Loading...
HomeMy WebLinkAbout2016-034 Contract - Viking Automatic Sprinkler Contract for GOODS AND SERVICES Small Procurement Less inan $5,000 CITY OF INDEPENDENT CONTRACTOR: Viking Automatic Sprinkler Company -ASHLAND 20 East Main Street CONTACT: Chris Anderson Ashland, Oregon 97520 ADDRESS: 4961 Industry Drive, Medford, OR, 97502-1200 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: (541) 773-1052 FAX: (541) 773-1609 BEGINNING DATE: April 1, 2016 COMPLETION DATE: July 1, 2016 COMPENSATION: Not to exceed $4,944 GOODS AND SERVICES TO BE PROVIDED: Viking Automatic Sprinkler Company (Contractor) agrees to provide inspection and testing services of fire sprinkler systems in City of Ashland (City) facilities, completed to NFPA-25 standards for the five-year inspection interval. Sprinkler systems shall be inspected in the following facilities: City Hall*, The Grove, Community Development Building, and Parking Garage. As described in Exhibit B (quotation), The inspection shall include: a. internal inspection of piping; b. flushing of the Fire Department Connection (except at City Hall, see below); c. trip test of the dry pipe valve shall be conducted in the Parking Structure; and d. written reports upon completion of inspection. Inspection reports shall be submitted to City within 30 days of performing the inspection and testing. In addition, a copy of the report shall be provided to the Fire Code Official (Chief Hickman, 455 Siskiyou Boulevard, Ashland, OR 97520). Report shall including a list of deficiencies and/or notes and recommendations, including estimated repair costs. City prefers contractor provide report on the Southern Oregon Fire Code Officials (SOFCO) NFPA 25 Form, or equal. Contractor shall contact City at least five full working days prior to planned start of inspection to coordinate access to facilities. All materials necessary for inspection and testing shall be furnished by Contractor. *Oregon Shakespeare Festival (OSF) offices are located in Pioneer Hall, which shares a wall and sprinkler system with City Hall. OSF completed a five-year sprinkler inspection on their side of the building on 12115115, including a flush of the Fire Department Connection. Consequently, sprinkler inspections in City Hall need only extend to the point of connection with OSF, as confirmed by Fire Code Official. 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 27913220, 2796225, 27913.230, 27913.235, 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. Revised 10-28-14 Page 1 of 3 12. Default. The Contractor shall be in default of this agreement if Contractor commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract. 13. Insurance. Contractor shall at its own expense provide the following insurance: a. a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers. Worker's compensation insurance is required if work is performed by employees, subcontractors, or volunteers. BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES UNDER PENALTY OF LAW THAT THE WORK REQUIRED BY THIS CONTRACT SHALL BE PERFORMED SOLELY BY THE UNDERSIGNED:. b. General Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 for each occurrence for Bodily Injury and Property Damage. C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. 14. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon 15. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Contrac r: City of Ashland: By By I'D _V. Signature Department Head ~rCoUS~, 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 10-28-14 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: X,_ (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) Revised 10-28-14 Page 3 of 3 tfh/~ f~ VIKING AUTOMATIC SPRINKLER COMPANY 4961 Industry Drive Medford, Oregon 97502-1200 FIRE PROTECTION Tel: (541) 773-1052 Fax: (541) 773-1609 FIRE PROTECTION COWNACTOR S SINCE 1930 City Of Ashland 1/7/16 RE: Fire Sprinkler Inspection Attn: Wes Hoadley Gentlemen, Five Year Fire Sprinkler Inspections located at: • The Grove • City Hall • Parking Garage • Community Development For the Time & Material Not to Exceed sum of $4,944 (Four Thousand Nine Hundred Forty Four Dollars). We propose to complete a five year inspection on the fire sprinkler systems on the above referenced facilities. The five year inspection involves internal inspection of piping & flushing the Fire Department Connection. In the parking structure we recommend a trip test of the dry pipe valve during warmer weather to prevent freezing. A written report will be provided upon completion of the inspection. This proposal does not include the following items: 1. Overtime Hours 2. Permits 3. Repairs other than listed above 4. Access to City Hall FDC check valve. We trust that the above meets with your approval and look forward to working with you on this project. Thank you for calling Viking. Best regards, &izid 14W&Tj" Chris Anderson Viking Automatic Sprinkler Company OREGON CORPORATION WASHINGTON CORPORATION IDAHO CORPORATION PORTLAND ♦ MEDFORD SEATTLE ♦ LONGVIEW MERIDIAN ♦ POCATELLO CCB #64837 CLN #VIKINAS373N'r LIC #FPSC - 003 Client#: 1:. 