HomeMy WebLinkAbout2015-364 Contract - Professional Pool Table Repair
Contract for GOODS AND SERVICES Less than $25,000
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' CONTRACTOR: Professional Pool Table Repair
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CONTACT: Mike Morang
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\ ~~3 REGR~P'~ ADDRESS: PO Box 2124, White City, OR 97503
340 S. Pioneer Street TELEPHONE: 541-778-3736
Ashland, Oregon 97520 ORIGINAL
Telephone: 541/488-5340 FAX: 541-826-6583
Fax: 541/488-5314
DATE AGREEMENT PREPARED: 2/9/15
BEGINNING DATE: TBD COMPLETION DATE: 3/15/15
COMPENSATION: $550.00
GOODS AND SERVICES TO BE PROVIDED: Tear down pool table at Oak Knoll Golf Course clubhouse;
reassemble at The Grove, 1195 E. Main Street in Ashland.
ADDITIONAL TERMS:
In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take
precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a
manner that will not conflict with the said primary City of Ashland Contract.
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows-
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel
assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned
in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are
so registered, licensed and bonded. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated, payments will be made for work completed and accepted to date of termination.
Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 27913.220, 27913.225, 27913.230, 27913.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $20,142.20 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a
living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor
who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached
hereto as Exhibit B predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs,
judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. City's Convenience. This contract may be terminated at an time b City upon 30 days' notice in writing
Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 1 of 4
r
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 Contractor, or at such later date as may be established by City under any of the following
conditions-
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach, may at any time terminate
the whole or any part of this contract if Contractor fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City.
Contractor shall have the complete responsibility for the performance of this contract.
11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.110 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 2 of 4
c. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one,
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
d. - Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the
parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The
Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
19. Nona ppropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Contractor: City of Ashland
By By
Signature _Department Head
Print Name P VED AS TO r " Print Name
w n and t. C Attome Lf
Title ' ate
Date-
W-9 One copy of a W-9 is to be submitted with Q t-~•c~/
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 3 of 4
• J
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
(1) 1 carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
A (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.
d~k C7 I*- (6) 1 assume financial responsibility for defective workmanship or for service not provided
as evidenced by the ownership of performance bonds, warranties, errors and omission
insurance or liability insurance relating to the labor or services to be provided.
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 4 of 4
ADDENDUM TO GOODS AND SERVICES AGREEMENT
1 1 "Helper" both
I 1 , , Contractor, and j - ,
certify by signing below that Helper has been sufficiently informed that Contractor is an
independent contractor, that Contractor is not an employee of the City of Ashland, and that
Helper is working for Contractor and NOT the City of Ashland.
Furthermore, Helper understands, and by signing below, acknowledges that he is NOT an
employee of the City of Ashland, that Helper works for Contractor, and the City of Ashland
will reject any claim by Helper for employment health or workers compensation benefits
should Helper become injured working for Contractor.
HAVING READ THE ABOVE AND BEING SATISFIED THAT I HAVE HAD
SUFFICIENT TIME AND OPPORTUNITY TO ASK FOR EXPLANATION, I CERTIFY
THE ABOVE BY MY FOLLOWING SIGNATURE:
CONTRACTOR HELPER
By: Date / By: ~j Date
" G✓
(Print Name) (Print Name)
r
COMMON POLICY DECLARATIONS '.MESA U!4DE- IVa17JEP;S SPECIALTY
INSURANCE COMPANY
Poilcy Number: IT 10 s0O4d,0~s£2- V Ned gross-pef
Renewal r-, (Rewrite
Prevk.vs Policy dumber;
Policy Period-, From C8/2" xt l4To Oli'/ `l~.z`_°:~ at32:01 A.W. Sta. and Tifv,a at your rna i^e aodress show,) below.
!Named Insured:
,4ROB'X$41:aaAL POW, TAJLx A.ZPA: R Tax State: OR
MICHAEL }IORal"2G s -his is evidence of insurance procured and
Mailing Address: developed und,&r tale Oregon surplus line laws. It is
P.O. BOX 2124 NOT covered by the provisions of ORS 734.510 to
734.710- re stmg to the Oregon Insurance Guaranty
wgiTa CITY o:a 97503 ci24 Association. if the insurer issuing this insurance
hacoma* Insolvent, than Oregon Insurance
C Uaranty Association has no obligation to stay
Agent and Malling Address: Agent a'Numbet- a~pa4 claims under thes evidence of Insurance.
Pacific c.iast z and S insurance services
3302 Fuhrmen Ave. E- Suite 30C
Seattle WA 99 5
Suslness Description:
POOL TABLE RIPArR AM INSTALLXTI.N'
Sa€iect Covert~ge FHB ;_t:r vitttelt;h insurance is iaelle}atdee)
od Commercial, General Liability $ ~000.00
Cf51?tmar-lei E opartiy
i I
o Commercial Inland Marine $ !
7Commerclat { rIme $
Garago S
TRiA NOT COVERED
I j
other t'Describe) $ I
~
POLICY VC1 $150,00
I
SURPLUS LINES TAX $21.011
S.L.S.C. 415.0111
FIRE XRRSHALL TAX $3.15
total Advance Premium $ 900.00
Total Other Charges $ 189.15 ~
Total $ 1,059.15
Premiums Shown are payable al, incer Lion or as indicateO on the individuai Coverage Declarations.
_Form(.s tend En mr t s including ii on dates, made aparl of tltks potty at the time of Issue. See Schedule of Forrns
Countersigned: 09111/2014
_ Autht. Azad Agent
V1
MUS 01 01 1 2 0412 1NISCREL)
MESA UNLDERWPIT'ER SPECIALTY
COMMERCIAL GENERAL LIABILITY Coverage Part Declarations INS',.1RANCE COMPANY
This Coverage Part consists of this Declarations Form, the Common Pooiov conditions, the GommercW General rLlabfi ty Conclitlons, the
Coverage Form(s), and the Coverage Endorsement(s) indiosted as applicable
R+de3med insured PPOTZSSIONAL POOL TABLE REPAIR
Pcii.-.y Nurnbew HP0046044000662
Effectlv;3 gate: 08/2 1/2014
LIMITS OF INSUIRANCE__ n "X" It Suppiernenta! Declarations is attac,hea.
General Aggregate Limit (Other Than Products/ Completed Ope ations) $ 2, ooo: ao
Products / Completed Operaticrs Aggregate Limit $ 2,000 '000
Personal
and Advertising Injury Limit $ 1,000,000 E3c)•i Occurrence ?unit 1, 000 000
Damage to Promises Rented to You Limit (Any I Promises) $ 5~', ao0
Medical Expense Limit (Any t Person) $ 000
SU-SIM.ESSJXSCfAP-TtOliANDA.0-C-ATION
Form of i usirmss:
® i,idivAL a' Joint Venture C7 Fartrusrship 1:1 Li r,ited Liability C:omrany El Organization (ctherl :
Business Description. POOL TABLE REPAIR AND lNiTALLA ION
.1. t9tz + 1. ill4ii~w~rr _f. e; you Own. R r~ ~r Occupy:_-_--------
6363 14UNTZ-VISTA CT, EAGLE POINT, OR 97324____
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CLASSII !CATI6N & PREMl-U P R_'-6VtQEP
Data _ Advanced Premium
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Code No ' Classification Descq tion 1 'EXP s resin ~ Oree'rat or s ~ C,Pro ucts orno `7 s ' t✓r eri3~orzs l Cam- cp
51390 Billiard or Pool Table Mfg S 50,000 .2400 .420 Bole INCLUOV11
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I11T S Additional Tneured(s) t 2 50,0000 INCLUDED 100 INCLUDED
-Par Vorm CG2010 I
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re »ium 3asi5 Types- P - Payroll (per $t )U4t of Payro!r, c - Cost (per i,000 Totdr Cos?) s - Swee ipar si ,oce Gross Safes)
a - Area (Per I ;OCP- Square feet of w 4a) rn - Aarnisslons 11w 1 .00,0 Admissions) u - units (per ur:,r;
t -Tote! (per each,
900
Porms,Tridorserrents A lIcable ee r h ~luie of Farms and Frdorserrents
11 US 01 01 20001 0412 INSURED page 1 of 2
< a ecr, OR11100N INSURANCE IDENTI#siCATION CARD
COMPAW
lia$zsr c SAFECO INSURANCE COMPANY OF ORGOON
MUMMER Er-v1F DATlr EXPIRATiON DATE
0$4072.51 DEC. 24 2014 JUNE ?42015
1996 TOYOTA JT4.UNZ207T002104G
ibow-ricouPARY i"Ulk* CAAD
(S41).479-266 7
122 14E BEACON DR
CANTS PASS OR 97S26-3840
LINDA LAKE
MICHAEL MORANG
PG BOX 2124
WHITE CITY OR 97503-0124
SEE IMPORTANT NOTICE ICI REVERSE SIDE
ck-70281cp twos
CC) ~
C I T Y 01F
[F(o S" L.,A N
VERBAL PHONE QUOTES
Small Procurement Less than $5,000
Use this form to document requests for price quotes. Request that all quotes be FOB Destination. Attach completed form to Purchase Order.
