HomeMy WebLinkAbout2016-236 Contract - Valley Web Printing
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Valley Web Printing Inc.
ASHLAND CONTACT: Todd Reichenbach
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 1299 Stowe Avenue, Medford, OR 97501
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-772-7039
DATE AGREEMENT PREPARED: 7/8/16 FAX: 541-772-1279 Email: toddr(a-)valleywebprinting.com
BEGINNING DATE: 7/1/16 COMPLETION DATE: June 30, 2017
COMPENSATION: $5,528.70
GOODS AND SERVICES TO BE PROVIDED:
Printing, mailing and delivery of three seasonal recreation guides for Ashland Parks and Recreation
Commission (APRC) for FY 16-17 - a period spanning July 1, 2016 through June 30, 2017.
• Approximately 5,200 for Fall 2016 (guides for two TARGET mailings and includes 700 extra prints for
community outreach).
• Approximately 17,200 for Winter/Spring 2017 (guides direct mailed to all Ashland and talent
households [exclusion businesses]; includes 700 extra prints for community outreach).
• Approximately 5,200 for Summer 2017 (guides for two TARGET mailings and includes 700 extra
prints for community outreach).
ADDITIONAL TERMS:
In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take
precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a
manner that will not conflict with the said primary City of Ashland Contract.
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel
assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned
in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are
so registered, licensed and bonded. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated, payments will be made for work completed and accepted to date of termination.
Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
i 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
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 1 of 6
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
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
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 2 of 6
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 Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the
parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The
Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
19. 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.
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 3 of 6
Contractor: City of Ashland
By 6 P f ~JO 10 0 By
Signature Department Head
Print Name Print Name
VIVY-W
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 4 of 6
EXHIBIT
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:
IX (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.
0,P f ,L
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 5 of 6
CITY OF ASHLAND, OREGON
EXHIBIT B
Ash land
City of
LIVING
A WA E
- P,IVE, 13 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 projector 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,
additional For 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
^AS H LA N D
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 6 of 6
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.
n (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.
i -
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 5 of 6
CERTIFICATE F LIABILITY INSURANCE DATOM1/ D/VYYY)
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R- i"IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOMER. THfS
LkTIFICATE 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 endorsements .
PRODUCER CONTACT
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WEIoIDTCO WEB PRINTING INCORPORATED, VALLEY WED PRiN r NG INSURER C: ,
1299 STOWE AVE
MEDFORD, OR 97503 INSURER :
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER': 7 REVISION NUMBER 0
THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
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4RTIFICATE HOLDER CANCELLATION
44-174-8 7 I
ITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
SHLAND, OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
(6) 1988-2014 ACORD CORPORATION. All rights reserved,
'ORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
www.saif.com saif corporation
February 25, 2016
WENOTCO WEB PRINTING INCORPORATED
DBA: VALLEY WEB PRINTING
1299 STOWE AVE
MEDFORD, OR 97501-6612
Policy Number: 480224
Dear Policyholder:
Your workers' compensation insurance policy with SAIF Corporation renews on April 1, 2016.
Enclosed is your policy information page that shows your estimated payrolls, premium modifiers,
and estimated premium amount. All previous policy endorsements continue to apply unless they
have been cancelled or amended.
We've also provided some key information below. You'll find everything else you need to know
about your policy, workplace safety, filing and managing a claim, and more in the easy-to-use
Employer Guide on our website. Just go to saif.com and click "Employer Guide." You can
request printed information on topics of interest to you and your workers by calling us at
503.373.8000 or 800.285.8525, or by emailing uwpayroll@saif.com.
Payroll reporting At the end of each annual reporting period, we'll send you a form to report
the actual payroll for your covered workers for that period.
For more on payroll reporting, see these key pages on saif.com:
- Learn how to complete your payroll report: saif.comiinstructions
- View details on the requirements for reporting your payroll by class:
saif.com/class
- See an explanation of who is covered (also called "subject workers") and who is
not: saif.com/whomiscovered
- Learn when to report a worker in multiple classifications: saif.com/vtr
For your convenience, you can report your payroll and mane your payments online.
Go to the Employer Guide on saif.com and log into (or register for) Business Online.
Your premium I Payment options based on your estimated premium of $15,520.08 are
listed below.
Installment Payment Plan Optional Annual Payment Plan
Due Date Amount Due Date Amount Due Date Amount
03/25/2016 $1,551-99 08/25/2016 $1,552.01 03/25/2016 $151520.08
04/25/2016 $1,552.01 09/25/2016 $1,552.01
05/25/2016 $1,552.01 10/25/2016 $1,552.01
06/25/2016 $1,552.01 11/25/2016 $1,552.01
07/25/2016 $1,552.01 12/25/2016 $1,552.01
Important: Changes in your payroll, classifications, or number of locations during the
policy year can result in an adjustment to your installment amounts. Please notify us
right away of any changes in your business.
r~F, 400 High St SE Salem, OR 97312 1 P 300.285.8525
#'i @?1vosai1.NtiI'.lif co saif rpo ra Lion
Carrier No: 2000'1 Endorsement No; WC990309C
Policy No: 480224
WENDTCO WEB PRINTING INCORPORATED
D BA.- VALLEY WEB PRINTING
1299 STOW AVE
MEDFORD, OR 97501-6612
I us Endorsement
The aAIFPlus endorsement provides you with specific payment and prerrijurn reduction
features.
Payment
At the inception, of your policy period, we estimate your premium based on anticipated payroll for
your business and you pay your premium in one or more installments. At the end of your policy
period; you report actual payroll for your workers on a payroll report fora. We compute the actual
premium due and send you a statement that explains the final premium amount and whether you
have a credit available or additional premium to pay. Part Five of the policy continues to
apply.
Premium Reduction
Your premium will be reduced by a AIFPlus credit factor. The factor and the maximum amount of
premium reduction in the Schedule apply for the policy period that begins on the effective date
shown below.
The factor is applied as a Multiplier to total estimated premium after experience rating, Oregon
Contracting Classification Premium Adjustment, Oregon Group Supplemental Experience Rating,
and other like adjustments, if any, but before premium discount.
The SAIFPlus discount applies to premium paid prior to the end of the policy period. It will
riot apply to any additional premium due and paid after the policy period end date. If you
Uver=e;siiiiate pad, ell during the policy, at, final r=ec~ncil,ation the SAIF.PIus_discoGnt -will-.be---- _
reduced to reflect the actual premium due and paid.
The maximum amount of premium reduction is applied to the premium for your policy unless your
policy is combined with another SAIF policy for rating purposes because of common controlling
A1F policy for rating purposes, the maximum
ownership. If your policy is combined with another
amount of premium reduction is applied to the total premiurn for those policies.
Schedule
SAIFPlus credit factor; .98
Maximum premium reduction; $600
00 High St 'SE i saiern, OR 973121 P. 800,285.8525
r O
Policy No: 480224 saff ation
Page 2
S IMu Endorsement
Effective Date: 04-01-2018
This endorsement is part of your policy. This endorsement amends and controls anything to the
contrary. It is otherwise subject to all other terms of your policy.
Countersigned 02-25-2016 at Salem, Oregon
2420 Derr arnett, President
and Chief Executive Officer
400 High St SE ' Sa{ern. OR 97312 P: 800,285.8525
cS-L-da ficor porat ion Information Page Carrier eta: 20001
Policy No: 480224
Employer Identification Igo: 0:3-0709400
NCGI Risk ID tea: 360787540
Item 1. The Insured: Entity Type.
WENDTC O WEB PRINTING INCORPORATED CORPORATION
Mailing address:
WPNDTCO WEB PRINTING INCORPORATED
DDA: VALLEY WEB PRINTING
1290 STOWE AVE
MEDFORD, OR 97501-6612
Other workplaces not shown above:
VVENDTC 0 WEB PRINTING INCORPORATED
1200 STOWE AVE, MEDlrORD, OR 97501-6612
VALLEY WEIR PRINTING
Item 2. The policy period is frorn 04-01-2016, 12:01 A.M. to 04-01-2017, 12-01 A.M. at the insured°s mailing
address
Item 3. A. Workers !Compensation Insurance. Part One of the policy applies to the Workers
Compensation Law of the states listed here: OREGON
B. Employers Liability Insurance. Part Two of the policy applies to work in each state listed in
item 3_A. The limits of our -liability under Part Two are:
Bodily Injury by Accident $500,000 each accident
Bodily Injury by Disease $500,000 each employee
Bodily Injury by Disease $500,000 policy limit
C. Other States Insurance: Part Three of the policy applies to the states; if any, listed here:
NONE
D. This policy includes these endorsements and schedules;
WC300601 E Oregon Cancellation Endorsement
WC000421 D Catastrophe (other than Certified Acts of Terrorism) Premium End
WC000422B Terrorism Risk Insurance Procg Reauthorization Act Disclosure End
WC000414 Notification of Change in Ownership EndorGemen'
WC000406A PrerniUrn Discount Endorsement
Y! C 360406 Premium Due Date Endorsement
WG990309C SAII=PIus, Endorsement
W0900602 Subject Officer Payroll Requirement - Corporation
WC360301 Oregon Unsafe Equipment Exclusion Endorsement
W0990610 Confidentiality Endorsement
Item 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans. The premium and rates and the experience rating modification factor, if any, may change on
your anniversary rating date of 04-01-2017. All information required below is subject to verification and
change by audit.
~ n
Policy No-, 4.80224 scurcorp r,
Pag 2
Information Page
Estimated I Rate Per
$100 of Estimated
Policy Period ~ I
Class Description Payroll .._.__n Pa !rs II Premium
w.~_w.__....M.___
Period: 04/01/2016 - 03/31/2017
Wendtco Web Printing Incorporated
4299 09 Printing $367,10 2.21 $8,112.95
7380 07 DriversiChauffrstMessencg. rs & Fielpr $12,885 4,65 $599.15
8810 03 Office Clerical 015
Total Payroll $6745545
Manual Premium $9,153.94
Experience Rating tVodificatior? 1.75110 mm.
Estimated Premium $16!019.40
Total Estimated Premium $16,019..40
SAIFPlus Credit (2% to a $ 00 ma imam) - $320.39
Estimated Standard Premium $15,699.01
Premium Discount _ $1,219.90
Terrorism Prenw.im r $67.45
Catastrophe Premium $67.45
Estimated Policy Period Premiun $14,614.01
DCBB Assessment 6.20% on $14,614,01 (excludes Dart Two & Federal Premium) Total Estimated Policy Premium Including DCBS Assessment $15,520.08
Policy Minimum Premiums; $500
Your policy premium is based on your current estirnated prernium and may be prorated for
policies in effect for less than a full year or adjusted based on actual payroll by classification-
The SAiFPlus discount applies only to prernium paid prior to the end of the policy period.
Terrorism Premium is in addition to Policy Minimum Premium.
Catastrophe Premium is in addition to Policy Minimum Prerfliurn.
Payroll Reporting Frequency: Annual
Policyholder Option to Reimburse AIF Corporation for Medical Expenses (Nondisabling Claims
Reimbursement Prograrn):
This policyholder has chosen to enroll in the Nondisabling Claims Reimbursement program with a quarterly claim evaluation.
This inforirnation page is part of your policy.
Gountersigned on 02-25-2016 at Salem, Oregon
Kerry arnett, Pr sidelnt
WCOOOOO1 A and Chief Executive Officer
wwwn s if.com i corporation
Farrier No: -90001 Endorsement No: W0990602
Policy No. 480224
WENDT00 WEB PRINTING INCOPPOI-2ATED
DBA: VALLEY WEB PRINTING
1299 ST+DWE AVE
MEDFORD, OR 97501-6612
u iect f leer, Payroll requirement Endorsement
CORPORATION
An officer paid by the corporation for Oregon work who is not a director or who does not have
a Substantial ownership interest i a subject worker of the corporation. Substantial ownership
interest is defined to be (1) an ownership of 10 percent or more or (2) an ownership equal to
or greater than the average ownership of all owners. A subject officer's payroll is to be reported
on your" payroll report within the following minirnurn and maximum annual reportable payroll
amounts for a full 52 week policy period:
Annual eoortable Payroll.
Minimum of: $46,800
lvlaxirnum Of $192,400
If your policy period is more or less than 52 weeks in length, divide the minimum and maximum
amounts by 52 and multiply the result by the total number of full and partial weeks in the
policy period to obtain the minimum and maximum amounts that apply for a subject officer
who is covered for the whole policy period.
Use these steps to determine the amount to report for a subject officer who is not covered
for all of a policy period:
_a1 divide the minimum aid i 1la-xE'nnu n annual report-able payroll amounts by 5 to
obtain the weekly minimum and maximum reportable payroll amounts
b) count the number of full and partial calendar weeks that the officer was covered
during the policy period
c) multiply tho number of weeks in step b) by the weekly mininlurri and maximum
reportable payroll amounts in step a) to obtain the minimums and maximum
limitations on reportable payroll for the officer
d) compare the officer's actual payroll for the time he or she was :covered as an officer
during the policy period to the minimum and maximum limitations in step c) and
report the minimum if actual payroll is less than the minimum, otherwise report
the actual payroll but no more than the maximum
Deportable payroll for subject officers must be included in the appropriate classification(s)
listed on the payroll report. If two or more classifications apply to an officer's duties the
reportable payroll amount may be split between the classifications provided verifiable time
records are maintained for the actual time spent working in each classification as indicated
400 r igh St S I Salem, OR 97,112: P: 800,285.8525
Policy No: 480224, r orate n
Page 2
in the payroll reporting instructions provided with your policy. If two or more classifications
apply hr,t verifiable time. records are not maintained you must use the highest rated
classification.
Effective Cate: 04-01-2016
This policy information page endorsement is part: of your policy. This endorsement amends
and controls the item that has been changed on the effective date shown.
Countersigned 02--25-2016 at Salem, Oregon
32102 Kerry arnott; Pr sident
and Chief Executive Officer
~SPurchase Order
r
Fiscal Year 2017 Page: 1 of: 1
y
~'S R E G R~o `y
- - = = neE
B Ashland Parks Commission
-
ATTN: Accounts Payable
L 20 E. Main Purchase 131
L Ashland, OR 97520 Order #
T Phone: 541/552-2010
O Email: payable@ashland.or.us
V VALLEY WEB PRINTING H C/O Recreation Division (Grove
E 1299 STOWE AVENUE I 1195 East Main Street
N P Ashland, OR 97520
D MEDFORD, OR 97501 Phone: 541/488-5340
O T Fax: 541/488-5314
R O
_ Vendor Phone Number vsn~Qdumbe =1ear~t . ~iF~-- _ -
541 772-7039 Rachel Dials
Qate ordered- V_ ndor Nun 6-de: mate=Required ;err
08/25/2016 575 FOB ASHLAND OR Parks Accounts Payable
Sit m# = -
td._LT==
(3) Seasonal Rec Guides
The Above Purchase Order Number Must Appear On All
Correspondence - Packing Sheets And Bills Of Lading
1 Printing, mailing and delivery of three (3) seasonal recreation 1.0 $5,528.7000 $5,528.70
guides for Ashland Parks and Recreation Commission for FY
2017 (July 1, 2016 through June 30, 2017)
Contract for Goods and Services Less than $25,000
Beginning date: 07/01/2016
Completion date: 06/30/2017
GL Account: $5,528.70
GL SUMMARY
L 125301 - 606100 $5,528.70
~ fi
By: , Date: F/~ f
Authorized Signature = _ = $5,528.701
FORM 43
..y & RGGF_
V
REQUISITION Date of request: 8/22/16
Required date for delivery: 8/31/16
Vendor Name Valley Wntin9~Attm Marsha and Todd R irhenhach
Address, City, State, Zip 1299 Stowe Avenue, Medford, OR 97501 Tel: 541-772-7039 toddr(a valleywebprintinq com
Contact Name & Tel 1 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
❑ 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:
(Date)
❑ (3) Written proposals/written solicitation Date approved by Council:
❑ Form #4, Personal Services $5K to $75K Valid until; Date
Description of SERVICES Total Cost
Printing, mailing and delivery of three seasonal recreation guides for Ashland Parks and
Recreation Commission for FY 16-17, a period spanning July 1, 2016, through June 30, 2017. $5,528.70
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
® Per attached quote/proposal TOTAL COST
$ 5,528.70
Project Number Account Numbers:
Account Number Account Number _ 211 - _12_ - 03 - 01 - _ 606100
*Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures,
IT Director in co oration with department to approve all hardware and software purchases:
IT Director Date Support -Yes / No
By signing this re uisi on form, 1 I ify that the City's public contracting requirements have been satisfied,
Employe : Department Head:
(Equal to or greater than $5,000)
Department Manager/Supervisor: City Administrator:
(Equal to or greater than $25,000)
Z
Funds appropriated for current fiscal year: (YES-,1Z NO
Finance Director- (Equal to or grea er than $5,000) Date '
Form #3 - Requisition