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HomeMy WebLinkAbout2015-336 Contract - Economy Plumbing Contract for GOODS AND SERVICES Small Procurement Less than $5,000 C I T Y OF INDEPENDENT CONTRACTOR: Economy Plumbing -ASHLAND CONTACT: Gerard Fowler 20 East Main Street ADDRESS: 309 Kent St. Ashland Oregon 97520 Ashland, Oregon 97520 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-482-4733 FAX: 541-488-0843 BEGINNING DATE: 11-17-15 COMPLETION DATE: 6-30-2016 COMPENSATION: Per Fee Schedule attached as exhibit "C" not to exceed $5,000 GOODS AND SERVICES TO BE PROVIDED: Plumbing services to be provided on an on -call basis including situations requiring immediate attention as determined by a representative of the Ashland Water Department. In the event of conflicts or discrepancies among Contract Documents, this standard form of the City of Ashland Contract will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with this standard form City of Ashland Contract. NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Ownership of Production: All documents, materials or items produced by Contractor pursuant to this contract shall be the property of City. 4. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 2796.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 5. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from those losses, expenses, or other damages resulting from injury to any person or damage to property arising out of or incident to the negligent performance of this contract by Contractor its employees, or agents. Contractor shall not be held responsible for any losses, expenses, or other damages, directly, solely, and proximately caused by the negligence of City. 6. Termination: City's Convenience. This contract may be terminated at any time by the City. 7. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 8. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. 9. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 10. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work. 11. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 12. Default. The Contractor shall be in default of this agreement if Contractor commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract. 13. Insurance. Contractor shall at its own expense provide the following insurance: a. a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers. Worker's compensation insurance is required if work is performed by employees, subcontractors, or volunteers. BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES UNDER PENALTY OF LAW THAT THE WORK REQUIRED BY THIS CONTRACT SHALL BE PERFORMED SOLELY BY THE UNDERSIGNED: b. General Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 for each occurrence for Bodily Injury and Property Damage. C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. 14. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon 15. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. Certification. C ntractor shall sign the certification attached hereto as Exhibit A and herein incorporated by ref rence. Cont tor: City of Ashland: By By G Ig ture Department ad 6j eya y~ s r_Q L1.) I ell ire v'.= / > , ~ ~ Print Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. Revised 10-29-14 Page 1 of 3 Revised 10-28-14 Page 2 of 3 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 j 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. V (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. Contractor (Date) Revised 10-28-14 Page 3 of 3 ~GOromY Flumb~n9 Gerard Fowler Contract & T 309 Kent Street Proposal Ashland, Oregon 97520 0 ~A Builders Board #62094 Plumbing (541) 482-4733 PROPOSAL SU QDQITTETO PHONE DATE STREET /~/yL `/•g/ 1 C' JOB NAME CITY, STATE AND ZIP ODE JOB LOCATION JOB PHON ~ ARCHITECT DATE OF PLANS E We hereby submit specifications and estimates for: 1 (J rG )5CC4161-n E? t~ r O (61 -e 'L4 c f ~~~1c ~v 1~"!`l tl/lam v` ~ C~-C_.lti c~'S~ !Zr•yct-'1, A -4 1 ~P1'F t^~ 7` I a V e F~{~C 7<~e~ Vve-vt io ~S~ `71'1 WO IVP FrnpnsP hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: dollars Payment to be made as follows: Abbitional 01 erms: 1. Workmanship and Materials specified above are warranted for one year from completion of the project. If defects of any sort appear, the contractor shall correct same, at its own expense, within a reasonable time following receipt of written notice. This shall be the limit of remedies available to the owner and contractor shall not be responsible for incidental or consequential damages of any sort. 2. The contractor is responsible only for its own performance and that of the subcontractors and employees which it hires. Defective performance by architects, other contractors, or other agents of the owner shall not be the contractor's responsibility. 3. The agreed price assumes conditions are as they appear from a reasonable inspection of the property. If, after the commencement of construction, it is discovered that the soil or the existing structure contain latent conditions which will cause contractor additional time or expenditure, these parties shall execute an addendum to the contract and renegotiate the payment terms. Contractor shall be entitled to immediately suspend = performance until said addendum is executed. Any alteration or deviation from the agreed plans and specifications will be performed only upon the execution of addenda to this contract specifying the modified payment terms. 