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HomeMy WebLinkAbout2017-130 Contract - Molecular Inc ~r~rac~ far ~C~DS AND ~RV~C~ ~~ss ~hanl ~5~0~~ ~ z ~ ~ ~ ~ ;CONTRACTOR: Molecular, Inc ~.,A. ~ 1 CONTACT": Chris iegrist 2C East IV1ain Street j As",(and, ~3regon 9~52~ .ADDRESS: ~ 2~ fenny lane l_ongvie~r A g8~~~ Telephone: ~~~l~~8-~~ s s=ax: 54~I43-53~ 1 ~ TELEA~IQNE: 3~fl-2~4-41~~ I i 4 ~~il\. BE~lNN1NG DATE: ;~f1I2(~1~` COMPLETION DATE: ~~~~312g~ COMPENSATION: as per ~Exhl~it C 4Q~g.Dg GOODS AND SBRVICES TO BE PI~O~IDED: Remove damaged coatings prepare substrate surface fer re- ~ coating in manhole and chat with Raven 4g~ epoxy as per Exhibit C ~ ADDITIONAL TERMS: jn the event cf contllots or ciscrepancies amore the Cod~trra~ dou~:nien,s. C'r<yl o` A,s:rPand ~ontraot ror ~acds anC sA~;iyes be prirnar~ and take precedence, and ar~y exhibits cr anciilar}~ ccntrac~ or a~reer~e~tt5 havir;g redctr~dant or contras~€ provisions 4'6~i11 subordinate to and interpreted a l manner tha: k~~ill not conr4i~ »rith the said prima C' c~ ~s'nland Contract. NOW THER~FPE, pursuant to AMC ~.~o.g9 and after cor~sideratian of tfae mutual covenants G(;"~^ed herein the CITY ADD CONTRACTOR >~~REE as follows: 1, All Costs by Contractor: Ct~nt+ractcr shah, provide aid *~*oc~d,, s as spec~i~ed above a+nyd s!~#a~1 at ifs o~~r?n rise and expense, perform any ~vorl~ described above and, unless 4er~~;~Je ~p~4~~ed, ~~+~n~.7i 1 ~i t~~~r, ~"~y~i~+rnd~~'1i ~r~~ ' materials required for the proper per€crmataCe of such ~~rorp. ~ t 2. Quali~€ied dark: Contractor has represented, and by entering into this can~act now represents, thaf a"'~` personnel assigned to the ~orlc regr~ired rander dais cr~ntract are fully qualified to perform the wodc to ~vhicl~ tl'~~ey ~4mli assigned I in a spilled and Worizer-nice manner arid, it required to ~e registered, licensed or landed ~y the Site of ~regor~, are so registered, licensed and handed. Contractor must also maintain a current City business license, 3, Cvm~aletian rate: Contractor shall provide all gads in accordance ~~ittt t~~e standards and specifi~cat%e~n4s, n.o later I than the date indicated above and sfart perc~rming the work under this contract hy.the beginning date ~d rated abova and complete the work by the completion date indicated above. ~ 4. Compensation. City shall pay Contractor for the specified goods arld foC any wgrl~ performed, incl~aaing costs and ~ expenses, the sum specified above. Payments shall be made within 3g days of the date of the °n~°ol.,e, Sht~~~id the contract be prematurely terminated, payrr~er~ts will ~ made fdr ~~vorlc Completed artd acCeptec~ to date cl~ ter urination. Compensation under this contract; ir~ciuding all costs and expenses of Caratractor, is limifed to s~~=g~g. anless a separate ~~r`rtten contract is entered into by the City. i O~+rnership of Documents: All docurrrents prepared by Contractor pursuant to this cc~ratrart shalf lve t,~e p~~opert~{ of City. 6. Statu~Qry Requirements: {SRS 27gB.2~t}, 2~B.22~. 298.23, 219B.23~. ORS Chapter 2 and OAS ~ ~g.o~~ are made part of this contract. 7. Living wage Requirements; if cocafractar is providing services ender ti~is contract and the amawn of t pis con#ract i !ss s2~,283.2~ or mare. Contractor is rewired to comply witty chapter' 3. ~2 of the Ashland Municipal Code by paying a ~ living waae. as defined in this chapter, to all employees performing warlc under dais contract and to any s~~~contractor ~ whc~ caerforms 5~% or mare of the work under th4s contract. Contractor is also required to post t"e ^.