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HomeMy WebLinkAbout2016-059 Contract - The Galli Group Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: The Galli Group ASHLAND CONTACT: Bill Galli PE 20 East Main Street Ashland, Oregon 97520 ADDRESS: 612 NW 3rd St., Grants Pass, OR 97526 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-955-1611 DATE AGREEMENT PREPARED: 3/17/2016 FAX: 541-955-8150 BEGINNING DATE: 3/21/2016 COMPLETION DATE: 12/21/2017 COMPENSATION: Not to exceed $30,000 as per Exhibit C attached. SERVICES TO BE PROVIDED: To provide engineering services as per scope, attached as Exhibit C to this contract. ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Personal Services will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with the said primary City of Ashland Contract. FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of City. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is $20,142.20 or more, Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a hiving wage, as defined in this chapter, to all employees performing work under this contract and to any Subcontractor who performs 50% or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to defend, indemnify and! save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 10. Termination: H:\Betsy Parks\N Mountain Park\20160317 Galli Group Contract N Mountain Park.doc a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: 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 Consultant to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. L Either City or Consultant may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 14. Insurance. Consultant shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,00 0 or Not Applicable for each claim, incident or occurrence. This is to cover damages caused by error, omission or negligent acts related to the professional services to be provided under this contract. C. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,0 00 or Not Applicable for each occurrence for Bodily Injury and Property Damage. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, 1 000 000, or Not Applicable for each accident for Bodily Injury and Property Damage, GAparks\A11 Parks Users\Betsy\N Mountain Park\20160317 Galli Group Contract N Mountain Park.doc including coverage for owned, hired or non-owned vehicles, as applicable. e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-insurance. 15. Governing Law; Jurisdiction; Venue- This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limlitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further liability to Consultant. Certification. Consultant shall sign the certification attached hereto as Exhibit A and herein incorporated b reference. Consultant: ry Le City of Ashland By - - - By / Signature Department Head Print Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. APPROVE AS TO FORM Ashl Asst. City Attomoy Data'` G:\parks\ All Parks Users\Betsy\N Mountain Park\20160317 Galli Group Contract N Mountain Park.doc 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. 2 - (3) Telephone listing is used for the business separate from the personal residence listing. fc') (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) GAparks\All Parks Users\Betsy\N Mountain Park\20160317 Galli Group Contract N Mountain Park.doc CITY OF ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGE per hour effective June 30, 2015 (Increases annually every June 30 by the ~r Consumer Price Index) portion of business of their 401 K and IRS eligible employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. ➢ For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: "Employee" does not employer and the City of $20,142.20. include temporary or part-time Ashland if the contract employees hired for less than exceeds $20,142.20 or more. ➢ If their employer is the City of 1040 hours in any twelve- Ashland including the Parks month period. For more ➢ For all hours worked in a and Recreation Department, details on applicability of this month if the employee spends policy, please see Ashland 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. f' CITY OF ASHLAND G\parksWll Parks Users\Betsy\N Moun ain ar 0160317 Galli Group Contract N Mountain Park.doc EXHIBIT C P5154 THI 6A111 GROUP Revised March 18, 2016 Geotechnical Consulting Jeff McFarland Ashland Parks Department 340 S. Pioneer Street Ashland, OR 97520 Subject: ENGINEERING SERVICES PROPOSAL NORTH MOUNTAIN PARK CULVERT FAILURE BEACH CREEK, ASHLAND, OREGON Mr. McFarland: In accordance with your request, we are pleased to provide this proposal for engineering services on the above-referenced failure repair. This proposal is based on our site visits, discussions with most of the agency people involved and input from City personnel. The proposal contains the scope of services for four (4) phases and cost estimates for each task and phase. SCOPE OF SERVICES The following is a scope of services that will 1) evaluate