8 :IAUT02 DATE (MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 2/0412016 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: 1f the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME ACT Shelley Elkins Propel Insurance Pa"/c° No Ext :503-467-7569 (FAC No): 866-577-_1326 Portland Workers' Compensation E-MAIL M ADDRESS: she_Iley-elkins@propelinsurance.com SW 5th Ave. Suite 1170 INSURER(S) AFFORDING COVERAGE NAIC # Portland, OR 97204 INSURER A : SAIF Corporation 36196 INSURED INSURER B:-Zurich-American Insurance Compa 16535 Viking Automatic Sprinkler Co - 3245 NW Front Ave INSURER C - ' Portland, OR 97210 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 CONTRACTOR 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE 1NSR WVD POLICY NUMBER (MMIDD/YYYY) (MWDD/YYYY). GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISESLEa occurrence) $ CLAIMS-MADE I OCCUR ! MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY- JEC T ~ PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON- WNED PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB I CLAIMS-MADE AGGREGATE $ DED _1 RETENTION $ $ WORKERS COMPENSATION A 763948 1010112015 1010112016 X WC T-ORY STATU- LIMIT _ ER OTH- AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE WC9696108 10101/2015 1010112016 E.L. EACH ACCIDENT- $1,000,000 OFFICER/MEMBER EXCLUDED? - N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000_ If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $1,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) WorkComp Evidence for OR, AK, CA, ID & MT Waiver of Subrogation applies per policy form USL&H Coverage applies in OR & WA CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2055285/M1877484 MF00 Client: 1: 8 UAUT02 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE y04 (MM/DD/04/2016 M/DD/ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Shelley Elkins Propel Insurance PHONE 503-467-7569 _ ~a Na1:866-577-1326 A/C, No, Et): Portland Commercial Insurance E-MAIL shelleyelkins@ProPelinsurance.com _ ADDRESS: 888 SW 5th Avenue, Suite 1170 ADDR INSURER(S) AFFORDING COVERAGE NAIC # Portland, OR 97204-2025 INSURER A: Nautilus Insurance Company .17370 INSURED INSURER B : Continental Insurance Company 35289 Viking Automatic Sprinkler Co INSURER C 3245 NW Front Ave INSURER D : Portland, OR 97210 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 CONTRACTOR 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/YYYY) (MM/DD/YYYY) LIMITS - A GENERAL LIABILITY ECP200453314 1131/2016 01131/2017 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISESO(Ea occurrence) $100,000 CLAIMS-MADE I X1 OCCUR MED EXP (Any one person) . $ 5,000 X BI/PD Ded:5,000 _PERSONAL & ADV INJURY $1,000,000 X WASHINGTON STOPGAP GENERAL AGGREGATE $2,0001000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 PRO- - POLICY LOC WA STOP GAP $1,000,000 COMBINED SINGLE LIMIT B AUTOMOBILE LIABILITY 5090740364 1/3112016 01/31/2017 (Ea accident) $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS X H - - - IRED AUTOS X 1 AO OSWNED (Per acrid nt) PROPERTY DAMAGE $ $ A UMBRELLA LIAB X OCCUR FFX200453414 1131/2016 01131/2017 EACH OCCURRENCE $6,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED I RETENTION $ $ WORKERS COMPENSATION WC STATU-S OTH- AND EMPLOYERS' LIABILITY Y/N _ TORY LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? n N / A - - _ - - (Mandatory in NH) _E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT $ A Pollution ECP200453314 113112016 0113112017 $1,000,000 1 $5,000 Ded A Professional Liab ECP200453314 1/31/2016 01131/2017 $1,000,000 1$5,000 Ded A Microbial Substan ECP200453314 113112016,0113112017 $1,000,000 $5,000 SIR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Operations of the named insured subject to policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2055288/M2052468 MF00 ECP200453314 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED - COVERAGE A, B & D - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY In consideration of the premium charged and notwithstanding anything contained in the policy to the contrary, it is hereby agreed and understood that this endorsement shall apply only to the Coverage Part(s) corresponding with the box or boxes marked below. COVERAGE A AND B - GENERAL LIABILITY F] COVERAGE D - CONTRACTORS POLLUTION LIABILITY SCHEDULE Name of Person or Organization: Any person or organization that you are required by written contract or agreement to include as an additional insured Job Description/Location: Any location SECTION III - WHO IS AN INSURED is amended to include as an insured, with respect to Coverage A, B and D, any person(s) or organization(s) shown in the schedule above. Such additional insured status applies only- 1. Under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY for claims or suits resulting from- a. Your work performed for such person(s) or organization(s) in the performance of your ongoing operations for the additional insured; or b. Your work performed for such person(s) or organization(s) and included in the products-completed operations hazard. 