~dCre attached { hereto as Exhibit B predarr~inar~tly in areas where it will be seen by all employees. ~ndem~ni~cation; Contractor agrees to defend,, indernn~y and save City, its officers, employees a agents harmless I ~ from any and afl lasses, claims, actions, costs, expenses, judgments, subroaatians, or rather tsar gages resu?tang from . ~ n t t ~ ~ ~raperty ~ f ~nlury to Gny person {including irajur$ resultincg in death}, or damage {including lass or destruLtiar! I ti~vhatsoever 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 tc~ perform wont r~r services attendant tc~ this contact). Contractor s~~11 not lie e~~ r espc~nsi~te ~~r any iasse~, expenses. cl~irns, subr~ga}ions. ~~'~'~r'iS. costs, judgments, or ofher damages, d~rectl~~, Solely, anC ~~'{)~r~latel~ ~~~$~c~ ~~'~,~~1e r~~'~IIC~e~~~ ~r~`~. Tet'r~11n~'li0n: a. Mutual Consent. This contract may be terminated at any tune b'y mutual consent of ~ parties.. b, City's Convenience, This contract may be terrrlinated at any time by City upon 3g days' notce in writing and delivered by cer~ red mail or in person. c. Fc~r Cause. City rna ter;~inat~' or raaadi~ this contract, rn wh{~ie ar in art__~______effective upon dei~ery of - Contact #r~r Goods and ser~.~ic~s Less than S2~,t.~0, Q6~30~'2~~ 6, Pace ~ of 5 written native to Contractor, ar at such later date as may be established by City under any of the fol{awing ~ conditions; i. If City funding from federal; state, county ar ether sources is not obtained and continued at levels sufficient to al#ow for the purchase 4f the indicated quantity of services; ii. if federal ar state regulations ar guidelines are modified, changed, car interpreted ire s4ch a ~a{ay ghat the services are no {anger al{owable or appropriate for purchase under this contract ar are :~o longer eligible for the funding proposed for payments authorised by this contract: tar ' iii, if any {icense or c~rtifiicate rewired b~qr {aw or recgu{atior to be he{d by Contractor to provide the ~ services required this contract is far arsy reasQr~ denied, revoked. suspended, cr not renewed. d. For Default or Breach. ° i. Either City ar Contractor may terminate this contract it the event of a breach of e contract by :he atl7er. Prior to such termination the party welting terrr~rnaban shall give to the other pasty ( ~~rrit#en notice of the breach and intent to terminate. the party ~rn,rnittir~g the breach has not entirely cured the breach within 15 days of the date of the notice, ar within such other period as ;he party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a ~°~rrtten nonce of termination by the party grvrng nonce. ii. Time is of the essence for Contractor's performance of each and event' oblic~atior and duty under this contract. City by tivritten notice to Can`~ractor Qf default ar breach, may at any time terminate the ~rhale ar any part of Phis contract if Contractor fails to provide services ca#led 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 rat exc{usive and are in addition to any other rights and remedies provided by lave ar under this contract. ; e. Oblia~tiortlLiabi#ity flf Parties, Termination or moc~ificatson of thss contract pursuant to subsections a, b, or c above shat{ be ~~~~ithaut prejudice to any obligations or iiabi{hies of either party a{ready accrued pr3c~r to such ~ termination ar madifecatian. F#o~4~ever, upgn receiving a notice of termination {regardless whether such r!otice is given pursuant to subsections a, b, c or d of this section, Contractor shell immediately cease ail activities under i this contract, unless expressly directed othenr~ise by City in the notice of termination. Further. open termination, Contractor she{! deliver to Gity a{{ contract documents, infarmatian, works-i;~-progress ar~d other property that are ~ or ~1~jauld be deliverables had the contract been completed. City she#{ pay Cantractar far w~c~rk performed prior to the termination date if such work gas performed i;? accordance with the Contract, ~ 'i 1 a, Independent Contractor Status: Car~tractar is an independent Contractor and not an employee of the City. ~ Contractor shat(have the complete responsibi{ity far the performance of this contract. ~ 11. Non-discrimination Certification: The undersigned certifies that the undersigned Can actor has not discriminated against minari#~~, wc;~er; ar emerging sma## businesses er;terprises in obtaining a"~`y required subcon~acts. Contractor further certifies that it shell rat discr~rninate in the award of such subcontracts, if any. The Contractor ~t understands and ackr~o~~rledges that it may be disaualifed from bidding an this contract, including but not fimited to City discovery of a misrepresentation or sham regarding a subcontract ar that the Bidder has violated any requirement of ORS 279A. ~ ~ 0 ar the adrninistrat~ve ru{es implementing the Statute. 12. Asbestos Abatement License: if required under ORS 468A.?1C1, Contractor or Subcontractor shah possess an asbestos abatement {~cerse. i tract any po~on of ~~e y~~ork ' 13. Assignment and Subcantracts. Contractor shat{not assign this contract ar subcon ~i:~ithaut the written consent of City. Any attempted assignment ar subcontract vvithaut written consent of wity shall be vaid. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors cst`~d of a{1 persflr~s employed by them. and the approval by City of any assignment vs subcontract sha,'~ r~~ot ~eafe a.~~y cantractua{ relation bettiveen the assignee or subcontractor and City. k 14. Use of Recyclable ?roducts. Contractor shall use recyclable products to the maximum extent ecor~t~rrically feasible in the performance of the contract work set Earth in this document. 1 Default. The Contractor shall be in default of this agreement if Contractor. commits any material breach or default of any covenant, dvarranty, cer~~ificatian, ar obligation it a~~es u/~nrder the C~ro/ynxt~ract; /if it/+~l(~a~[is1y'e~;sMi itsyl+QR(/~,F fK'status pursuawgn~ft`~rt,~o~y tf le K, `F 1 F~le~ ar (a~~4V a9',~k •~+ey *^'V ~ii iYyYtV ~r VYt 619i~i~'Nf P that ~s' rVMM~~e~ ~Y ~Vi I~JI' 1 a ~h4 ~~~+'r"^ ~ir~a~l~~ 41V 4l QRF if Cantractar has qualified as a QRF for this agreement: ir9stitutes an action far relief in bankruptcy ar has -f - ~ ~ ~ r { assi rment for the benefit of creditors; ar ceases doing ~nstrtuted against ar act~ar nor mso{~ency, makes a gene a g . business an a regular basis of the type identified in Eta ab#igatians under the Contract: ar attempts to ass3gr~ rights ir, ( ar delegate dutfes eider, the Contract" t~. lnsuranee. Contractor shall at its ca~~~r~ expense provide the foElawing insc~rar~ce: ? ~w_____ Worker's Comaensation insurance in cornp~iance u~~ih t?RS 656.017, ~~hieh rewires s~t<ect e~p~eyers to provide Oregon v~arkers' campensafion ct~werage for ail i'neir subject ~~~orkers b. GenerGl Liability insurance ~vit"~ a combined single limit, or the equivalent, of not less th~ary Enter one: ~2Qc~,~OQ, SSQI~,C~O, ~1,OQO,OI~G, $2 fltl~,QU® or Not Applicable for each occurrence for Sadily lnyu,n.