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2016-273 Contract - SOS Plumbing
Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: SOS Plumbing -ASHLAND CONTACT: Mike Davis 20 East Main Street Ashland, Oregon 97520 ADDRESS: 206 S Pacific Hwy, Talent OR 97540 Telephone: 5411488-6002 Fax: 5411488-5311 TELEPHONE: 541-535-5063 DATE AGREEMENT PREPARED: FAX: 541-535-3964 September 29, 2016 BEGINNING DATE: September 2016 COMPLETION DATE: 6/30/2017 COMPENSATION: Per fee schedule attached as Exhibit C Not to Exceed $3,500 GOODS AND SERVICES TO BE PROVIDED: Plumbing repairs and maintenance services to be provided on an on-call or as needed basis, including situations requiring immediate attention, as determined by a representative of the City of Ashland. For the remainder of fiscal year 2017. 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 rims 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 skil'ed and worker-like manner and, if requ;; ed 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, 2796.230, 279B.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 i:o 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 +li;s 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 resultirg 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 an time b mutual consent of both parties, Contract for Goods and Services Less than $25,000, Revised 0610212015, Page 1 of 5 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 lacer 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 ;Mould 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. 11 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 triis 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 ide,itified 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 Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 2 of 5 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 procee!ling (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 conducteu solely and exclusively within the United States District Court for the Districi_ of Oregon filed in Jackson County, Jregon. 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 ` PECIFIC 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. Contractor: City of Ashland r ~Z By By Signature Department Head , o, L) k-0- 1) vc 10. vvcc P4 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, Revised 06/0212015, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS' Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-Y9 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 (1) 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 enforceak*ia in accordance with its terms, ( the work under the Contract shall be performed in accordant-e with the highest professional standards, and (d) Contractor is qualified, professionally competer! and duly licensed to perform rte 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 service.-:; 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 _i/ ;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 ct performance bonds, warranties, errors and omission insurance or liability insurance r(iating to the labor or services to be provided. 1 Contractor (Date) Contract for 3oods and Services Less than $25,000, Revised 06/02/2015, Page 4 of 5 CITY OF ASHLAND, OREGON - - - - - - - - - EXHIBIT B City of Ashland LIVING so, 0. 4 WAGE A per hour effective June 30, 2015 (Increases annually every June 30' by the %all 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 project or 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 pert-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 x.12.020. working on a project or of health care, retirement, additional For Call the Ashland City Administrators office at 541-488-8002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www,ashlF n .or,u . Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLANYD Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 5 of 5 . 206 Sol P.acific,Hvvy., S_.,OS Jalot,OR 97540 Plumbing & Drain Service 535 5Ub3 ` (Talent). - - . 481a-268'0 ~Ashland~ r Fax: 535-3964 J CCB- #079604 Schedule of Labor Rates: Standard Service Calls (Orie Plumber) $120'.00/- H R Lrarger Projects.{.1 v' lultiple'Plumbers} : $90/HR per plumber Notes: ; . We no longer offer after hours or weekend emergency service. Any job"that that will need to be done after -hoursor on the weekend will be organized beforehand- with ari agreed upon:bid amaunt. Our nours.of operation are Monday-Friday'.7:3Q a.m.-4:30 p.m. Same day service might, not always, be passible; but wewill always make'every effort to accommodate emergency calls: .a DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/29/2016 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 have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER Brown & Brown Northwest N AME: Sand L. Orr 3256 Hillcrest Park Drive PHONE FAX Medford, OR 97504 a ANo Ext : 541-494-2687 A/C No): 541-494-2787 ADDRESS: sorr@bbnw.com INSURERS AFFORDING COVERAGE NAIC # www.bbnw.com INSURER A : American Hallmark Insurance Company of Texas 43494 INSURED INSURER B : SOS Plumbing & Drain Service Inc. 206 South Pacific Highway INSURERC: Talent OR 97540 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 32127830 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 LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ 44CL44337609 3/11/2016 3/11/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE ✓ OCCUR PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO 2,000,000 JECT LOC PRODUCTS COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY 44CL44337609 3/11/2016 3/11/2017 EO BINEDtSINGLELIMIT $ 1'000'000 ✓ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A ✓ UMBRELLA LIAR OCCUR 44CU44337709 3/11/2016 3/11/2017 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED ✓ RETENTION $10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If 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) General Liability coverage includes Blanket Additional Insured coverage including Primary/Non-contributory, Per Project Aggregate and Waiver of Subrogation when required by written contract per attached endorsement MP97670408. Subject to policy terms, limits, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Susan Wilson ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 32127830 110527 116-17 GL/UMB/AUTO Sandy L. Orr 9/29/2016 11:58:21 AM (PDT) Page 1 of 7 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDQlYYYY) 9/29/2016 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 NOMTACT Thomas Wilson Ashland Insurance Inc PHONE (541)857-0679 FAX Na.