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HomeMy WebLinkAbout2016-338 Contract - SCJ Alliance Contract for Persona! Services less than $35,000.00 CITY OF CONSULTANT: SCJ Alliance ASHLAND CONTACT: Anne Sylvester 20 East Main Street Ashland, Oregon 97520 ADDRESS: 315 Vilest Mill Plain Blvd, Suite 208 Telephone: 541/488-6002 Vancouver, WA 98660 Fax: 541/488-5311 TELEPHONE: 503.341.6248 DATE AGREEMENT PREPARED: 11/28/2016 BEGINNING DATE: 11/2812016 COMPLETION DATE: 06/30/2017 COMPENSATION. See exhibit C; not to exceed $18,466 SERVICES TO BE PROVIDED: See exhibit C; conduct a Traffic Impact Analysis for a proposed bridge to connect existing segments of E Nevada Street in the Cit of Ashland. ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Personal 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 Cit of Ashland Contract. FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings 1 Recitations. The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service 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. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service 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. 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of City. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is $20,283.20 or more, Consultant 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 service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to indemnify and save City, its officers, employees and agents harmless from losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature to the extent the harm caused arises out of or is incident to the negligent acts, or errors or omissions in performance of this contract by Consultant (including but not limited to, Consultants' employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subro ations, actions costs, judgments, or other damages, directly, solely, and proximately Contract for Personal Services less than $35,000.00, Page 1 of 5 caused by the negligence of City. 10. 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 part, effective upon delivery of written notice to Consultant, 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 Consultant 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 Consultant 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 Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any Part of this contract if Consultant 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, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant 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 Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant 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. Consultant 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. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant 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. 14. Insurance. Consultant 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. Professional Li ' ' insurance with a combined single limit, or the equivalent, of not less than Enter one: $250.000,$500,000 1,000,00 G or Not Applicable for each claim, incident or occurrence. This is to cover damages cause mission or negligent acts related to the professional services to be provided under this contract. C. General 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 occurrence for Bodily Injury and Property Damage. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: Contract for Personal Services less than $35,000.00, Page 2 of 5 $100,000, $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. e. 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 Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies, excluding Professional Liability and Workers' Compensation, required herein, but only with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. 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 Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-insurance. 15. 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 Consultant 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. Consultant, 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. 16. 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. CONSULTANT, 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. 17. 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. Consultant 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 Consultant, with no further liability to Consultant. Certification. Consultant hall sign the certification attached hereto as Exhibit A and erein incorporated b reference. onsultant: City of Ashland Sig re Department Head 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 Personal Services less than $35,000.00, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contactor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following I criteria. (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. I (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. 