HomeMy WebLinkAbout2017-116 Contract - Center for Social Ecology & Public Policy
Contract for GOODS AND SERVICES Small Procurement Less than $5,000
INDEPENDENT CONTRACTOR: Center for Social Ecology and Public Policy
. C ~ ~r v ~ ~ CONTACT: Kevin Preister, PHD
fiJ ~ ADDRESS: 479 Russell Street, Suite 101A
20 East Main Street Ashland, OR 97501
Ashland, Oregon 97520
Telephone: 541 /488-6002
Fax: 5411488-5311 TELEPHONE: 541-601-4797 EMAIL:
kevinpreister@csepp. us
BEGINNING DATE: 02!1512017 COMPLETION DATE: TBD
COMPENSATION:$450.00
GOODS AND SERVICES TO BE PROVIDED: Meeting Facilitation and afollow-up executive summary of the meeting.
In the event of conflicts or discrepancies among Contract Documents, this standard form of the City of Ashland Contract 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 this standard form 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. Ownership of Production: All documents, materials or items produced by Contractor pursuant to this contract shall be the property of City.
4. Statutory Requirements: ORS 2796.220, 2798.225, 2796.230, 2796.235, ORS Chapter 244 and ORS 670.600 are made part of this contract.
5. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from those losses, expenses,
or other damages resulting from injury to any person or damage to property arising out of or incident to the negligent performance of this contract
by Contractor its employees, or agents. Contractor shall not be held responsible far any losses, expenses, or other damages, directly, solely, and
proximately caused by the negligence of City.
6. Termination: City's Convenience. This contract may be terminated at any time by the City.
7. 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.
8. 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.
9. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license.
10. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work.
11. 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.
12. 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.
13. Insurance. Contractor shall at its own expense provide the following insurance:
a. a. Worker's Compensation insurance incompliance with ORS 656.017, which requires subject employers to provide Oregon workers'
compensation coverage for all their subject workers. Worker's compensation insurance is required if work is performed by employees,
subcontractors, or volunteers.
BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES UNDER PENA FLAW THAT THE WORK REQUIRED BY THIS
CONTRACT SHALL BE PERFORMED SOLELY BY THE UNf?ERSIGNED:
b. General Liability insurance with a combined single limit, or the equivalent, of less than $1,000,000 for each occurrence for Bodily Injury
and Property Damage. (Not Applicable)
c. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 for each accident for Bodily
Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. (Not Applicable)
14. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon
15. 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 U ESS IN WRITING AND SIGNED BY BOTH
PARTIES.
Certification. Contractor shall sign the certification attached hereto as Exhibit A and herei~cin orporate by reference.
Contractor: , Ci~~ of Aland:
~ _ ~ ~
B
' ig ture partment Head
Print Na Print Name
~b^C ~ f ~
Title to
W-9 One copy of a W-9 is to be submitted with the signed contract. PUrChaSe Order 0. ~ [O
Revised 10-28-14 Page 1 of 3
EXHIBIT A
CERTIFICATIONSlREPRESENTATIONS: 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 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) I 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.
~ ,
L.-
Contractor (Date)
Revised 10-28-14 Page 3 of 3
CERTIFICATION OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE REQUIREMENTS
Contractor is exempt from the requirement to obtain workers compensation insurance under ORS
Chapter 656 for the following reason. Contractor is to initial the appropriate box as follows:
SOLE PROPRIETOR
(Initials) ■ 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
(Initials) ■ 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 be performed by the officers and directors; Contractor will not hire other employees or subcontractors
to perform this contract.
CORPORATION -NONPROFIT
(1 gals) ■ 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
(Initials) ■ 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
(Initials) ■ 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
~ ,.-~'~ap~urtenan~es thereto.**
a
(Signatu of Authorized Signer) (Date)
~~c ~
(Signer'sTitle
*NOTE: Under OAR436-50-050 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.
4
.
~ ~
'S ,k~ v~ x:.2' T~ds
t F
Ye✓ > ry
~ ~ .
March 10, 2017
To: Linda Reid, City of Ashland Housing Program
From: Kevin Preister, Center for Social Ecology and Public Policy (CSEPP), Inc.
