HomeMy WebLinkAbout2017-052 Contract - Greenway Spray
Contract for GOODS AND SERVICES less than $25,000
CITY OF CONTRACTOR: Greenway Spray LLC
-AS H LAND CONTACT: Greg Stewart
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 208 Glenwood Dr, Eagle Point, OR 97524
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: (541) 622-9949
DATE AGREEMENT PREPARED: 2.27.17 FAX: Greg@GreenWaySpray.com
BEGINNING DATE: 3.6.17 COMPLETION DATE: 4,21.17
COMPENSATION: Not to exceed $4400.00
GOODS AND SERVICES TO BE PROVIDED: Herbicide application at Ashland Airport, per Exhibit C (proposal),
plus a six-inch swath at interface of paved/vegetated areas per conversation on 2.27.17
ADDITIONAL TERMS:
In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take
precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a
manner that will not conflict with the said rims City of Ashland Contract.
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY
AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel
assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned
in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are
so registered, licensed and bonded. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated, payments will be made for work completed and accepted to date of termination.
Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 27913.220, 27913.225, 27913.230, 27913.235, 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 b City under an of the following
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 1 of 5
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach, may at any time terminate
the whole or any part of this contract if Contractor fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City.
Contractor shall have the complete responsibility for the performance of this contract.
11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.110 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage.
C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 2 of 5
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 by
reference.
Contractor: City of Ashland
Y 2. 6 r 'i
ignature~ Dep
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Print Name Print Name
title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 3 of 5
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer 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:
i' (1) 1 carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
year.
(6) 1 assume financial responsibility for defective workmanship or for service not provided
as evidenced by the ownership of performance bonds, warranties, errors and omission
insurance or liability insurance relating to the labor or services to be provided.
Contractor (Date)
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 4 of 5
EXHIBIT B
City of Ash land
LIVING
WA E
Is time
Emmer hour effective June
30, 2016
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,
Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,
20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us.
Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees.
CITY OF
ASHLAND
Contract for Goods and Services Less than $25,000, 06/30/2016, Page 5 of 5
EXHIBIT C - PROPOSAL
February 27, 2017
City of Ashland Public Works / Engineering
51 Winburn Way
Ashland, OR 97520
Attention:
Kaylea Kathol
Project Manager
Kaylea,
Thank you for providing the opportunity to meet with you on February 22nd to discuss the work you are
interested in having performed at the Ashland Airport. The scope of work is focused on the elimination of weed
growth that is causing a deterioration of the asphalt and is an obstruction to the lighting and reflectors along the
taxiway and runway. Below is a breakdown of the scope of work we discussed and how we plan on targeting
each of these areas.
The following areas will be sprayed with a GPS guided and calibrated spray boom:
Where visible cracks in the asphalt are closer than 8' apart.
Unpaved areas between the hanger doors.
The outdoor airplane parking area that adjoins the South taxiway.
The 12' wide swath along the vegetative Swale that will take in the taxiway reflectors and the landing
lights on both sides of the runway.
The areas below would be spot sprayed using a calibrated hand gun:
- 15' around drains that lead directly to streams.
- The taxiway asphalt from where it narrows to the North end. This areas has cracks that are spaced
greater then 8'.
- Underneath all parked aircraft.
- Where the large fuel tanks are located.
- Signs and lights inside the 12' swale border.
- The areas at the back of the two East airplane hangars, where the space is too narrow for equipment-
Below are the products that we have chosen to use and why we think they would best suit your needs:
- Alligare Glyphosate 5.4 is a glyphosate product that is labeled for aquatic sites and airports. Greenway
Spray LLC will be using this product for all post emergent herbicide applications. Glyphosate is a safe
contact herbicide that only affects vegetation it is sprayed on. It doesn't contain a surfactant making it a
safer product where drainage is a concern.
- Some of the weeds we will be targeting are star thistle, black mustard, tar weed and henbit. The pre-
emergent application we recommend for the airport vegetative swale border is combination of Payload
and Esplanade. This chemistry is desirable because it binds with the soil and has a limited ability to
move off site- It also will target many of the weed seeds that you currently have in the existing seed bed
impeding seed germination this coming season.
The pre-emergent we recommend for the cracks in the blacktop will be Payload. We use the same
active ingredient in vineyard rows for weed suppression at the base of the grape vines. It has
characteristics that allow it to bind with clay so movement is very limited.
For safety, Greenway Spray LLC will use the best surfactant package on the market. We would use
Crosshair by Wilbur-Ellis for our drift control. The Rogue Valley has seen many cases of off target
applications and we won't be one of them. For our spreader/sticker we would use Rainier EA labeled for
airports and aquatic sites.
In advance of starting the work, we will be posting the areas to be sprayed 48 hours prior to any pesticide
application at the interior airport entrances. This is to notify the public of the work that will be taking place.
Greenway Spray will be placing flags, as we progress through the airport, warning visitors that the area is off
limits until the spray has dried. We will also coordinate with your office as to the date, the time and the method
of application.
It will be necessary to time this application before the rainy season ends. In order to activate the pre-emergent
we will need to receive at least .5" of rain. We recommend this application takes place no later than the end of
March. The application timing will be based on the weather forecast. With favorable weather we don't see this
project taking more than 5 hours to complete. Our schedule is booked tight this spring. Upon approval, and a
written notice to proceed, we will coordinate with your office to get the herbicide application done within five
weeks.
Greenway Spray is committed to the safe application of herbicides with the least amount of environmental
impact. We do this by using products that will best control the target according to their site. We are licensed
through the Oregon Department of Agriculture, bonded and insured. Herbicides will not be sprayed on ground
that has standing water. Reasonable buffers will be in place for all areas with water including streams, springs,
irrigation runoff and riparian areas. Native plants and trees will NOT be sprayed, only the areas previously
approved by you.
Greenway Spray is a safety first company. We supply our team with up to date training in pesticide handling and
application. I have an extensive background in herbicide selection and application, and will be on this project
throughout.
We appreciate your interest in Greenway Spray and look forward to doing business with the City of Ashland. If
you have any questions or concerns regarding the attached estimate please feel free to contact me directly.
Sincer ,
Gre tewart r
Greenway Spray LLC
AG-L1015139CPA
AG-L1030214CP0
(541) 622-9949
Greenway Spray LLC
~ 208 Glenwood Drive Estimate
Eagle. Point, OR 97524
Greg(a)Greenwa}'SPray.com
GreenwaySpray.com Date Estimate #
541.622.9949
2/24i2017 192
Name / Address
City of Ashland Public Works/Engineering
51 Winbum Way
Ashland, OR 97520
Project
Description Qty Rate Total
Custom spray 16 acres of weeds at the Ashland Airport with pre and 16 275.00 4,400.00
post emergent herbicide .
Areas include:
All taxiway asphalt cracks and edges.
Unpaved areas between the hanger doors.
A 12' swath that follows the vegetative swale on the taxiway and
runway shoulders. (approximately 2' inside lights/reflectors)
Signs and lights inside the 12' swale border.
West side of runway to back side of lights.
'thank you for your business. Total
$4,400.00
Exhibit D
CITY OF ASHLAND
WORKERS' COMPENSATION INSURANCE CERTIFICATION
[CONTRACTOR MUST INITIAL APPLICABLE BLANK BELOW)
C T ICATION 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 insurance 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.
PARTNERSHIP
• 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.**
t7-
Signa re Authorized Signer) (Date)
(Signer'sTitle)
Exhibit D
*NOTE: 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.
www.saif.com
Oregon Workers' Compensation
s a I
Certificate of Insurance Flcorporation
Mail to: Certificate holder:
GREENWAY SPRAY LLC CITY OF ASHLAND
208 GLENWOOD DR 20 EAST MAIN STREET
EAGLE POINT, OR 97524-8596 ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named below for the policy period
indicated. The insurance afforded by this policy is subject to all the terms, exclusions and conditions of
such policy; this policy is subject to change or cancellation at any time.
Insured Producer/contact
Greenway Spray LLC SAIF Corporation
208 Glenwood Dr Portland Service Center
Eagle Point, Or 97524-8596 971.242.5001 servic@saif.com
Issued 03/01/2017 Limits of liability
Policy 857891 Bodily Injury by Accident $500,000 each accident
Period 02101/2017 to 02/01/2018 Bodily Injury by Disease $500,000 each employee
Body Injury by Disease $500,000 policy limit
Description of operations/locations/special items
Important
This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate
does not amend, extend or alter the coverage afforded by the policies above. This
certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the
certificate holder.
Authorized representative
Kerry Barnett
President and CEO
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9812
Poiicy_OLCA Certificate0flnsurance
Progressive RDT 3 3/6/2017 12:58:29 PM PAGE 2/003 Fax Server
PA949R,Frriv,F
TOW N E CENTRE INS COMMERCIAL
315 SE 7TH STREET
GRANTS PASS, OR 97526
1-541-476-3311
Policy number: 03967552-0
Underwritten by:
ARTISAN AND TRUCKERS CASUALTY CO
March 6, 2017
Page 1 of 2
Certificate of Insurance
Certificate Holder Insured Agent
Additional Insured GREENWAY SPRAY LLC TOWNE CENTRE INS
CITY OF ASHLAND 208 GLENWOOD DR 315 SE 7TH STREET
20 EAST MAIN ST EAGLE POINT, OR 97524 GRANTS PASS, OR 97526
ASHLAND, OR 97520
This document certifies that insurance policies identified below have been issued by the designated insurer to the insured
named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon
the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below.
