2/8/2015 2/8/2017 $1,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Misc Surveying Services 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 to: Brad Barber 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CITY OF ASHLAND WORKERS' COMPENSATION INSURANCE CERTIFICATION [CONTRACTOR MUST INITIAL APPLICABLE BLANK BELOW] CERTIFICATION OF COVERAGE: Contractor will maintain Workers' Compensation insurance coverage for the term of the contract and will provide Certificate of Workers' Compensation Insurance before Project Beginning Date. CERTIFICATION OF EXEMPTION FROM COVERAGE: Contractor is exempt from the requirement to obtain workers compensation insurance under ORS Chapter 666 for the following reason (initial the appropriate box). SOLE PROPRIETOR - Contractor is a sole proprietor, and - Contractor has no employees, and - Contractor will not hire employees or subcontractors to perform this contract. CORPORATION - FOR PROFIT - Contractor's business is incorporated; and - All employees of the corporation are officers and directors and have a substantial ownership interest* in the corporation. and - All work will beperformed by the officers and directors: Contractor will not hire other employees or subcontractors to perform this contract. CORPORATION - NONPROFIT Contractor's business is incorporated as a nonprofit corporation. and Contractor has no employees: all work is performed by volunteers, and - Contractor will not hire employees or subcontractors to perform this contract. PARTNERSHIP Contractor is a partnership, and Contractorhas no employees. and - All work will be performed by the partners: Contractor will not hire employees or subcontractors to perform this contract. and Contractor is not engaged in work performed indirect connection with the construction. alteration, repair, improvement. moving or demolition of an improvement to real property or appurtenances thereto.** LIMITED LIABILITY COMPANY - Contractor is a limited liability company. and - Contractor has no employees. and - All work will be performed by the members; Contractor will not hire employees or subcontractors to perform this contract. and - If Contractor has more than one member. Contractor is not en_a:ed in %vork performed in direct connection with the construction, alteration, repair, improvement. moving or demolition of an i rovement to real property or appurtenances thereto.** / (Signature of Auth ized Signer) (Date) (Signer's'T itle) *NOTE: Under OAR 436-50-050 a shareholder has a "substantial ownership" interest if the shareholder owns 10% of the corporation, or if less than 10% is owned, the shareholder has ownership that is at least equal to or greater than the average percentage of ownership of all shareholders. **NOTE: Under certain circumstances partnerships and limited liability companies can claim an exemption even when performing construction work. The requirements for this exemption are complicated. Consult with City Attorney's Office before an exemption request is accepted from a contractor who will perform construction work. Page 1 / 1 CITY OF DATE PO NUMBER ASHLAND IVA& 20 E MAIN ST. 11/6/2015 13227 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 003354 SHIP TO: Ashland Public Works TERRASURVEY, INC (541) 488-5587 274 FOURTH STREET 51 WINBURN WAY ASHLAND, OR 97520 ASHLAND, OR 97520 FOB Point: Ashland, Oreqon Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Scott Fluery Special Inst: Confirming? NO Quantity Unit Description Unit Price Ext. Price Miscellaneous On-Call Surveyinq Services 15,000.00 50/50 City/Parks (Separate PO issued for Parks portion) Contract for Personal Services Beqinninq date: 07/01/2015 Completion date: 06/30/2017 f SUBTOTAL 15 000.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 15,000.00 ASHLAND, OR 97520 Account Number Project Number Amount Account umber Project Number Amount E 260.08.12.00.60410 3,000.00 E 280.08.00.00.60410 3,000.00 E 670.08.18.00.60410 2,500.00 E 670.08.19.00.60410 2,500.00 E 675.08.17.00.60410 2,000.00 E 675.08.19.00.60410 2,000.00 v~ VENDOR Authorized Signature COPY .