Re: Invoice for Services
Invoice for Services
Invoice # 22-16
Professional Facilitation Services, Public Forum on Affordable Housing, March 8, 2017
Amount due: $450
Payable upon receipt.
Thank you for the opportunity to serve the City of. Ashland
www.csepp.us
Enhancing Prodifctive Harmony between Human and Natural Environments
479 Russell Street, Suite 101-A Ashland, OR 97520 ~ 541/ 601-4797 FAX 541/ 552-9683 info ~t cse .us
837 Steele Street Denver, CO 80206 970/ 927-4424 ~ FAX 970/ 927-4443 international ~jkagroup,com
r~ Fiscal Year 2017 Page: 1 of: 1
B City of Ashland ~--~~~~~~~~~I
- =
T N: Accounts Payable
. ~ 20 E. Main Purchase
As Order #
hland, OR 97520
T Phone: 5411552-2010
O Email: payable@ashland.or.us
~ H CIO Planning Division
E CENTER FOR SOCIAL ECOLOGY & PUBLIC POLICY 151 Winburn Way
D 479 RUSSELL STREET SUITE 101A P Ashland, OR 97520
O ASHLAND, OR 97520 Phone: 5411488-5305
R T Fax:5411552-2050
0
1/endQrPhon~ Numk~~r = 1len~QrFa__~-Num~eF ~es~~~it~r~~.~ ~~r~1$~_~--~-^=_=_______-_
541 601-4797 Linda Reid
Dade Orderesi'__ _ 1~en~Qf NumbQr = @a~e-l~quir~~ = ~ -fir ~ ~ = ~3 . - - ~n -~finr~=-
03131/2017 1413 FOB ASHLAND ORlNET30 Cit Accounts Pa able
_ - _ - _
Item#._ = _ ~ ~ - -
_ - = ~ten~~~=P~Ice==
Meeting Facilitation
1 Professional Facilitation Services 1 $450.0000 $450.00
Public Forum on Affordable Housing March 8, 2017
Amount due: $450.00
Contract for Goods and Services Small Procurement less than
$5,000
Beginning date: 0211512017
Completion date: TBD
Project Account:
GL SUMMARY
~ 092716 - 604100 $450.00
~a
By: ~ Date:
Authorized Signature = _ - - $450.00
# -
- _
~ s<
RE U I S I T I ®IV Date of request,' ~ ~ ~
Q
Required date for delivery;
Vendor Name ~
Address, City, State, Zip ~ ~ ~ ~ f~ ~ ~ ' ~
t,
Contact Name &Telephone Number' ~ ~ ~
I, i\ ~ ~ 1
Fax Number
SOURCING METHOD
❑ 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
❑ ritten uote or ro osal attached _ Attach co of council communication _ If council a royal re uired, attach co of CC
Small Procurement Cooperative Procurement
❑ Request for Proposal (Copies on file)
Less than $5,000 ❑ State of Oregon
❑ Direct Award Date approved by Council; Contract #
❑ VerballWritten quote(s) or proposal(s) -(Attach copy of council communication) ❑ State of Washington
Intermediate Procurement ❑ Sole Source Contract #
GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract
$5,000 to $100,000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract #
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5,000 to $75,000 ❑ Form #9, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council;
❑ (3) Written proposalslwrittensoIicitation Date approved by Council; (Date)
❑ Form #4, Personal Sen+ices $5K to $75K Valid until; Date - (Attach copy of council communication)
Description of SERVICES Total Cost
~ {
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL ~oST
❑ Per attached quotelproposal $
Project Number _ _ _ _ _ _ • _ _ _ Account Number _ _ _ • _ _ • _ -
AccountNumber_Q9•~1.9~•__•~®~~~® AccountNumber___•__•_ - -
Expenditure must be charged fo the appropriate account numbers for the financials fo accurately refiecf the actual expenditures.
IT Direcfor in collaboration with department to approve all hardware and software purchases:
IT Direcfor Dafe Support -Yes / No
By signing Phis req isr~ion`form, ! certify that f City's~ubGc contracting requirements have been satisfied,
Employee: Depa ment fl, -
(Equal to or eater than $5,000)
Department ManagerlSupervisor: ity Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year: YES / NO
Finance Director- (Equal to or greater than $5, 000) Dafe
Comments:
Form #3 -Requisition