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HomeMy WebLinkAbout2017-015 Contract - Jefferson State Fire Sprinkler Attachment A Contract for GOODS AND SERVICES less than $25,000 CITY OF CONTRACTOR: Jefferson State Fire Sprinkler, LLC ASHLAND CONTACT: Travis Jackson, Owner 20 East Main Street Ashland, Oregon 97520 ADDRESS: 221 N. Central Ave, #318, Medford, OR 97501 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541.890.1657 DATE AGREEMENT PREPARED: 1/23/17 FAX: 541.727.7366 BEGINNING DATE: 1/25/17 COMPLETION DATE: 3/31/17 COMPENSATION: $9,303.00 GOODS AND SERVICES TO BE PROVIDED: NFPA 13D fire sprinkler retrofit installation at 3204 Auburn, Medford, OR, as specified in the invitation to bid Ashland Form #2 RFQ dated 10/27/16, Additional Information provided by AF&R on 11/9/2016, the proposal submitted by JSFS on November 22, 2016 and quote breakdown submitted by JSFS on November 30, 2016, as attached. ADDITIONAL TERMS: Work begins at the connection to the municipal water system and/or the domestic service line feeding the home. Provide the following language on the submitted plans: This is considered a voluntary system in accordance with Oregon Fire Code 901.4.2 and is a non-required fire protection system. The system is provided with piping sized for both a one- and two-head calc; however, based on the available flow conducted on site, the water supply with the current piping will only serve a one- head calc. This will allow the two-head calc to operate if there is a water supply line improvement in the future. Based on data from NFPA, 84% of home fires utilize a single-head operation. (http://www.nfpa.org/public- education/by-topic/fire-and-life-safety-equipment/home-fire-sprinklers) By providing this sprinkler system, the residents are better protected than without a sprinkler system, and this is recognized and supported by the local enforcing authorities. Contractor may provide invoice for up to 50% of the total compensation prior to the completion of the project. In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with the said primary City of Ashland Contract. NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of Contract for Goods and Services Less than $25,000, 06/30/2016, Page 1 of 6 City. 6. Statutory Requirements: ORS 27913.220, 279B.225, 279B.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 part, effective upon delivery of 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. An attempted assignment or subcontract without written consent of City shall be Contract for Goods and Services Less than $25,000, 06/30/2016, Page 2 of 6 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: $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- $1,000,000,' or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to the City. e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies, excluding Workers' Compensation, required herein but only with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-insurance. 17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further liability to Contractor. 20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated b Contract for Goods and Services Less than $25,000, 06/30/2016, Page 3 of 6 reference. Contract r: City of Ashland By By , Signature Dep ' me - Head Print Name Print Name Title ate W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. API-IR D AS TO FORM Ashlan st. Ci Attomoy Dat f 2 4' 1 Contract for Goods and Services Less than $25,000, 06/30/2016, Page 4 of 6 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: (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. l (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. 