the site conditions in order to determine what method of repair is needed, 2) coordinate with state and federal agencies to arrive at a repair solution that meets the needs and regulations of all involved and submit packages for the agency permits, 3) provide plans and specifications and detailed construction narrative for repair, 4) coordination with the City in the bid process, 5) completed Building permit submitted to the City of Ashland, 6) construction inspection and testing and documentation reports during repair work, 7) Operations and Maintenance Manual for the site and surrounding area and 8) Agency permit completion and final as-built drawings for portions of the project that were changed during the construction process. The scope provided is intended to contain all items suggested by City personnel and that are generally required to get a project such as this permitted and constructed. The scope of each phase is as follows: Phase I Scope 1. Initial discussions with ODFW, CORPS, ODSL and City of Ashland to verify what will be allowed and what permits will likely be required. Exchange of 612 NW Third Street, Grants Pass, Oregon 97526 • Phone (541) 955-1611 • Fax (541) 955-8150 P5154 Page 2 preliminary plan and cross section of proposed work. Coordinate to verify Nationwide Permit is available for rapid approvals. Site meeting with ODFW to verify what repair they will allow. 2. Limited site survey in order to verify actual height of failure slope, length of failed culvert and areal extent of the remedial measures. 3. Site plan and cross section sketches based on survey, of proposed remedial measure as altered by discussion with the agencies. 4. Brief descriptive narrative of proposed repair/remedial measure to repair the culvert and stabilize the failed fill. 5. Engineer's preliminary estimate of proposed remedial measure construction. 6. Write up of agency discussions and permits required for proposed repair. Phase II Scope I . Consultation with appropriate agencies to finalize which permits are required. The Galli Group will prepare and submit permit applications and track questions and permit approval process. Provide all required information to agencies for permit approval. 2. Additional detailed site topography survey data to help refine actual site conditions to full extent of work area and access. 3. Detailed Plan and Cross Section drawings for the culvert and slope repairs, field and streambed stabilization at the outfall, support of the bridge abutment and edge of the path. 4. Erosion and Sediment Control Plan for all areas of work. Include methods to prevent silt entering the stream. 5. Formal Revegetation Plan for entire work and access area per Oregon Department of Fish and Wildlife (ODFW) regulations. Including list of ODFW approved plants and planting methods. 6. Revised plan and/or cross sections as requested/required by the various agencies to insure rapid permit approval (if possible). 7. Construction narrative of how the remedial measures shall be implemented with accompanying Construction Notes specifications for the work. When completed we would provide one electronic copy and five (5) bound copies of the plans, narrative specifications and permit applications (if included as part of the scope). Phase III Scope I . Complete all permit issues with local, state and federal agencies in order to expedite the permits. Prepare and submit plans for Building permits from City of Ashland Building Safety Department. Incorporate with Construction Plans and Specifications completion. 2. Help with bidding and project start up. 3. Construction and inspection services during project work. 4. Construction progress reports and Final Construction Completion report. P5154 Engineering Services Proposal - N Mountain Park.docx The Galli Group P5154 Page 3 5. Provide as-built drawings for any changes made to plans during construction process. Phase IV Scope 1. Close out report to Local, State and Federal agencies. 2. Write up Operations and Maintenance recommendations for the project site and stream area adjacent to the site. 3. Work with City to obtain permits (if required) to be able to perform yearly maintenance. COST OF SERVICES Below we have provided an estimate of costs for each of the tasks and a summary for each phase. Please note that if individual tasks are accomplished alone, with time lapse between, the overall costs will likely increase. Phase I Costs A list of tasks and estimated costs for Phase I work is listed below: 1. Agency and Parks Dept. Interaction $3,890.00 2. Site Survey Work 850.00 3. Conceptual Repair Sketches 1,160.00 4. Narrative of Repair 460.00 5. Engineer's Cost Estimate of Repair 870.00 6. Write up of Agency Permit Issue 650.00 TOTAL ESTIMATED COSTS 57,880.00 Based on this list of costs we estimate the Phase I scope will cost between $7,600.00 and $8,200.00. Phase II Costs A list of tasks and estimated costs for the Phase II work is listed below: 1. Agency and Permit