HomeMy WebLinkAbout2016-049 Contract - Pacific Electrical
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Pacific Electrical
-A5 H LAND CONTACT: Scott Cancilla
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 920 South Grape St, Medford, OR 97501
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-773-7751
DATE AGREEMENT PREPARED: 03/01/2016 FAX: 541-779-2072
BEGINNING DATE: 03/01/2016 COMPLETION DATE: 03/14/2016
COMPENSATION: $4,918.00 per bid attached as Exhibit D.
GOODS AND SERVICES TO BE PROVIDED: The Grove Building Network Infrastructure Wiring Project
(Parks Remodel Project). Contractor to provide labor and materials to perform scope of work attached as
Exhibit C and bid attached as Exhibit D.
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 rims 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 any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 1 of 5
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.
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 e,
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 2 of 5
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. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Contract6f City of Ashland
By By
nature's Department Head
M A
Print Name Print Name
i l b
Title D to
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 3 of 5
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
(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.
4 (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.
\ S fit' (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.
Cohract@r" (Date)
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 4 of 5
CITY OF ASHLAND, OREGON
EXHIBIT B
City of Ashland
LIVING
WAGE
per hour effective June 30, 2015
(Increases annually every June 30 by the
Consumer Price Index)
portion of business of their 401K and IRS eligible
employer, if the employer has cafeteria plans (including
ten or more employees, and childcare) benefits to the
has received financial amount of wages received by
assistance for the project or the employee.
➢ For all hours worked under a business from the City of
service contract between their Ashland in excess of ➢ Note: "Employee" does not
employer and the City of $20,142.20. include temporary or part-time
Ashland if the contract employees hired for less than
exceeds $20,142.20 or more. ➢ If their employer is the City of 1040 hours in any twelve-
Ashland including the Parks month period. For more
➢ For all hours worked in a and Recreation Department. details on applicability of this
month if the employee spends policy, please see Ashland
50% or more of the ➢ In calculating the living wage, Municipal Code Section
employee's time in that month employers may add the value 3.12.020.
working on a project or of health care, retirement,
For additional information:
Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,
20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us.
Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all
employees.
CITY OF
ASHLAND
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 5 of 5
J s
Scope of Work
Project: City of Ashland, the Grove Building Network Infrastructure.
Contact: Dan Hendrix, IT Manager
Description:
The City of Ashland is remodeling a site referred to as "The Grove." It is located 1195 East Main St, Ashland OR.
This bidding will be for low voltage cabling installation, rack relocation, phone cross-connects in attic and
installation of CatSe cabling, patch panels, ladder rack, cable management and wire cleanup, to provide the site
voice/data for office spaces. Included in this project is relocating 24 existing cables from the current rack location
to the new rack location. All new workstation wall receptacles get (4) CatSe connections, unless otherwise noted,
to support either phone or data. Contractor will terminate, certify, and label all connections.
See floorplan with wall receptacles, for specific locations.
There is also an IP security camera that will need to have a CatSe termination receptacle and jacks.
New CatSe wall receptacles to be white in color (not to match existing),
Plenum-rated cabling is not required.
Solid-core CatSe cabling is required.
All labor and material must be of commercial quality. All work must comply with applicable building and electrical
codes and industry standards, and all materials are to be used within their manufacturer ratings and specifications.
All new terminations TIA/EIA-568-B.2-2001 certified and done in T568B cable orientation.
Contractor quotes must include itemized break-out of material and labor costs, to assist the City in bid
comparison/selection.
Task Details by Location:
Demarcation Point
The existing demarc is being moved/extended into the newly constructed wiring closet. All new wiring will
feed directly from the wiring closet patch panel (contractor purchased) out to the new workstation
receptacles. Cilf the existing fiber optic slack-loop at the demarc provides enough scope, that will be used
to reach the new closet. If not, additional fiber will be spliced in to reach the new wiring closet. City AFN
installers will handle the fiber cleaving/re-termination. Vendor cooperation with AFN technicians will be
required to complete the fiber relocation. Securely install new plywood telecomm back-board in
demarc room.
Mount, terminate, label, and certify new patch panels and all newly terminated cable runs.
All cables in existing rack (24) will need to be moved to new rack location. This will involve running some
new cabling and swinging over some existing. The bidding contractor will need to determine the ones that
can be reused and the ones that need to be rerun, and reflect that in their quote.
Wiring Closet
Mount the rack/enclosure (already purchased by IT), (2) 48-port patch panels, (1) 24-port voice patch
panel, sliding (drawer type) fiber patch panel, horizontal cable management between each patch panel
Page 1 of 2 Date: 2/5/2016
File: H:\Documents\Purchasing Records\_2016\Pending Purchases\The Grove Move\Grove Wiring SoW.docx
and the switch hardware. Total of (2), 2U horizontal cable management and (2) 1U horizontal cable
management.
Purchase/mount ladder rack near "ceiling" of closet to carry cable bundles from wall point-of-entry to
patch panel. Ladder rack should be enterprise-grade and common inside of wire closets.
Front-Window Workstations (2)
Network cabling and termination from wall receptacles to wiring closet patch panel via in-wall conduit,
independently suspended above drop ceiling, into new rack enclosure via the provided conduit and
contractor-installed ladder rack. All cables need to be tested and labeled. All low voltage receptacles will
need to be named and labeled in accordance with what is currently installed.
New-Wall Workstations (3)
Wiring already roughed in wall, but all cables need to be terminated, tested, and labeled. All low voltage
receptacles will need to be named and labeled in accordance with what is currently installed. All roughed
in cables will need to be terminated inside the receptacle and the patch panels.