(541)857-9883 801 O'Hare Parkway, Ste 101 AODR ,twilson@ashlandinsurance.com INSURERS AFFORDING COVERAGE NAIC #i Medford OR 97504 INSURERA:SAIF Corporation INSURED INSURER B : SOS Plumbing and Drain Service, Inc. INSURER C : 206 S Pacific Hwy. INSURER D : INSURER E Talent OR 97540 INSURER F COVERAGES CERTIFICATE NUMBER:CL165906188 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. NO'YWITHSTANDING 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 A L POLICY EFF POLICY EXP LIMITS TR TYPE OF INSURANCE POLICY NUMBER MM1DD MMl COMMEPC1AL GENERAL LIABILITY EACH OCCURRENCE 5 DAMAGE T E E CLAIMS-MADE F~ OCCUR S a MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 7~1 PJECT RO- 7 LOC PRODUCTS - COMP/OP AGG 5 PRO S OTHER: AUTOMOBILE LIABILITY MCB NEDD SINGLE LIMIT S ANY AUTO BODILY INJURY (Per person) S ALL OWNED SCHEDULED BODILY INJURY (Per accidant) 5 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE S Per a Cid nt HIRED AUTOS AUTOS S UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMS-MADE AGGREGATE 5 DED I RETENTIONS 5 WORKERS COMPENSATION x PEAT TE ERH AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? ❑ NIA A (Mandatory In NH) 754526 10/1/2015 10/1/2016 E.L. DISEASE - EA EMPLOYE $ 500,000 If yyes, doscrlbo under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 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 20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR AUTHORIZED REPRESENTATIVE "7"~ SAC r-r~ Marcene Forney/MARC ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name :.ind logo are registered marks of ACORD INS025 rgni4m1 l C~ DATE (MMIDD[YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/29/2416 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 NA M Thomas WiISOri Ashland Insurance Inc PHONE (541) 857-0679 FAx {54x)857-saes A1C No 801 O'Hare Parkway, Ste 101 ADDRESS: twilson@ashlandinsurance.com INSURERS AFFORDING COVERAGE NAIC # Medford OR 97504 INSURERA:SAIF Co oration INSURED 4 INSURER B SOS Plumbing and Drain Service, Inc. INSURER C : 206 S Pacific Hwy. INSURER D: INSURER E : Talent OR 97540 INSURER F : COVERAGES CERTIFICATE NUMBER:CL1692906467 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. NO-ViTHSTANDING 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 ADDLSUBR POLICY NUMBER MMiDDIYYYY MM DDAFYYY LIMITS LTR INSQ -t= COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ AMA O RENTED ' C:AIMS-MADE 7 OCCUR PREMISES E. u $ MED EXP (Any ono person) $ - PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ I POLICY I_7 jE F7 LOC ` PRODUCTS - COMP/OP AGG $ OTHER, Ij $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ accld nt BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Peracdclent) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccidont $ EACH OCCURRENCE $ UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION PER OTH- STAY T R AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT S 500 OOO OFFICER/MEMOER EXCLUDED? ❑ N I A A (Mandatory In KH) 754526 10/1/2016 10/1/2017 E.L. DISEASE - EA EMPLOYE $ 500 000 1f es.describeunder D SCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 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 Y ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St Ashland, OR AUTHORIZED REPRESENTATIVE Marceae Forney/TOM (D 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 M1401) Purchase Order ,va Fiscal Year 2017 Page: 1 of: 1 =EgRQ N =NLL - - - - - E'=== B City of Ashland M I ATTN: Accounts Payable L 20 E. Main Purchase 373 L Ashland, OR 97520 Order # T Phone: 541/552-2010 O Email: payable@ashland.or.us V S.O.S. PLUMBING, INC H C/O Facilities Maintenance Div E S PACIFIC HWY I 90 North Mountain Ave N 206 P Ashland, OR 97520 D TALENT, OR 97540 Phone: 541/488-5358 O T Fax: 541/552-2304 R O ~nsaTPrnNumbeT= _-7:Rdor_l~l&M-7=-r WNW- 0 - - - - - - - Wes Hoadle Date~r•der~~= -~d~riJ~~nbe~ =_a~F~s-q-'rte-- _ - : - - - _ _ : - - _ _ _ - - - 10/10/2016 232 FOB ASHLAND OR City Accounts Pa able e tam R rt _ _ _ - - - - _ - - = = - = _ On-call Plumbing Services 1 On=call plumbing services on an as needed basis NTE $3,500.00 1 $3,500.0000 $3,500.00 per fee schedule attached as Exhibit C. Contract for Goods and Services less than $25,000 Beginning date: September, 2016 Completion date: 06/30/2017 GL SUMMARY 082400 - 602400 $3,500.00 B U_ Date: Authorized; Signature $3 500.00 FORM #3 CITY OF ASHLAND Date of REQUISITION 10/06/2016 request: Required date for delivery: Vendor Name SOS D1i imh'nq Address, City, State, Zip 205 S Pacific H l Talnnt O 97540 Contact Name & Telephone Number Mile Days 541-.935-5063 Fax Number 541-535-3964 - 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 # ❑ 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 Provide on call misc. plumbing services on an as needed basis NTE 3500 as per fee schedule $3,500 exhibit C. Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ Project Number Account Number 410-08-24-00-602400 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 requisition for, I certify that.the City's public contracting requirements have been satisfied. t f ':r Employee: Department Head: (Equal to or greater'than $5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year. YES / NO Finance Director- (Equal to or greater than $5,000) Date Form #3 - Requisition