Completion Work $1,850.00 2. Additional Site Topo Survey 750.00 3. Plans, Cross Sections and Details for the Repair 2,000.00 4. Construction Narrative and Specifications 700.00 5. Project Management and Expenses 450.00 TOTAL ESTIMATED COSTS $5,750.00 Based on this list of costs we estimate the Phase 11 scope will cost between $5,600.00 and $5,950.00 depending upon how much information and what plan changes the agencies require for permits. P5154 Engineering Services Proposal - N Mountain Park.docx The Galli Group P5154 Page 4 Phase III Costs A list of tasks and estimated costs for the Phase III work is listed below: 1. Permit Completion Items $800.00 2. Complete and Submit for Building Permit 900.00 3. Bidding Help and Start Up 1,280.00 4. Construction Inspection Services 7,650.00 5. Construction Reports and Completion Report 680.00 6. As Built Charges to Project 900.00 7. Expenses 500.00 TOTAL ESTIMATED COSTS $12,710.00 Based on this list of costs we estimate the Phase III scope will cost between $11,500.00 and $12,350.00. Phase IV Costs A list of tasks and estimated costs for the Phase IV work is listed below: 1. Close out With Agencies $450.00 2. Operations and Maintenance Manual 1,950.00 3. Other Permit Work 950.00 TOTAL ESTIMATED COSTS $3,350.00 Based on this list of costs we estimate the Phase 11 scope will cost between $3,000.00 and $3,500.00 depending upon how much information and what plan changes the agencies require for permits. Overall total costs are estimated to be as follows: Phase I $ 7,600.00 to $ 8,200.00 Phase II $ 5,800.00 to $ 5,950.00 Phase III $11,500.00 to $12,350.00 Phase IV $ 3,000.00 to $ 3,500.00 OVERALL COST ESTIMATE $27,900.00 to $30,000.00 We recommend a Not-To-Exceed budget of $30,000.00 be authorized for this work. Note: Scope of work on all phases of the work listed above may be changed as determined by the City of Ashland Parks Department. We will proceed on only tasks which we are authorized to perform. PLEASE INITIAL BESIDE THE TASKS LISTED W THE VARIOUS PHASES ABOVE WHICH WE ARE AUTHORIZED TO PERFORM. Phases III and IV shall not be started without written approval by the City. The Galli Group will provide the City with a revised cost estimate for any proposed work under Phase III and Phase IV after Phase I and 11 are completed (i.e., when final scope of project is known) if so desired by the City. Note: The scope of each phase could also be altered as the Parks Department sees fit to meet their needs. P5154 Engineering Services Proposal - N Mountain Park.docx The Galli Group P5154 Page 5 At this time we believe this budget is sufficient to complete these tasks even if the agencies require a different repair approach. We propose to accomplish all tasks on a time-and-expense basis in accordance with the attached Standard Fee Schedule and General Conditions and the standard Professional Services Contract with the City of Ashland. AUTHORIZATION AND SCHEDULE We are prepared to proceed ahead on your verbal authorization assuming a signed agreement will be forthcoming. In the meantime we will continue to work with the agencies and make site visits with agency and City personnel. We would be able to begin our field work within several days (no rain is best) and our completion of Phase I with our short report, conceptual sketches and Engineers Cost Estimate would take 2 to 3 weeks after being authorized. Phase II will take an additional 11/2 to 2 weeks, assuming the agencies work with us in a reasonably expeditious way. Phase III and Phase IV will take approximately 2 weeks beyond construction completion. We look forward to working with you and to helping make this a successful project. If you have any questions, please call at your convenience. Respectfully Submitted, THE GALLI GROUP T William F. Galli, P.E., G.E. Senior Principal Engineer Attachment: Standard Fee Schedule and General Conditions (please sign and return) My signature below indicates I have read, understand and accept the terms and conditions of this proposal letter and the attached Standard Fee Schedule and General Conditions. Name Date Signature Title Please initial which Phase is authorized: Phase I: Phase III Phase 11: Phase IV P5154 Engineering Services Proposal - N Mountain Park.docx The Galli Group ,d►co CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/18/2016 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). PROD-CER Phone: (425) 771-5197 Fax: (425) 673-4427 CONTACT Chris NAME ORION INSURANCE GROUP, INC. PHONE FAX (425) 673-4427 3405 188TH ST SW A/c N. Fx (425) 771-5197 ac Nn) E-MAIL SUITE #302 ADDRESS ChrisDay@OrionlnsGroup.com LYNNWOOD WA 98037 INSURER(S) AFFORDING COVERAGE NAIC #t INSUREP A RLI Insurance NSUBED GALLI GROUP, P.C. INSUREP B 612 NW THIRD STREET INSUREF C GRANTS PASS OR 97526 wsUREe D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 16582 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE. FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L SUBR POLICY EFF POLICY EXP