HomeMy WebLinkAbout2017-099 Contract - Lawco Fire Protection
Contract for GOODS AND SERVICES less than $25,000
CITY O F CONTRACTOR: Lawco Fire Protection
~SHLAI~ID x
CONTACT. Shawn Co
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 5350 Bounty Lane Central Point, Or 97502
Telephone: 5411488-6002
Fax: 541/488-5311 TELEPHONE: (541) 690-1631
DATE AGREEMENT PREPARED: 28 Feb 2017 FAX: 541-773-1069
BEGINNING DATE: 1 March 2017 COMPLETION DATE: 31 Ma 2017
COMPENSATION:
Not to Exceed $4085.78
GOODS AND SERVICES TO BE PROVIDED:
Perform D Valve replacement as per exhibit C
ADDITIONAL TERMS:
In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take
precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a
manner that will not conflict with the said rims Cit 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 2796.220, 2796.225, 2798.230, 2796.235, 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 beheld 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 ma be established b Cit under an of the followin
Contract for Goods and Services Less than $25,000, 063012016, Page 1 of 6
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. ObligationlLiability 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:
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, ,0~0 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,
includin covera a for owned, hired or non-owned vehicles, as applicable.
Contract for Goods and Services Less than $25,000, 0613012016, Page 2 of 6
d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverages) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. Additional InsuredlCertificates 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 andlorself-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, suitor
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
HEISHE 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
E"'
By ~ ~ BY
Signature Department Hea
~ ~~~c
Print Name Print Name
Title Date
W-9 One co of a W-9 is to be submitted with l
PY
the signed contract. Purchase Order No.
Contract for Goods and Services Less than $25,000, 0613012016, Page 3 of 6
EXHIBIT A
CERTIFICATIONSIREPRESENTATIONS: 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) I 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 forthe business.
~ (3) Telephone listing is used forthe 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.
X (6) I assume financial responsibility for defective workmanship orfor 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.
C~~ ~
Contractor (Date)
Contract for Goods and Services Less than $25,000, 0613012016, Page 4 of 6
LAwca1 oP la: DR
A~ °P CERTIFICATE OF LIABILITY INSl1RANCE DATE~MMIDDIYYYYI
0310812017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FIOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVEi_Y AMEND, EXTEND OR AL'T'ER THE COVERAGE AFFQRDED 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: !f the certificate holder is an ADDITIONAL INSURED, the palicy(ies) must be endorsed. If SUBROGATION 1S 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 endorsements .
PRODUCER Phone: 541.779-0177 NAM~aCT
Insurance Marketplace, Inc, Fax: T=AX 772-$235 PHONE ~ FAX
1998 Skypark Dr Suite 100 _tac, Nv, Ext): _ _ I (wc, Na): _
Medford, QR 97504 E-MAIL
James A Hatton ADDRESS _
INSURER{S} AFFpRL11NG COVERAGE NAIC #
_ , INSURER A : Saif Corporation ~ ~
INSURED LawCO Fire Protection LLC iNSUReR e : Rockhiil Insurance Company
Shawn Cox
5354 Bounty Ln INSURER c : .M w.~
Central Paint, OR 97502 INSURER D : _ TM
INSURER £
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISIQN NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE F01"t THE POLICY PERIOD
INDICATED. NpTWITHSTANDING ANY REQUIREMENT, TERM OR C4NpITION 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.
INSRr~--- ADDL' UBR ~'~N__ . POLICY EFF POLICY EIfP ~'°'J'---
LTR TYPE 4F INSURANCE I POLICY NUMBER MM1DblYYYY MMIDDIYYYY LIMITS
G£N£RAL LIABILITY ~ EACH OCCURRENCE N $ 1,004,04
T REN ED
8 X COMMERCIAL GEN>;RAL LIABILITY X RFSCAK000154.00 ; 0211212017 ~ 02!12!2018 PREMISES jEa occurrence) : ~ ~ 140,00
CLAIMS-MADE X~ OCCUR i ~ ' ,A ~ t
MED EXP (Any one person} ~ $ _ 5,00
' ; I ~ PERSONAL & ADV INJURY $ 1,000,00
..w
I ~ G>:NERAL AGGREGATE ~ 2,440,00
GEN'L AGGREGATE LIMIT APPLIE=S PER. I i ~ j PRODUCTS • COMPIOP AGG j $ ~ 2,000,00
I~ PRO- ~ LOC ~ ~---.~.w_..__- , $ _
PaLICY X
AUTOMOBILE LIABILITY ~ ~ COMBINED SINGLE LIMIT
accident $ _
ANY AUTO ~ BODILY INJURY (Per person} $
ALL OWNED SCHEDULED .M.....
- AUTOS : AUTOS I BODILY INJURY (Per accident} $
NON-OWNED ~ PROPERTY DAMAGE -w
i HIRED AUTOS i AUTOS ' ~ ~ jeer accident) $
I ~ ' ~
X UMBRELLA LIAB I X !OCCUR ~ 1=ACH OCCURRENCE $ 1,444,40
8 I EXCESS LIAR CLAIMS~MAD~ RFSXAK000077.04 02112!2017 02/1212018 AGGREGATE 1$ 1,400,00
i$
DED ' ~ ETENTION 100aQ
I WORKERS COMPENSATION ~ ~ WC STATU- IOTW-
AND EMPLOYERS' LIABILITY Y f N ~ I I ~ T RY LIMI7S ~ ~f~T
A ANY PROPRIETORIPARTNERIEXECUTIVE ❑ 76232$AR 0710112015 07x0112017 E.L. EACH ACCIDENT ' $ 1,000,00
OFFICERIMEMBER EXCLUDED? N ! A
(Mandatary in NH) E.L. DISEASE - EA EMPLOYEE $ 1,040,00
If yes, describe under ~
DESCRIPTION OF OPERATIONS below ! I E.L. DISEASE - POLICY uMIT ' ~ '1,440,44
s ~
i
~ ~ j ~ ~
DESCRIPTION OF OPERATIONS! LOCATIONS !VEHICLES IAttach ACORD 101, Additional Remarks Schedule, tf mare apace is required!
City of Ashland as additional insured forms CG2010 0704, CG2001 p413 &
CG2037 0704 attached
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLIGIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTIGE WILL BE i?ELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
20E Main St
Ashland, OR 97520 pUTHORI~ED REPRESENTATIVE
James A Hatton
01988.2010 ACORD CORPORATION. Ail rights reserved.
ACORD 25 (2010145} The ACORD name and logo are registered marks of ACORD
LAWCD•1 PAGE 2
NOTEPAD INSURED'SNAME Lawco Fire Protection LLC OP ID: CR DATE 03/08117
included as additional insured on a primary, non-contributory basis with
regard to Commercial General per the attached forms (for ongoing and
Completed operations), and Excess L~.ability as it pertains to the named
insured's operations in connection with the above captioned project(s~
where required by contract. Waiver of subrogation in favor of the
additional insureds applies where required by contract and allowable by ~
law per the attached endorsement. ~
POE.ICY NUMBER: RI=S~AK~00154-U1 COMMERCIAL GENERAL LIABILITY
CG X010 07 04
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ Ifi CAREFULLY
ADDITIONAL INSURED -OWNERS, LESSEES OR
CONTRACTORS SCHEDULED PERSON OR
ORGANIZATION
This endorsement rnodifres insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
scHEQULE
Name Of Additional insured Persons}
Qr 0 anization s : Locations 0# Covered 0 rations
Blanket where required by written contract
Information r wired to corn late this Schedule, if not shown above, will be shown in the Deciaratrons,
A. Section II -Who Is An Insured is amended to B. With respect to the insurance 'afforded to these
include as an additional insured the person(s) or additional insureds, the folbwinc~ additional exciu-
organization~s) shown in the Schedule, but only sions apply:
with respect to liability for "bodily injury', "property This insurance does n~ apply to "bodily injury' or
damage" ar "personal and advertising injury" property damage" oc~urnng after:
caused, in whole or in part, by:
1. Your acts or omis~ons; or 1. All work, including materials, parts or equip-
ment furnished in connec#ion wrth such work,
2. The acts or omissions of tt~se acting on your on the project (other than service, maintenance
behalf; or repairs} to be performed by or on behalf of
in the performance of your ongoing operations for the additional insureds} at the location of the
the additional insureds} at the location(s) desig~ covered operations has been completed; or
Hated above. ~ 2. That portion of "your work" out of which the
injury or damage arises has been put to its in-
tended use by any person or organization other
than ano#her contractor or subcontractor err
gaged in performing operations for a principal
as a part of the same project.
CG 2010 O7 04 ~ ISO Properties, lnc., 2004 Page 1 of 1 d
a
CpMN1tERCiAL GENERAL LIABILifiY
CG 20 0104'!3
THIS END~RSEII~ENT CHANGES THE POI~CY, PLEASE READ I~' CAREFULLY.
pR~MARY ANC NCJNC~NTRI
~UT'~RY
t~~'HER INSURANCE CaNDITI~N
This endorsement modifies insurance provided under the following:
CpMMERGIAL GENERAL LIABlI.ITY CQVERAGE PART -
PRpCUCT51CpMPLETED pPERATIONSLIABILITY CpVERAGE PART
The fallavuing is added tQ the 0th®r Insurance ~2~ You have agreed in writing in a contact or
Candifion and supersedes any provision to the agreement that this insurance would be
contrary: primary and would not seek contribution
Primary And Noncontributory insurance from any other insurance available to the
This insurance. is primary to and will not seek addi6anal insured.
contribution from any other insurance available
to an additional insured under your policy
provided #hat:
41~ The additional insured is a Named Insured
under such other insurance; and
r
t.
