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HomeMy WebLinkAbout2016-248 CONT Addendum - Full Circle Real Estate { i ADDENDUM TO CITY OF ASHLAND CONTRACT FOR PERSONAL SERVICES LESS THAN $35,000 Addendum made this 31 st day of August 2016, between the City of Ashland ("City") and Full Circle Real Estate ("Consultant"). Recitals: I A. On 1011912015 City and Consultant entered into a "City of Ashland Contract for Personal Services Less than $35,000" (further referred to in this addendum as "the agreement"). B. The parties desire to amend the agreement to extend the date of completion. City and Consultant agree to amend the agreement in the following manner: 1. The date for completion as specified in Paragraph 4 of the agreement is extended to October 15, 2016. 3. Except as modified above the terms of the agreement shall remain in full force and effect. CON LTANT CITY OF A LAND: BY /C / /-,o e? BY ~e art P t Head its ..~V4 fir' Y X Date l~ L DATE Purchase Order # 00508 Acct. No.: 411.12.00.00.604100 (For City purposes only) 1- CITY OF ASHLAND, ADDENDUM TO CONTRACT FOR PERSONAL SERVICES ® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/06/2016 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). PRODUCER CONTACT NAME: Jon Snowden Jon Snowden alto No Ext : (541) 482-2461 FAX No : (541) 482-4957 StateFarm 420 Bridge St ADDRIESS: jon@jonsnowden.com Ashland, OR 97520 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :State Farm Fire and Casualty Company 25143 INSURED Full Circle Real Estate, LLC INSURER B : 240 E Main St INSURER C : Ashland, OR 97520 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y 97-GA-5094-1 04/03/2016 04/03/2017 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE ❑ OCCUR PREMISES DAMAGES J EaRENTEDoccurrence $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY F] PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A - (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Real Estate Office CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND, ITS ELECTED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE OFFICIALS, OFFICERS AND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EMPLOYEES ACCORDANCE WITH THE POLICY PROVISIONS. 20 E MAIN ST ASHLAND OR 97520-1850 AUTHORIZED REPRESENTATIVE Karen HinckIe Dig lt.lly 19-d n Karen by kKar- le, -State DN: =re HincIe -State Farm, ou=Jon Snowcen, emal1=Karen@Jon3nowa9n com, -US Data 201'0.09.06 13'.12'.13 -0700 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 www.saif.com Oregon Workers' Compensation I.WA say Certificate of Insurance Fv corporation Mail to: Certificate holder: FULL CIRCLE REAL ESTATE LLC CITY OF ASHLAND FULL CIRCLE REAL ESTATE 20 E MAIN STREET 240 E MAIN ST ASHLAND, OR 97520 ASHLAND, OR 97520-1831 The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by this policy is subject to all the terms, exclusions and conditions of such policy; this policy is subject to change or cancellation at any time. Insured Producer/contact Full Circle Real Estate LLC United Insurance Agencies Full Circle Real Estate United Insurance Agencies 240 E Main St 541.242.6464 kellyc@uiaoregon.com Ashland, OR 97520-1831 Issued 09/06/2016 Limits of liability Policy 854801 Bodily Injury by Accident $500,000 each accident Period 10/02/2015 to 10/01/2016 Bodily Injury by Disease $500,000 each employee Body Injury by Disease $500,000 policy limit Description of operations/locations/special items Important This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. Authorized representative ) 6~ ~ PV4~ Kerry Barnett President and CEO 400 High Street SE Salem, OR 97312 P: 800.285.8525 F: 503.584.9812 Policy_OLCA_CertificateOfl nsurance From: Eric Strona To: Susan Dysseaard Subject: Fwd: Auto Insurance Confirmation Date: Tuesday, September 06, 2016 1:27:22 PM Hi Susan, Here's the auto. i o ensure delivery to your inbox, please add USAA Customer ServiceCcbmailcenter usaa com to yoar address book. Auto Insurance A Confirmation I Privacy Promise I Please use this as confirmation of auto insurance; however, this does not take the place of an insurance identification card. Registered owner : ERIC A POOLE Address: 186 OHIO ST ASHLAND OR 97520 Policy CIC 007513130 7101 Policy effective: July 18, 2016 Policy expiration: January 18, 2017, Vehicle: 2014 SUBARU OUTBACK VIN : 4S4BRBLC4E3226253 Bodily injury liability limit: $1,000,000 each person / $1,000,000 each accident Property damage liability $500,000 each accident limit: Comprehensive $500 deductible: Collision deductible: $500 Lienholder : WELLS FARGO DEALER SERVICES PO BOX 5075 CORAOPOLIS PA 15108 5075 Meets Oregon minimum statutory liability requirements This confirmation of coverage neither affirmatively nor negatively amends, extends or alters the coverage given by the policy issued by USAA Casualty Insurance Company. Thank you for choosing us for your auto insurance needs. If you have questions, please call us at 210-531-USAA (8722), our mobile shortcut #8722 or 800-531-8722. Thank you, USAA Casualty Insurance Company ®u USAA Casualty Insurance Company, 9800 Fredericksburg Road, San Antonio, Texas 78288 Privacy Promise Please do not reply to this e-mail. To contact USAA, visit our secure contact oaae. 93127-0111 Eric Strong Business Development Full Circle Real Estate 240 East Main St. Ashland, OR 97520 541.601.2014 ~s<~ Purchase Order 2 F Fiscal Year 2017 Page: 1 of: 1 \ v X02' ~~S $ R E G47Eo `"yh_ _ - - - - L13L~1~IP L B Ashland Parks Commission I ATTN: Accounts Payable L 20 E. Main Purchase 152 L Ashland, OR 97520 Order # T Phone: 541/552-2010 O Email: payable@ashland.or.us S C/O Parks Department E FULL CIRCLE REAL ESTATE LLC H Admin Office N 240 EAST MAIN STREET 1 340 South Pioneer E D ASHLAND, OR 97520 P Ashland, OR 97520 O T Phone: 541/488-5340 R O Fax: 541/488-5314 Ze_WKEP Qf~ n~filmbe fe sip= F _ = - - 541 482-6868 Michael Black UM M-Aq 09/08/2016 16.34 FOB ASHLAND OR Parks Accounts Payable -Item - - - tfit - Land Acquisition - Eden PO 508 1 Land Acquisition Opportunities - Eden PO 508 1 $3,699.9900 $3,699.99 Seek out land acquisition opportunities for APRC toward completion of OS Plan. Project #000058.999 2 Processed change order 09108/2016 1 $1,000.0000 $1,000.00 Request to increase PO $1,000.00 per attached Form #10,Contract Amendment Approval Request Form GL SUMMARY 123000 604100 $4,699.99 By:~ aDate: r NEI Authorized Signature + - $4,699.99 FO #10 CITY OF CONTRACT AMENDMENT APPROVAL REQUEST FORM ASHLAND Request for a Change Order Name of Supplier 1 Contractor 1 Consultant: Full Circle Real Estate, Eric Poole Total amount of this contract amendment: Purchase Order Number: 00508 Title 1 Description: Seek out land acquisition opportunities for APRC toward completion of OS Plan $ 11000.00 ® Per attached contract amendment Contract Amendment Original contract amount $ 4,999.99 100% of original contract Total amount of previous contract amendments 0 0 % of original contract Amount of this contract amendment $1,000.00 20% of original contract TOTAL AMOUNT OF CONTRACT $ $5,999.99 120% of original contract In accordance with OAR 137-047-0800: 1) The amendment is within the scope of procurement as described in the solicitation documents, Sole Source notice or approval of Special Procurement. 2) The amendment is necessary to comply with a change in law that affects performance of the contract. 3) The amendment results from renegotiation of the terms and conditions, including the contract price, of a contract and the amendment is advantageous to the City of Ashland, subject to all of the following conditions: a) goods and services to be provided under the amended contract are the same as the goods and services to be provided under the unamended contract; b) The City determines that, with all things considered, the amended contract is at least as favorable to the City as the unamended contract; c) The amended contract does not have a total term greater than allowed in the solicitation document, contract or approval of a Special Procurement. An amendment is not within the scope of the procurement if the City determines that if it had described the changes to be made by the amendment in the procurement documents, it would likely have increased competition or affected award of contract. Contract amendment is within the scope of procurement: YES X NO* (If "NO", requires Council approval I Attach copy of CC.) Sourcing Method: SMALL PROCUREMENT - Less than $5,000 INVITATION TO BID or COOPERATIVE PROCUREMENT, QRF or ❑ "YES", the total amount of contract and cumulative REQUEST FOR PROPOSAL EXEMPTION PURSUANT TO AMC 2.50 amendments $6,000. ❑ "YES", the total amount of cumulative amendments ❑ "YES", the total amount of original contract and ❑ If "NO", amount exceeding authority requires 25% of original contract amount or $250,000 cumulative amendments $100K for Goods & Services, Council approval. Attach copy of Council whichever is less. $75K for Personal Services, < $50K for Attorney Fees. Communication. ❑ If "NO", amount exceeding authority requires ❑ If "NO", amount exceeding authority requires Council ❑ Exempt- Reason: Council approval. Attach copy of Council approval. Attach copy of Council Communication. PERSONAL SERVICES Communication. ❑ Exempt - Reason: ® "YES", Direct appointment $35,000 ❑ Exempt -Reason: ❑ If "NO", requires approval. INTERMEDIATE PROCUREMENT SOLE SOURCE EMERGENCY PROCUREMENT Goods & Services - $5,000 to $100,000 ❑ "YES", the total amount of cumulative amendments ❑ Written Findings: Document the nature of the Personal Services - $5,000 to $75,000 25% of original contract amount or $250,000 emergency, including necessity and circumstances ❑ "YES", the total amount of cumulative whichever is less. requiring the contract amendment amendments s 25% of original contract amount. ❑ If ❑ If "NO", amount exceeding authority requires ❑ Obtain direction and written approval from City "NO", amount exceeding authority requires Council Council approval. Attach copy of Council Administrator approval. Attach copy of Council Communication. Communication. ❑ If applicable, attach copy of Council Communication ❑ Exempt- Reason: ❑ Exempt- Reason: ❑ Exempt -Reason: SPECIAL PROCUREMENT INTERGOVERNMENTAL AGREEMENT ❑ "YES", the total amount of original contract and cumulative amendments are ❑ "YES", the original contract was approved by City Council. within the amount and terms initially approved by Council as a Special Provide date approved by City Council: (Date) Procurement. If "NO", Council approval is required. Attach copy of Council Communication. ❑ If "NO", amount exceeding authority requires Council approval. ❑ Contract amendment approved and signed by City Administrator. Attach copy of Council Communication. Project Number- 000058 _ - 999 Account Number- 411 -12-00-00-604100 _ Account Number------. *Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. Attach extra, pdQ6igss if needed. Employee Signature: Department Head Signature: (Total amount of contract $5,000) City Administrator: (Equal to or greater than $25,000 or 105/o) Funds appropriated for current fiscal year: YES / NO Finance Director (Equal to or greater than $5,000) Date Comments: Form #10 - Contract Amendment Approval Request Form, Request for a Change Order, Page 1 of 1, 9/7/2016