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HomeMy WebLinkAbout2017-143 Contract - Bertocchi Builders Contract for GOODS AND SERVICES less than $25,000 CITY O F CONTRACTOR: Bertocchi Builders Inc. ASHLAND h; CONTACT. Mark Bertocc 20 East Main Street Ashland, Oregon 97520 ADDRESS: 1860 Gabriel Way, Medford, OR 97501 Telephone: 5411488-6002 Fax: 5411488-5311 TELEPHONE: 541.944.7137 DATE AGREEMENT PREPARED; FAX: BEGINNING DATE: Ma 1, 2017 COMPLETION DATE: Jul 31, 2017 COMPENSATION: $8, 745.00 GOODS AND SERVICES TO BE PROVIDED: IT De artment remodel o tion 1 and o tion 2 er 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 rima 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, 2796.230, 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, 0613012016, 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. 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, 2 000 000 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, includin covers a for owned, hired or non-owned vehicles, as a licable. Contract for Goods and Services Less than $25,000, 0613012016, 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 coverages) 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 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 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. Contrac _ City of Ashland ,r ' f;, a~ By By ~ ature Department Head t ~ t. , Print Name Print Name W..- ~ Title Date W-9 One copy of a W-9 is to be submitted with 6 the signed contract. Purchase Order No. Contract for Goods and Services Less than $25,000, 06130/2016, Page 3 of 5 EXHIBIT A CERTIFICATIONSIREPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached vv-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. Contractor (Date) Contract for Goods antl Services Less than $25,000, 0613012016, Page 4 of 5 ~ ~ ~ ~ ~ ~ EXHIBIT B ~ o s an . . per hour effective June 30, 2016 (Increases annually every June 30 by the ~r Consumer Price Index - , - ~ , ~ portion of business of their 401K and IRS eligible employer, ifthe employer has cafeteria plans (including ten ormore employees, and childcare) benefits to the has received financial amount of wages received by assistance for the projector the employee. ➢ For all hours worked undera 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 orpart-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 SHLAND Contract for Goods and Services Less than $25,000, 0613012016, Page 5 of 5 CERTIFICATION OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REQUIREMENTS Contractor is exempt from the requirement to obtain workers compensation insurance under ORS Chapter X56 for the following reason. Contractor is to initial the appropriate box as follows: ,~'~'7 , , f 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 ([nitia(sj ■ 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 (Initials) ■ 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.