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HomeMy WebLinkAbout2016-304 Contract - Thermo Fluids Contract for GOODS AND SERVICES less than $25,000 CITY OF CONTRACTOR: Thermo fluids -As H LA N D CONTACT: Erik felber 20 East Main Street Ashland, Oregon 97520 ADDRESS: 535 Industrial Cir, White City, OR 97503 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: (541) 830-1100 DATE AGREEMENT PREPARED: 9/01/2016 FAX: BEGINNING DATE: 09/5/2016 COMPLETION DATE: 06/30/2017 COMPENSATION: Asper Exhibit C GOODS AND SERVICES TO BE PROVIDED: Vac out wash bay oil separators at golf course shop, b street and SPRiice GEr?tpr Dispose of contaminated soil for electric department 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 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. 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, 2'98.230, 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 $20,283.20 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 delivery of Contract for Goods and Services Less than $25,000, 06/3012016, 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, $5001000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property e, 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. e 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A a Perein incorporated by reference. Contractor: City of Ashland By By - Signature Department _ ~~K Fe-,Ldp Print Name Print Name Title Date W-9 is to be submitted with W-9 One copy of a the signed contract. Purchase Order No. j 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 1D (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: x (1) 1 carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. (3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. < (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. Z 7"~' 'Z lO - - Contractor (Date) Contract for Goods and Services Less than $25,000, 06/30/2016, Page 4 of 5 { r THERMO ~t FLUIDS' Service Agreement The Responsible Solution 1.800.350.7565 www.thermofluids.com Company City Of Ashland y Address 90 N Mountain Ave W City/Stateop Ashland Or 97520 m o Contact Wes Hoadle a Phone 541-552-2355 a Fax Mobile W Multiple Locations ill ESTIMATED PRICING or UNITS EFFECTIVE DATE SERVICE ANNUAL VOLUMES (PAYMENT)' INTERVAL Collection Services Used Oi! Collection (Bulk) (Max. S% water) FIXED ✓ INDEXED gallon Used Oil Collection (Drums) drum Used Oil Filter Collection DRUMS BINS drlbin Non-RCRA Waste Antifreeze Collection gallon Absorbent Collection GRANULAR SOCK/PAD drum Other - TYPE: Absorbent Roll each Commercial & Industrial Wastewater and/or Vacuum Truck Services Oily Water Collection PROFILE COMPLETE ✓ $ 0.750 gallon 9/15/2016 Sludge Collection $ 2.000 gallon 9/15/2016 Truck Time $ 90.000 hour 9/15/2016 N Technician Time hour Other - TYPE: Fuel Charge %of total yes each 9/15/2016 °o Parts Washing Services & Equipment o. 16 Gallon Solvent Tank COMS ✓ LEASE oath w w 30 Gallon Solvent Tank COMS ✓ LEASE each s Aqueous Based - TYPE: each o: y Equipment Sales - TYPE: each v Other - TYPE: each s Coolant & Other Products h Pre-mix Conventional LT DUTY AUTO HVY DUTY DIESEL gallon m d Pre-mix Extended Life LT DUTY AUTO HVY DUTY DIESEL gallon Washer Fluid - TYPE: gallon Other - TYPE: window wash all season Lab Analysis Analytical Testing PW SOLVENT OILY WATER each Field Halogen Test USED OIL OILY WATER each Other - TYPE: each NOTES and/or OTHER SERVICES/PRODUCTS Total not to Exceed $ 4500. This Agreement is governed by and subject to Thermo Fluids Inc.'s Terms & Conditions. "Fuel charges may apply. Thermo Fluids Representative Customer Representative Cr Print: Lee Michael Print: Wes Hoadle a Signature: Signature: Z5 Title: Account Manager Title: Maintenance Superviser Date: 9/23/2016 Date: W NAC Account: no Dispatch Upon Receipt: ❑ W Account Manager: Lee Michael New Customer: ❑ LL Local TFI Office: Medford Change Order: ❑ U. ° Vertical Market: White = Dispatch, Yellow = Client, Pink = Sales a, .a CITY • ASHLAND9 OREGON EXHIBIT B City of Ashland LIVING- A I,$ WA E • Per hour effective June 30, 2016 ow (Increases annually every June 30 by the 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 $20,283.20. include temporary or port-time Ashland if the contract employees hired for less than exceeds $20,283.20 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, Municipai 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 CLEAHAR-01 KHARATS CERTIFICATE OF LIABILITY INSURANCE 2ATE9/14/201YYY) (MMIDDN 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 