4. In the event that the owner shall fail to make payment as agreed herein, i erest shall accrue at the rate of 1112% per month respecting any delinquent payments. In addition, the contractor shall be entitled to suspend all performance hereunder in the eve t any payment shall be delinquent three days. 5. It is understood that contractor is not providing insurance coverage of any sort for owner. 6. In the event that litigation of an shall arise respec is a r ent, the prevailing party shall be entitled to an award of reasonable attorney fees incurred at trial and on appeal, or for collection measures if a it not filed. Note: This proposal may be CLt1~ withdrawn by us if not accepted within days. Con ctor Armptanre of Froposal -The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance: - I ---"N ECON01C OP ID: HSA ACORO DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE TE(MM/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 NCONTACT AME: Therese Rayburn United Risk Solutions, Inc. PHONE - - - - TFAX - PO Box 936 A/C No Ell: 541-245-1111 (A/c No): 541-245-11.12 Medford, OR 97501-0067 E-MAIL ADDRESS: therese.rayburn@unitedrisk.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Western National Assurance CO 24465 INSURED Economy Plumbing, Inc. INSURER 309 Kent St. - Ashland, OR 97520-1017 INSURER C INSURER D : INSURER E : I _ 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 X BOP10007262 06/01/2015 06/01/2016 DAMAGE TO RENTED $ 100,00 CLAIMS-MADE 1 i OCCUR X PREMISES Ea occurrence) MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ included GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 2,000,00 X POLICY PRO JECT- LOC PRODUCTS - COMP/OP AGG-t $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ea accidents A X ANY AUTO X CPP107477902 06/01/2015 ! 06/01/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR MADE EACH OCCURRENCE EXCESS LIAB AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE_,~ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA' (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ _ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ II I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is Additional Insured for general liability as provided by Endt BP0642 (01/06) and for auto liability as provided by Endt WNCA27 (11/12) CERTIFICATE HOLDER CANCELLATION CITAS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland Service ACCORDANCE WITH THE POLICY PROVISIONS. Water Dept Steve Walker AUTHORIZED REPRESENTATIVE 90 N. Mountain Ave. ~ A d . , Ashland, OR 97520-2014 /~_~(,~Q~ rJyZ~~ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ECON01W OP ID: HSA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/20/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; _ KC Ferguson United Risk Solutions, Inc. PHONE FAx PO Box 936 a_ c No. Ell: 541-494-7752 r(A/C, No : 541-245-1112 Medford, OR 97501-0067 ADDRESS: kc.ferguson@unitedrisk.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : SAIF Corporation 36196 INSURED Economy Plumbing, Inc. INSURER B : 309 Kent St. Ashland, OR 97520-1017 INSURER C INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' ADDL SUBR'j POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR ~DAMAGE TO RENTED EMISES (Ea occurrences$ D EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRO- LOC I. PRODUCT COMP/OP AGG $ POLICY JECT F OTHER' $ AUTOMOBILE LIABILITY ! COMBINED SINGLE LIMIT $ Ea accident - ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS 9 AUTOS BODILY INJURY (Per accident) $ - NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS $ Per accident L _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LI ~GGREGATE - $ AB CLAIMS -MADE - - DED RETENTION $ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY 'STATUTE - ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 782608 10/01/2015 10/01/2016 E.L. EACH ACCIDENT $ 500,000 D Y / N OFFICER/MEMBER ER EXCLUDED? N (Mandatory in NH) ~ (yes, describe under E.L. DISEASE - EA EMPLOYEE $ 500,00 DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 500,00 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: All Operations of the Named Insured CERTIFICATE HOLDER CANCELLATION CITAS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Water Dept. Attn: Steve Walker AUTHORIZED REPRESENTATIVE 90 N. Mountain Ave. n Ashland, OR 97520-2014e~ v a © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD BUSINESSOWNERS BP 06 42 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH ADDITIONAL INSURED REQUIREMENT IN CONSTRUCTION CONTRACT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to Paragraph C. Who Is An caused by your ongoing operations for the Insured in Section II - Liability: additional insured and only to the extent 3. Any person(s) or organization(s) for whom that such "bodily injury", "property dam- you are performing operations is also an age" or "personal and advertising injury" is additional insured, if you and such per- caused by your negligence or the negli- son(s) or organization(s) have agreed in gence of those performing operations on writing in a contract or agreement that your behalf. such person(s) or organization(s) be in- A person's or organization's status as an cluded as an additional insured on your insured under this endorsement ends when policy. Such person(s) or organization(s) is your operations for that insured are com- an additional insured only with respect to pleted or the