12- 1,4. Contractor (Date) Contract for Personal Services less than $35,000.00, Page 4 of 5 CITY • ASHLAND, OREGON S EXHIBIT B r s City of Ashland i LIVING WAGE per hour effective June 30, 2016 I (Increases annually every June 30 by the Consumer Price Index) ~r . - . , portion of business of their 401 K and IRS eligible employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the projector the employee. ➢ For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: "Employee" does not employer and the City of $20,283.20. include temporary or part-time Ashland if the contract employees hired for less than exceeds $20,283.20 or more. ➢ 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 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 Personal Services less than $35,000.00, Page 5 of 5 i J ALLIANCE CONSULTING SERVICES EXHIBIT C f November 23, 2016 i Mike Faught, Public Works Director City of Ashland i 51 Winburn Way Ashland, Oregon 97520 Re: Scope of Work and Fee Proposal for E Nevada Street TIA Dear Mike: Per your request, I have prepared this scope of work and fee estimate to conduct a Traffic Impact Analysis for a proposed bridge to connect existing segments of E Nevada Street in the City of Ashland. Key work elements would be as follows: SCOPE OF WORK Task 1- Obtain and Review Data and Prior Studies 1. Develop average weekday peak hour traffic volumes from new counts to be provided by the City. Review new PM peak hour turning movement count provided by the City, and review prior counts from TSP and/or other sources provided by the City. 2. Review prior available base and future year model output. 3. Obtain new model output from TPAU for base year and future year with and without the street connection. 4. Review prior intersection operations analysis, conduct updated analysis at key locations where new data is available and updated analysis is appropriate. Assume no more than 3 or 4 locations would be included in this analysis. 5. Review TSP and/or other documents related to E Nevada Street. Task 2 - AnaiVZe and Document Traffic Volume Shifts and Impacts 1. Identify potential traffic shift on key links and at key intersections. 2. Evaluate potential traffic performance with and without E Nevada connection along key streets in the project vicinity. 3. Evaluate potential impact on transit, bicycle and pedestrian circulation. 4. Identify emergency access routes and potential impacts on response times. 5. Summarize findings and conclusions. 6. Prepare draft and final TIA including report graphics to illustrate conclusions. Task 3 - Meetings and Coordination 1. Prepare for and attend Transportation Commission meeting (currently scheduled for January 26, 2017). 2. Other miscellaneous coordination to facilitate analysis and document results. 3. Progress reports and billing. 315 West Mill Plain Blvd, Suite 208 • Vancouver, WA 98660 4 Office Cell 503.341.6248 • scjalliance.com Mike Faught November 28, 2016 -de-, Page 2 of 2 Task 4 - Contingency A $5,000 contingency will be added to this agreement to cover services not specifically included in the above Scope of Work. Work under this task will be conducted upon receipt of specific authorization I from the City. i ESTIMATED FEE SO will conduct the foregoing analysis for a not-to-exceed fee of $18,466 based on the labor and direct expense assumptions in the attached spreadsheet. I have tried to be as thorough as possible and i anticipate all costs associated with a thorough look at this issue. Please feel free to give me a call if you have any questions. 1 Respectfully, SO Alliance Anne Sylvester, PTE Senior Consultant I Consultant Fee Estimate SCJ Alliance Client: City of Ashland Project: E Nevada Sir eel Connection TIA Job Y: 0 File N: so Consultant Fee Determination DIRECT LABOR REVENUE Dlsctoline Rau BM effloun Prlndpai-in-Charge 1.0 $225 $22S Senior Consultant 48.0 $180 $8,640 Traffic Analyse 31.0 $120 $3,720 Project Manager 0.0 SD Senior Project Manager 0.0 5112 $0 Project Engineer 1 0.0 $0 Senior Designer 0.0 $0 Design Engineer 0.0 $95 $0 Engineer Tech It 0.0 $0 Engineer Tech 1 0.0 $0 Project Coordinator t 1.0 $85 $85 Project Accountant 2.0 S95 $190 Subtotal SC&3i 83 $12,860 INDIRECT COSTS Subconsultant Fees; Subtotal: $0 Subconsultant Adr;tln Fee (100.b) $0 Total Subconsultant: i$0 Expenses: Copies, Regroductlons, etc (1.0% of tee) $129 Lodging and Meals $153 ktkeage (600 napes @ $0.540) $324 Total Expenses: $606 TOTAL ESTIMATED FEE $13,466 SCJ Alliance 11/2312016 Page 1 EXHIBIT B Labor Hour Estimate SCJ Alliance Client: City of Ashland Project: E Nevada Street Connection TIA Job X: File III: rash No lash Descr an Sen" Rex p v Prig gw o Se.rnr Protect CnrraUdant Charge "'o` Carsuhara Traffic Analyst Ata P.ojerl Cewd r Prtyecr Acct. J'elar Hours %Cost ruage: Phase 1- Prepare Traffic, Impact Analysis Task I - Obtii, and Review Data end Prior shxrws - - 1 Develop average weekday traffc volumes, review PM peak TMCs - 1 1 6 2 Review prior available base and future year mmlet output ? 1 2 _ 3 3 Request and review new travel model output 4 6 4 Review prior Intersection operation analysis, oW&%n uiid Synchro model 4 i 5 Review TSP arlNor other documents related to E. Nevada Street ~ g 1 g 6 Task 1 Total Hours: 11,0 15.0 26.0 Billing Rate b category- $225.00 $180.00 $120.00 #155.00 $85.00 $95.00 Total Task Cost: #1,980.00 $1,800.00 $3,780.00 Task 2 - Analyia and Doctwwl Trallfio Volume Shft Z Meads i Identity potential tragic Hdlt with project on key inks and at key krlersections i 1 4- _ _ 6 2 Evaluate potential traffic pertormance with and wt pout E Nevada connection 1 4 5 3 Evakralo potential transit, bke end pedestrian circulation Impacts 1 1 Evabrate emergency response impacts (poice, fife, ho3pilaQ 2 2 4 Summarae Whips and conclusions q 4 8 5 Prepare TUb inckdkV report graphics to illustrate conclusions t 8 2 11 Task 2 Total Hours: 1.0 15.0 16.0 32.0 Billing Rate b cat 225.00 $180.00 $120.00 $iS5.00 85,00 $95.00 Total Task Cost: $225.00 $2,700.00 1,920.00 #4,845.00 Task 3 - Meet:rys and Coadrnation 1 Prepare for and attend Transportation Commission meeting 16 16.0 2 Other miscellaneous coordination 4 -1 5.0 3 Progross Report and Billing (2) 2 i 2 4.0 4 _ Task 3 Total Hours: 22.0 1.0 2.0 25.0 ellling Rate b category: $225.00 $180.00 #120.00 ;155.00 $85.0o S95.00 Total Task Cost: $3,960.00 85.00 $190.00 4,235.00 TOTAL PHASE 1 $225.00 $8,640.00 #3,720.00 #85.00 #190.00 #12,860.00 Total Hours All Phases: 1.0 r 31.0 w 2.0 r Total Costs All Phases:--- r $8,64a.00 3,720.00 si.90.00 66D.00 SG Alliance 1 of 1 11/23/2016 CITY OF ^AS H LA N D FORM #4 DETERMINATIONS TO PROCURE PERSONAL SERVICES $5,000 to $75,000 To: John Karns, Interim City Administrator From: Michael R. Faught-Director of Public Works Date: 121212016 Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES In accordance with AMC 2.50.120(A), for personal services contracts greater than $5,000, but less than $75,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City does not have the personnel or resources to perform the services required under the proposed contract. However, the City Attorney, the Public Contracting Officer, or Local Contract Review Board, can require a formal solicitation for bids to ensure that the purposes of this chapter are upheld. Background The Department (~f Public Works ' intent is to contract frith a private consultant for the appropriate scope of services developed. for project nun7ber 2012-28. The scope of ivork.for this project is associated tivith conducting a Traffic Impact Analysis for a proposed bridge to connect existhjig segnients of E Nevada .5'treet in the Cily of Ashland. The work is expected to take place in. fiscal gear 2017 with a not to exceed budget ainount of 'S18, 466. Pursuant to AMC 2.50.120(A), has a reasonable inquiry been conducted as to the availability of City personnel to perform the services, and that the City does not have the personnel and resources to perform the services required under the proposed contract? The City ofAshland Engineering Division does not have the adequate staff tune or appropriate resources to provide the scope of service conteinplated under this contract. In addition, no other Department in the City has the resources or technical knoivIedge to complete the ivork associated ivith this personal services contract. Form #4 - Department Head Determinations to Procure Personal Services, Page 1 of 1, 12/2/2016 Client#: 116497 SHEACARR ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) L11/30/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Suzanne Paschke Propel Insurance PHONE 800 499-0933 FvC, No : 866 577-1326 A/C, No, Ext Tacoma Commercial Insurance E-MAIL ADDRESS: suzanne.p v aschkenpropelinsurance.com 1201 Pacific Ave, Suite 1000 INSURER(S) AFFORDING COVERAGE NAIC # Tacoma, WA 98402 INSURER A : American Casualty Co of Reading 20427 INSURED INSURER B : Continental Casualty Company 20443 Shea,Carr & Jewell Inc dba SCJ Alliance INSURER C : Beazley Insurance Company, Inc. 37540 8730 Tallon Lane NE, Suite 200 INSURER D : Hartford Fire Insurance Company Lacey, WA 98516 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR /YYYY LIMITS INSR TYPE OF INSURANCE INSR WV D ADDL POLICY NUMBER MM/DY/YYEFF YY MM/DDY LT A GENERAL LIABILITY Y Y 2090667295 6/15/2016 06/15/201 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES (E. occur ence $ 300,000 CLAIMS-MADE a OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY X JPE O LOC $ AUTOMOBILE LIABILITY Y Y 4012152794 6/15/2016 06/15/201 Ea acccdentSINGLE LIMIT $1,000,000 A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident B X UMBRELLA LIAB X OCCUR Y Y 4016829451 611512016 06/15/201 EACH OCCURRENCE s3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s3,000,000 DED RETENTION $ $ D WORKERS COMPENSATION 52WECJY4968 3/19/2016 03/19/201 W RYTLIT T ER" AND EMPLOYERS' LIABILITY ANY PROP RIETOR/PARTNER/EXECUTIVE Y/ N E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 C Professional V10BC2150701 6/17/2016 06/17/201 Each Claim-$1,000,000 Liability Aggregate-$2,000,000 Ded: $60,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: project number 0722.02. The City of Ashland, Oregon, and its elected officials, officers and employees See attached endorsements. CERTIFICATE HOLDER CANCELLATION City of Ashland, Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2501378/M2501336 SDP00 CNA SB-146932-E (Ed. 06/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - LIABILITY EXTENSION This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. 1. ADDITIONAL INSURED - BLANKET VENDORS own acts or omission or those of its employees or anyone else acting on its WHO IS AN INSURED is amended to include as an behalf. However, this exclusion does not additional insured any person or organization (referred apply to: to below as vendor) with whom you agreed, because of a written contract or agreement to provide (1) The exceptions contained in insurance, but only with respect to "bodily injury" or Subparagraphs d. or f.; or "property damage" arising out of "your products" which (2) Such inspections, adjustments, tests or are distributed or sold in the regular course of the servicing as the vendor has agreed to vendor's business, subject to the following additional make or normally undertakes to make in exclusions: the usual course of business, in 1. The insurance afforded the vendor does not apply connection with the distribution or sale of to: the products. a. "Bodily injury" or "property damage" for which 2. This insurance does not apply to any insured the vendor is obligated to pay damages by person or organization, from whom you have reason of the assumption of liability in a acquired such products, or any ingredient, part or contract or agreement. This exclusion does container, entering into, accompanying or not apply to liability for damages that the containing such products. vendor would have in the absence of the 3. This provision 2. does not apply to any vendor contract or agreement, included as an insured by an endorsement issued b. Any