HomeMy WebLinkAbout2016-263 Contract - Eselin Concrete Construction
Contract for GOODS AND SERVICES less than $25,000
CITY OF CONTRACTOR: Eselin Concrete Const. Inc.
-AS H LAND CONTACT: Joe Eselin
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 800 Cherry Street Medford OR 97501
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-821-1636
DATE AGREEMENT PREPARED: FAX: 541-773-4811
BEGINNING DATE: 09/20/2016 COMPLETION DATE:
COMPENSATION: as per exhibit C
GOODS AND SERVICES TO BE PROVIDED: saw cut form and pour new drain trench and box for golf
course shop as per exhibit C
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
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 $20,283.20 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a
living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor
who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached
hereto as Exhibit B predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs,
judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
C. For Cause. City may terminate or modify this contract, in whole or in art, effective upon deliver of
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 1 of 5
written notice to Contractor, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services,
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach, may at any time terminate
the whole or any part of this contract if Contractor fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City.
Contractor shall have the complete responsibility for the performance of this contract.
11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.110 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage.
C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage,
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 2 of 5
including coverage for owned, hired or non-owned vehicles, as applicable.
d. - Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies, excluding Workers'
Compensation, 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. Certif' t'on. C ntractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
ref ence.
Contr tor: City of Ashland
By By 11 i,z.(cS, a C-
-7 ignature epa ~ent Head
e
j-,;~ S ~11~ V~ ~c oZT" P, - ~
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.
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 3 of 5
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
t YT (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
ear.
(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)
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 4 of 5
CITY OF ASHLAND, OREGON
EXHIBIT B
City of Ash land
LIVING
WA E
per hour effective June 30, 2016
(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.
r 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 $20,283.20. include temporary or part-time
Ashland if the contract employees hired for less than
exceeds $20,283.20 or more. y 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 r In calculating the living wage, Municipal Code Section
employee's time in that month employers may add the value 3.12.020.
working on a project or of health care, retirement,
For additional information:
Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,
20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us.
Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees.
CITY OF
ASHLAND
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 5 of 5
EMEFRON FAX NO. :773-4811 Sep. 19 2016 08:43AM P1
P
a- Tr-3-0
L B fseQtn C~~cnete C'on t..
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9.1v - Ph s s i n e_
I~l s t/1 I gal- 1&.36
edOhd, b i
DATE
PROPOSAL SUBMITTED TO: ORK r0 BE PERFORMED AT.
NAME
i
t r'
G
ADDRESS ~...x. - `L.~:-. , , .
DPTE OF PLANS
a - k._.... - - - - -
PHONE Q. ARCli- I'-ECT
M -
We hereby pro oso to fur t the materials and perform tFi,.e labq( nece3s,ily.for a com.plotion of
t:'o
Q
P
All material is guaranteed to bj~ as specified, and the above work to be pericrmed in accordance with the drawings and. specifications
submitted for above work, and completed in a substantial workmanlike rr,.,,,tr rer for the sum of
Dollars
with payments to be made as follows:
Respectfully submit:ed
Any alteration or devianoo trorn above 3pecifioatiow3 iov0lvinf4 ruira cr)ats
will h® exc,!culo(l only upori wriltoti orum. end will becurne an extra ohiinae I le r
over ana above the estimate. All agreements contingent upon strikes, ac- - -
cidents, or delays beyond our control,
Note -This proposal may be withdrawn
_............,:.__.~~.._..r:.._...x._...,......_ by us if not accepted withi " days.
®O.
" ACC.EPTANC o el FurCbO AL
' o the work
The :above prices, .specifications and conditions are, satisfactory, and y,accepPed. You are'authorized to d d
as specified. Payments will be made as outlined above.
SignatirEi .
Date Signat trf......_...._
I milml
D8118 PROP0v!i ~.L
eemrm MAOF IN USA
Sheri Hamilton BBNW (2/2) 09/20/2016 11:23:43 AM -0700
~co CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/
9/20/2016
16
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: Sheri Hamilton
PHONE 541 772-1111 FAX (541) 772-3785
Brown & Brown Northwest A/C No Ext)• ) A/C No :
3256 Hillcrest Park Drive E-MAIL shamilton@bbnw.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC 11
Medford OR 97504 INSURERA:Contractors Bonding and Insurance 37206
INSURED INSURER B :Travelers Casualty Ins CO of 19046
ESELIN CONCRETE CONSTRUCTION INC INSURERC:SAIF Corporation 52412
800 CHERRY ST INSURER D :
INSURER E :
MEDFORD OR 97501 INSURER F :
COVERAGES CERTIFICATE NUMBER:CL168346539 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 NUMBER MM DY EFF POLICY EXP LIMITS
LTR
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A CLAIMS-MADE 17X OCCUR PREMISES EaEoccurrence $ 300,000
D11PE9029 4/17/2016 4/17/2017 MED EXP (Anyone person) $ 5,000
PERSONAL a ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
y POLICY JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000
I
$
OTHER: Property damage-single limit
AUTOMOBILE LIABILITY i IO MBBII NEeDtSINGLE LIMIT $ 1,000,000
X ANY AUTO BODILY INJURY (Per person) $
B ALL OWNED SCHEDULED
AUTOS AUTOS B717224P837 4/17/2016 4/17/2017 BODILY INJURY (Per accident) $
NON-OWNED P Oa c'de DAMAGE $
HIRED AUTOS AUTOS
Uninsured motorist combined $ 1,000,000
UMBRELLA LIAR OCCUR EACH OCCURRENCE S
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $
WORKERS COMPENSATION I IPER STATUTE ERH
AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N / A E.L. EACH ACCIDENT $ 500,000
C OFFICER/MEMBER EXCLUDED 853195 7/1/2016 7/1/2017
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 5,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Re: Verification of Insurance
This form is subject to policy terms, conditions, and exclusions-
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
90 North Mountain Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97520
AUTHORIZED REPRESENTATIVE
Sheri Hamilton/SHERHA oj*- -
®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)
A Purchase Order
Fiscal Year 2017 Page: 1 of: 1
B City of Ashland
I
ATTN: Accounts Payable
L 20 E. Main Purchase 270
L Ashland, OR 97520 Order #
T Phone: 541/552-2010
O Email: payable@ashland.or.us
V H C/O Fleet/Shop Division
E ESELIN CONCRETE CONSTRUCTION INC I 90 North Mountain Ave
N 800 CHERRY ST P Ashland, OR 97520
D MEDFORD, OR 97501 Phone: 541/488-5358
O T Fax: 541/552-2304
R O
Venn orPhQne- Numbers _ alend' Fa I v~ ur - - - - - - - -
Wes Hoadle
Date 4rd6r~ - VY -d- or Number -ea l ggriired _ s= - = - - a-_ - -
-EV 09/26/2016 2492 Cit Accounts Pa able
Item#_ _ ~ = - =
Trench drain/drain bx wash bay
1 Saw cut, remove material, set forms, pour and finish trench drain 1 $3,375.0000 $3,375.00
and drain box for wash bay.
Contract for Goods and Services less than $25,000
Beginning date: 09/20/2016
Completion date: (left blank)
GL SUMMARY
086500 - 704100 $3,375.00
F
By: A .6 f`.. Date:
Authorized Signature = $3,375.00
FORM #3 CITY OF
SHLAND
REQUISITION Date of request: 09/20/2016
Required date for delivery:
Vendor Name HE i rp+^ (nnSI Inc
Address, City, State, Zip 800 Cherry St. Medford OR 97501
Contact Name & Telephone Number Joe Eselin 541-821-1636
Fax Number 541-773-4811
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 _(A tach co of council communication _ If council approval required, attach co of CC
❑ Small Procurement Cooperative Procurement
Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon
® Direct Award Date approved by Council: Contract #
-(Attach copy of council communication) ❑ State of Washington
❑ Verbal/Written quote(s) or proposal(s)
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 El Special Procurement Intergovernmental Agreement
❑ Agency
$5,000 to $75,000 [:1 Form #9, Request for Approval Date original contract approved by Council:
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached (Date)
❑ (3) Written proposals/written solicitation Date approved by Council: _ (Attach copy of council communication)
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
Saw cut, remove material, set forms, pour, and finish trench drain and drain box for wash bay. $3375.00
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
® Per attached quote/proposal
Project Number _ _ - Account Number 730-08-24-00-704100
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:
I T Director Date Support -Yes /No
By signing this regyisition form, 1#rrtify that the,,.City's public contracting requirements have been satisfied,
i
.f
IX,
Employee: Department Hea&
....,..,w.. (Equal to or greater than $5,000)
Department Manager/Supervisor:'' 1 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:
Gnrm -Hq - Rcrn d4zitinn