~ and Property . ~ damage. 1 c. Automabife ~.iability insurance witf' a combined single limit, or the equivalent, of not less thar'~ Enter one' ~50a,~0~, S1,~Qt~,000, or Not A livable for each accident for Bodil ln~urv and Pro e Dan^age, ~ZQl~,0~0, Contract for Gams and Ser~~ices Less than ~ZS,QQQ, Q6130!2010, Page 2 of 5 including coverage for awned, hired ornon-owned vehicles, as applicable. R d. Notice of cancellation or change, There shah be no cancelia#ivn, rnateriai change, reduction of limits or intent not to renew the insurance coverages}without 34 days' written notice from the Contractor or its insurers} to the City. e. .Additional insuredlCertificates of Insurance. Contractor shall Warne The City of Ashland, Oregon, and its elected officials, Officers and employees aS Add#t#onal Insureds on any Insurance pol#CseS, excluding UVorkers' 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 shah furnish acceptable insurance certificates prior to commencing work under this contract, The contractor's insurance is primary and nor-contributory. The certificate will specify ail of the parties who are Additional Insureds. lnsurir~g companies or entities are subject to the City's acceptance. If requested, carnplete copies of insurance policies, trust agreements. etc. shall be provided to the City. The contractor shall be financially responsible for ail per+4inent deductibles, self-insured retentions anchorself-insurance. 17. Governing Law; Jurisdi:ction2 Venue: 'This contract shall be g©verned and construed in accordance }~;~i"th the laws of the State of Oregon without resort to any jurisdiction"s conflict of laws, rules or dact#~nes. Any claim, action, suitor proceeding ~coUectively, "the claim"} between the City {andlor any other or department of the State of Qregvn;~ and the Contractor that arises from or relates to this contract shall be brought and conducted so~e~y and exc~us#vely wlth~n the Circuit Court of .lacksan county far the State of Oregon. If, I~owever, tl~e claim must be bro~ag'r#t in a federal forum, then it shall be brought and conducted solely and exclusively ~afithln the United States Dist#~ict Court fQr the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized. representative, hereby consents to the in personarn jurisdiction of said courts. In na event shall this section be construed as a waiver by city of any form of defense or immunity, based on the Eleventh Amendment to ta~se United States Constitution, or otherwise, from arty claim or from the ~udsdictivn. 1$. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO'~1V'AIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHAL L BIND EITHER PARTY UNLESS IN V~R(TING AND SIGNED BY B+DTH PARTIES, SUCH ~JAIVER. CCJNSENT. MODIFICATION OR CHANGE, IF MADE.. SMALL BE EFFECTIVE ONLY iN THE SPECIFIC INSTANCE AND FQR THE SPECIFIC PURP~?SE GIVEN. Th'ERE ARE NO UNDERSTANDINGS,. AGREEMENTS, OR REPRESENTATIQNS, ORAL OR i!