GG 24 0144 93 ~ Insurance Services pffiCe, Inc., 2012 Page ~ of ~
POLICY NUMBER: RFSCAiC000154-01 COMMERCIAL GENERAL LIABILITY
CC 2437'07'04
THIS ENDQRSEIVIENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AaDIT~~NAL 1NSUREa - QWNERS, LESSEES C1R
CCJNTRACT~RS - CQI~~LETED aPERATI~NS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEQULE
Name Of Additional Insured Persota(s~
Or Or anixation s : Location And Descri Lion Of Com feted 0 rations
Blanket where required by written contract.
lnforma~an r uired to com lets this Schedule, if not shown above, will ~ shown in the Declarations.
Section II Who Is An Insured is amended to
include as an additional insured the persan(s} ar
organizatian(s}shown in the Schedule, but only with
respect to liability for "bodily injury" or "property dam-
age" caused, in whale or in part, by "your work" at
the location designated and described in the sched-
ule of this endorsement performed far that additional
insured and included in the "products-completed
operations hazard"~
CG 20 37 07 04 ®lSO Properties, Inc., 2004 Page 10# 1 Q
r ~ ~~~4 r a s rd
Fiscal Year 2017 Page: 1 of: 1
I
- - - - " : -=~1~1-
B City of Ashland _
_ _ -
L ATTN: Accounts Payable Purchase
L 20 E. Main
Ashland, OR 97520 Order #
T Phone: 5411552-2010
O Email: payable@ashland.or.us
V LAWCO FIRE PROTECTION LLC H CIO Facilities Maintenance Div
N 5350 BOUNTY LANE ~ 190 North Mountain Ave
D CENTRAL POINT, OR 97502 P Ashland, OR 97520
0 Phone: 5411488-5358
R ~ Fax:5411552-2304
Ven~QrPh~n-~1~lumber _ ~n~or~1~~~- c~~ - -
_ David Arnold
_ Qate ~r~sre~ 11~n~>~um~ U_ = _ - - _ _ - . - -
_ - ~ _
0311612017 3109 FOB ASHLAND ORINET30 Cit Accounts Pa able
Replace Dry Valve
1 Perform replacement of Dry Valve as described in Exhibit C. 1 $4,085.7800 $4,085.78
Contract for Goods and Services Less than $25,000
Beginning date: 03101/2017
Completion date: 05131/2017
Project Account: E-000218-999
GL SUMMARY
082400 - 602400. $4,085.78 ~ ~ ~ ~
F
~ Jf
.
% .Date: ~ ~l
Authorized `Signature ~ - - $4 085.78
~
t~', s p~ _
~ z
` CITY ® F
Y
a~ 0.
Date of request; 03113/2017
Required date for delivery;
Vendor Name .La~cc' ire Prp~rtinn
Address, City, State, Zip 5250 Bounty Lane Central Point OR 97502
Contact Name ~ Telephone Number Shawn Cox (541) 690-1631
Fax Number (541) 773-1069
SOURCING METH®D
❑ Exempt from Competitive Bidding ❑ Emer enc
❑ 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 vote or ro osal attached Attach co of council communication _ If council a royal re uired, 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 #
❑ UerballWritten 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 ❑ Farm #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 proposalslwrittensnlicitation Date approved by Council; (Date)
❑ Form #4, Personal Services $5K to $75K Ualid until; Date - (Attach copy of council communication)
Description of SERVICES Total Cost
Perform Replacement of Dry Valve as described in exhibit C $4085,18
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
® Per attached quotelproposal
Project Number _ 00021 x.999 $4085.1 Account Number _ 410.0.24.00.602400
*Expenditure must be charged to fhe appropriate account numbers for fhe financials fo accurately refiecf fhe actual expenditures.
1T Director in collaboration with department to approve all hardware and software purchases:
IT Director Dale Support -Yes /No
By signing Phis req~isifion form I certify that fhe y's public contracting requirements have been satisfied.
f,
Employee: ~ Department Head: ~
,1 (Equal t or grea er than $5,000)
Department ManagerlSupervisor: City Administrator;
(Equal to or greater than $25,000)
punds appropriated for current fiscal year: YES / NO
Finance Direcfor (Equal fo or greater than $5,000) Dafe
Comments:
Form #3 -Requisition