** ~ , ;i;~~°<< LIMITED L IABILITY 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 indirect connection with the ,:e;anstx~ac~on, alteration, repair, improvement, moving or demolition of an improvement to real property or it r f K ~ ~ ! ~ ~ ~ ~ J fey' ~ r ~ ~ ~ ~ ---.i t , - ' e (S,i~gnature of Authorized Signer) (Date) fv ~_f ~ Y ~ (Signer'sTrtle *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. **I\10TE: 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. V~1 ~~an 1 ~ 2- c, uildErs Inc® Proposal Dated 3-14-201? n. t f .T f ~ i, 1 fs 4 1~: 1 ' j Mark Bertocchi - ozUf~e►~ ' . e CCB #181329 . . - ~ ~ Licensed & Bonded To: City of Ashland cc UVes Hoadley, Dave Arnold 90 N. Mountain Ave Ashland Or 97520 Proposal regarding: I T Department remodel options Option one: remove three existing doors 1. Provide and install dust protection 2. Demo two doors in hall and remove one window 3. Frame in for new openings 4. Right side to be 5 feet 5. deft side to be 6 feet 6. Repair drywall prep for paint 7. lnstall New trim frames with MDF 8. To last door around corner, remove frame in drywall, prep for paint 9. Painting of this areas to include three entire wall areas 10. Clean up remove debris from site Total cast $3,495.00 Option two: Install new office as per drawing 1. Provide and install dust protection 2. Frame in new office walls and door way 2x4 metal studs 3. Insta(I new walls to the height of existing T-bar cell grid 4. Fasten new walls to upper second floor 5. Client to install electrical needs 6. lnstall sound insulation bats to studs and ceiling 7. install 5/8"drywall, tape mud, prep for paint 8. Provide and install 3' new wood full light fluted glass door 9. Paint new walls and door jamb 10. Install cove base board 11. Provide new key lever door hardware 12. Clean up remove debris from site Total Cost $5250.00 Option three: Hall security doors 1. Remove main security door entering I T area 2. Install new door slab w/window 3. Malce adjustments to door jamb for client provided lock 4. To door in back hall, make adjustments in jamb for client provided lock Total cost $925.00 Note Client is responsible for moving furniture, any and all Electrical, any and all HVAC Frorn:Ferrante Insurance Services 1+925+674+1663 05/31/2017 07:13 #523 P.001/001 ~ DATE (MM10D(Y`(Y1~ ~4C~C?R~' CERTIFICATE pF LIABILITY INSURANCE o~13111~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITVTE A CONTRACT BETWEEN THE ISSUING INSURER{S}, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy{fes~ must have ADDITIONAL INSURED provisions or be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer ri hts to the certificate holder in lieu of such endorsements . PRODUCER CONTACT Ferrante Insurance Services, Inc. PNONE .925-674-1755 arc Nn: 925-614-1663 1401 Willow Pass Road Ste 105 E-MAIL cs ferranteinsurance.cam Concord, CA 9452 INSURERS AFFORDING COVERAGE NAIC ~ OD91034 INSURERA: Securi NatianallnsuranceCo 19879 INSURED INSURER B BBnOCChI BUlld$rS Inc. INSURERC; INSURER D ; 1860 Gabriel tNay INSURER E ; Medford OR 91501 F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOU`! 