~'RiTTEN, NOT SPECIFIED NEREiN REGARDING THIS CQNTRACT. CONTRAGTCiR, BY SIGNATURE OF ITS AUTHORISED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE~SHE HAS READ THIS CQNTRACT, UNDERSTAftiDS iT. AND AGREES TC`a BE BC7UND BY ITS TERMS AND CONDITIONS. ' 19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and i authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. vontnactor understands and agrees that City's payment of amounts under this contract attributable to ~~~ork perforrneC after the last day of the current fiscal year is contingent on City appropriations, ar other expenditure authorit~r sufficient tv allow ; City in the exercise of its reasonable administraatived~scretion, to continue to make payments under this contract. In the event city has insufficient appropriations, limitations or other expenditure authority, Git~y may terminate this contract without emit or Ilabili to City, effectsve upon the delivery of written nQtiCe tC7 Contractor. ~~titr~l rho further ~ p y liability to Contractor. 2Q. Prior Approval Required Provision. Approval by the City of Ashland Co~sncii or the Public Contrasting 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 inccr~vrated by reference. City of Ashland i Contractor; r' f j~ ~ , B y y Signat~#re Department Head Print Nam Print Name ~~~1 I L Title Date omitted w~h O ~ VU-9 one copy of a U19-9 #s to be su the signed contract, Purchase Order No. .~_I Contract for Goods and Services Less than $25,000, 06~30~201 Page 3 of 5 i ' ' 1 • ~ i ~ 1 ~ 1' !"i M' ~ f i i i f 'i ~ t. 1 4 per hair ef~~~~ve one , ~ ~crea~es ~r~~~r~l ~v~ ~ ~ ~ 6 c~r~s~nn~r Pr~~e tn~~~ ~ ;portion business their ! 40~ K and SRS e~iQi~~e err►p~oyer, it ~e ernp~o~er has cafeteria ~ar~s ~inc~~~~~~ ten or more er~lo~ees, and ~ chiicare j hene~ts has r~ceivet~ ;~nancia~ I amount of ~pfi,~c~es recei~~ b assistance #~r project or ~ ern~o~ee. nor al hours ~rorked under a r business ~rorn the of service contract ~etreen their ~ Ashfan~ in excess o~ 'r ~ ~ a eri"i~ioyer and the City Ashland it the contract ~ ; ( ~ ~{t}el `ff11l~.J `C; 1 P 7~ t if}~ ~ ,`..i p h i i .r _ e~cee~s $20,2~3.2~ or more. their ernolo~ er is the C~~~ of ~ .~r ~r ~ ~ ~ ~ r 1 i ~ Ash4an~ inc4uding tie writs ~ ,i ~ ~ o al hours ~r~or~ec~ n a ~ and recreation ~eart~~ent. ~ ~ ~ , . rnanth i~ the e~ployee s~en~s 5D°°4 or more otthe r In calculat~n the lining ~~age~ ~ r . employee's time in that month . employers ~~ay a~~ the value ~ ~ _ . . ~~vorkinr~ on a project or ~ o~ health ire. retirement3 ~ Ca!I the Ashfanc~ City Administ~ator'~ office at ~~-~~~-0002 or Trite tie City A~mir~isfrator, aii~ 20 East l'~~ain Street Ash!anc~, UR 97520 or visit the oity's ~~e~site at ,ya,~~~4n, ,,;..E,~{, r,, ~ 3.. !`f~i.1~~ L{~ ~S~~~Q"~~~~: 1''t{~J ~~l~~W~ ~v~ ~t~~J±~ ~r~~+v~'r~G~i~ i~C ~ ~~f~~'C~ ?i ~,~t i ~ i~f Gift ~s~u'~v~'`3. Ct~ntract far ~oo~s and Services Less than ~2~,OOO, o6f3o12016, Page 5 of 5 ~~u pll! „ ~n~i ~ ~ ~ ~ 'L ` ~ r x.20 Jenny bane ~ ~.an~uoe~u, INA 98G~2 fY. 36+D-274-~12~ ~ ~ wrww.mo(ecu~ar~nc.c~m ~ 4/28 2417 ~~'S ~~~~e~ City of Ashland Public Works 90 N. Mountain Ave, Ashland, CSR 97520 ~escri tiara o~ ~c~b: C~atir~ in base ~f 48" d~~~e~e~ ~nanht~~~ ~wev~e. a~ .acati~n: As~~an, ~R SCOPE C3F 1~'~C~RK: Mobilization and subsistence to Ashland, ~3regor~ • Remove damaged dating, prepare substrate sur~aee fc~r re-coating in manhole and coat with Raven ~~5 epoxy. ~si~a~e~ ~ro~ec~ ~~st. $4~5~.