Front Counter Area
4 jacks in each receptacle on both wings of the counter (left, and right).
1 receptacle for security camera in wall above front counters with (2) CatSe cables to it.
Move existing wall-penetrating network cable to inside wall of music studio.
Conference Room
Floor box receptacle has been installed with 1" conduit for 2 or 4 network drops to be run to the floor
box. Contractor needs to determine if conduit is installed from the conference room drop ceiling to the
drop ceiling near the new rack/. It is our understanding that the conduit is there but contractor needs to
verify. 2 drops will be installed in the double gang mud ring on conference wall.
To be provided by the contractor (this is not intended to be a comprehensive list of all materials)
• All solid core twisted pair cat5e cabling required for required jack terminations
• (2) 48-port Leviton patch panels
• (1) 24-port Leviton patch panel
• (1) 24-port Leviton Amphenol connected patch panel for voice
• 25-pair cable and 66 block installed directly next to the existing 66 block for voice
• Horizontal cable management, of commercial (enterprise-grade) quality
• All required faceplates, Leviton keystone style jacks in black color
• Horizontal Ladder Rack (in wiring closet)
• Plywood backer board for rack
• Screws and mounting hardware for rack, patch panels, cable suspension, and any other required hangers
and misc.
Items provided by City IT Department
• Kendal Howard equipment rack/enclosure
• APC UPS
• Cisco Switch
• Rack mount sliding Fiber panel
• Fiber optic cabling and splicing
Page 2 of 2 Date: 2/5/2016
File: H:\Documents\Purchasing Records\_2016\Pending Purchases\The Grove Move\Grove Wiring SoW.docx
PACIFIC
ELECTRICAL CONTRACTORS
CCB #3651 BCD #15-10C
PROPOSAL AND ACCEPTANCE
SUBMITTED TO Marques Johnson PHONE 541-552-2406 DATE 2/19/2016
ATTENTION FAX
STREET 90 N. MOutaln Ave. JOB NAME The Grove Network Infastructure
CITY, STATE, zip Ashland, OR. 97520 JOB LOCATION The Grove
EMAIL marques.Johnson Pashland. or.us JOB PHONE
We hereby submit specifications and estimates for:
Install new data cable, relocate old data cables, build new IT closet and extend phone demac.
As discribed in the Scope of work provided, By Marques Johnson and discused in job walk.
Exclude: Patch, Paint, Repair and ceilling tiles
Pec Will Provide Low Voltage Permit
We Propose hereby to furnish material and labor - complete in accordance with the above specifications, for the sum total of:
FOUR THOUSAND NINE HUNDRED EIGHTEEN DOLLARS dollars $4,918
Payment to be made as follows:
Within 10 days of receipt of invoice
All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according Authorized
to standard practices. Any alteration or deviation from the above specifications involving extra costs will Signature
be executed only upon written order, and will become an extra charge over and above the estimate. This
proposal is contingent upon strikes, accidents, delays or price increases of necessary commodities such
as wire and steel exceeding 10%; therefore, increases are possible beyond the # of days shown at the Note: This proposal may be withdrawn by
right. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by
Workmen's Comoensation Insurance. us if not accepted within -30 days.
Acceptance of Proposal - The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are
authorized to do the work as specified. Payments will be made as
outlined above. Signature
Date of Acceptance Signature
920 South Grape Street • Medford, Oregon 97501 • Phone 541-773-7751 - Fax 541-779-2072 www.PacificElectrical.com
Page 1 / 1
ASHLAND PARK COMMISSION'
20 E MAIN ST. DATE PO NUMBER
ASHLAND, OR 97520 3/3/2016 00547
(541) 488-5300
VENDOR: 004559 SHIP TO:
PACIFIC ELECTRICAL CONTRACTORS
920 S GRAPE STREET
MEDFORD, OR 97501
FOB Point: Ashland, Oreqon Req. No.:
Terms: net Dept.:
Req. Del. Date: Contact: Jason Minica
Special Inst: Confirming? NO
Quantity Unit Description - Unit Price Ext. Price
The Grove Buildinq Network 4,918.00
Infrasturcture Wirinq Protect (Parks
Remodel Protect)
Contract for Goods and Services
Beqinninq date: 03/01/2016
Completion date: 03/14/2016
SUBTOTAL 4,918.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 4,918.00
Account Number Project Number Amount Account Number Project Number Amount
E 411.12.00.00.70420 E 000065.120 4,918.00
Autfi'ofized Signature VENDOR COPY
FORM0 CITY OF
ASHLAND
REQUISITION Date of request:
Required date for delivery:
Vendor Name ~4,r,
Address, City, State, Zip
Contact Name & Telephone Number ~y f_ -7 '7 -7
Fax Number
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 ❑ Request for Proposal (Copies on file) ❑ State of Oregon
❑ Direct Award Date approved by Council; Contract #
4~ Of 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 ❑ Form #9, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3) Written proposals/written solicitation Date approved by Council: (Date)
❑ Form #4, Personal Services $5K to $75K Valid until: Date - (Attach copy of council communication)
Description of SERVICES Total Cost
I
Item #f Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
Per attached quotelproposal $
Project Numbero0z :,L6r_ - t Z° Account Number _ _ _ - _ _ - _
Account Number`li~ Zf 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 ce ify that the City's public contracting requirements have been satisfied.
010,
Employee
• Department Head:
(Equal to or greater than $5,000)
Department Manager/Supervisor: milt City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year YES / NO
Finance Director- (Equal to orgreaterthan $5,000) Date
Comments:
Form #3 - Requisition