The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and
conditions of these policies.
Policy Effective Date: Dec 8, 2016 Policy Expiration Date: Dec 8, 2017
Insurance coverage(s) Limits
BODILY INJURY/PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT
.
UNINSURED MOTORIST BODILY INJURY $1,000,000 COMBINED SINGLE LIMIT
EMPLOYER'S NON-OWNED AUTO BIPD $1,000,000 COMBINED SINGLE LIMIT
HIRED AUTO BODILY INJURY/PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT
Description of Location/Vehicles/Special Items
Scheduled autos only
2005 DODGE RAM 2500 3D6WS26D05G832400
UNINSURED MOTORIST PROPERTY DAMAGE $20,000 W/$200 DED ($300 IF HIT & RUN)
PERSONAL INJURY PROTECTION $15,000
COMPREHENSIVE $500 DED
COLLISION $500 DED
RENTAL REIMBURSEMENT $30 PER DAY ($900 MAX)
ROADSIDE ASSISTANCE SELECTED
1992 FORD F2501 FTHX26G6NKB46378
UNINSURED MOTORIST PROPERTY DAMAGE $20,000 W/$200 DED ($300 IF HIT & RUN)
PERSONAL INJURY PROTECTION $15,000
ROADSIDE ASSISTANCE SELECTED
2017 DNS TRLR BLDRS TRAILER 1D9D1VC2XHM731023 Stated Amount $2,600
COMPREHENSIVE $250 DED
2015 HOMEMADE TRAILER 99999999999999999
Continued
Progressive RDT 3 3/6/2017 12:58:29 PM PAGE 3/003 Fax Server
Policy number: 03967552-0
Page 2 of 2
Certificate number
06517NET552
Please be advised that additional insureds and loss payees will be notified in the event of a mid-term
cancellation.
Form 5241 (10/02)
/06/2017 10:56 5414765626 TOWNE CENTRE INSURANCE :2412 P.001/001
CERTIFICATE DATE (MMIPP(YYYY)
OF LIABILITY INSURANCE 2/28/2017
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 13Y 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: It 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
SAME!
Towne Centre Ins Service, LLC PHONE FAx^-
315 SE 7th St E. IL - -
Grants Pass, OR 97526 Ann F_aa:
INBLiRcep a AFFORDING COVERAGE NAIL >y
INSURER A ; Scottsdale Insurance Company
{NSUJtEA INSURER B :
Greenway Spray LLC INSURER C :
208 Glenwood Dr INSURER D :
Eagle Point, OR 97524 -
~
lN9URFI1 F:
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POI-ICIES 01= INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVF 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.
INS y BAR POLICY EFF PoLlCY EXP LIMITS
LT TYPE OF INSURANCE Ina& viva POLICY NUMBER M MM
GENERAL LIABILITY x CPS-2600850 2/1512017 2/16/2018 EACH OCCURRENCE ~ 1,000,000
X COMMERCIAL GENERAL LIABILITY G S E QNCSetfL@!L r $ 1001000 -
A CLAIMS-MADE IA OCCUR MED EXP (Any one person $ 5,000
PERSONAL B ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,)00,000 _
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
7 POI-ICY 1-1 P LOC $
AUTOMOBILE LIABILITY 91NED SIN(3L LJM
ANY AUTO BODILY INJURY (Par person) $
AUTO5CHGOULED
OWNED Al-L AUTOS
BODILY INJURY (Per acodanl) $
NON-OWNED P D_00 5RTY PA MAGE
HIRED AUTOS AUTOS er sWakwl
$
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE _
DEp RETENTION E
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY Y / N - ER PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT S
OFFICERIMEA48E F7
ry f1 EXCLUDED?
(Manda
(Mandatory In in N NM) N / A E.L. DISEASE - EA EMPLOYE _
If yyeg aesGlAe unacr
dEB
L~RIPTION OF OPERATIONR ha:aw E.L. DISEASE -POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VE14CLES (AttaeA ACORO 161, Additional Remame 15chedule, If more apace is redulrod)
Certificate holder is listed as an additional insured.
CERTIFICATE HOLDER CANCELLATION
CITY OF ASHLAND
20 FAST MAIN ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ASHLAND, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPJROSENTATIVE
'00_
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