contractor's agreement is ter- liability for "bodily injury", "property dam- minated. age" or "personal and advertising injury" BP 06 42 01 06 Copyright, ISO Properties, Inc., 2005 Page 1 of 1 WN CA 27 11 12 BUSINESS AUTO ENHANCEMENT ENDORSEMENT The Business Auto Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Accidental Airbag Deployment Coverage 4 Auto Loan/Lease Gap Coverage 4 Blanket Additional Insured 2 Blanket Waiver of Subrogation 5 Broadened Definition of Insured includes: Newly Acquired Organizations for up to 180 Days 2 Employees as Insureds 2 Subsidiaries in Which You Own 50% or More 2 Broadened Definition of Bodily Injury to Include Mental Anguish 5 Deductible Waiver for Glass Repair 3 Employee Hired Auto 2,5 Fellow Employee Coverage 3 Hired Auto Physical Damage Coverage 3 Knowledge of Accident, Claim, Suit or Loss 4 Loss Of Use Expenses - Amended 3 Personal Effects 3 Rental Reimbursement Coverage 3 Supplementary Payments - Amended: Bail Bonds up to $5,000 2 Loss of Earnings up to $500/Day 2 Transportation Expense Limits - Amended 3 Unintentional Failure to Disclose Hazards 5 WN CA 27 11 12 Includes copyrighted material of Insurance Services Office, with its permission Page 1 of 5 WN CA 27 It 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 II. (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 WNCA271112 "insured" at our request, including actual loss Causes of Loss, or Collision coverages are of earnings up to $500 a day because of time provided under this coverage form for any off from work. "auto" you own, then the Physical Damage Coverages provided are extended to "autos" D. Fellow Employee Coverage you hire of like kind and use, subject to the SECTION II - LIABILITY COVERAGE, B. following: Exclusions, S. Fellow Employee does not apply. a. The most we will pay for any one "loss" is $50,000 or the actual cash value or cost SECTION III - PHYSICAL DAMAGE COVERAGE to repair or replace, whichever is less, AMENDMENTS minus a deductible; A. Transportation Expense - Limits Amended b. The deductible will be equal to the largest SECTION III - PHYSICAL DAMAGE deductible applicable to any owned "auto" COVERAGE, A. Coverage, 4. Coverage for that coverage. Any Comprehensive 9e, 9a deductible does not apply to "loss" caused Extensions, a. Transportation Expenses is by fire or lightening; amended by replacing $20 per day/$600 maximum limit with $50 per day/$1000 maximum. c. Hired Auto Physical Damage coverage is excess over any other collectible B. Hired Auto Physical Damage - Loss Of Use insurance; and Expenses - Limits Amended d. Subject to the above limit, deductible and SECTION III - PHYSICAL DAMAGE excess provisions we will provide COVERAGE, Item A. Coverage, 4. Coverage coverage equal to the broadest coverage Extensions, b. Loss of Use Expenses is applicable to any covered "auto" you own. amended by replacing the $20 per day/$600 If a limit for Hired Auto Physical Damage is maximum limit with $50 per day/$750 maximum indicated in the Declarations, then that limit limit. replaces, and is not added to, the $50,000 limit C. Personal Effects Coverage indicated above. SECTION III - PHYSICAL DAMAGE F. Rental Reimbursement COVERAGE, Item A., Coverage, 4. Coverage Extensions is amended by adding the following: SECTION III - PHYSICAL DAMAGE COVERAGE Item A. Coverage, is amended by c. Personal Effects adding the following: We will pay up to $500 for "loss" to personal 6. This coverage applies only to a covered "auto" effects, which are: of the private passenger or light truck type as follows: (1) Owned by an "insured"; and a. We will pay for rental reimbursement (2) In or on your covered "auto." expenses incurred by you for the rental of This coverage applies only in the event of the total a private passenger or light truck type theft of your covered "auto." No deductible applies "auto" because of "lossi to a covered to this coverage private passenger or light truck type "auto". Payment applies in addition to the D. Glass Repair - Deductible Waiver otherwise applicable amount of each coverage you have on a covered private SECTION III - PHYSICAL DAMAGE passenger or light truck type "auto." No COVERAGE, Item A. Coverage, 3. Glass deductibles apply to this coverage. Breakage, is amended by adding the following: b. We will pay only for those expenses No deductible will apply to glass breakage if such incurred during the policy period glass is repaired, in a manner acceptable to us, beginning 24 hours after the "loss" and rather than replaced. ending, regardless of the policy's expiration, with the lesser of the following E. Hired Auto Physical Damage number of days: SECTION III - PHYSICAL DAMAGE 1. The number of days reasonably COVERAGE, Item A. Coverage is amended by required to repair or replace the adding the following: covered private passenger or light truck type "auto". If "loss" is caused S. If hired "autos" are covered "autos" for Liability by theft, this number of days is added Coverage and if Comprehensive, Specified to the number of days it takes to WN CA 27 11 12 Includes copyrighted material of Insurance Services Office, with its permission Page 3 of 5 WN CA 27 11 12 locate the covered private passenger In the event of a covered total "loss" to a or light truck type "auto" and return it covered "auto" described or designated in the to you; or Schedule or in the Declarations, we will pay 2. 