-yam-- FC'RM#3 CITY OFC~~ ASHLAND X11 sa 0 r~-r REQUISITION Date of request: 07/14/15 Required date for delivery: ASAP Vendor Name Terrasurvey, Inc. Address, City, State, Zip 274 Fourth Street, Ashland, OR 97520 Contact Name & Telephone Number Richard Alspach, P.L.S., (541) 482-6474 Fax Number N/A SOURCING METHOD ❑ Exempt from competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ® Direct Award Date approved by Council: Contract # ❑ Verbal/Written quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract $5,000 to $100,000 ❑ Written quote or proposal attached Agency ❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovern mental Agreement $5,000 to $75,000 ❑ Form #9, Request for Approval ❑ Agency ® Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Written proposals/written solicitation Date approved by Council: (Date) ® Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost Miscellaneous on call surveying services on a time and materials basis. Reference Exhibit C Fee Not to exceed $30,000 Schedule. Item # Quantity Unit Description of MATERIALS Unit Price Total Cost ® Per attached quotelproposal TOTAL COST $ Project Number Account Number - - Account Account (Seeattached) `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: I T Director Date Support -Yes/ No By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. Employee: ~~5~~~,.✓ iLJ~~ 7-14/-.IJ- Department Head: 1c (Equal to or greater than $5,000) Department Manager/Superv- -r7==-~-- City Administrator: V (Equal to or greater than $25,000) Funds appropriated for current fiscal ea ' / NO "a1 Finance Director- (Equal to orgreatWthan $5,000) Date Comments: Reference attached memo on account number break down Form #3 - Requisition u CITY OF Memo -,S H LAN D Date: July 14, 2015 From: Scott A. Fleury-Engineering Services Manager To: Kari Olson-Purchasing Representative RE: Miscellaneous Surveying Account Breakdown for Purchase Order-Terra Please split monies for purchase order as detailed below: Parks Department 211.12.02.06.604100-$15,000 Street Operations 260.08.12.00.604100-$3,000 Water Distribution 670.08.018.00.604100-$2,500 Water Treatment 670.08.19.00.604100-$2,500 Wastewater Collections 675.08.17:00.604100-$2,000 Wastewater Treatment 675.08.19.00.604100-$2,000 Airport 280.08.00.00.604100-$3,000 Total Purchase Order $30,000 G:\pub-wrks\eng\15-10 Misc. Surveying FY16_17 Bien niu m\Ad min\Terra Surveying Account Breakdown 7-13-2015.doc ASHLAND PARKS AND RECRIUMN COMMISSION 340 S. PIONEER STREET ASHLAND, OREGON 97520 COMMISSIONERS: Michael A. Black Mike Gardiner Director Rick Landt Jim Levris TEL:541.488.5340 , Matt Miller FAX:541.488.5314 parksinfo@ashland.or.us Mallon Shaw July 7, 2015 Scott Fleury, Engineering Services Manager Public Works, City of Ashland 51 Winbum Way Ashland, OR 97520 Dear Scott, Thank you for offering to include Ashland Parks & Recreation Commission (APRC) in the two year surveying contract that you are putting together right now. We would like APRC to be included for general surveying in the following amounts for the two year period: • Terra Surveying - $15,000 • Polaris Surveying -$15,000 Total for two year period - $30,000 The account number to use for APRC related surveying in the contract will be: 211.12.02.06.604100. Thanks again for including. us in this contract, Sincerely, 0~- Michael A, Black, Director Ashland Parks & Recreation Commission (APRC) 541.488.5340 Home of Famous Uthia Park CITY OF FORM #4 ASHLAND DETERMINATIONS TO PROCURE PERSONAL SERVICES $5,000 to $75,000 To: Dave Kanner, Public Contracting Officer From: Michael R. Faught-Director of Public Works Date: 07114115 Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES In accordance with AMC 2.50.120(A), for personal services contracts greater than $5,000, but less than $75,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City does not have the personnel or resources to perform the services required under the proposed contract. However, the City Attorney, the Public Contracting Officer, or Local Contract Review Board, can require a formal solicitation for bids to ensure that the purposes of this chapter are upheld. Backaround The Department of Public Works intent is to enter in to a personal services contract to provide on-call surveying services on a time and materials basis as needed. The monies for this project comes from the appropriated funds from the Street Operations, Water Distribution, Water Treatment. Waste-mwter Collections, Wasteivater Treatment and Parks Department. The ivork is expected to take place during FY2016 & FY2017. Pursuant to AMC 2.50.120(A), has a reasonable inquiry been conducted as to the availability of City personnel to perform the services, and that the City does not have the personnel and resources to perform the services required under the proposed contract? The City ofAshland Engineering Division does not have the adequate staff time or appropriate resources to provide the scope of service contemplated under this contract- In addition, no other Department in the City has the resources or technical knowledge to complete the work associated -wdth this personal services contract. Form #4 - Department Head Determinations to Procure Personal Services, Page 1 of 1, 7/14/2015