2. Under COVERAGE D CONTRACTORS POLLUTION LIABILITY for claims or suits arising out of out pollution conditions that are the results of a. Your work performed for such person(s) or organization(s) in the performance of your ongoing operations for the additional insured; or b. Your work performed for such person(s) or organization(s) and included in the products-completed operations hazard. With respect to damages caused by your work, as described above, the coverage provided hereunder shall be primary and not contributing with any other insurance available to those person(s) or organization(s) shown in the schedule above. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. © 2010 by Berkley Specialty Underwriting Managers LLC, an affiliate of Nautilus Insurance Company and Great Divide Insurance Company. All rights reserved. © 1985-2006 by Insurance Services Office, Inc., material used by permission. ECP 1005 04 10 Page 1 of 1 Viking Automatic Sprinkler Co ECP200453314 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. i WAIVER OF SUBROGATION It is agreed that the Company, in the event of any payment under this policy, waives its right of recovery against any Principal, but only at the specific written request of the Named Insured either before or after loss, wherein such waiver has been included before loss as part of a contractual undertaking by the Named Insured. This waiver shall apply only with respect to losses occurring due to operations undertaken as per the specific contract existing between the Named Insured and such Principal and shall not be construed to be a waiver with respect to other operations of such Principal in which the Named Insured has no contractual interest. No waiver of subrogation shall directly or indirectly apply to any employee, employees or agents of either the Named Insured or of the Principal, and the Company reserves its right or lien to be reimbursed from any recovery funds obtained by any injured employee. This waiver does not apply in any jurisdiction or situation where such waiver is held to be illegal or against public policy or in any situation wherein the Principal against whom subrogation is to be waived is found to be solely negligent. © 2006 by Berkley Specialty Underwriting Managers LLC, an affiliate of Nautilus Insurance Company and Great Divide Insurance Company. All rights reserved. © 1985-2006 by Insurance Services Office, Inc., material used by permission. ENV 2004 09 06 Page 1 of 1 Viking Automatic Sprinkler Co .ECP200453314 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT SCHEDULE Designated Construction Projects: All projects of the named insured. A. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I - COVERAGE A which can be attributed only to ongoing operations as shown in the schedule above: 1. A separate Designated Construction Project Limit applies to each designated construction project and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations page. 2. Except for damages because of bodily injury or property damage included in the products-completed operations hazard, the Designated Construction Project Limit is the most we will pay for the sum of all damages under SECTION I -COVERAGE A regardless of the number of: a. Insureds; b. Claims made or suits brought; or c. Persons or organizations making claims or bringing suits. 3. Any payments made under SECTION I -COVERAGE A for damages shall reduce the Designated Construction Project Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations page nor shall they reduce any other Designated Construction Project Limit, except as affected by the Designated Construction Project Aggregate Limit described below. 4. The limits shown in the Declarations page for Each Occurrence and Damage to Premises Rented to you continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project Limit. 5. a. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under the Designated Construction Project Limit, described in 1. and 2. above. b. Regardless of the number of construction projects or designated construction projects covered under this policy, the most we will pay as the Designated Construction Project General Aggregate is $2,000,000 per project. B. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I -COVERAGE A which cannot be attributed only to ongoing operations as shown in the schedule above: 1. Any payments made under SECTION 1-COVERAGE A for damages shall reduce the amount available under the General Aggregate Limit or the Products Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the products-completed operations hazard is provided, any payments C 2006 by Berkley Specialty Underwriting Managers LLC, an affiliate of Nautilus Insurance Company and Great Divide Insurance Company. All rights reserved. ®1965-2006 by Insurance Services Office, Inc., material used by permission. ECP 1021 10 06 Page 1 of 2 for damages because of bodily injury or property damage included in the products-completed operations hazard will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of SECTION IV - LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated. ® 2006 by Berkley Specialty Underwriting Managers LLC, an affiliate of Nautilus Insurance Company and Great Divide Insurance Company_ All rights reserved. ®1985-2006 by Insurance Services Office, Inc., material used by permission. ECP 1021 10 06 Page 2 of 2 POLICY NUMBER: 5090740364 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: Named Insured: Viking Automatic Sprinkler Co Authorized Representative SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION WHICH IS REQUIRED TO BE NAMED AS A RESULT OF A WRITTEN CONTRACT. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 POLICY NUMBER: 5090740364 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided underthe following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): WHERE REQUIRED BY WRITTEN CONTRACT- Information required to complete this Schedule if not shown above will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 VIKING AUTOMATIC SPRINKLER COMPANY I~ 4961 Industry Drive Medford, Oregon 97502-1200 FIRE PROTECTION Tel: (541) 773-1052 Fax: (541) 773-1609 FIRE PROTEC7ION C0NTRAC7"01Z S SINCE 1930 City Of Ashland 1/7/16 RE: Fire Sprinkler Inspection Attn: Wes Hoadley Gentlemen, Five Year Fire Sprinkler Inspections located at: • The Grove • City Hall • Parking Garage • Community Development For the Time & Material Not to Exceed sum of $4,944 (Four Thousand Nine Hundred Forty Four Dollars). We propose to complete a five year inspection on the fire sprinkler systems on the above referenced facilities. The five year inspection involves internal inspection of piping & flushing the Fire Department Connection. In the parking structure we recommend a trip test of the dry pipe valve during warmer weather to prevent freezing. A written report will be provided upon completion of the inspection. This proposal does not include the following items: 1. Overtime Hours 2. Permits 3. Repairs other than listed above 4. Access to City Hall FDC check valve. We trust that the above meets with your approval and look forward to working with you on this project. Thank you for calling Viking. Best regards, 66ved 140414" Chris Anderson Viking Automatic Sprinkler Company OREGON CORPORATION WASHINGTON CORPORATION IDAHO CORPORATION PORTLAND ♦ MEDFORD SEATTLE ♦ LONGVIEW MERIDIAN ♦ POCATFLLO CCB #64837 CLN #VIKINAS373NT LIC #FPSC 003 CITY OF ASHLAND NOTICE OF TRANSMITTAL TO: Kariann Olson DATE: 11-Feb-2016 PROJECT: 16-05 Fire sprinkler inspection JOB NO.: SUBJECT: P.O. requisition THE FOLLOWING ITEMS ARE BEING SENT TO YOU: (a) Form 3: Request for Purchase Order (b) Contract for Goods and Services less than $5,000 (c) Exhibit A: Contractor Certifications/Representations (d) Exhibit B: Contractor's quote and scope of work (e) W9 (f) Insurance Certifications ENCLOSED X UNDER SEPARATE COVER REMARKS : Please let me know if there is anything I haven't addressed in the request for a Po. Department of Public Works By: Kaylea Kathol Phone: 541 552 2419 Title: Project Manager - Facilities PUBLIC WORKS Tel: 541-488-5587 20 E. Main Street Fax: 541-488-6006 Ashland, Ore on 97520 TTY: 800-735-2900 www.ashiand.or.us /r Page 1 / 1 CITY OF ASHLAND DATE PO NUMBER 20 E MAIN ST. 2/16/2016 13381 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 015955 SHIP TO: Ashland Public Works VIKING AUTOMATIC SPRINKLER CO (541) 488-5587 3245 NW FRONT AVE 51 WINBURN WAY PORTLAND, OR 97210 ASHLAND, OR 97520 FOB Point: Ashland, Oreqon Req. No.: Terms: Net Dept.: Req. Del. Date: contact: Kaylea Kathol Special Inst: Confirming? NO Quantity Unit Description Unit Price Ext. Price Contractor to perform 5-year fire 4,994.00 sprinkler inspection on applicable facilities. Contract for Goods and Services Small Procurement Less than $5,000 Beqinninq date: April 1, 2016 Completion date: July 1, 2016 SUBTOTAL 4,994.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 4,994.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 410.08.24.00.60410 E 201605.999 4,994.00 Authori&d Signature VENDOR COPY FORM #3 CITY OF ASHLAND 1 2016 REQUISITION Date of request: 2/10/2016 Required date for delivery: 2/18/2016 Vendor Name Viking Automatic sprinkler Company Address, City, State, Zip 4961 Industry Drive, Medford, OR 97502 Contact Name & Telephone Number Chris Anderson (541) 773-1052 Fax Number (541) 773-1609 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 _(Attach co of council communication _ If council approval required, attach co of CC ® Small Procurement Cooperative Procurement Less than $5,000 ❑ Reauest 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 ❑ Special Procurement Intergovernmental Agreement $5,000 to $75,000 ❑ Agency ❑ Form #9, Request for Approval ❑ Less than $35,000, by direct appointment El 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 Contractor to perform 5-year fire sprinkler inspection on applicable facilities. $4994.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost XXX XXX XXX TOTAL COST ® Per attached quote/proposal Project Number 2016-05 Account Number 410.08.24.00.604100 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, A Employee: Department Head: ` (Equal to or greate ;000) Department Manager/Supervis City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year YES / NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition