HomeMy WebLinkAbout2016-271 Contract - Kocer Crane & Training
Sep.26. 2016 2:52PM No.0938 P. 1
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Contract for GOODS AND SERVICES less than $25,000
C I T Y OF CONTRACTOR: Koc er Crane & Training
ASHLAND CONTACT. Levi Kocer
20 East Main Street
Ashland, Oregon 97520 ADDRESS: PO box 911 Pleasant Hill OR 97455
Telephone: 541/488-6002
Pax: 5411488-5311 TELEPHONE: 541-607-8715
DATE AGREEMENT PREPARED: FAX. 541-607-0715
BEGINNING DATE: 09/20/2016 COMPLETION DATE: 6/30/2017
COMPENSATION:
As per exhibit C
GOODS AND SERVICES TO BE PROVIDED: Preform annual overhead crane inspection 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 contrasts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a
manner that will not conflict with the said rime C" 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.
S. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
city.
6. Statutory Requirements: ORS 27913.220, 2798.225, 27913.230, 2796.235, 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 resultng 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, Contractors 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. Ci 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 b City under an of the following
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 1 of 6
Sep.26. 2016 2:53PM No-0938 P. 2
.
conditions.
L 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 CRS 279A.110 or the administrative rules implementing the Statute.
12. Asbestos Abatement License; if required under CARS 46$A.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 m ensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liabili insurance with a combined single limit, or the equivalent, of not less than Enter one:
$2001000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage.
C. Automobile Liabili 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.
Contract for Goods and Services Less than $26,000, 06/30/2016, Page 2 of 5
Sep-26. 2016 2:53PM No.0938 P. 3
d. Notice of cancellation or change. Thera 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 ifs 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.
29. 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.
Contractor: City of Ashland
By By -K;; ~4 2e~, Signature Department Hea
Print Name Print Name
Q xeV- o ho 1I(,
Title Date
W-9 One spy of a W-0 is to be submitted with ~
T
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, 05/30/2016, Page 3 of 5
Sep.26. 2016 2:53PM No.0938 P. 4
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-J 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} I 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.
__J:::f' (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.
k'*"' (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
Sep.26. 2016 2:53PM No.0938 P. 5
CITY OF ASHLAN[3q OREGON
EXHIBIT B
Cloty of Ashland
LIVING
ALL employers described i
below must comply with City
of Ashland laws regulating
payment of a living wage.
or hour effective June 30, 2016
(increases annually every June 30 by the
Consumer Prue 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
➢ For all hours worked under a assistance for the project or the employee.
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 $20,283.24 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 an a project or of health care, retirement,
For additional information:
Cap the Ashland City Administrator's office at 541-488-6002 or wnle 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 mast be posted predominantly in areas where it can be seen by all employees.
CITY OF
AAHLA D
Contract for wads and services Less then $25,000, 06/3=016, Page 5 of 5
OSep, 26. 20161 2:54PM5416070715 KOCCR CPANE No. 0938 P. 11 06/06
"'w" CE R.
Ir"i
CRANE
TRAINING, LTC
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Wes, X41'; Fleet
As per your request, here Is an - stlrnated" grate an condudtr g the 2016 annual awuheW crane insR~
shop, V4*a Water Treakmerrt. Fire Department, and Reeder Gukh fadl4
Subjed: 2010 Annual Overhead Crane Inspections for the Fleet, WW-T,, Fire CkWardmeM and Reeder Gulch facility
Propowl it 16-933
Yves
Kow , CmnQ and 'training would like to thank you for the opport<.inity to quote on the above mendwed projW, and
looks forward to worlding wilh you and the City of Ashland on making your facilities a War work plaac e.
Scope of Waft
1. Kcoer Crane and Training will oondW (6) overhead aww inspections fbr the (Fleet Shop FoAltyy), (4) ovwhead
crane inspections for the (W.W.T. PIsW), (2) overhead a in ns for the (Reeder Gulch Facility), and (1)
overhead crane inspeMon for the (Fine Depattrraa Q as per OR-OSHA rum and reguletions, and In socordenc a and
speckmtion of ANSI and the rrmnuWureW.
2. Kom Crania and Training will issue a c ertif ale of inspection sticker to be placed an every MdMduai host eme.
3, Koew Crane and Training will issue an individual omne inspeeian report for every indivlduai crane for your
records,
Estutnd Cost of Crane Inspecom: $,2W
Nate: The dum is an estimated c wA on oonducMg the crane inspectim detem*wd by the amount of c anesmoi
that were inspected at #w teaities In 2015. The cask can and will change deterrnined by any cranez/hcWs e+m nmv
have beers taken out of servkWi emoved, and/or that have been installed/added.
The "City of Ashland" Wilkin aftil provide wKe aoms to the es/no at and their o nponents by rmmns of scissor
lift/manCft, a•#mme step ladders, eta., but ewdensiion ladders will not be used.
Tenrs:100% payment 30-tlays after final invoice has been issued.
vVASy
It you could please go atmmd end fax me Dyer ell of the infcxrrsmron required of me I will get it all together and fox it
back oust' to you to get the aontractorhandor informaWn up to date. If you should have any questions or concerns
plow feel Ne to gNs me a call- The of phone a is (541) 6074715, fax# (541) 507-0715, acrd cell # (541)
606-6707. Thank you.
Levi Kom
Kaver Crete & Training, LLC.
P-0-BOX 9113Plcamt dill, OR 97455 PH. (541) 607-8715, FAX (541)607-0715
2
Certificate of Insurance
KOCER CRANE & TRAINING, LLC
Policy plumber: 411732 / 1756403
Subject to all policy terms, conditions, exclusions and endorsements of each respective policy. This is for
informational purposes only.
This insurance was pra~r9ed and developed under the Oregon Surplus Lines laws. It is NOT ouvered by the
provisions of cars ?34520 to 734.710 relating to the Oregon Inwwance Guaranty .Amcmdon. If the insurer
is g this insu ce becomes insolvent, the Oregon insurance Guaranty Associatim has no obligation to pay
claims under this insurance. (SL. Lir-# 130M)
6 W~
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B
Lawrence T.P. Molloy
binders" 138
DATE(MMIDD/YYYY)
AC"J?LT CERTIFICATE OF LIABILITY INSURANCE 12/812014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
j 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 poltcy(ies) most 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:
COMPLETE EQUITY STS INC PHONE No E 0 _ (647} 541-0900 (847) 541-0444 i
1190 Flex Court
ADDRESS
Lake Zurich, IL 60047 0M)RCAIS) AFFORotwx COVERAGE NAIC 4 !
INSURER A Underwriters at Lloyd's, London ?
INSURED Kocer Crane & Training, LLC INSURER e a
PO Box 911 INSURER C
I Pleasant Hill, OR 97455
INSURER C
INSURER E
INSURER F 1
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMIED ABOVE FOR THE POLICY PERIOD k
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 DF-SCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
PLTR TYPE OF INSURANCE u`tt$R LIMITS j POLICY EXP
LTR Ono tlINO I POLICY NUMBER t3EFF I+ WO()fYYYY
X COMkMERCU►L GENERAL. LIABILITY ; EACH OCCURRENCE !s 1 000 , 000 3
CLAIMS MADE OCCUR PREMISES (Ea occxxrence) *_s_ 50~000--
5 000
411732 !x2/09/2014 12/09/2015 IVIED E XP (Am Te _
A PERSONAL & ADV INJURY 1$ 1,0001000
. ~
E ~:;ENERAL AGGREGATE s 2,000,000
vErrL AGGREGATE LIMIT APPLIES PER
'
X' POLICY i ~ PRO JEC T r Lac ( f ? 1 , 000,000
PRODUCTS c rGP AGG $
OTHER: i i
AUTOMOBILE LIABILITY cow SINGLE LIMIT
j ANYAUTO ! ! BODILY INJURY (Pw Arson) $
ALL OWPIED I SCHEDULED
AUTOS AUTOS ! BODILY INJURY (Per accrderat) -
NON OWNED !
W?5 I s {
HIRED AUIIDS AUTOS
a Pex s~ctcs~rn' :
1
9 !UMBRELLA LIAR ? OCCUR ? ! EACH OCCURRENCE S
{ EXCESS LIAR GkAAdAUF AGGREGATE
DED RETENTION ! i _ ± 3
WORKERS COMPENSATION -
STATUTE a ER
TAT TE ; ER V :
AND EMPLOYERS LIABILITY YIN t PER
ANY PROPMETORIPARTNERIEXECUTWE E.L. EACH ACCIDENT S !
OFFICEPUWMER EXCLUDE' 01 N, A
(Mandatory to NH) t i E L DISEASE - EA EMPLOYE S
It yyesz dewbe under
DESCRIPTION OF OPERATIONS beicra ! ~ ? I L 13rSEASE - POLICY LO6gT ! s
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A Professional a 175fi40 :12/04/2014 112/04/2015
$1,000,000 Each Claim
Li albi 1 i t I
$2z0O0,0O0 Aggregate
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, AddstiarW Remarks Sctw4. te, may be avaoied?I mart space is regwred!
IThis is a 2 page certificate,
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CERTIFICATE HOLDER CANCELLATION
r
j SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
j ! THE EXPIRATION DATE THEREOF, E40TICE WILL BE. DELIVERED IN
i ACCORDANCE WITH THE POLICY PROVISI()I 5
} For Informational Purposes Only
!
AUTHORIZED REPRFSENIANVE ii
i
(ID 1988-2014 ACORD CORPORATION. An rights reserved
ACORD25(2014101) The ACORD narne and logo are registered marks of ACORD
Pax Server 9/15/2016 1:41:15 PM PAGE 1/003 Fax Server
Nationwide@
is on your side
aft-
Attn:
To:
Fax: 15416070715
From: Jenna Platt
Pages: 03
Date: Thursday, September 15, 2016
Notes:
CONFIDENTIALITY N071CE: This facsimile is intended for the use of the person to whom it is addressed and contains
information that is confidential, the disclosure of which is governed by applicable law and which, under certain
circumstances, may also be privileged. If the reader of this facsimile is not the intended recipient, or the employee or
agent responsible to deliver it to the intended recipient, you are hereby notified that any diisemination,
distribution or copying of this infromation is STRICTLY PROHIBITED. If you have received this message in error,
please notify the sendor immediately and destroy the facsimile. Receipt by anyone other than the intended reciplent(s) is
not a waiver of any attorney-client or other privileges.
tax Server 8/15/2016 1:41:15 PM PAGE 2/003 Fax Server
Your Insurance Identification Card
Nationwide Detach your identification cards along the perforated lines.
is on your s Keep this card in your vehicle.
• See section following ID Cards for What's enclosed.
IMPORTANT NOTICE...
Richard D. Kocer
Evidence of insurance must be carried in the vehicle or otherwise Po Box 911
available for display upon demand of a police officer. Failure to do Pleasart Fill OR 97455-0911
so would be reasonable grounds for the officer to believe that the
person is operating the vehicle in violation of ORS 806.010.
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t'.) IdaWf{catlon Card ii kW#tMcatbn Clint
0
O PoiicyNumber Effective Date Expiration Date Poky Number Wreetive Date Expiration Date
PPNNMO224032-S Aug 15 2010 Fab 15 2017 PPNM0016224932-6 Aug 16 2016 Feb 16 2017
Year Make(Model Vehicle Identification Number (VIM) Year Make/Model Vehicleidentllleatlon NumberIVIN)
O 1988 ChevrolWCorvette 161YY22GZW6106337 2012 ChevroleUS#verado 1ACRKSE 0=295M
24 Hour Claims 1.840.421.3535 24 Hour Claims 1.800.421.3535
See the reverse We for more aiformauon. See the remw We for more alormation.
Richard D. Kocer Richard D. Kocer
Po Box 911 Po Box 911
Pleasant Hill, OR 97455-0911 Pleasant Hill, OR 97455-0911
Nationwide Insurance Company of America Nationwide Insurance Company of America
1100 Locust St Dept 1100 1100 Locust St Dept 1100
Des Moines, IA 50391-1 1 00 Des Moines, IA 50391-1100
NAIC Company Number 25453 NAIC Company Number: 25453
n
r. N~tleiwrltlt' Oregon Msur nce Oregon Insuramm
W1 • kle"ficatlon card ld*MMcatbn Card
Polley Nun*er Wective Date Expiraton Date Policy Number 8174ctlve Date Expiration Date
PPNMD018224942-6 Aug 15 2016 Fab 15 2017 PPNfW001ti224632-9 Aug 16 2016 Feb 16 2017
Year Makefflodel Vehicle Identification Number (VIM) Year Make/Model Vehicle Identlfltation Number (VIN)
2007 ChevroletOlverado 23CEC1W071584266 2007 ChevroleVWvaado IGCHK29WIESM766
24 Hour Claims 1.800.421.3535 24 Hour Claims 1.800.421.3535
Seethe reverse side for more information. See the reverse aide for more irformatior.
Richard D. Kocer Richard D. Kocer
Po Box 911 Po Box 911
Pleasant Hill, OR 97455-0911 Pleasant Hill, OR 97455-0911
Nationwide Insurance Company of America Nationwide Insurance Company of America
1100 Locust St Dept 1100 1100 Locust St Dept 1100
Des Moines, IA 50391-1100 Des Moines, IA 50391-1100
ID0036 (02.12) NAIC Company Number. 25453 NAIC
Ctxr>Qany Number: 25453
KOCER
CRANE
TRAINING, LLC
Dear Mr. Hoadley,
Enclosed is the "original" signed 2016 contract for goods and services for Kocer Crane to
conduct the 2016 .annual overhead crane inspections. There is also a W-9 and all of the
insurance information needed. If there should be any other needed information please let
me know as soon as you can so we can get everything in order. I have the annual
overhead crane inspections tentatively set up for the dates of October the 12t' and 13th. If
this does not work for you please let me know. Also, if you could please call me and
confirm such said dates it would be highly appreciated. Thank you for all of your help in
this matter.
Respectfully,
Levi Kocer i
Kocer Crane and Training
P.O.BOX 91 l,Pleasant Hill, OR 97455 PH. (541) 607-8715, FAX (541)607-0715
Purchase Order
Fiscal Year 2017 Page: 1 of: 1
B City of Ashland
I ATTN: Accounts Payable
L. Purchase 372
L 20 E. Main Order #
Ashland, OR 97520
T Phone: 541/552-2010
O Email: payable@ashland.or.us
V S C/O Fleet/Shop Division
E KOCER CRANE & TRAINING LLC H 90 North Mountain Ave
N P0BOX911
D PLEASANT HILL, OR 97455 P Ashland, OR 97520
Phone: 541/488-5358
O R
Fax: 541/552-2304
_Vendiar Ph ~e Numt e = _V~ns WiTax=11~~_b_~~ s~= rU~
541 607-8715 Wes Hoadle
DatszOrsler sf /eh oT N~m~ mat, B Aoir Ha = _ - - _ fry = -
10/10/2016 289 FOB ASHLAND OR City Accounts Payable
Item# W IM - -=Qscr
Annual Crane Inspections
1 Perform annual crane inspections 1 $2,280.0000 $2,280.00
Contract for Goods and Services Less than $25,000
Beginning date: 09/20/2016
Completion date: 06/30/2017
GL SUMMARY
082400 - 610400 $2,280.00
{ Date: = i
Authorized ;Signature = - _ $2,280.00
FORM #3 CITY OF
ASHLAND
REQUISITION Date of request: 10/06/2016
Required date for delivery:
Vendor Name K^^^r rr2n^ ^"d Traininn
Address, City, State, Zip P.O. box 911 Pleasant Hill OR 97455
Contact Name & Telephone Number Levi Kocer 541-607-8715
Fax Number 541-607-0715
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
® Direct Award Date approved by Council: Contract #
Z 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 ❑ Form #9, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3) Written proposals/written solicitation Date approved by Council: (Date)
❑ Form #4, Personal Services $5K to $75K Valid until: Date - (Attach copy of council communication)
Description of SERVICES Total Cost
Preform annual crane inspections as per exhibit C $ 2,280
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
® Per attached quote/proposal
d
Project Number - - - - - - - - - - Account Number 41 0 - 0 8 - 2 4 - 0 0 - 61 0400
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 req jsition,form, 1 cerfify1hat the City's public, contracting requirements have been satisfied.
F-
Employee: Department Head:
(Equal to or gre~aterthan $5,000)
Department Manager/Supervisor-T` 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