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 TH15 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS 5UBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOU7N MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL 5UBR POLICY EFF POLICY EXP INSR TYPE OF INSURANCE POLICY NUMBER MM D M LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 OOO OOO DAMAGE TO RENTED 100 X00 CLAIhiS•MADE ~ OCCUR PREMISES Ea ocairrence $ I MED EXP (An one person) $ 5 X00 q NA115205201 103/23/17 03123118 PERSONAL a ADV IN~uRY $ 1 000 000 GEN'L AGGREGATE LIh11T APPLIES PER: ~ GENERAL AGGREGATE $ 2 OOO OOO PRO• ~ PRODUCTS - COMPIOP AGG $ 2 OOO 000 X POLICY ~ JECT ~ LUC $ OTHERS AUTOINOBIIE LIABILITY I COMBINED SINGLE LIMIT $ i ANYAUTU BODIL`(INJUR'f {Per person) $ O~YNED SCHEDULED BODILY INJURY (Per acci~enQ $ AUTOS ONLY AUTOS I HIRED NON-U'NNED ~ PROPERTY DAIJIAGE $ AUTOS ONLY AUTOS ONLY Peraccidenl UMBRELLA LIAR p~CUR EACH OCCURRENCE $ EXCESS LIAB CLAI~IS•MADE AGGREGATE $ DED RETENTION $ I ~ $ WORKERS COMPENSATION STATUTE ERH AND EMPLOYERS' LIABILITY Y f N ~ E.l. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTfVE ❑ N JA OFFICERir+1EM8ER EXCLUDED (Mandatory in NH} ~i E.L. DISEASE • EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS belov~ E.L. DISEASE- POLICY LIMIT $ I i DESCRIPTION OF OPERATIONS 1 LOCATIONS 1VEHICLES (ACORD 1 D1, Additional Remarks Schedule, may be attached if more space is required) Certificate to provide proof of insurance. CERTIFICATE HOLDER CANCELLATION Proof of Insurance SHOULD ANY 4F THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988.2415 ACORD CORPORATION. All rights reserved. ACORD 25 {2016143) The ACORD name and logo are registered marks of ACORD Jun 01 17,10:26a Jon Snowden -State Farm 5414824957 p.2 ,~~'1 ~ o VEHICLE 4R EQUIPMENT CERTIFICATE QF INSURANCE DATEIMhIIDD~YYYY1 0610112017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORtIRATION ONLY AKD CONFERS NO RIGHTS UPON THE CERTIFICD►TE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT l3ETWEEN THE ISSUING iNSURER~S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. This form is used to report coverages pravlded tD a single specific vehicle or equipment, Da not use this form to repot liability coverage provided to multiple vehicles under a single policy, Use ACORD z5 for that purpose. PRfl011CER NTA T Jon Snowden NAME: Jan Snowden FAX A+CNNo EYt; (541} 482.2461 Arc No : (541) 482-4957 420 Bridge Street E.MA>I. ~ AooRESS~ Jon@jonsnowden.com Ashland, OR 9752b PRODUCER CUSTOMER 10 IN SURER(SI AFFORDING COVERAGE NAIC p ~suRED INSUReRa ~ State Farrn hluiual Automobile Insu!ance CD^~pany 25178 8ertocchi, Mark INSURE=R B ; DBA Bt?r1000hi Builders INSURER C ; 1860 Gabriel "Nay' INSURER D Medford, OR 97501 INSUaEAE: DESCRIPTION OF VEHICLE bR EQUIPMENT YEAR MAKE►NANUFACTURER MODEL BDDYTYPE UENICLEIDENTIFICATIDNNU'MBER 2005 Chevy K2500 pickup 1GCHK23235F847007 DESCRIPTIO•V VENICLElEQUIPN ENT VALUE SERIAL N UId6 ER COVERAGES CERTIFICATE NUMBER; Rf~VISION NUMBER: THIS (S TO CERTIFY THAT THE PpLICY(IESy OF INSURANCE L1STEd BELOW HAS~HAVE Bi:EN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODS} INDICATED, NOTW'ITHSTAN0ING F+NY REQUIREMENT, PERM OR CONDITION OFANY CbNTRACTOR OTHER DOCUh1ENT U~1TH RESPECT TO bVH1CH PHIS CERTIFICATE MAY BE ISSUED OR htAY PERTAIN, THE INSURANCE AFFORDED BY THE POL~CY(IES) DESCRIBED HEREIN IS,ARE 5UBdECTTO ALL THE TERti9S. EXCLUSIONS ANp CONDITIONS OF SUCH POLICY{IFS). INSR ~oo•L POLICY EFFECTIVE POLICY EXPIRATION LTR I~SRD TYPE OFINSURANCE POLICY NUMBER DATE (IAMIDDlYYYY) DATE {MM+DD+YYYY) LIMITS X VEHICLE LIABILIN ~ COIABI yED SINGLE Llt,~iT ; Y 002 6612-F22-37N 1212212016 06f2212017 BODILY INJURY (Pecpersoll 5 100000 BOD:LY INJURY (PeracciderK} S 300000 PRO~E~TY DAMAGE ~ 59000 GENERAL LIA8IUTY EAGH OCCUREIdCE S OCCLIRREA'CE GENERALAGGREGATE S CIAIIAS MADE f INSR uoss POLICY EFFECTIVE POLICY FJIPlRATIbN LTR PAYEE' TYPE OF INSURANCE PDLIGY NUMBER .GATE (MMIDQ+YYYY1 GATE lN1M(DDIYYYYI LIMI'I'S1 DEDUCTIBLE X VEl- COLLISION LOSS ❑ ACv ❑ .AGREED AMT S LIMIT Y 002 6612-F22-37N ~ 12122.+201fi 0612212017 ❑ ❑ 5TATEDAMT S 10x0 bED VEN COMP VEH OTC ❑ ACV ❑ AGFEEOAMT ~ LIMIT 002 6612-F22-37N 121222016 0612212017 ❑ ❑ ~TATEO AM" 5 2~(j DED EQUIPMENT ❑ ACl' ❑ ,~.GREEOAAIT BASIC BRpAp I S LIMIT RC ~J STATED,4MT ❑ S OE D SPECIAL i I RE't'IARKS (INCLUDING SPECIAL CONDIT10N510TNER COVERAGESI {Attach ACORD 101, Addillonel Remarks SCf,edule, I(more apace Is requ(redl AaDITIONAL INTEREST CANCELLATION Select one of the following; SHOULD ANY OF THE ABOVE pE5CRIgED PQLICIES BE GANCEt.IED The additional interest cescnbed below rtals been ad4ea to the policylies) fisted neren by ~ottiy number{s). 9t:FORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE A request has been SubmiNed to aAd the additional interest dtscnbed below to the col cy(ies) DELIVERED IN ACCQRDANCE WITH THE POLICY PROVISIONS. listed herein c numder s , VEHICLE! EQUIPNE1uTINTERE5T; LEASED FINANCED DESCa~T10N OF THE ADDITIONAL INTEREST NAME AND ADDRESS OF ADDITIONAL [NTEREST X ADDITIONAL INSURED ~ LOSS PAYEE City of Ashland I LENDER'S LOSS PAYEQ 20 E. Main Street LOAN! LEASE NUMBER Ashland, OR 97526 AUTHORIZED R E T VE r Q 1997-~41 AC CQRP4RATI0 ,All rights reserved. ACORD 23 (2016103) Tho ACORD name and logo are registered marks of ACORp OOd~1 142987.3 01-26•~01E Jun 01 17,10;26a Jon Snowden -State Farm 5414824957 p.3 . ~ /~4VR► ® DATE IMANDDIYYYY) VEHICLE CSR E+QUIPMEIVT CERTIFICATE l~F INSURANCE a+;ro~rza~7 THIS CLcRTIFiCATE IS ISSUED AS A MATTER OF INFORMAT7©N ONLY AHD CONFERS NO R(CHTS UPON TH£ CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NQT CONSTITUTE A CONTRACT BETWIrEN THE ISSUING INSURER`S), AUTHQRIZEt] R!~PRESENTA7IVE OR PRODUCER, AND THE CERTIFICATE HOLDER. Thfs form is used tQ Iepart coverages provided to a single specific vehicle or equipment. Do not erse this form to report liability coverage provided to multiple vehicles undera single policy, Ilse ACflRD 25 farthat purpese. PRoaucER N~EA Jon Snowden Sta~eFa~ Jon Snowden ~a c ~ Ext ~ t54t) 482,2469 ivc No : f 541 f 4$2.4857 ~ ~ 420 Bridge Street a~oo~ss: Jpn~jonsnc~wden.carn Ashland, tbR 97520 PR°DUCEa cusTO~R It) IN5URER(5) AFFORDING COVERAGE NA(C t INSURED lNSURERA; Slate Farm Mutual Automobile Insurance Company 25978 Berlocchi, Mark rfSURER a : DBA Bertacchi BL'ilders INSURER C : 18fia Gabrie(wday ~sURER D Medford, QR 97501 INSURER E ; DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKE f MANUFACTURER MODEL B{}DY TYPE VEHICLE IDENTIFICATION NiJMHER 2095 Chevy K2500 Pickup 1GCE•lK23235F847007 DESCRIPTION YEHICI.FJEQUIPMEN7 YALUE SERIAL NUMBER COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS f5 TO CERTIFY THAT THE POLICY4fES) C~F INSURkhlCE LISTED BELOW HA5JHAVE t3EEN ISSUED TO THE IN5URED NAMED ABOVE FOR THE= POLJ CY PERIQ[~;S) INDICATED, NOTVVITHSTANDINGAHY REQUIREMENT, TERtit OR CONDtTI(}N OF ANY CONTRACT QR {3ThER DOCUMENT VNTH RESPECT TO WHICH THIS CERTIFICATE NWY 6E ISSUED Oft IaAAY PERTAIN, THE INSURANCE AFFORDED i3Y THE