30 days. any unpaid amount due on the lease or loan for a covered "auto" less: c. Our payment is limited to the lesser of the a. The amount paid under the Physical following amounts: Damage Coverage Section on the policy; 1. Necessary and actual expenses and incurred, or b. Any: 2. $50 per day, up to a maximum of $1,000. (1) Overdue lease/loan payments at the time of the "loss"; d. This coverage does not apply while there are spare or reserve private passenger or (2) Financial penalties imposed under a light truck type "autos" available to you for lease for excessive use, abnormal your operations. wear and tear or high mileage; e. If "loss" results from the total theft of a (3) Security deposits not returned by the covered "auto" of the private passenger or lessor; light truck type, we will pay under this (4) Costs for extended warranties, Credit coverage only that amount of your rental Life reimbursement expenses which is not Insurance, Health, Accident or already provided for under SECTION III - Disability Insurance purchased with PHYSICAL DAMAGE COVERAGE, A. the loan or lease; and Coverage, 4. Coverage Extension. (5) Carry-over balances from previous For the purposes of this Rental Reimbursement loans or leases. coverage, light truck is defined as a truck with a gross vehicle weight of 10,000 lbs. or less as SECTION IV - BUSINESS AUTO CONDITION defined by the manufacturer as the maximum AMENDMENTS loaded weight the auto is designed to carry. A. Duties In The Event Of Accident, Claim, Suit Or G. Accidental Airbag Deployment Coverage Loss Amended SECTION III - PHYSICAL DAMAGE SECTION IV - BUSINESS AUTO CONDITIONS, COVERAGE Item A. Coverage is amended by A. Loss Conditions, 2. Duties In The Event Of adding the following: Accident, Claim, Suit Or Loss, a. is amended by 7. We will pay to reset or replace factory adding the following: installed airbag(s) in any covered "auto" for This condition applies only when the "accident" or accidental discharge, other than discharge "loss" is known to: due to a collision loss. This coverage is applicable only if (1) You, if you are an individual; comprehensive coverage applies to the (2) A partner, if you are a partnership; covered "auto". (3) An executive officer or insurance manager, if This coverage is excess over any other you are a corporation; or collectible insurance or reimbursement by manufacturer's warranty. (4) A member or manager, if you are a limited liability company. H. Auto Loan/Lease Gap Coverage But, this section does not amend the provisions SECTION III PHYSICAL DAMAGE COVERAGE, relating to notification of police, protection or Item A., Coverage, is amended by adding the examination of the property which was subject to following: the "loss". 8. This coverage applies only to a covered "auto" described or designated in the Schedule or in the Declarations as including physical damage coverage. WN CA 27 11 12 Includes copyrighted material of Insurance Services Office, with its permission Page 4 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, S. Transfer of Rights of B. General Conditions, S. 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 waiver applies only to the person or organization (2) Any covered "auto" hired or rented by designated in such contract. your "employee" under a contract in that 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 DATE PO NUMBER ASHLAND 20 E MAIN ST. 12/10/2015 13283 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 001578 SHIP TO: Ashland Water Department ECONOMY PLUMBING, INC (541) 488-5354 309 KENT ST 90 N MOUNTAIN ASHLAND, OR 97520 ASHLAND, OR 97520 FOB Point: Ashland, Oreqon Req. N~.: Terms: Net 30 days Dept.: Req. Del. Date: Conta.t: Steve Walker Special Inst: Confirming? NO Quantity Unit Description Unit Price Ext. Price On-call plumbinq services for 4,995.00 situations requiring immediate attention. Contract for Goods and Services Beginninq date: 11/17/2015 Completion date: 06/30/2016 i SUBTOTAL 4,995.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 4,995.00 ASHLAND, OR 97520 Account Number Project Number Amount Account'Number Project Number Amount E 670.08.18.00.60240 4,995.00 p" Authorized'Signature VENDOR COPY FIFORM #3 CITY OF ASHLAND REQUISITION Date of request: 11-23-15 Required date for delivery: ASAP Vendor Name Ecrlnamy liimhing Address, City, State, Zip 309 Kent St. Ashland Oregon 97520 Contact Name & Telephone Number Gerard Fowler 541-482-4733 Fax Number 541-488-0843 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 X Small Procurement Cooperative Procurement Less than $5.000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon XDirect 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 ❑ Agency ❑ Form #9; Request for Approval ❑ Less than $35,000, by direct appointment ❑ Written giuote 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 Provide the City of Ashland Water Dept. with miscellaneous plumbing services on an as $ 4,995. needed basis Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ Project Number _ _ _ _ _ _ - _ _ _ Account Number 670.08.18.00.602400 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: By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. IT Director Date Support -Yes /No Employee: Department Head: tel.- I p S~IS (Equal to or Brea er an $5,000) Department Manager/Supervisor: ~ity Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year.F / NO y4(~ Finance Director- (Equalto orgreaterthan $5,000) Date Comments: Form #3 - Requisition