LIMITS _TR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MWDD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE is DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occwence) $ CLAIMS-MADE L]OCCUR MED. EXP (Any oie person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ POLICY PR LOC $ JECT AUTOMOBILE LIABILITY COMEINED SINGLE _IM17 (Ea accidew) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED JSCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (per accidentl _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ ~DED RETENTION $ $ WCSTATU- OTH WORKERS COMPENSATION TORY LIMITS ER $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N F. L. EACH ACCIDENT $ OFFICERiMEMBER EXCLUDED? N/A E. L. DISEASE-EA EMPLOYEE $ (Mandatory in I - If yes. -scribe under , E.L. DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below - A Professional Liability X RDP0019311 03/15/16 03/15/17 $1,000,000 Each Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 30 days cencellation wording applies. CERTIFICATE HOLDER CANCELLATION Ashland Parks and Recreation Commission SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 340 S. Pioneer Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. A-T IOR17En R,--PPFS=NTATIVE Attention: Christopher R. Day ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 9GALLGR OP ID: MW F Y) AcoRO CERTIFICATE OF LIABILITY INSURANCE 0 DATE 03/14/2016 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). CONTACT PRODUCER Phone: 541-479-5521 N AME: Hart Insurance PHONE FAX P. O. Box 1240 Fax: 541-474-1890 A/c Nq, Ext): (A/c, Nol: Grants Pass, OR 97528 E-MAIL Hart Insurance Agency ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Ohio Security Insurance Co 41939 INSURED The Galli Group PC INSURER B : SAIF Corporation 612 NW 3rd Street Grants Pass, OR 97526 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DDL UBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE A X COMMERCIAL GENERAL LIABILITY X BZS56410713 01111/2016 01111/2017 PREMISES Ea ccurence $ 1,000900 CLAIMS-MADE OCCUR MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE S 2,000,00 GEN1 AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,00 -1 POLICY X PE OT- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident) S _ B X ANY AUTO BAS56410713 01/11/2016 01/11/2017 BODILY INJURY (Per person) S ALL OWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS AUTOS - NON-OWNED PROPERTY DAMAGE S (Per HIRED AUTOS AUTOS accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS _ ER _ 948255 11/01/2015 11101/2016 E.L. EACH ACCIDENT S 500,00 C ANY PROPRIETOR/PARTNER/EXECUTIVE - N/A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Ashland, Oregon, and its elected officials, officers and employees are additional insured with primary/non-contributory wording per attached BP7996 and BP1488. Policy contains 30 day notice of cancellation and 10 day notice of cancellation for non-payment of premium per attached BPO178 CERTIFICATE HOLDER CANCELLATION CITYAS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, Oregon ACCORDANCE WITH THE POLICY PROVISIONS. Ashland Parks & Rec Commission 340 S Pioneer Street AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Hart Insurance Agency © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD BUSINESSOWNERS BP 79 96 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SUBJECT PAGE AGGREGATE LIMITS OF INSURANCE 3 AMENDMENT OF INSURED CONTRACT DEFINITION 4 BLANKET ADDITIONAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 2 BODILY INJURY 4 BROADENED COVERAGE FOR DAMAGE TO PREMISES RENTED TO YOU 2 DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 4 INCIDENTAL MEDICAL MALPRACTICE 2 MOBILE EQUIPMENT 2 NEWLY FORMED OR ACQUIRED ORGANIZATIONS 3 PERSONAL AND ADVERTISING INJURY 4 SUPPLEMENTARY PAYMENTS 2 Bail Bonds Loss Of Earnings © 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4 Section II - Liability is amended as follows: I. SUPPLEMENTARY PAYMENTS Paragraph f.(1)(b) of A Coverages is replaced by the following; (b) Up to $3000 for cost of bail bond required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury" applies. We do not have to furnish the bonds. Paragraph 1.f.(1)(d) of A Coverages is replaced by the following; (d) All reasonable expenses incurred by the insured at our request to assist us in the Investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. II. BROADENED COVERAGE FOR DAMAGE TO PREMISES RENTED TO YOU With respect to the coverage provided under this endorsement, Section II - Liability is amended as follows: 1. The final paragraph of B.1. Exclusions - Applicable To Business Liability Coverage is deleted and replaced by the following: With respect to the premises which are rented to you or temporarily occupied by you with the permission of the owner, Exclusions c., d., e., g., h., k., I., m., n. and o. do not apply to "property damage". 2. Paragraph D.2. Liability And Medical Expenses Limits Of Insurance is deleted and replaced by the following: The most we will pay under this endorsement for the sum of all damages because of all "property damage" to premises while rented to you or temporarily occupied by you with the permission of the owner is the Limit of Insurance shown in the Declaration. 3. Paragraph D.3. Liability And Medical Expenses Limits Of Insurance is deleted. III. INCIDENTAL MEDICAL MALPRACTICE Exclusion 1.j.(4) does not apply to Incidental Medical Malpractice Injury coverage. The following is added to F. LIABILITY AND MEDICAL EXPENSES DEFINITIONS: 23. "Incidental Medical Malpractice Injury" means bodily injury arising out of the rendering of or failure to render, during the policy period, the following services: a. medical, surgical, dental, x-ray or nursing service or treatment or the furnishing of food or beverages in connection therewith; or b. the furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances. This coverage does not apply to: 1. expenses incurred by the insured for first-aid to others at the time of an accident and the Duties in the Event of Occurrence, Claim or Suit Condition is amended accordingly; 2. any insured engaged in the business or occupation of providing any of the services described under a. and b. above; 3. injury caused by any indemnitee if such indemnitee is engaged in the business or occupation of providing any of the services described under a. and b. above. IV. MOBILE EQUIPMENT 1. Section C. Who is An Insured is amended to include any person driving "mobile equipment" with your permission. V. BLANKET ADDITIONAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 1. Section C. Who Is An Insured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy under a written contract or written agreement. The written contract or agreement must be: a. currently in effect or becoming effective during the term of this policy; and b. executed prior to the "bodily injury", "property damage", "personal and advertising injury". C 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4 2. The insurance provided the additional insured is limited as follows: a. The person or organization is only an additional insured with respect to liability arising out of (1) Real property, as described in a written contract or written agreement, you own, rent, lease, maintain or occupy; (2) Caused in whole or in part by your ongoing operations performed for that insured. b. The limits of insurance applicable to the additional insured are those specified in the written contract or written agreement or the limits available under this policy, as stated in the Declarations, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. C. The insurance provided the additional insured does not apply to: (1) Liability arising out of the sole negligence of the additional insured; (2) "Bodily injury", "property damage", "personal and advertising injury"; or defense coverage under the Supplementary Payments section of the policy arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: (a) The preparing, approving maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (3) Any "occurrence" that takes place after you cease to be a tenant in the premises described in the Declarations; or (4) Structural alterations, new construction or demolition operations performed by or for the person or organization designated in the Declarations. 3. Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a contract specifically requires that this insurance be primary or you request that it apply on a primary basis. VI. NEWLY FORMED OR ACQUIRED ORGANIZATIONS The following is added to C. Who Is An Insured: 3. Any business entity acquired by you or incorporated or organized by you under the laws of any individual state of the United States of America over which you maintain majority ownership interest exceeding fifty percent. Such acquired or newly formed organization will qualify as a Named Insured if there is no similar insurance available to that entity. However, a. Coverage under this provision is afforded only until the 180th day after the entity was acquired or incorporated or organized by you or the end of the policy period, whichever is earlier; b. Coverages A. Paragraph 1. Business Liability, does not apply to: (1) "Bodily injury" or "property damage" that occurred before the entity was acquired or incorporated or organized by you; and (2) "Personal and advertising injury" arising out of an offense committed before the entity was acquired or incorporated or organized by you; and c. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. VII. AGGREGATE LIMITS The following is added to Aggregate Limits Paragraph 4. of D. Liability and Medical Expenses Limits of Insurance: The Aggregate Limits apply separately to each of "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. The Aggregate Limits also apply separately to each of your projects away from premises owned by or rented to you. For the purpose of this endorsement only, "location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. © 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4 VIII. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 1. The requirement in E. Liability And Medical Expenses General Conditions paragraph 2.a. that you must see to it that we are notified of an "occurrence" or offense which may result in a claim applies only when the "occurrence" is known to any insured listed in Paragraph C.1. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. 2. The requirements in E. Liability And Medical Expenses General Conditions paragraph 2.b. that you must see to it that we receive notice of a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is known to any insured listed under Paragraph C.I. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. IX. BODILY INJURY Paragraph 3. of F. Liability And Medical Expenses Definitions is replaced by the following: 3. "Bodily Injury" means: a. Bodily injury, sickness, disease, or incidental medical malpractice injury sustained by a person, and includes mental anguish resulting from any of these; and including death resulting from any of these at any time. X. AMENDMENT OF INSURED CONTRACT DEFINITION Paragraph 9. of F. Liability And Medical Expenses Definitions is replaced by the following: 9. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; C. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "property damage" is caused, in whole or in part, by you or by those acting on your behalf. However, such part of a contract or agreement shall only be considered an "insured contract" to the extent your assumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. XI. PERSONAL AND ADVERTISING INJURY Paragraph 14. b. of F. Liability And Medical Expenses Definitions is replaced by the following: b. Malicious prosecution or abuse of process. © 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4 BUSINESSOWNERS BP 14 88 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to Paragraph H. Other 2. You have agreed in writing in a contract or Insurance of Section III - Common Policy agreement that this insurance would be Conditions and supersedes any provision to the primary and would not seek contribution from contrary: any other insurance available to the additional Primary And Noncontributory Insurance insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: 1. The additional insured is a Named Insured under such other insurance; and BP 14 88 07 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 BUSINESSOWNERS BP 01 78 01 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON CHANGES This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM A. Section I - Property is amended as follows: 3. Paragraph F.2. Mortgageholders Proper- 1. Paragraph E.2. Appraisal Property Loss ty General Conditions is replaced by the Conditions is replaced by the following: following: 2. Appraisal 2. Mortgageholders If we and you disagree on the value a. Oregon law states as follows: of the property or the amount of loss (1) "If loss hereunder is made both parties may agree to an apprais- payable, in whole or in part, al of the loss and to be bound by the to a designated mortgagee results of that appraisal. If both par- not named herein as the in- ties so agree, then each party will se- sured, such interest in this lect a competent and impartial ap- policy may be canceled by praiser. The two appraisers will giving such mortgagee a ten select an umpire. If they cannot days' written notice of can- agree, either may request that selec- cellation." tion be made by a judge of a court (2) "If the insured fails to render having jurisdiction. The appraisers proof of loss such mortgag- will state separately the value of the ee, upon notice, shall render property and amount of loss. If they proof of loss in the form fail to agree, they will submit their herein specified within 60 differences to the umpire. A decision days thereafter and shall be agreed to by any two will be binding. subject to the provisions Each party will: hereof relating to appraisal a. Pay its chosen appraiser; and and time of payment and of b. Bear the other expenses of the bringing suit. If this com- appraisal and umpire equally. pany shall claim that no li- If there is an appraisal, we will still retain ability existed as to the our right to deny the claim. mortgagor or owner, it shall, 2. Paragraph E.3.a.(7) Duties In The Event to the extent of payment of Of Loss Or Damage Property Loss Condi- loss to the mortgagee, be tions is replaced by the following: subrogated to all the mort- gagee's rights of recovery, (7) Send us a signed, sworn proof of but without impairing mort- loss containing the information gagee's right to sue; or it we request to investigate the may pay off the mortgage claim. You must do this within debt and require an assign- 90 days after you receive the ment thereof and of the necessary forms from us. mortgage. Other provisions relating to the interests and obligations of such mort- gagee may be added hereto by agreement in writing." BP 01 78 01 10 © Insurance Services Office, Inc., 2009 Page 1 of 3 b. The term mortgageholder in- g. If we elect not to renew this poli- cludes trustee. cy, we will give written notice to c. We will pay for covered loss of the mortgageholder at least ten or damage to buildings or struc- days before the expiration date tures to each mortgageholder of this policy. shown in the Declarations in B. Section II - Liability is amended as follows: their order of precedence, as in- The term "spouse" is replaced by the follow- terests may appear. ing: d. The mortgageholder has the Spouse or individual who is in a domes- right to receive loss payment tic partnership recognized under Oregon even if the mortgageholder has law. started foreclosure or similar ac- C. Section III - Common Policy Conditions is tion on the building or structure. amended as follows: e. If we deny your claim because of 1. Paragraph A. Cancellation is amended as your acts or because you have follows: failed to comply with the terms of this insurance, the a. Paragraph 2. is replaced by the fol- mortgageholder will still have : the right to receive loss payment 2. If this policy has been in effect if the mortgageholder: for: ° (1) Pays any premium due un- a. Fewer than 60 days and is der this insurance at our re- not a renewal policy, we quest if you have failed to do may cancel for any reason. so; b. 60 days or more or is a re- (2) Submits a signed, sworn newal policy, we may cancel proof of loss in accordance only for one or more of the with Paragraph a.(2); and following reasons: (3) Has notified us of any (1) Nonpayment of premi- change in ownership, occu- um; pancy or substantial change (2) Fraud or material mis- in risk known to the representation made by mortgageholder. you or with your knowl- All the terms of the affected in- edge in obtaining the surance will then apply directly policy, continuing the to the mortgageholder. policy or in presenting a f. If we cancel this policy, we will claim under the policy; give written notice to the (3) Substantial increase in mortgageholder: the risk of loss after in- (1) In accordance with Para- surance coverage has graph a.(1); or been issued or re- newed, including but not limited to an in- (a) Ten days before the ef- crease in exposure due fective date of the can- to rules, legislation or cellation if we cancel for court decision; your nonpayment of (4) Failure to comply with premium; or reasonable loss control (b) 30 days before the effec- recommendations; tive date of the cancella- (5) Substantial breach of tion if we cancel for any contractual duties, con- other reason other than ditions or warranties; provided for in Para- graph a.(1). BP 01 78 01 10 © Insurance Services Office, Inc., 2009 Page 2 of 3 (6) Determination by the 2. All statements made by you or commissioner that the on your behalf, in the absence of continuation of a line of fraud, will be deemed represen- insurance or class of tations and not warranties. No business to which the such statements that arise from policy belongs will jeop- an error in the application will be ardize our solvency or used in defense of a claim under will place us in violation this Coverage Form unless: of the insurance laws of a. The statements are contain- Oregon or any other ed in a written application; state; or and (7) Loss or decrease in re- b. A copy of the application is insurance covering the endorsed upon or attached risk. to this Coverage Form when c. 60 days or more or is a re- issued. newal policy, we may cancel 3. In order to use any representa- for any other reason ap- tion made by you or on your be- proved by the commissioner half in defense of a claim under by rule. the Coverage Form, we must b. Paragraph 3. is amended by the addi- show that the representations tion of the following: are material and that we relied 3. We will mail or deliver to the on them. first Named Insured written no- 3. The following paragraphs are added and tice of cancellation, stating the supersede any provision to the contrary: reason for cancellation. M. Nonrenewal c. Paragraph 6. Cancellation does not We may elect not to renew this poli- apply. cy by mailing or delivering to the first d. The following paragraph is added: Named Insured, at the last mailing 7. Number of Days' Notice of Can- address known to us, written notice cellation: of nonrenewal before the: a. Cancellation will not be ef- a. Expiration date of the policy; or fective until at least ten b. Anniversary date of the policy if working days after the first the policy is written for a term of Named Insured receives our more than one year or without a notice. fixed expiration date. 2. Paragraph C. Concealment, Misrepresen- However, if this policy is issued for a tation Or Fraud is replaced by the follow- term of more than one year and for ing: additional consideration the premi- C. Concealment, Misrepresentation Or um is guaranteed, we may not refuse Fraud to renew the policy at its anniversary 1. Subject to Paragraphs 2. and 3. date. below, this entire policy will be Nonrenewal will not be effective un- void if, whether before or after a til at least 45 days after the first loss, you have willfully con- Named Insured receives our notice. cealed or misrepresented any N. Mailing Of Notices material fact or circumstance If notice of cancellation or concerning this insurance or the nonrenewal is mailed, a post office subject of it, or your interest in it, certificate of mailing will be conclu- or in case of any fraud or false sive proof that the first Named In- swearing by you relating to it. sured received the notice on the third calendar day after the date of the cer- tificate of mailing. BP 01 78 01 10 © Insurance Services Office, Inc., 2009 Page 3 of 3 Page 1 / 1 ASHLAND PARK COMMISSION - 20 E MAIN ST. DATE PO NUMBER ASHLAND, OR 97520 3/22/2016 00551 (541) 488-5300 VENDOR: 000814 SHIP TO: GALLI GROUP, THE 612 NW THIRD STREET GRANTS PASS, OR 97526 FOB Point: Ashland, Oreqon Req. No.: Terms: net Dept.: Req. Del. Date: Contact: Michael Black Special Inst: Confirming? No Quantity Unit Description Unit Price Ext. Price Enqineerinq services for the N. 30,000.00 Mountain Park culvert failure at Beach Creek per attached proposal. Contract for Personal Services Beqinninq date: 03/21/2016 Completion date: 12/21/2017 SUBTOTAL 30 000.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 30,000.00 Account Number Project Number Amount Account Number Project Number Amount E 211.12.02.06.60211 6,000.00 E 211.12.02.06.60410 24,000.00 Authorized Signa re VENDOR COPY FORM #3~ CITY OF y r ASHLAND REQUISITION Date of request: 3/21/16 Required date for delivery: 3/23/16 Vendor Name ThP Gall' Grnun Address, City, State, Zip 612 NW 3rd St. Grants Pass OR 97526 Contact Name & Telephone Number Bill Galli, PE 541-955-1611 Fax Number 541-955-8150 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 ❑ 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) 0 Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost To provide engineering services for the N. Mountain Park culvert failure at Beach Creek as per proposal. $ 30,000,00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quote/proposal $ Project Number _ _ _ _ _ _ - _ _ _ Account Number 211.12.02.06.604105 ($24,000) Account Number: 211.12.02.06.602118 ($6,000) 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. Employee: Department Head. tk~ ual to or greater than $5,000) Department Manager/Supervisor: City Administrator: have / (Equal to or greater than $25,000) Funds appropriated for current fiscal year, YES / NO A4a~~ 11,2 mance Director- (Equattoorgreater th ,ooo) Date Comments: Form #3 - Requisition ASHL9 FORM #4 ° ~S & REGRF-P~ DETERMINATIONS TO PROCURE PERSONAL SERVICES $5,000 to $75,000 To: Dave Kanner, Public Contracting Officer From: Michael Black Date: 03%'21; 2016 Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES In accordance with AMC 2.50.120(A), for personal services contracts greater than $5,000, but less than 575,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City does not have the personnel or resources to perform the services required under the proposed contract. However, the City Attorney, the Public Contracting Officer, or Local Contract Review Board, can require a formal solicitation for bids to ensure that the purposes of this chapter are upheld. Background .9shland Parks and RecrealiOn Colninission 's inleni is to colltracl 1111h a pril'ate consllhanl the al)propriale scope of 'scl'vices de,'eloped,fi)r e77~ril7eel ing scr~'ice.c for the,Vorlh Alozinlain Park - Beach Creek C lihert F'ailllre .11ili alio17 projecl. The scope of lrork fill' this prolecl 1S to ei'a111C11e slle and com )1cte pre111111mtri' 171111g(7lloil 77leasilres to repair 111e c°uh'Cl-I (117(1 s7abili_e the palhira-y and bric~,,,e. The hrid re and path have bee77 closed clue to a lc1/'(C fill slope and C'L/11'e]'t fadlll'C Oll the doirnsh'emn side of the hlkin~ trail The irork is expected to lake place in, fiscal year 2016 irilh a not to excecd budget ainollnt of 'S30. 000. f )r en(),ineering scri,iccs. The ainollnl appropri.aled in Ille C'1117'ent ('01117(11 C1ppr01'ed bndgel 10 JWI'fol'711 11715 11'Ol'k 1S' 111 the (IC17e1'al 171CnY1lellanC'e and lll'bCln fol'es111' ln1C itC171S 01'117e, 01)CI-06017,s, II Pursuant to AMC 2.50.120(A), has a reasonable inquiry been conducted as to the availability of City personnel to perform the services, and that the City does not have the personnel and resources to perform the services required under the proposed contract? r(s,hland Parks, and Recreation Col77rnission does riot haiv the adegwile staf f lilne or al)propriate resources tol)rol'idc the scope Of Sel-IIC'C C01710711)IC11Cd 1177dC1' this C'01111VC'1. 177 Cld0111017, 110 Oilier Del)arllnenl in the Cil~' has' the resources or Technical knoirled(,,e to Co1771)ICIC the irork associaled frith 117ispcrso17a1 ser~ices col7h°uct.