express warranty unauthorized by you; by us and made a part of this Policy. c. Any physical or chemical change in the 4. This provision 2. does not apply if "bodily injury" or product made intentionally by the vendor; "property damage" included within the "products- completed operations hazard" is excluded either ° d. Repackaging, except when unpacked solely by the provisions of the Policy or by endorsement. for the purpose of inspection, demonstration, testing, or the substitution of parts under 2. MISCELLANEOUS ADDITIONAL INSUREDS instructions from the manufacturer, and then WHO IS AN INSURED is amended to include as an repackaged in the original container, insured any person or organization (called additional e. Any failure to make such inspections, insured) described in paragraphs 2.a. through 2.h. adjustments, tests or servicing as the vendor below whom you are required to add as an additional has agreed to make or normally undertakes to insured on this policy under a written contract or make in the usual course of business, in agreement but the written contract or agreement must connection with the distribution or sale of the be: products; 1. Currently in effect or becoming effective during the f. Demonstration, installation, servicing or repair term of this policy; and operations, except such operations performed 2. Executed prior to the "bodily injury," "property at the vendor's premises in connection with damage" or "personal and advertising injury," but the sale of the product; Only the following persons or organizations are g. Products which, after distribution or sale by additional insureds under this endorsement and you, have been labeled or relabeled or used coverage provided to such additional insureds is as a container, part or ingredient of any other limited as provided herein: thing or substance by or for the vendor; or a. Additional Insured -Your Work h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its That person or organization for whom you do work is an additional insured solely for liability SB-146932-E Page 1 of 5 (Ed. 06/11) SB-146932-E CAA (Ed. 06/11) Paragraphs 3, 4, 5, and 6 of this (2) Any partner, if you or an additional exclusion do not apply to liability insured is a partnership, assumed under a sidetrack agreement. (3) Any manager, if you or an additional Paragraph 6 of this exclusion does not insured is a limited liability company, apply to "property damage" included in (4) Any "executive officer" or insurance the products-completed operations manager, if you or an additional insured is hazard." a corporation; B. Under B. Exclusions, 1. Applicable to (5) Any trustee, if you or an additional Business Liability Coverage, the last insured is a trust, or paragraph of 2. Exclusions is deleted and replaced by the following: (6) Any elected or appointed official, if you or Exclusions c, d, e, f, g, h, if k, I, m, n, and of an additional insured is a political do not apply to damage by fire to premises subdivision or public entity. while rented to you or temporarily occupied by This paragraph e. applies separately to you you with permission of the owner or to the and any additional insured. contents of premises rented to you for a period of 7 or fewer consecutive days. A 7. Bodily Injury separate limit of insurance applies to this Section F. Liability and Medical Expenses coverage as described in Section D. Liability Definitions, item 3. "Bodily Injury" is deleted and And Medical Expenses Limits Of replaced with the following: Insurance. "Bodily injury" means bodily injury, sickness or C. The first Paragraph under item 5. Damage To disease sustained by a person, including death, Premises Rented To You Limit of Section humiliation, shock, mental anguish or mental D. Liability And Medical Expenses Limits injury by that person at any time which results as Of Insurance is replaced by the following: a consequence of the bodily injury, sickness or The most we will pay under Business Liability disease. for damages because of "property damage" g. Expanded Personal and Advertising Injury to any one premises, while rented to you, or Definition temporarily occupied by you, with the permission of the owner, including contents of a. The following is added to Section F. Liability such premises rented to you for a period of 7 and Medical Expenses Definitions, item 14. or fewer consecutive days, is the Damage to Personal and Advertising Injury, in the Premises Rented to You limit shown in the Businessowners General Liability Declaration. Coverage Form: 5. Blanket Waiver of Subrogation h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural We waive any right of recovery we may have person, but only if such discrimination or against: humiliation is: a. Any person or organization with whom you 1. Not done intentionally by or at the have a written contract that requires such a direction of: waiver. a. The insured; or 6. Broad Knowledge of Occurrence b. Any "executive officer," director, The following items are added to E. stockholder, partner, member or Businessowners General Liability Conditions manager (if you are a limited liability in the Businessowners Liability Coverage company) of the insured; and Form: 2. Not directly or indirectly related to the e. Paragraphs a. and b. apply to you or to any employment, prospective employment, additional insured only when such past employment or termination of "occurrence," offense claim or "suit" is known employment of any person or person by to: any insured. (1) You or any additional insured that is an b. The following is added to Exclusions, Section individual; B.: SB-146932-E Page 4 of 5 (Ed. 06/11) CNA SB-146932-E (Ed. 06/11) (2) Structural alterations, new Damage To Property, is replaced by the construction or demolition operations following: performed by or on behalf of such k. Damage To Property additional insured. g. Co-owner of Insured Premises "Property damage" to: A co-owner of a premises co-owned by you 1. Property you own, rent or occupy, and covered under this insurance but only including any costs or expenses with respect to the co-owners liability as co- incurred by you, or any other person, owner of such premises. organization or entity, for repair, replacement, enhancement, h. Lessor of Equipment restoration or maintenance of such Any person or organization from whom you property for any reason, including lease equipment. Such person or organization prevention of injury to a person or are insureds only with respect to their liability damage to another's property, arising out of the maintenance, operation or 2. Premises you sell, give away or use by you of equipment leased to you by abandon, if the "property damage" such person or organization. A person's or arises out of any part of those organization's status as an insured under this premises; endorsement ends when their written contract 3. Property loaned to you; or agreement with you for such leased equipment ends. 4. Personal property in the care, With respect to the insurance afforded these custody or control of the insured, additional insureds, the following additional 5. That particular part of any real exclusions apply: property on which you or any This insurance does not apply: contractors or subcontractors working directly or indirectly in your behalf are (1) To any "occurrence" which takes place performing operations, if the "property after the equipment lease expires; or damage" arises out of those (2) To "bodily injury," "property damage" or operations; or "personal and advertising injury" arising 6. That particular part of any property out of the sole negligence of such that must be restored, repaired or additional insured. replaced because "your work" was Any insurance provided to an additional insured incorrectly performed on it. designated under paragraphs b. through h. above Paragraph 2 of this exclusion does not does not apply to "bodily injury" or "property apply if the premises are "your work" and damage" included within the "products-completed were never occupied, rented or held for operations hazard." rental by you. 3. The following is added to Paragraph H. of the Paragraphs 1, 3, and 4, of this exclusion BUSINESSOWNERS COMMON POLICY do not apply to "property damage" (other CONDITIONS: than damage by fire or explosion) to premises: H. Other Insurance 4. This insurance is excess over any other (1) rented to you: insurance naming the additional insured (2) temporarily occupied by you with the as an insured whether primary, excess, permission of the owner, or contingent or on any other basis unless a (3) to the contents of premises rented to written contract or written agreement you for a period of 7 or fewer specifically requires that this insurance be consecutive days. either primary or primary and A separate limit of insurance applies to noncontributing. Damage To Premises Rented To You as 4. LEGAL LIABILITY - DAMAGE TO PREMISES described in Section D - Liability and Medical Expenses Limits of Insurance. A. Under B. Exclusions, 1. Applicable to Business Liability Coverage, Exclusion k. SB-146932-E Page 3 of 5 (Ed. 06/11) This page has been left blank intentionally. BHA SB-146932-E (Ed. 06/11) (15) Discrimination Relating to Room, Personal and Advertising Injury Liability is Dwelling or Premises excluded either by the provisions of the Policy Caused by discrimination directly or or by endorsement. indirectly related to the sale, rental, lease 9. Personal and Advertising Injury Re-defined or sub-lease or prospective sale, rental, Section F. Liability and Medical Expenses lease or sub-lease of any room, dwelling or premises by or at the direction of any Definitions, item 14, Personal Advertising Injury, insured. Paragraph c. is replaced by the following: (16) Fines or Penalties c. The wrongful eviction from, wrongful entry into, or invasion of the right of private Fines or penalties levied or imposed by a occupancy of a room dwelling or premises governmental entity because of that a person or organization occupies discrimination. committed by or on behalf of it's owner, landlord or lessor. c. This provision (Expanded Personal and Advertising Injury) does not apply if SB-146932-E Page 5 of 5 (Ed. 06/11) S B-146968-A CAA (Ed. 01/06) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO IS AN INSURED (Section C.) of the 4. The insurance provided to the additional insured Businessowners Liability Coverage Form is amended does not apply to "bodily injury," "property to include as an insured any person or organization damage," "personal and advertising injury" arising whom you are required to add as an additional insured out of an architect's, engineer's, or surveyor's on this policy under a written contract or written rendering of or failure to render any professional agreement; but the written contract or written services including: agreement must be: a. The preparing, approving, or failing to prepare 1. Currently in effect or becoming effective during the or approve maps, shop drawings, opinions, term of this policy; and reports, surveys, field orders, change orders 2. Executed prior to the "bodily injury," "property or drawings and specifications by any damage," or "personal and advertising injury." architect, engineer or surveyor performing services on a project of which you serve as B. The insurance provided to the additional insured is construction manager; or limited as follows: b. Inspection, supervision, quality control, 1. That person or organization is an additional engineering or architectural services done by insured solely for liability due to your negligence you on a project of which you serve as specifically resulting from "your work" for the construction manager. additional insured which is the subject of the 5. This insurance does not apply to "bodily injury," written contract or written agreement. No "property damage," or "personal and advertising coverage applies to liability resulting from the sole injury" arising out of: negligence of the additional insured. 