Willis Towers Watson Certificate Center AtONT Willis of Massachusetts, Inc. HON (877) 945,7378 FAX CIO 26 Century Blvd A/C No): 888 467-2378 P.O. Box 305191 E-MAIL ADDRESS: certificate willis.corn Nashville, TN 37230-5191 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : ACE American Insurance Company 122667 INSURED INSURER B : American Guarantee and Liability Insurance Company 26247 Thermo Fluids Inc. INSURER C : Indemnity Insurance Company of North America 43575 94624 N. Scottsdale Rd., Suite 300 INSURER D Scottsdale, AZ 85254 - INSURER E : I INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE XCO SIR I POLICY E POLICY XP LIMITS LTR IN $D WVD POLICY NUMBER MMIDDNYYY) (MMIDDIYY~ A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,040,000 AMAGE TO RENTED 1 CLAIMS-MADE FY-1 OCCUR X HDOG2740067A 11101/2015 11/01/2016 PR EMISES En occurrence $ 500,000 X' XCU MED EXP (Any one person) $ 5,000 X Contractual PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JE j LOC PRODUCTS -COMP/OP AGG $ 4,DOQ>OOU i OTHER: $ AUTOMOBILE LIABILITY COMdeD SINGLE LIMIT $ 5,000,000 (Ea A X ANY AUTO X 'ISAH08860889 11/01/2015 11/01/2016 BODILY IN.lURY (Per person) $ X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ ' NON-OWNED PRO RTY AMAGE $ X HIRED AUTOS X AUTOS (Per accident X MCS-90 X UMBRELLA LIAR X OCCUR f EACH OCCJRRENCE 5 10,000,000 B EXCESS LIAB CLAIMS-MACE i f AUC 4275262-11 1 11/0112015 11101/2016 AGGREGATE $ 10,000,000 DED X RETENTIONS 0i $ WORKERS COMPENSATION X PER ER AND EMPLOYERS' LIABIUTY STATUTE ER YIN - C ANY PROPRIETOR/PARTNER/EXECUTIVE ®N 1 A - - WLRC48592739 (AOS) X1/0112015- 1-110112016 - E.L. EACH ACCIDENT-- ----2,000,000 OFFICER/rdEMBER EXCLUDED? (Mandatcry in NH) j E.L. DISEASE - EA EMPLOYEE $ 2,000,000 It yus, describo under 2,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE =01 JCY LIMIT $ A ;Work Comp & Emp Liab WLRC48592715 (AZ, CA, MA) 11/0112015,11101/2016 See Attached DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may bo a=chod If more space is roquired) Scope of Work: Vacuum truck cleaning out oil water separators. Certificate Holder is named as an Additional Insured for General and Auto Liability as their interests may appear if required by written contract but only with respect to liability arising out of operations of the Named Insured. It is further agreed that the General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE Attn: Wes Hoadley 90 N. Mountain Ave, t/! I ~i (Ashland OR 97520 ©1988-2014 ACORD CORPORATION. All rights reserved. " ACORD 25 (2014101) The ACORD name and logo are registered marks.of ACORD 1 t Purchase Order Fiscal Year 2017 Page: 1 of: 1 AftN FALL B City of Ashland TN: Accounts Payable L 20 E. Main Purchase 408 L Ashland, OR 97520 Order # T Phone: 541/552-2010 O Email: payable@ashland.or.us V S C/O Fleet/Shop Division E THERMO FLUIDS INC. H 90 North Mountain Ave N PO BOX 7170 I D PASADENA, CA 91109-7170 P Ashland, OR 97520 Phone: 541/488-5358 O R O Fax: 541/552-2304 Vin 4rPhone~umb60 - ~Jum 888 834-2228 _ Wes Hoadle Date 4~~iered V~ndr number--@a-Qg~rs@ - _ _ - = ea 11/14/2016 807 FOB ASHLAND OR City Accounts Payable Vac out wash bay oil separator 1 Vac out wash bar oil separators at golf course shop, B Street and 1 $4,500.0000 $4,500.00 service center. Dispose of contaminated soil for electric department as per contract. Not to exceed $4,500.00 GL SUMMARY 082400 - 602351 $4,500.00 By-.. Date: I Auth6rized Signature = $4,500.00 CITY OF FORM #3 _ ASHLAND F e REQUISITION t Date of request: 09/01/2016 Required date for delivery: Vendor Name Ther mn Fliii c Address, City, State, Zip 535 Industrial Cir, White City, OR 97503 Contact Name & Telephone Number (541) 830-1100 Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached 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 Date approved by Council: ® Direct Award Contract # F1 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 Vac out wash bay oil separators at golf course shop, b street and service center. Dispose $4500 of contaminated soil for electric department as per exhibit c. not to exceed $4500 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quote/proposal Project Number - - - - - - - - - - Account Number 410-0 8 - 2 4 - 0 0 - 6 02 3 51 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 form, I certify that the City's public contracting requirements have been satisfied. Employee: Department Head: L\ r ~ ~(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 Comments: Form #3 - Requisition