PdLiCY(IES) DESCRI@ED HEREIN jSfARE S#1g,1FCT TO ALL THETERNI5, EXCl4JSIpNSANO GONDITICtNS OF SUCH POLIGY(IES}. lNSR ~bo't POI.ICYEFFECTNE Ppt,ICYEXPIRATION LTR INSRDI TYPE OF INSURANCE POLICY N1IMBER ' DATE IN11H10QlYYYY) LATE {MM1lDDtYYYYI LIMIT5 UEHIClE LIABILITY ~ COM3lNED 51NGLE LIMIT b BODILY INJURY ,Per perspnl S ~ (J()~ Y Oat 6612-F22-37N 06!22'2017 1212212p17 300111' INJURY ;Pty accidenq s s~aaa j PROPERTY DAt,JAGE S 50aa0 GENERAL. LiA91L1TY i EACH CCCU.REtiCE. S OCCIJRRE1,FEi: ~ CFNERALA.GGREGATE 5 CLAIMS MADE S INSR joss POLICY EFFEGnVf POLICY EXPIRATION LTR AYES TYPE OF INSURANCE POLICY NUMBER DATE (MMVDDrYYYYt bAT@ {NNVlIt~DIYYYY) Lt!'~TS 1 DEDUCTrBLE V'EHCQ~'25ONLOSS ❑ ACV ❑ kuREEDAhAT S LIGOT Y oat 6612-F22-3r1v a612212a17 9212212x17 ❑ ❑ 5TAT~DAMi S ~QQa QED `✓EH COMP VEH OTC ❑ xCV ❑ AGREEQ AfvIT ~ LIIJIT OQ2 6612-F22-37N 06/22!2017 I i 212212017 ❑ STA"EQAh11' S 25Q DED EpUIPktENT ❑ ACV ❑ P.GREEO AMT { S LIhIIT BASIC BROAD ❑ RC ❑ STATED,~,MT ❑ ~ DED SPECIAL I----~ RENlARHS (INCLUDING SPECIAL COPtD1T1CNS 1 OTHERCCNERAGES) {Attach ACgR0107, Additional Remarks ScTheAule, if mote space Is iequlred) AODIT#ONAL INTEREST CANCElLATIOfY Select one oithe following: SHOULD ANY Qf 'CHE ABCtVE pESGR113E©POLICIES BE CANCELLED T.headdilio.'~al Interest described below nag been added to ~e policy?ieaJ Ils~ed herein by policy numbC"{sa. BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL E3E A request hes teen suDmilled to add rie addil ono' irttaresl desc,iaed belox to the poJic7(,esJ DELIVEREzD IN ACC{}RpANCE 1NITH THE POLICY PR©YISIC?NS. isied h3•Bin b ~akc number S . VENICE€1 EQUIPMENT INTEREST: LEASED FINANCED DESCR~TION OF THE ADDITIONAL INTEREST NAI~EAND AppRE55 OF ADDITrONAL ElTEREST ~ ADDITIONAL INSURED LOSS PAYEE Gilt' of Ashland LENDEtrs Loss PAYf~ 20 E. Main Street ' LoA~, ~ ~eASE R Ashland, OR 97520 AtITH 12E P ESENTATIVE ,/t✓" ~ 199 -2 ORD CQ ORATION. All rights reserved. ACORO 23 (2416103) The ACQRD name and f4go are registered marks of AC4RD t~a3st ~a23e7s ay•zs-zel~ i I i f i City of Ashland 5415522436 Jun-1-2017 10:07AM Job Date Time Type Identification Duration Pages Result 1654 6/ 1/2017 10:05:21AM Receive 5414824957 1:42 3 OK Jun 01 17,10:26a Jon Snowden • State Farm 5414824957 p.1 StateFarm Jon Snowden Agency 420 Bridge Street • Ashtaad, OR. 97520 • • Phone: 541.482.2461 Fax: 541.482-4957 lot~f'onsnowden.com FAX DATE: 611!17 TO Name; Mary Company: City of Ashland CC: Phone; Fax: 541.522-2436 Total tl of Pages: 3 FROM Jon Snowden, Agent Ryan Schorovsky ,Insurance Account Rep. Karen Hinckle, Insurance Account Rep. (XJ Tracey Howard, Customer Service Rep. Message: Hi Mary, Mark Bertocchf called todsy and requested we laz you his Cert~cate of Insurance on his truck. I am faxing to as the renewal date is the 22^+ of this month. if you need anything further, please do not hesitate to eoataet us. Thank you. Tracey 54148249 57 p • 1 Jun 01 17,10.26a Jon Snowden -State Farm Jan Snowden Agency 420 Bridge Street Ashland, 0R. 9?520 Phone: 541-4$2.2481 Eau: 541.482-495? ~on~jonsnowden.com DATE: fi11l1? TQ Name: Mary Company: City of Ashland CC; Phone: Fax: 541-522.2436 Total # of Pages: 3 FROM [ ] Jan Snowden, Agent [ ] Ryan Scharovsky ,Insurance Account Rep. [ ] Karen Hinckle, Insurance Account