2. The Limits of Insurance applicable to the a. The construction or demolition work while you additional insured are those specified in the are acting as a construction or demolition written contract or written agreement or in the contractor. This exclusion does not apply to Declarations of this policy, whichever is less. work done for or by you at your premises. These Limits of Insurance are inclusive of, and not C. BUSINESSOWNERS GENERAL LIABILITY in addition to, the Limits of Insurance shown in the CONDITIONS - Duties In The Event of Occurrence, Declarations. Offense, Claim or Suit (Section E.2.) of the 3. The coverage provided to the additional insured Businessowners Liability Coverage Form is amended within this endorsement and section titled to add the following: LIABILITY AND MEDICAL EXPENSE An additional insured under this endorsement will as DEFINITIONS - "Insured Contract" (Section soon as practicable: F.9.) within the Businessowners Liability Coverage 1. Give written notice of an occurrence or an offense Form, does not apply to "bodily injury" or "property to us which may result in a claim or "suit" under damage" arising out of the "products-completed operations hazard" unless required by the written this insurance; contract or written agreement. SB-146968-A Page 1 of 2 (Ed. 01 /06) SB-146968-A (Ed. 01/06) 2. Tender the defense and indemnity of any claim or against that "suit" If no other insurer defends, we "suit" to us for a loss we cover under this will undertake to do so, but we will be entitled to Coverage Part; the additional insured's rights against all those 3. Tender the defense and indemnity of any claim or other insurers. "suit" to any other insurer which also has When this insurance is excess over other insurance for a loss we cover under this Coverage insurance, we will pay only our share of the Part; and amount of the loss, if any, that exceeds the sum 4. Agree to make available any other insurance of. which the additional insured has for a loss we (a) The total amount that all such other insurance cover under this Coverage Part. would pay for the loss in the absence of this We have no duty to defend or indemnify an additional insurance; and insured under this endorsement until we receive (b) The total of all deductible and self-insured written notice of a claim or "suit" from the additional amounts under all that other insurance. insured. We will share the remaining loss, if any, with any D. OTHER INSURANCE (Section H. 2. & 3.) of the other insurance that is not described in this Businessowners Common Policy Conditions are Excess Insurance provision and was not bought deleted and replaced with the following: specifically to apply in excess of the Limits of 2. This insurance is excess over any other insurance Insurance shown in the Declarations of this Coverage Part. naming the additional insured as an insured whether primary, excess, contingent or on any E. TRANSFER OF RIGHTS OF RECOVERY AGAINST other basis unless a written contract or written OTHERS TO US (Section K.2.) of the agreement specifically requires that this insurance Businessowners Common Policy Conditions is deleted be either primary or primary and noncontributing and replaced with the following: to the additional insured's own coverage. This 2 We waive any right of recovery we may have insurance is excess over any other insurance to against any person or organization against whom you which the additional insured has been added as have agreed to waive such right of recovery in a an additional insured by endorsement. written contract or agreement because of payments 3. When this insurance is excess, we will have no we make for injury or damage arising out of your duty under Coverages A or B to defend the ongoing operations or "your work" done under a additional insured against any "suit" if any other contract with that person or organization and included insurer has a duty to defend the additional insured within the "products-completed operations hazard." SB-146968-A Page 2 of 2 (Ed. 01/06) CNA63359XX CHA (Ed. 04/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS EXTENDED COVERAGE ENDORSEMENT - BUSINESS AUTO PLUS - This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1. LIABILITY COVERAGE name, with your permission, while performing duties related to the conduct of your business. A. Who Is An Insured "Policy," as used in this provision A. Who Is An The following is added to Section II, Paragraph Insured, includes those policies that were in force A.1., Who Is An Insured: on the inception date of this Coverage Form but: 1. a. Any incorporated entity of which the 1. Which are no longer in force; or Named Insured owns a majority of the voting stock on the date of inception of 2. Whose limits have been exhausted. this Coverage Form; provided that, B. Bail Bonds and Loss of Earnings b. The insurance afforded by this provision Section ll, Paragraphs A.2. (2) and A.2. (4) are A.1. does not apply to any such entity revised as follows: that is an "insured" under any other liability "policy" providing "auto" coverage. 