~ CI`rent to ~rc~vide: ~e~al access to site • Traffic Control, if required. • Pumping and 6~{bass pumpgr~g, ;f required. ~le~S2 CfC~te thaf thQ abt3~°'e ~?S;mate L~GeS nt~t ~ncluwe sales tax rna;f~rsaDS, Or p?r~r~t5. G~Ve propose t~ furnish all rrtaterials and labor to perform work upon designated areas. Mc~lecularp lr~c. ~~~iii noti~ th,e cust~~ner of any problems or change of conditions. Disposal of ~#~aste will be in accordance ~+~~ith ail state reauiations, and any as~d;,tic~nal 4~vork found during the course of c;eaning and inspection, ~~ill be fcar~a~art~ed upQ~n ant~ther pr~a,u~sai. Other services we can provide: • Manhole Rehabilitation- l~tlonolithic epoxy • Small diameter pipe luting ;2" tc~ ~2 CIPF Coating, ,grouting and leak stopping. Channel liners and spot repairs bench repair.. udder step replacment. tnc~ustrial Epoxy Coating • Industrial Abrasive sand blasting For questions or additional information, please call me at ~3~~~27A-~~.25 Sincerely, Chris Siegrisi Molecular, lnc Office 36~-27~-~~25 molecularinc~.msn.com ;~StG"n~r a~ rees t0 ~aV a'} tie COSTS and f~'`~S C"32r~~~ fir S~? ~{C"S re~r;d~re~+ as S'tat°tS C~,'t tf~t5 prCSal. €£'~'*#15 car' ~~3 r#~~.ti«'vrg a~~JSO°B~;Y at cred+t, 3.5r~ vn ,unpaid balance rnonihl~j. 1f collect;o:, seruices are required, scle3y ~n the p,~ini~n of 1~"~'ecuiar, 3r~c., co~e~~ tie ~et'it, agree tc pad reasonable costs for coifection including a~orney fees and costs and any collection agenc+~ fees. !f le~~*al a~don is required the r~~~s ~~see tfaat the ven~,~e of the action Evil1 be Co~rlitz amour;:k, supe~'or Cc~ur~, State cf ~~`ash}ngton. !t is f;,¢rther a;reed that an~~° accounts ^~st d ~ ',~~sfi a~~res;ev at iat? tees of ? .S°!~ per month, cumulative. Customer ~igrtature ~ pr;rat Name _ ~~te_~ ~~olec;~far,lnc. Sagnatur~ Print Marne date ' Pric;n~ is ~cwd fc~r 9~ days fro;a~ date q€ pro~osa~ Y I N S U RAN C E DATE (MMlDDIYYYY) CERTIFICATE OF LIABILIT 05!0112017 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 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT JUIIe CarmlCle Premier NW Insurance PHONE 503 655 6344 arc, Nod; 503.655.2035 421 High St #200 jAlCs No.,_ExtL _ Oregon City, OR 97045 E-MAi~ carmlcle remiernw.net ADDRESS:) _~p W. Mike Moll PRODUCER _ _ CUSTOMER ID MOLEC-1 _ - INSURER(S) AFFORDING COVERAGE NAIC # _ _ - INSURED Molecular, Inc. INSURER A : Ohio Security Insurance CO 24082 247 Schutt Road - - _ _ _ - tle Rock WA 98611 INSURER B :Ohio Casualty Insurance Co 24074 Cas INSURER C _ _ . _ _ _ - INSURER D - 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 HAUE BEEN REDUCED BY PAID CLAIMS. _ _ _ - _ _ ADDL SUER ~ - ' P011CY FFF POLICY ExP INSR TYPE OF INSURANCE POLICY NUMBER MMlDDIYYYY MMlDDIYYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE 5 1,000,00 _ DAMAGE'~0 ~2ENTI=~ A X ,COMMERCIAL GENERAL LIABILITY X BK$ 55674154 1011012016 1011012017 PREMISES (Ea occurrence) a 1,000,000 CLAIMS-MADE X 'OCCUR MED EXP IAny cne person) ~ 15,000 - _ . - _ PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE S 2,000,00 _ _ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPiOP AGG 3 2+000,000 POLICY X PRO- LOC S AUTOMOBILE LIA84lITY CJ49,8144E~ SS~'vtE'u49i4Ti ~ 1,000,00 BAS 55674154 10110!2016 1011012017 (Ea acc~denU A X ANY AUTO BODILY INJURY (Per person) ~ _ _ ALL OWNED AUTOS BODILY INJURY {Per accident) S SCHEDULED AUTOS _ _ _ . - PROPERTY DAMAGE ~ HIRED AUTOS (PER ACCIDENT) NON-OWNED AUTOS _ - _ ~ X .UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 _ EXCESS LlAB CLAIMS-MADE AGGREGATE ~ 2,Oa0,00 g ~ _ _ _ _ . _ _ _ USO 55674154 1011012016 1011012017 - - - " 'DEDUCTIBLE ~ - _ RETENTION $ ~ WORKERS COMPENSATION VUC STATU- X OTH~ AND EMPLOYERS' LIABILITY TORY LIMITS ER - - A .ANY PRUPRIETORIPARTNER/EXECUTIVE Y l N N ! A BKS 55674154 1011012016 1011012017 E L EACH ACCIDENT ~ 1.000,00 OFFlCERlMEMBER EXCLUDED? ~ WA STOP GAP COVERAGE E.L. DISEASE - EA EMPLOYEE. S 1x000,000 (Mandatory in