PREPARED BY: Tom Cronin DATE PREPARED: 12112/14
DEPARTMENT' Ashland Parks and Recreation /OK Golf Course DATE QUOTES DUE: 1/27/15
PHONE NO: 541-482-4311 TIME QUOTES DUE: 5:00 p.m.
VENDOR I VENDOR 2 VENDOR 3
Date 12112/14 Date 213/2015 Date 2/312015
company Professional Pool Table Company Medford Moving and Company J's Moving Specialists
Repair Storage
Contact Mike Morang Contact Sean Contact Wendy
Address PO Box 2124 Address 6461 Crater Lake Hwy Address 3299 Winterbrook Ln
White City, OR 97503 Central Point, OR 97502 Central Point, OR 97502
Phone 541-778-3736 Phone 541-831-0064 Phone 541-210-5668
FAX 541-826-6583 FAX 541-831-0068 FAX
VENDOR ? VENDOR 2 VENDOR 3
UNIT TOTAL UNIT TOTAL UNI TOTAL
ITEM DESCRIPTION QUANTITY PRICE PRICE PRIC PRICE T PRICE
E PRI
CE
1 Tear down pool table at 1 550.00 550.00 Declined to Declined to
clubhouse; reassemble at The quote quote
Grove
SHIPPING & HANDLING CHARGES
*Prefer FOB Ashland - Freight Prepaid
(Seller has title during transit and files any claims. Seller Pays Freight)
TOTALS 550.00
Form #1, Small Procurement, Verbal Phone Quotes, Page 1 of 1, 2/9/2015
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Page 1 / 1
ASHLAND PARK COMMISSION
20 E MAIN ST. DATE PO NUMBER
ASHLAND, OR 97520 3/27/2015 00441
(541) 488-5300
VENDOR: 004590 SHIP TO:
PROFESSIONAL POOL TABLE REPAIR
PO BOX 2124
WHITE CITY, OR 97503
FOB Point: Req. No.:
Terms: net Dept.:
Req. Del. Date: Contact: Susan Dyssegard
Special Inst: Confirming? No
Quantity Unit Description Unit Price Ext. Price
Tear down pool table at Oak Knoll 550.00
clubhouse and transport and reassemble
pool table at the Grove, 1195 E. Main
Street
Contract for Goods and Services
Beqinninq date. TBD
Completion date: 03/15/2015
Work scheduled for Thursday,
April 2, 2015
SUBTOTAL 550.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL. 550.00
Account Number Project Number Amount Account Number Project Number Amount
E 211.12.03.01.60410 550.00
Author ed Signature VENDOR COPY
FORM #3 CITY OF
~y- LAN D
F1 chase Ord-r
REQUISITION -7ques 3/24/15
Ashland Parks and Recreation U Date of Delivery: 4/2/15
FBO: Oak Knoll Golf Course, a division of APR
340 S. Pioneer Street
Ashland, OR 97520
Vendor Name Professional End Table Repair, Attn- Mik Morang
Address, City, State, Zip PO Box 2124, White City, OR 9,7503
Contact Name & Telephone Number 541-778-3736 - Tel
Fax Number 541-826-6583 - Fax
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 Intergovernmental Agreement
$5,000 to $75,000 ❑ Agency
❑ Form #9, Request for Approval
❑ 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
$ 550.00
Tear down pool table at Oak Knoll clubhouse; reassemble at The Grove, 1195 E. Main Street
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
1 1 ea Labor / expertise for tearing down pool table at golf clubhouse and 550.00 550.00
reassembling table at The Grove, 1195 E. Main Street in Ashland.
® Per attached quotelproposal TOTAL COST
$ 550.00
Project Number Account Number - - -
Account Number 211 .12.03.01 .604100 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:
ITDirector Date Support-Yes/No
By signing this requisition form, I certify that the City's public contracting requirements have been satisfied.
Employee: Department Head:
v v (Equal to or greater than $5,000)
Department Manager/Supervisor: City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year.' YES / NO
Finance Director- (Equal to or greater than $5,000) Date
Comments:
Form #3 - Requisition