Rep, [ X] Tracey Howard, Customer Service Rep, Message: Hi MaryT Mark Bertacchi called today and requested we tax you his Certificate of Insurance on his truck. I am faxing to as the renewal date is the 22~ of this month. !f you need anything further, please do not hesita#e to Contact us. Thank you. Tracey . ;s Purchase r ~ der v~ Fiscai Year 2017 Page: 1 of: 1 ~7~(~Pl~l1~~E~11@T~#P_P-_E.AR aN ALL-== B City of Ashland =J ~~~~L~1N_~~(1~~11NENTS ATTN: Accounts Payable L 20 E. Main Purchase 1 L Ashland OR 97520 Order# T Phone: 5411552-2010 0 Email: payable@ashland.or.us ~ H CIO Information Technology Dep N BERTOCCHI BUILDERS INC 190 North Mountain Ave 1860 GABRIEL WAY p Ashland, OR 97520 ~ MEDFORD, OR 97501 Phone: 541/552-2400 R T Fax:5411552-2435 0 Vendor Phone Number = V~n~Q~~~[~e~=~~~1~ -ZT~~~~~- ,-~~e~a_s~ = 541 770-3671 Ma McCla Qafe ~r.~ered:= V~ndQr Numb~r~ ~a~l~~ - ~g~ 0610612017 797 FOB ASHLAND ORINET30 Cit Accounts Pa able Items = ~ ~Q~s~r~ ~r L~~li---- - = = _I~ ~l~t~~_~ ~~t~_ ntl_ E~_ Prig IT Department Remodel 1 Information Technology Department Remodel 1 $8,745.0000 $8,745.00 Per attached bid (option 1 and option 2} Contract for Goods and Services Less than $25,000 Beginning date: May 1, 2017 Completion date:. July 31, 2017 Project Account: E-000481-999 **~*****~*****x GL SUMMARY ~ 020500 - 704100 $8,745 00 ~ ~ ~ By: _ ~ - Date: n~ - Authorized Signature T~~ $8 745.00 ' j ~ a r~~ ~ ~r a, . 3 I ~A ad SH LAN ~q{ REQUISITION ` ~ ~ ~ osi31n7 ~,,,r` ~ 5 Date of request: Required date for delivery: Vendor Name BERTOCCHI BUILDERS INC. Address, City, State, Zip 1860 GABRIEL WAY, MEDFORD, OR 97501 Contact Name & Telephone Number MARK BERTOCCHI, 541944,7137 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 ❑ Written note 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 Date approved by Council; ® Direct Award -(Attach copy of council communication) Contract # ® VerballWritten quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract $5,000 to $100,000 ❑ Written quote or proposal attached Agency ❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5,000 to $75,000 ❑ Form #9, Request for Approval ❑ Agency ❑ Less than $35,000, b direct a ointment Date original. contract approved by Council; Y pp ❑ Written quote or proposal attached ❑ (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 INFORMATION TECHNOLOGY DEPARTMENT REMODEL WITH OPTION 1, AND $,745.00 OPTION 2 PER EXHIBIT C Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quotelproposal $8,145.00 Project Number 000481.999 Account Number 020500.704100 ~Expendifure must be charged fo the appropriate account numbers for the financials fo accurately reflect the acfual expenditures. i~ Director in collaboration with department to approve aii hardware and software purchases° i~ Director Date Support -Yes /No By signing fhis requisition form, I certify fhaf the City's public confracfing requirements have been satisfied, 9 ~ ~ ~ 4 Employee: ~ ~ ~ ~a ~ ~ Department Head; ~ ~ ~ (Equal to or greater than $5,000) Department ManagerlSuper~isor: ~ City Administrator: (Equal to or greater than $25,000) ~ . Funds appropriated for current ~iscai year: :YES ,0 ~ ~ , , ~~`~e Eir~ance Director=~=(F~ua~ to or greater ~~~an oooi Dafe Comments: Form #3 -Requisition