1 ts<rz Contractor (Date) Contract for Goods and Services Less than $25,000, 06/30/2016, Page 5 of 6 CITY OF ASHLAND, OREGON EXHIBIT B City of Ash land LIVING WAGE • • 1 _ per hour effective June 30, 2016 (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 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, additional For 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 ^ASH LAN D Contract for Goods and Services Less than $25,000, 06/30/2016, Page 6 of 6 CITY OF FORM #2 ASHLAND REQUEST FOR QUOTATION - GOODS AND MATERIALS INTERMEDIATE PROCUREMENT Release date: 10/27/2016 Requested by (name/dept/telephone/fax/email): Margueritte Hickman, City of Ashland Fire Department, 541-552-2229, margueritte.hickman a ashland.or.us. Quotes are due by (time/day/date): 2:00 PM 11/22/16 Complete delivery required by (date): N/A Delivery Address/Contact Name: N/A Preferred method of shipment: FOB Ashland - Freight Prepaid Quotes may be faxed, emailed or hand delivered. Vendors shall submit their quotes on company letterhead. Informal email quotes and/or late quotes will not be accepted. Terms or discounts which are conditioned upon payment within a certain time will not be considered for purposes of comparison of quotes. "OR EQUAL": Any brand name listed in the specifications as "or equal" or "or equivalent" shall establish the minimum requirements for quality, utility, durability, function, purpose, etc. Other product brands may be offered that are equal to or better than the product brand name. Bidder may show cost differences, alternates and options in the space provided in the quote. This clause is not meant to be restrictive, but to set the minimum standard. THE CITY SHALL DETERMINE, IN ITS SOLE DISCRETION, WHETHER A PRODUCT OFFERED IS "EQUAL." When the designation is "or equal" or "equivalent" City shall make its decision after Bid Closing. All Pricing Must Be Held Firm For 30 Days DESCRIPTION QUANTITY Single Family Home Fire Sprinkler Retrofit Contract Recruitments Overview The scope of this project is to install an NFPA 13D home fire sprinkler system in a single family home located at 3204 Auburn, Medford, OR. The project will be used to provide home fire sprinkler education to the community and is part of a FEMA Fire Prevention and Safety Grant. The project will be managed by members of Ashland Fire & Rescue and/or Medford Fire Rescue from the beginning to the end. At the end of the project, once final inspection is complete, the home fire sprinkler system will become property of the homeowner, including any and all maintenance obligations. During the project, Ashland Fire & Rescue and/or Medford Fire Rescue will use the project site as a home fire sprinkler system public education tool which may involve visits to the site by representatives of the fire department, news media or other parties helpful to carrying the message of home fire sprinklers. All visits will be coordinated with the homeowner and with the contractor as necessary. The retrofit will occur in an operating foster care home. (contractor needs to Form #2 - Intermediate Procurement, Request for Quotation/Goods & Materials, Page I of 4, 12/5/2016 be sensitive to the needs of the home and residents. The home is owned by Living Opportunities, who has indicated that there are no restrictions on the timeframes when the home could be worked in. Living Opportunities Contact: Ann Dahl adahlLlivingopps.org 541.941.1887 HOME FIRE SPRINKLER RETROFIT SPECIFICATIONS 1. Contractor to furnish complete bid as specified by specifications listed below. Complete bid includes any and all engineering design work, permitting requirements, materials and installation to conform with approved final plan. 2. Provide home fire sprinkler system designed in accordance with 2013 NFPA 13D. 3. Contractor to maintain Oregon Contractor's License, City of Medford Business License and City of Ashland Business License through the completion of the project. Contract will be required to enter into a Goods and Services contract with the City of Ashland for project and provide insurance as required. Contract is attached as Attachment A. 4. Provide an approximate timeline for installation as agreed upon with the homeowner and Ashland Fire & Rescue. 5. The retrofit will occur in an operating foster care home. Contractor needs to be sensitive to the needs of the home and residents. The home is owned by Living Opportunities, who has indicated that there are no restrictions on the timeframes when the home could be worked in. Contractor to coordinate all work activities with the homes operator during the project. 6. Contractor shall perform all work in a manner that is the least disruptive. Contractor shall use two-way communications to communicate from one location to another to prevent loud communications. 7. Worksite will be cleaned up at the end of each day and after completion of the project, to the sites pre-existing condition. 8. Repair and paint penetrations and/or damage caused by the system installation to meet a minimum of the pre-existing condition of the home. 9. It is the responsibility of the sprinkler contractor to subcontract with others as necessary to complete project within given timelines. The City of Ashland to approve any subcontractors for project as required by contract. 10. Sprinkler contractor will allow Ashland Fire & Rescue and/or Medford Fire-Rescue to schedule news media to lour the project for H:AFire Sprinkler Grant Project\Fire Sprinkler Retrofit\Fire Sprinkler Retrofit ITB\Fire ITB Medford-Sprinkler System.doc 2 the purposes of promoting fire sprinklers. This could include video of the installer working, in progress and completed work. 11. Sprinkler contractor and sub-contractors will provide warranty of completed work to the homeowner. 12. Obtain all permits and inspections necessary to obtain an approved final inspection from Medford Building Department. 13. The project shall be completed, approved and invoiced to Ashland Fire & Rescue no later than January 30, 2017. 14. The budget for this project is based on a grant with a termination date. Work completed after this date will not be the responsibility of Ashland Fire & Rescue, Medford Fire-Rescue, the City of Ashland or the City of Medford or the homeowner. 15. A non-mandatory pre-bid conference will be provided on Tuesday, 11/8/16 at 3:30 p.m. at 3204 Auburn, Medford, OR to view the home and ask questions regarding the project. This will be the only opportunity to visit the home prior to bid. DESIGN SPECIFCATIONS 16. Home fire sprinkler system shall be designed to meet the abilities of the existing installed 3/4"x 3/4" meter. 17. Left blank intentionally. 18. Provide connection to the municipal water system. 19. Concealed sprinkler heads, with white cover plates, are required to be used. 20. All material to be CPVC, PEX, copper, or other material that is listed for potable water use. 21. Piping in attic spaces to be routed low to the structure to allow for adequate insulation coverage for protection from freezing. 22. All piping to be covered with existing or new insulation as necessary to adequately cover pipe and protect from freezing. 23. Design system to meet passive purge if possible to avoid installing a backflow device in order to reduce annual testing fees. 24. Provide a flow switch and exterior-mounted bell. 25. Retrofits can include inherent challenges for routing pipe and placement of sprinkler heads. Variances from the standard will be considered by the AHJ on a case-by-case basis during the design and layout phase. H:AFire Sprinkler Grant Project\Fire Sprinkler Retrofit\Fire Sprinkler Retrofit ITB\Fire ITB Medford-Sprinkler System.doc 3 Preferred method of shipment: FOB Ashland- Freight Prepaid (Vendor to include shipping terms and cost in their bid.) Method of Award. ORS 27913.070 Intermediate Procurements. (4) If a contract is awarded, the contracting agency shall award the contract to the offeror whose quote or proposal will best serve the interests of the contracting agency, taking into account price as well as considerations including, but not limited to, experience, expertise, product functionality, suitability for a particular purpose and contractor responsibility under ORS 29B.110. H:Tire Sprinkler Grant Project\Fire Sprinkler Retrofit\Fire Sprinkler Retrofit ITB\Fire ITB Medford-Sprinkler System.doc 4 CITY OF Fire Sprinkler System - Additional Information - 11/9/20 16 ASHLAND 3204 Auburn, Medford • The floor layout in this document was provided by the homeowner. The footprint of the house were found on the Jackson County Assessor's website. Measurements are not verified and the drawing is not to scale. • Attic access is "normal" according to Chase Browning, Medford Fire Rescue. • A bucket test at the connection to the water heater revealed that there is 12 gpm and 50 psi static. • This should allow for a one head calc with 16x16 spacing, which will be allowed. It is anticipated that if the water line supplying the house is 1" or larger, a greater flow will be available. A two-head calculation should be included in order to indicate the needs of the system to meet the two-head calc in the future. • Four pendant sprinklers should also be provided in the garage, as they are using the space for routine dwelling purposes. The interior of the garage is heated. If the attic above the garage has no insulation, include insulation in the bid, or plan to install two sidewalls to protect the garage, with pipe running exposed, or the use of dry sidewalls fed from the kitchen area. • A Talco Home Hydrant water supply, to be placed in the garage, could be included in the bids as alternate line. Because this is a voluntary retrofit, we will write a statement of design intent similar to the following: The installation of this fire sprinkler system is voluntary and is being installed in an existing structure. In accordance with the 2014 Oregon Fire Code 901.4.2, "any fire protection system or portion thereof not required by this code or the International Building Code shall be allowed to be furnished for partial or complete protection provided such installed system meets the applicable requirements of this code and the International Building Code. This home fire sprinkler system is permitted to be designed with the existing water supply to meet the minimum requirements of a one-head fire sprinkler flow greatly increases the safety of the residents in this home. The piping is designed so that with a potential upgrade of the water service in the future, the system will meet the minimum requirements of a two-head calculation. ASHLAND FIRE & RESCUE 455 Siskiyou Boulevard Ashland. OR 97520 !L1 (541) 482-2770 • Fax (541) 488-5318 TTY: 800-735-2900 F3 EL; f;t E(, Y~,LED rr,E'FR CITY OF ASHLAND Q cn cnE O Y O o -c 2_ v' t L U O N N C X c~ O W UL W LL W o 4 t7 ~ D C U E c~ O E Gc Q io m f- L Q N° No N ea M ~ 4 w m ASHLAND FIRE & RESCUE 455 Siskiyou Boulevard Ashland, OR 97520 (541) 482-2770 • Fax (541) 488-5318 TTY: 800-735-2900 CITY OF ASHLAND 0zz 13.0' a11.0' " 0 1 0.0' Q ? co X A 0 o D o cn ~n o M tip rn 0 10.0' o_ ? C ° _ T m 10.0' J O N 4.0' o J O- 40.0' ASHLAND FIRE & RESCUE 455 Siskiyou Boulevard Ashland. OR 97520 (541) 482-2770 • Fax (541) 488-5318 TTY: 800-735-2900 • Jefferson State Fire Sprinkler, LLC November 22, 2016 Ashland Fire Department Margueritte Hickman Marguerite.hickman@ashland,or,us Re: 3204 Auburn Way, Medford The following is our proposal to retro-fit a new NFPA 13D residential automatic fire sprinkler system into the existing residence at 3204 Auburn Way, Medford, Oregon. This proposal includes all necessary labor and material for this project. We intend to provide concealed pendent sprinkler coverage to all of the living areas of the residence, except as omitted by code, starting at the provided Talco HH3-150C residential fire pump and storage tank assembly. All requirements of the Request for Quotation will be met and as well as your requests at the pre-bid meeting including calculations for both single sprinkler flow and 2 sprinklers and protection of the garage. This proposal also includes all of the electrical wiring and plumbing required for the Talco pump and on-site alarms. Quote: $13,590.00 (Thirteen thousand five hundred ninety dollars) Exclusions from proposal: 1. Protection of areas not required by NFPA 13D (i.e. attic, small bathrooms, etc) 2. Special order colors for concealed sprinkler plates 3. Passive purge system Thank you for giving us the opportunity to submit this proposal to you for your consideration. Please feel free to let me know if you have any questions or concerns. This proposal will be valid for 30 days from the above listed date. Sincerely, Travis Jackson Owner 221 N. Central Ave. #318, Medford, OR 97501 Phone: 541-890-1657 / Fax: 541-727-7366 / OR CCB #195621 Jefferson State Fire Sprinkler, LLC November 30, 2016 Ashland Fire Department Margueritte Hickman Marguerite.hickman@ashland,or,us Re: Residential quote breakdowns The following is our breakdown of the two quotes sent to you earlier this month. 714 Glendale, Ashland: Retro-fit installation: $6,332.00 Concealed sprinklers: $ 308.00 Alarms: 923.00 Total Quote: $7,563.00 3204 Auburn, Medford: Retro-fit installation: $ 5,610.00 Concealed sprinklers: $ 418.00 Garage protection: $ 1,140.00 Pump & tank system: 6,422.00 Original Quote: $13,590.00 If the pump & tank system is not used we will need to add back the double check assembly and the alarms. Those items are listed below as alternates not shown in the original quote: Double check assembly: $1,212.00 Alarms: 923.00 Alternate Quote: $2,135.00 Sincerely, Travis Jackson Owner 221 N. Central Ave. #318, Medford, OR 97501 Phone: 541-890-1657 / Fax: 541-727-7366 / OR CCB #195621 TEMPORARY AUTO IDENTIFICATION CARD STATE FARM° This card is invalid if the policy for which it was issued lapses or is terminated. CAR INSURANCE CARD SfafeFarm IF YOU HAVE AN ACCIDENT- NOTIFY POLICE IMMEDIATELY 1. Get names, addresses, and phone numbers of persons involved and POLICY NUMBER 343 3589-E10-37 witnesses. Also get driver license numbers of persons involved and license State Farm Mutual Automobile Insurance Company plate numbers/states of vehicles. 2. Don't admit fault or discuss the accident with anyone but State Farm or INSURED JACKSON,TIFFANY & TRAVIS police. 3. Promptly notify your agent, log on to statefarm.comO, or visit State Farm Pocket AgentO to file a claim. EFFECTIVE DATE DEC-12-2016 EXPIRATION DATE MAY-10-2017 For Emergency Road Service call 1-877-627-5757 CAR-YEAR/MAKENEHICLE IDENTIFICATION NUMBER • TO IDENTIFY YOUR COVERAGES 2000 FORD F350 SD PICKUP 1 FTSW31 F2YEA67497 SEE POLICY FOR FULL NAME AND DEFINITION (All coverages not available in all states.) COVERAGES A BODILY INJURY/PROPERTY AcrAB Liability (Bodily Injury/Property U Uninsured Motor Vehicle DAMAGE LIABILITY Damage) U Underinsured Motor Vehicle P PERSONAL INJURY PROTECTION C, N Medical Payments in Washington U 1 D Comprehensive or Other Than U Uninsured and Underinsured Motor Collision (OTC) Vehicle-BI/PD in Alaska DWG Comprehensive with Full Glass U1 Uninsured Motor Vehicle-PD NAIC #25178 E Fire, Theft, Other Specified U1 Uninsured and Underinsured Motor Perils Vehicle-in Alaska F,G,or J Collision U1 Uninsured Motor Vehicle-BIlPD AGENT DEAN STIRM INS AGENCY IN H Emergency Road Service in Indiana 99 PINE ST L Physical Damage U1 Underinsured Motor Vehicle-PD ROGUE RIVER, OR 97537-9428 N Property Protection in Washington (Name varies by state) U2 Uninsured and Underinsured P, O Personal Injury/No Fault Motor Vehicle-PD PHONE# 541-582-1234 (Name varies by state) UNOC Use of Nonowned Cars R Car Rental W Underinsured Motorist R1 R2 Car Rental and Travel Expense Y Limited Property Damage S Death, Dismemberment Liability (Michigan) STATE FARM® T Disability Z Loss of Earnings Because many states require evidence of insurance on demand, one copy of this form should be carried in the vehicle at all times. A toll free number is available for Emergency Road Service and is located on your insurance card. 1006984 2000 144746 200 07-02-2014 Binder of Insurance Pending issuance and delivery of a policy pursuant to the application of the insured and to all the terms and conditions of the policy issued by the company the State Farm Mutual Automobile Insurance Company Does hereby insure: TIFFANY & TRAVIS JACKSON 6044 TOLO RD CENTRAL POINT, OR 97502-9373 Policy Number: 343 3589-E10-37 Year Make Vehicle Identification Number (VIN) 2000 FORD F350 SD PICKUP 1FTSW31F2YEA67497 Coverages Liability Comprehensive Collision Ded 1M/1M/1M Effective December 12, 2016, expiring not to exceed thirty (30) days hence and to become void immediately upon the issuance of a policy in place hereof. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES. Date , Authorized Representative Policy Number: Date Entered: 12/12/2016 CERTIFICATE OF LIABILITY INSURANCE DATE ( M1D ) 2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT WCFL Insurance Services NAME: Jennifer Butler 700 Mistletoe Rd Ste 206 AICNo EXt: (541) 488-4014 AIC,No: (541) 488-4017 E-MAIL ennifer@workcompforless.com Ashland, OR 97520 ADDRESS: ~ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Preferred Contractors Ins Co INSURED Jefferson State Fire Sprinkler LLC INSURER B : Travis Jackson INSURER C : 221 N Central Ave #318 INSURER D : Medford, OR 97501 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDAYYY LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PC107823 05/11/2016 05/11/2017 PREMISES Ea occurrence $ 5O'000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F__] PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY Per accident _ AUTOS ONLY F_ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Ashland, Oregon, and its elected officials, officers and employees are named as additional insured per the general liability. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Margueritte Hickman, Fire Marshall email : kimberley.summers@ashland.or.us AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Producedusing Forms Boss Plus software.www. Forms Boss. com I m pressivePubl ishi ng 800-208-1977 12/13/2016 CliclQGov Business Licenses - License Information Public License Information Renew (renewlicense.html?OWASP_CSRFTOKEN=NAZP-MX07-65P6-1 WVK-OZNG-A4Z9-SBNV- Z8B2&licenseYear=17&licenseNumber=00038404) License Number: 17-00038404 Location ID: 000025637 Business Control: 0019953 Business Information Business Name: JEFFERSON STATE FIRE SPRINKLER LLC Business Address: *OUTSIDE CITY LIMITS UNKNOWN XXXXX Mailing Address: 221 N CENTRAL AVE #318 MEDFORD OR 97501 Owner Name: CLOGSTON, DANIEL S Date Opened: 02/02/2009 Business Phone: (000) 000-0000 Contractor Flag: Y Federal Tax ID: Type of Ownership: Status: Active License Information Classification: CNTBLHO - CONTRACTOR-HOME OCL License Status, Date: ACTIVE, 05/03/2016 Application Issue Date: 05/02/2016, 05/03/2016 License Valid Thru Date: 03/01/2017 Additional Requirements Code Description Document Expiration Date Number CONTR# OREGON CONSTRUCTION 195621 12/14/2017 CONTR Showing 1 to 1 of 1 entries https-.//egov.citWfinedford.org/ClicWGo\,OL/licensedetaiI.html?OWASP CSRFTOKEN=NA: P-MX07-65P6-lWVK-OZNG-A4ZO-SBNV-Z8B2&centurT1&year=... 1/2 CITY OF ASHLAND TAX REGISTRATION (FOR REVENUE PURPOSES ONLY) BUSINESS LOCATION INFORMATION REGISTRATION NO. STREETADDRESS : 6044 TOLO RD BL-009649 OWNER INFORMATION PHONE: (541) 890-1657 NAME: TRAVIS JACKSON Barbara Christensen CITY RECORDERffREASURER REGISTRATION EXPIRES JUNE 30. JEFFERSON STATE FIRE SPRINKLER, LLC 221 N CENTRAL AVE 318 2017 MEDFORD, OR 97501 TO BE POSTED IN A CONSPICUOUS PLACE. CITY O ASHLAND WORKERS' COMPENSATION INSURANCE CERTIFICATION [CONTRACTOR ST INITIAL APPLICABLE BLANK BELO CERTIFICATION OF COVERAGE: Contractor will maintain Workers' Compensation insurance coverage for the term of the contract and will provide Certificate of Workers' Compensation Insurance before Project Beginning Date. CERTIFICATION OF EXEMPTION FROM COVERAGE: Contractor is exempt from the requirement to obtain workers compensation insuranct. under ORS Chapter 656 for the following reason (initial the appropriate box). SOLE PROPRIETOR ® Contractor is a sole proprietor, and ® Contractor has no employees, and ® Contractor will not hire employees or subcontractors to perform this contract. CORPORATION - FOR PROFIT • Contractor's business is incorporated; and ® All employees of the corporation are officers and directors and have a substantial ownership interest* in the corporation, and • All work will beperformed by the officers and directors; Contractor will not hire other employees or subcontractors to perform this contract. CORPORATION - NONPROFIT • Contractor's business is incorporated as a nonprofit corporation, and • Contractor has no employees; all work is performed by volunteers, and • Contractor will not hire employees or subcontractors to perform this contract. PARTNERSIIIP Contractor is a partnership, and Contractor has no employees, and • All work will be performed by the partners; Contractor will not hire employees or subcontractors to perform this contract, and • Contractor is not engaged in work performed in direct connection with the construction, alteration, repair, improvement, moving or demolition of an improvement to real property or appurtenances thereto." LIMITED LIABILITY COMPANY • Contractor is a limited liability company, and • Contractor has no employees, and • All work will be performed by the members; Contractor will not hire employees or subcontractors to perform this contract, and ® If Contractor has more than one member, Contractor is not engaged in work performed in direct connection with the construction, alteration, repair, improvement, moving or demolition of an improvement to real property or appurtenances thereto. (Signatwre of thorized Signer) (Date) (Signer`sTit{e) W TE: Under OAR 436-50-050 a shareholder has a "substantial ownership" interest if the shareholder owns 10% of the corporation, or if less than 10% is owned, the shareholder has ownership that is at least equal to or greater than the average percentage of ownership of all shareholders. ~NOTE: Under certain circumstances partnerships and limited liability companies can claim an exemption even when performing construction work. The requirements for this exemption are complicated. Consult with City Attorney's Office before an exemption request is accepted from a contractor who will perform construction work. Purchase Order Fiscal Year 2017 Page: 1 of: 1 THIS PO NUMBER MUST APPEAR ON ALL INVOICES, AND SHIPPING DOCUMENTS. B City of Ashland I ATTN: Accounts Payable L Purchase 537 L 20 E. Main Order # Ashland, OR 97520 T Phone: 541/552-2010 0 Email: payable _ ashland.or.us V JEFFERSON STATE FIRE SPRINKLER LLC H C/O Fire and Rescue Department E 1 455 Siskiyou Blvd N 221 N CENTRAL AVE #318 D MEDFORD, OR 97501 P Ashland, OR 97520 Phone: 541/482-2770 O R O Fax: 541/488-5318 Vendor Phone Number Vendor Fax Number Requisition Number Delivery Reference Mar ueritte Hickman Date Ordered Vendor Number Date Required Freight Method/Terms Department/Location 02/02/2017 2981 Cit Accounts Pa able Item# Descri tion/PartNo QTY UOM Unit Price Extended Price Fire Sprinkler Retrofit 1 Fire Sprinkler Retrofit at 3204 Auburn, Medford 1 $9,303.0000 $9,303.00 Adult Foster Care Part of FEMA Fire Prevention & Safety Grant Contract for Goods and Services Less than $25,000 Beginning date: 01/25/2017 Completion date: 03/31/2017 GL SUMMARY 075100 - 610300 $9,303.00 tF , ~ r Date: Authorized Ign6ture / _ PO Total $9,303.00, l F, FORM. #3 CITY OF ASHLAND REQUISITION Date of request: 1/25/17 Required date for delivery: 3/31/17 Vendor Name Jeffprgnn StAtp Fira qnr~ inkler Address, City, State, Zip 221 N Central Ave #318 Medford OR 97501 Contact Name & Telephone Number Travis Jackson, 541.890.1657 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 -(Attach copy of council communication) Contract # ❑ Verbal/Written quote(s) or proposal(s) ❑ 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 El 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 Fire Sprinkler retrofit at 3204 Auburn, Medford -Adult Foster Care $ 9303.00 Part of a FEMA Fire Prevention & Safety Grant Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quotelproposal $ 9303.00 Project Number 000480 - 999 Account Number 110 - 07- 51 - 00 - 610300 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, 1 certify that the City's public contracting requirements have been satisfied, z E, 4 Employee: Ale Department Head: F. ` (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 e F Finance Dire,Ibr- (Equal to orgreaterthan $5,000) Date Comments: Form #3 - Requisition