1. In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and 2. Any organization you newly acquire or form, other than a limited liability company, 2. In a.(4), the limit for the loss of earnings is partnership or joint venture, and over which changed from $250 to $500 a day. you maintain majority ownership interest. C. Fellow Employee The insurance afforded by this provision A.2.: Section II, Paragraph B.5 does not apply. a. Is effective on the acquisition or formation Such coverage as is afforded by this provision C. date, and is afforded only until the end of is excess over any other collectible insurance. the policy period of this Coverage Form, or the next anniversary of its inception ll. PHYSICAL DAMAGE COVERAGE date, whichever is earlier. A. Glass Breakage - Hitting A Bird Or Animal - b. Does not apply to: Falling Objects Or Missiles (1) "Bodily injury" or "property damage" The following is added to Section III, Paragraph caused by an "accident" that A.3.: occurred before you acquired or With respect to any covered "auto," any deductible formed the organization; or shown in the Declarations will not apply to glass (2) Any such organization that is an breakage if such glass is repaired, in a manner "insured" under any other liability acceptable to us, rather than replaced. "policy" providing "auto" coverage. B. Transportation Expenses 3. Any person or organization that you are with required by a written contract to name as an Section III, Paragraph A.4.a. is revised, "insured" but only with respect to transportation expense incurred by you, additional insured is an to provide: respect to their legal liability for acts or omissions of a person, who qualifies as an a. $60 per day, in lieu of $20; subject to "insured" under Section II - Who Is An Insured and for whom Liability Coverage is b. $1,800 maximum, in lieu of $600. afforded under this policy. If required by C. Loss of Use Expenses written contract, this insurance will be primary and non-contributory to insurance on which Section III, Paragraph AA.b. is revised, with the additional insured is a Named Insured. respect to loss of use expenses incurred by you, to provide: 4. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a a. $1,000 maximum, in lieu of $600. contract or agreement in that "employee's" CNA63359XX Copyright, CNA Corporation, 2000. Page 1 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Servi--es Office used with its permission. CNA63359XX (Ed. 04/12) D. Hired "Autos" d. A $100 per occurrence deductible applies to The following is added to Section III. Paragraph the coverage provided by this provision. A.: G. Diminution In Value 5. Hired "Autos" The following is added to Section III, Paragraph If Physical Damage coverage is provided under B.6.. this policy, and such coverage does not extend to Subject to the following, the "diminution in value" Hired Autos, then Physical Damage coverage is exclusion does not apply to: extended to: a. Any covered "auto" of the private a. Any covered "auto" you lease, hire, rent passenger type you lease, hire, rent or or borrow without a driver; and borrow, without a driver for a period of 30 b. Any covered "auto" hired or rented by days or less, while performing duties your "employee" without a driver, under a related to the conduct of your business; contract in that individual "employee's" and name, with your permission, while b. Any covered "auto" of the private performing duties related to the conduct passenger type hired or rented by your of your business. "employee" without a driver for a period of c. The most we will pay for any one 30 days or less under a contract in that "accident" or "loss" is the actual cash individual employees name, with your value cost of replacement permission, while performing duties , cost of repair, or $75,000, whichever is less, minus a related to the conduct of your business. $500 deductible for each covered auto. c. Such coverage as is provided by this No deductible applies to "loss" caused by provision is limited to a "diminution in fire or lightning. value" loss arising directly out of d. The physical damage coverage as is accidental damage and not as a result of provided by this provision is equal to the the failure to make repairs; faulty or physical damage coverage(s) provided on incomplete maintenance or repairs; or the your owned "autos." installation of substandard parts. e. Such physical damage coverage for hired d. The most we will pay for "loss" to a "autos" will: covered "auto" in any one accident is the lesser of: (1) Include loss of use, provided it is the consequence of an "accident" for (1) $5,000; or which the Named Insured is legally (2) 20% of the "auto's" actual cash value liable, and as a result of which a (ACV). monetary loss is sustained by the III. Drive Other Car Coverage - Executive Officers leasing or rental concern. (2) Such coverage as is provided by this The following is added to Sections II and III: provision will be subject to a limit of 1. Any "auto" you don't own, hire or borrow is a $750 per "accident." covered "auto" for Liability Coverage while being E. Airbag Coverage used by, and for Physical Damage Coverage while in the care, custody or control of, any of your The following is added to Section III, Paragraph "executive officers," except: 8.3.: a. An "auto" owned by that "executive officer" or The accidental discharge of an airbag shall not be a member of that person's household; or considered mechanical breakdown. b. An "auto" used by that "executive officer" F. Electronic Equipment