NH) _ _ - Ityes, describe under 1.000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT a DESCRIPTION OF OPERATIONS t LOCATIONS 1 VEN{GEES (Attach ACORD 101, Additional Remarks Schedule if more space is required) The City of Ashland Oregon and its elected afficialsr officers and emplo ees are additional insured with respects their interest in the operations of the named insured. Coverage is primary and non-contributory per the CG8810 04/13. All operations of the named insured subject to policy conditions, limitations and exclusions. CERTIFICATE HOLDER CANCELLATION CITY002 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED {N ACCORDANCE WtTN THE POLICY PRO'VtSt0~1S. City of Ashland fax 541.488.5311 20 E Main AUTHORIZED REPRESENTATIV,Epp~ Ashland, OR 97520 . ~~1trr16Gc.(r 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Purchase Order v Fiscal Year 2017 Page: 1 of: 1 B City of Ashland - - _ _J L ATTN: Accounts Payable Purchase L 20 E. Main 724 Ashland, OR 97520 Order # T Phone: 5411552-2010 - 0 Email: payable@ashland.or.us V H CIO FleetlShop Division E MOLECULAR, INC 190 North Mountain Ave D 247 SCHUTT RD P Ashland, OR 97520 O CASTLE ROCK, WA 98611 Phone: 5411488-5358 R ~ Fax:5411552-2304 ~lendoePJ~-ro~_ ~am~~_ ~tsi~~~ = - . - : - ~ = - - : - Wes Hoadle _ Dat~Qr~s_C __~~a~s~ff'~b~~ -~a_~--- - emu--- Vii= - = - = " ¢~~r 05110/2017 3333 Cit Accounts Pa able _ - tern#~ Del _tt - - - - - - = = _ - _ ~ Wash Rack Manhole Repair 1 Remove damaged coating, prepare,for recoating and recoat with 1 $4,050.0000 $4,050.00 Raven 405 epoxy per attached Exhibit C. Contract for Goods and Services less than $25,000 Beginning date: 05101/2017 Completion date: 06/3012017 Project Account: GL SUMMARY 082400 - 602400 $4,050.00 r`~ _ ~ ~ .~`A ~ Date: ! ~ Authorized ignature ~ _ _ = = $4 050.00 ~ r FQ!RI~I #3 . ~ ~ e ~g CITY OF ~,SH LAN 9 ~e F 4 e¢1 ~ 4 ' ' REQU'S'~I®N t .f' ~ ~ ,y Date of request. 51512017 Required date for delivery; 613012017 Vendor Name Mr1Lar~ilar Inr Address, City, State, Zip 12n ,lennv I one I nnnview WA 9~~3~ Contact Name ~ Telephone Number Fax Number Chris Si clri~t X60-274-4125 SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergenc~r ❑ 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 note or ro osal attached _ Attach co of council communication _ If council a royal re aired, 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 IntergovernmentalRgreement $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 proposalslwritten 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 Remove lama ed coatin ,Prepare for recoatin and recoat as per exhibit C $4050.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quoteiproposal $ Project Number______•_--_ AccountNumber0~2400 •602400 Account Number - Account Number - - *Expendifure musf be charged fo the appropriate account numbers for fhe financials fo accurately reflect the actual expenditures. °1' Direr for In collaboration ~Ifh department tQ approve ail hard~are and scft~are purchases: IT Director ~ Date Support -Yes / X110 ,4_ By signing Phis requisition form, I certify that fhe City's public contracting requiremenfs have been safisfred. Employee ~ ~ Department Head: ~ , ~ _ - ~ ~ ~ ~ (Equal to or~grea er than $5,000) Department ManagerlSuperv~~cr~~~~-~~~~~ City Administrator. (Equal to or greater than $25,000) Funds appropriated far Current fiscal dear: YFS / NQ Finance Dil"ecfar- (Equaf fo or greater than .~5, ooo) Dafe Comments: Form #3 -Requisition