HomeMy WebLinkAbout2016-216 Contract - John Cornet
Contract for GOODS AND SERVICES Small Procurement Less than $5,000
CITY OF INDEPENDENT CONTRACTOR: UhI, f oqvL
l
,
-ASHLAND CONTACT: '1 _ .,J
20 East Main Street ADDRESS: OX l(.GLn t)r fit, n -2n OZa7SWt
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: FAX:
5u~ S35-S232
BEGINNING DATE: ~ COMPLETION DATE: 3 0I ko
COMPENSATION: 1CD\D
GOODS AND SERVICES TO BE PROVIDED:
In the event of conflicts or discrepancies among Contract Documents, this standard form of the City of Ashland Contract will be primary and
take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and
interpreted in a manner that will not conflict with this standard form City of Ashland Contract.
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR
AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work
described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required
under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be
registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City
business license.
3. Ownership of Production: All documents, materials or items produced by Contractor pursuant to this contract shall be the property of City.
4. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 279B.235, ORS Chapter 244 and ORS 670.600 are made part of this contract.
5. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from those losses, expenses,
or other damages resulting from injury to any person or damage to property arising out of or incident to the negligent performance of this contract
by Contractor its employees, or agents. Contractor shall not be held responsible for any losses, expenses, or other damages, directly, solely, and
proximately caused by the negligence of City.
6. Termination: City's Convenience. This contract may be terminated at any time by the City.
7. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete
responsibility for the performance of this contract.
8. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or
emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award
of such subcontracts, if any.
9. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license.
10. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work.
11. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the
contract work set forth in this document.
12. Default. The Contractor shall be in default of this agreement if Contractor commits any material breach or default of any covenant, warranty,
certification, or obligation it owes under the Contract.
13. Insurance. Contractor shall at its own expense provide the following insurance:
a. a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers'
compensation coverage for all their subject workers. Worker's compensation insurance is required if work is performed by employees,
subcontractors, or volunteers.
BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES UNDER PENALTY OF LAW THAT THE WORK REQUIRED BY THIS
CONTRACT SHALL BE PERFORMED SOLELY BY THE UNDERSIGNED:
b. le equivalent, own ilwy
a
ee with a cc bi'' nit, u, the equivalent, of nut less than $1,666,1588 fa, edcl --duuu!~n~[ dily
c.
In. no.jtivpPl' e ~ u CA J.
14. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon
15. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT,
MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH
PARTIES.
Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference.
Contractor: City of Ashland:
By By
Signature arttrgent He d
6h7 Corwc-T Alaw k 6LdC-
Print Name Pri t Na e
,rG ~ v,erc. ~ a5 6
Title Date
W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order NO.
A DA5 TO FORM
=07 t. C Attomey
Revised 10-28-14 Page 1 of 2 Da ~ `
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.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one year.
(6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by
the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating
to the labor or services to be provided.
2'1 J, (1 Zo 1 b
Contractor (Date)
Revised 10-28-14 Page 2 of 2
John Cornet
18 8 8 Alcan Dr.
Medford, OR 97504
541-535-5232
Coordination of 2016 4th of July Run
Payment of $1000 after completion of 2016 Event
John Cornet will prepare and run the bi-monthly organizing meetings,
facilitate, send out minutes, race day event coordination including set-
up, clean up, staging and safety of water stations, awards volunteer and
senior project coordination, historical race data, sponsorship
coordination for the 2016 event.
Purchase
Order
or
0
Fiscal Year 2017 Page: 1 of: 1
~S ~P~yh
& REGR oM
B Ashland Parks Commission = 1~RIt~M~APEE
TTN: Accounts Payable
L 20 E. Main Purchase 74
Ashland, OR 97520 Order #
T
O
V CORNET, JOHN H C/O Recreation Division
E 1888 ALCAN DR I 1195 East Main Street
D MEDFORD, OR 97504 P Ashland, OR 97520
O Phone: 541/488-5340
R TT Fax: 5411488-5314
Uen~or WE NU _ /Qr_F. umWK - gs psi
_ Rachel Dials The Grove
Qate Ordered= 1/ ndgr_Number -Date_ I e u r d; _ - fi - _ e~ = ran=
08/11 /2016 1860 FOB ASHLAND OR Parks Accounts Payable
It-t# Rr1c__
July 4th Run Services
The Above Purchase Order Number Must Appear On All
Correspondence - Packing Sheets And Bills Of Lading
1 July 4th Run Services 1.0 $1,000.00 $1,000.00
Contract for Goods and Services Small Procurement Less than
$5,000
Beginning date: March 1, 2016
Completion date: August 31, 2016
GL Account: $1,000.00
GL SUMMARY
125302 - 610260 $1,000.00
By:-~ Date: 2,oA~L
Authorized Signature = _ - $1 000.00
FORM #3 CITY OF
j
~F ASHLAND
REQUISITION Date of request:
Required date for delivery:
Vendor Name
Address, City, State, Zip I AIV411 ~
Contact Name & Telephone Number bpr,,LL4 01-1 a~ t(3 13 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
'a Direct Award Date approved by Council: Contract #
F1 Verbal/Written quote(s) or proposal(s) -(Attach copy of council communication) ❑ State of Washington
Intermediate Procurement ❑ Sole Source Contract #
GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract
$5,000 to $100,000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract #
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5,000 to $75,000 ❑ Agency
❑ Form #9, Request for Approval
❑ Less than $35,000, by direct appointment ❑ 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
4 R
0
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
Per attached quotelproposal $ - ODD
Project Number - Account Number - -
Account Number--- Account Number--- -
*Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support -Yes / No
By signing this requisi 'on form, 1 ce y that the City's public contracting requirements have been satisfied.
Employee: 6~kp Department Head:
(Equal to or greater than $5,000)
Department Manager/Supervisor: City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year., YES / NO
Finance Director- (Equal to or greater than $5,000) Date
Comments:
Form #3 - Requisition