while working in a business of selling, servicing, repairing or parking "autos." Section III, Paragraphs B.4.c and B.4.d. are deleted and replaced by the following: Such Liability and/or Physical Damage Coverage c. Physical Damage Coverage on a covered as is afforded by this provision. "auto" also applies to "loss" to any (1) Equal to the greatest of those coverages permanently installed electronic equipment afforded any covered "auto"; and including its antennas and other accessories. CNA63359XX Copyright, CNA Corporation, 2000. Page 2 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission. CNA63359XX (Ed. 04/12) (2) Excess over any other collectible damage, against any person or organization for insurance. whom or which you are required by written contract or agreement to obtain this waiver from 2. For purposes of this provision, executive officer' us. means a person holding any of the officer positions created by your charter, constitution, by- This injury or damage must arise out of your laws or any other similar governing document, activities under a contract with that person or and, while a resident of the same household, organization. includes that person's spouse. You must agree to that requirement prior to an Such "executive officers" are "insureds" while "accident" or "loss." using a covered "auto" described in this provision. C. Concealment, Misrepresentation or Fraud IV. BUSINESS AUTO CONDITIONS The following is added to Section IV, Paragraph A. Duties In The Event Of Accident, Claim, Suit Or B.2.: Loss Your failure to disclose all hazards existing on the date The following is added to Section IV, Paragraph of inception of this Coverage Form shall not prejudice A.2.a.: you with respect to the coverage afforded provided (4) Your "employees" may know of an such failure or omission is not intentional. "accident" or "loss." This will not mean D. Other Insurance that you have such knowledge, unless "loss" is known to you The following is added to Section IV, Paragraph such "accident" or B or if you are not an individual, to any of .5.. your executive officers or partners or your Regardless of the provisions of Paragraphs 5.a. insurance manager. and 5.d. above, the coverage provided by this The following is added to Section IV, Paragraph policy shall be on a primary non-contributory A.2.b.: basis. This provision is applicable only when required by a written contract. That written (6) Your "employees" may know of contract must have been entered into prior to documents received concerning a claim "Accident" or "Loss." or "suit." This will not mean that you have E. Policy Period, Coverage Territory such knowledge, unless receipt of such documents is known to you or if you are Section IV, Paragraph B. 7.(5).(a). is revised to not an individual, to any of your executive provide: officers or partners or your insurance a. 45 days of coverage in lieu of 30 days. manager. B. Transfer Of Rights Of Recovery Against Others V. DEFINITIONS To Us Section V. Paragraph C. is deleted and replaced by The following is added to Section IV, Paragraph the following: A.5. Transfer Of Rights Of Recovery Against "Bodily injury" means bodily injury, sickness or disease Others To Us: sustained by a person, including mental anguish, We waive any right of recovery we may have, mental injury or death resulting from any of these. because of payments we make for injury or CNA63359XX Copyright, CNA Corporation, 2000. Page 3 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission. Purchase Order Fiscal Year 2017 Page: 1 of: 1 THIS PO NUMBER MUST APPEAR ON ALL INVOICES, AND SHIPPING DOCUMENTS. B City of Ashland L ATTN: Accounts Payable Purchase L 20 E. Main Order # 476 Ashland, OR 97520 T Phone: 541/552-2010 O Email: payable(a)ashland.or.us V SCJ ALLIANCE H C/O Public Works Department E 2102 CARRIAGE DRIVE SW 1 51 Winburn Way N SUITE H P Ashland, OR 97520 D OLYMPIA, WA 98502 Phone: 541/488-5347 OR O Fax: 541/488-6006 Vendor Phone Number. Vendor Fax Number Requisition Number Delivery Reference Michael Fau ht Date Ordered Vendor Number Date; Required Freight Method/Terms Department/Location 12/20/2016 1090 FOB ASHLAND OR City Accounts Payable Item# Descri tion/PartNo QTY UOM Unit Price Extended Price Traffic Impact Analysis 1 Conduct a traffic impact analysis for a proposed bridge to connect 1 $18,466.0000 $18,466.00 existing segments of E. Nevada Street in the City of Ashland. Contract for Personal Services Less than $35,000.00 Beginning date: 11/28/2016 Completion date: 06/30/2017 GL SUMMARY 081200 - 604100 $18,466.00 Bykuthorized-8 Date: g' ture i" PO Total $18,466.00 FORM #3 CITY OF SHLAND 7 a , 11 l r3 I ..I i REQUISITION Date of request: 11/28/2016 Required date for delivery: Vendor Name SCA AiiiamP Address, City, State, Zip 315 West Mill Plain Blvd. Suite 208 Vancouver WA 98660 Contact Name & Telephone Number 503,341,6248 Anne Sylvester 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 ❑ Direct Award Date approved by Council; Contract # El 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 Conduct a Traffic Impact Analysis for a proposed bridge to connect $18,466.00 existing segments of E Nevada Street in the City of Ashland. Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quote/proposal` -~g $ A(,~ . Project Number Account Number 260.08.12.00.604100 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. cam, ' Employee: X0'1'Ly'- Department Head: v a j (Equal to or greater than $5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than $25,000) r Funds appropriated for current fiscal year: YES / NO 1.771 ,f R ance Di.recto~- (Equal to or greater than $5, 000) Date Comments: