Loading...
HomeMy WebLinkAbout2017-158 Contract - Copeland Construction ~ontracf for GOODS AND SERVICES less than $25,000 G i T Y O F CONTRACTOR: Copeland Construction, LLC ~SHLA~D C0IVTACT: Taunya Copeland 20 East Main Street Ashland, Oregon 97520 ADDRESS: 321 Pruett Rd Eagle Point, OR~ 97524 Telephone: 541-1488-6002 Fax: 5411488-5311 TELEPHONE: 541-826-2314 DATE AGREEMENT PREPARED: June 28, 2a17 FAX: 541-826-1014 BEGINNING DATE: Jul 1, 2017 COMPLETION DATE: July 31, 2417 COMPENSATION: Lump sum, $5000.00 GOODS AND SERVICES TO BE PROVIDED: Pressure test of 24 inch waterline per attached proposal (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 Ci 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: Contractar 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 Oregan, 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 Gity. 5. ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 2798.220, 2798.225, 2798.230; 2799.235, 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 $20,688.86 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 ExhibiiB predominantly in areas weer-e-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 ou# ofror incident to theperformance of thts~contract by Contractor ~includin~g but not limited to, Contractor's employees, agents, and others designated~by Contractor to perform work or services-attendant to this contract). Contractor shall not be held responsible fir any fosses, expenses, claims, subrogations, actions, costs, judgments, or other dafnages, directly, saleiy, and proximately caused by_ the negligence of City. 9. Termination: a. Mutua! 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. Cit ma terminate or modi this contract, in whole or in art, effective u on delive of Contract for Goods and Services Less than $25,00(}, 0611912017, Page 1 of 5 written notice to Contractor, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow far 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 far 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 isfor- 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 part}r seeking termination shalM 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 ar 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. Obli_ ationlLiability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shaft 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 ar 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 shat! 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~greement if Contractor: commits any material breach or default of any covenant, warranty,_certification, or obligation it awes under tt7e Contract; if it loses its QRF status .pursuant to -the QRF Rules or loses any fcense-; certificate or certification that is required to perform the work onto qualify as a QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy ar has instituted against ~it afl 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. fnsu_ ranee. Cont-ractor shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with 0RS 656.017, which requires-subject employers to provide Oregon workers' compensation coverage for all their subject wor--keys b. general Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 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 $1,000,000 for each accident for Bodily injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as a licable. Contract for Goods and Services Less than $25,000, 0611 9120 1 7, Page 2 of 5 d. Notice of cancellation or change. Then 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 andlor self-insurance. 17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suitor proceeding (collectively, "the claim"} between the City (andlor 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 far the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in persanam 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 By By Signature Department Head Print fiiame Print Name Title Date 1 W-9 One copy of a W-9 rs to be submitted with ~ ~ ~ ~ ~ ~ r~D fihe signed contract. Purchase Order Na Contract far Goods and Services Less than $25,000, Ofi119/2017, Page 3 of 5 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 for the business. ~ (3} Telephone listing is used for the business separate from the personal residence listing. 4 Labor or services are erformed onl ursuant to written contracts. p YP (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. G~ ~ u ~ ~ i, ~g l ~ Contractor (ate} Contract for Goods and Services Less than $25,000, 06r~ 9iza~ 7, Page 4 of 5 i ► ► 1 • 1 EXHIBIT B ~ ~ s an 1 ~ f ~ • • I ~ 1 • ~ I , ~ ~ per hour effective June 30, 2017 _ (Lncreases annually every June 30 by the Consumer Price Index - ~ - ~ . ~ portion of business of their 401 K and IRS eligible employer, if the 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 under a business from the City of service contract between their Ashland in excess of ➢ Note: "Employee" does not employer and the City of $2p,fi88.8fi. include temporary orpart-time Ashland if the contract employees hired for less than exceeds $20,fi88.8fi or more. ➢ If their employer is the City of 1040 hours in any twelve- Ashlandincluding the Parks month period. For more ➢ Far 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, P~~unicipal 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 pity Administrator's office at 54 ;-488-6002 or write to the City Administrator, City Hall, 20 East Fain Street, Ashland, OR 97520 or visit the city's webstte_at www.ashland.or.us. l~otice to Employers; This notice must be posted predominantly in areas where it can be seen by all employees. CITY 4F ~S H N D Contract far Goods and Services Less than $25,000, 0611912017, Page 5 of 5 Copeland Construction, Ilc 321 Pruett Rd. Eagle Point, OR 97524 Office: 541-826-2314 Fax: 541-826-1014 copelandconst. Ilc~earthlink. net Date: 6/26/2017 To: Kevin Caldwell, Engineering Project Manager Project: Pressure Test of TiD 24"Waterline Upper Lithia Park, City of Ashland The Price includes the following: * 2 hour pressure test of 24n waterline a# 180psi using 2015 ODOT/APWA hydrostatic testing methods Cut pipe near Water Treatment Plant, insert and weld watertight a steel plate. Remove plate after test and weld a watertight band on pipe. Hydrostatic pump must have a minimum output of 11 gpm. Test port is a hydrant located at the intersection of Granite Street and Glenview Drive. Total testing length of pipe is approximately 2 miles. As per 01140.51, it's important to quantify the water lost from the main for the 2 hour period. Labor, equipment and materials for the test and capping including excavation for welding Filling the line and removing air. Provide written summary of test results within 24 hours of comple~on. City to supply water for filiingltesting. The Price does not include the following: *Permits, Fees, or Bonding *Any testing or work with test crew beyond 2 hours {$3001 per hour) We propose ~o furnish equipment, materials, and labor in accordance with above specifications, For the lump sum- of: $5,000:00 Here and accepted- by-authorized sig.natu~~e. Signed: ~ G----~ Date: ~ ~ DATE (MMlDDlYYYY) ~ CERTIFICATE OF LIABILITY INSURANCE 6/2/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY 0R NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies} must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTA T JeSSlca Emloree NAME: Zarosinski-Leavitt Ins Agency of Oregon, IAC PHONE (503)639-4220 F'~ (503)639-d449 _(AtC No, Ext}: _ _ i1AlCi Nod; Leavitt Group of Portland EMAIL Jessica-embree@leavitt.com ADDRESS: _ _ 8285 SW NimbuB Ave, Ste 220 INSURER~AFFORDINGCOVERAGE NAIC# Beaverton OR 97008 INSURERA:C1nClnllatl Insurance. Company 10677 INSURED INSURER B :SAIF 036196 Copeland Construction LLC INSURER C 321 Pruett Rd. INSURERD: INSURER E Eagle Point OR 97524 INSURER F COVERAGES CERTIFICATE NUMBER:1? / 18 Pckg REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREEN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ,p~DLT$UBR _ , POLICY EFF POLICY EXP T _ _ LTR TYPE OF INSURANCE POLICY NUMBER MM D YY ' LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1, 000, 000 A ~ CLAIMS-MADE X OCCUR ' bAMAGE TO RENTED r 100, 000 ,PREMISES (Ea occurrence) E S _ _ X ' EPP0441387 6/3/2017 6/3/2018 MED EXP (Any one person) $ 10, 000 PERSONAL 6 ADV INJURY $ 1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 000, 000 X POLICY PRO ' LOC PRODUCTS ~ COMPiOP AGG S 2, 000, 000 _ _ JECT _ _ _ } OTHER: ' ' $ AUTOMOBILE LIABILITY ; COM6INED SINGLE LIMIT ' S 1, 000, 000 (Ea accident) X ANY AUTO BODILY INJURY (Per person) S A~ ALL OWNED SCHEDULED AUTOS AUTOS ' EBA0441387 6/3/2017 6/3/2018 .BODILY INJURY (Peracc~dent) S _ _ NON-OWNED ! ~ PROPERTY DAMAGE $ . HIRED AUTOS ......AUTOS ;_~Per acciden(~__ _ _ . _ _ S X UMBRELLA LIAB K 'OCCUR EACH OCCURRENCE $ 1, 000, 000 A EXCESS LIAB CLAIMS-MADE'. f AGGREGATE . $ 1, 000, 000 DED RETENTIONS EPP0441387 6/3/2017 6/3/2418 $ "WORKERS COMPENSATfON X PER ' OTH- ANDEMPLOYERS' LIABILITY Y ! N STATUTE _ ER ANY PROPRIETORIPARTNER+EXECUTIVE El EACH ACCIDENT $ 500, 000 OFFICER/MEMBER EXCLUDED? N!A _ _ $ Mandatory in NH) 980838 1/1/2017 1/1/2018 , E L DISEASE - EA EMPLOYEE $ 500 000 If yes, describe under _ _ _ ~ DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS !LOCATIONS !VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Ashland, Oregon and its elected officials, officers and employees are named as additional insured in regards to the general liability coverage per written contract or agreement per form GA2330R0910 attached. Coverage is primary and non contributozy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE A84VE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St Ashland OR 97 52 0 AUTHORIZED REPRESENTATIVE J Embree, Exec/JDE <<~~~~ ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS0251zo~ao~) a THIS ENLtOR~E~ENT CHl~I~GES THE PC~LiC'~. P°LEA~E RED lT C~►REFULLIP. E 43T1~TC3R' ~t~N~I~E~Cf~►~. GENERAL ~~IL BA~E~E~? E~R~RaEMET This endorsement modifies insurance provided under the fn#~twing: CQMMERCIAI GENER~►L LIABILITY Ct~IERAGE PART Enda~rs+~ment - Table t~f Cc~rrt+c~z. ~gg~,~, ~3eoins on Page; 't. Emp#ayee Benefit i_iabi#ity Coverage...•1MNwl1,.H...#.1..pN.NU,..N..L.H,Y.......,N.1.4...N.b.. U.L.YU..,,.Rl,Jil1,1N.~ Ylf Uninter~tiana# Failure to ~isciose Na~ards ..R.ia Y...11R.. a. w...Ili...11.tRl.l.IN.R..IR..MI..f{....Vf....l\4.ww,. s.s.llli...f•NUi..~ Damage to Premises Rented to You .•.,w.{..it.lM.....Y.f«...M...♦...........a,..........f..........,.Rt Y.... N... Y..........f,~ 4. Suppler~ntary Payments r.........r.,.,.........n...,.....,..s........,...N..r........er..».,......,.i......w r, r....... H+..r.+....,l~ S. Medical PayrrterttSS..R.Y........~ ..................................,...Y..Y.,,M.....a...Yt........t........~...,..........._.,.....I...t'#0 Voluntary Property Damage Coverage a.~ and Care, Custody ar Control Liability Coverage Coverage b.~..,.Y.•.....,,~ ........................................Y...,.,......l............N..,«...•.....l.. ~Y get. 180 Day Coverage for Newly Formed ar Acquired Organiza~ons .y.,t...IU..YR..,.HN..Y.I,....aaY..eV.Xr..w.~/~{ Y. tNai~er of Stlrbragattior► a.r...s..•...s•..•I...s..Ir..o..r..tsn,f.r..*..t..».YS.•.+..r......•......R..wr.....r1.. r.1.......r ...i.r. ~7/ 9. Automatic Additiona# Insured - Specfied Re#atianshipsY ..+1.f.IMNN...1....INMU1.....1.M/.YO.M{{l.•...aNl.1Hl. 11 x Managers or t.essors of Pternises; ~ Lessor of Leased Equipmerr~ x Vendors; ~ State or Pol~ica# Subdivisions -Permits Re#atirtg to Prem~es; x State or Poli~cal Subdivisions -Permits; and X Cat~radots` t3perati0n5 Bra~iened Contractual Liabity -Work Vl~tthin 50' of Ra~road Property 16 4 ....Y......... N.,. F......1 I....M...•1 Property Damage to 8cxrowed Equipment I,,.....,.l.......,N......,.4......M.,......Y .............».....Y........Y.1...1. 1~. Employees as insureds -Specified #iea#th Care Services:....~ ..................~..,....,..t..,.Y,.......Y........1~ ~ Nunes; ~ Emergency Medical Technicians; and x Paramedics /R. 13. Broade~►ed Notice of Occurrence,.R....a....IM.aNY1....YM...J.........a4..U...4,...lM...#.uM.t.t.MS.H.M.Y.U......u... ~6 B. Limits of Insurances The Commercial General Liabi#it}r Limits of Insurance applyto die insurance provided by the endorsement, except as provided b+~b~r: Emplo~►+ee Btnefrt Liability Coverage Each Err~ioyee Limit: $ y,00Q,00Q Aggregate Limit $ 3,Q~0,000 Deducti#~le; $ 1,t}00 3. Damage t,o Pternlsfs Rented to You The lesser of: a. The Each Ckcurrertce Limit shown in the Declarations; or b. $500,400 unless otherwise stated $ Supplementary Pa~ymerr~ a. Bail bands: $ 1,000 b. Lass of earnings: $ 350 5. Medica# Fr~ymenfs Medical Expense Limit: $ 1 U,000 includes tap►yrighted materia# of Insurance GA Z33 aR 0~ 1U Services Uffce, Inc., with iLs perntissinn. page 1 of'#6 6, Voluntary Pr©pert~r Damage (Coverage a.7 and Care, Custody► or Cor~+al Elab~tll#y CareraQe (Coverage b.) Limn~of Insurance {Each Occurrence} Coverage b. $S,OC~ unless otherwise stated $ Deductibles {Each Ckcurrence} Coverage a. $~50 Coverage b. $~50 unless otherwise stated $ COVERAGE Pa.EMIUM BJ~.515 RATE AUVA~NCE PREMIUM Area {For Limits in Fxcess of {For Limn in Ewcess of {b} Payroll ~5,~Q} ~5,QQD} {c} Gross Sales Unit e ~ b, Care, Custody ~ or Control Tt~TAI.l4~NNN~tAL PREMItJl1~ 11. Properly Damage ~o Borra~wed Equlpmettt Each Occurrence Limn $ 1Q.OOQ Deductible: $ 25U C. Coverages: tour right and duty to 1. Employer Benefit Llabi~y Coverage defend ends when we have used up the app~- a, The folbwing is added to SECTIUN ! cable limit of insurance C4vERAGES: Employee 8ern~lt in the payment of Liabllit~t Coverage. judgments or settle- {1) Insuring reement {a) tKe will pay those sums that No other obligation or liabil- the insured becomes legally ~ to PaY sums or perform obligated to pay as dam- oats or services ~ covered ages caused by any acts er- unless explicitly provided for ror ~or omission of the in- under Supplementary Pay cured, or of any other per- mend, son for whose acts the in- {b} This insurance applies to cured is legally liable, to damages only if the act, er- which this insurance ap- ror or omission, is neg~- plies, 1Ne will have the right gerrtlr committed in the and duty to defend the in- "administration" of your cured against any "suiC' "employee benefit program"; seekng those damages. and However, we will have na duty to defend against any ~ 1} Occurs during the pol- "suit" seeking damages to icy period; or Which this insurance does not apply. We may, at our 2} Occurred prior to the discretion, investig~~e any effectirre date of this report of an act, error or endorsement provided: omission" and sefitle any a} You did not have claim or sub` that may re- knowledge of a salt. But; claim or "suit" an 1} The amount we will pay or before the of for damages is lin~ted fective date of this as described in SEC- endorsement TION tll -LIMITS OF You wil! be lh1SUR~NCE► and deemed to have Includes copyrighted material of Insurance CA 23~ OR ~ '10 5ecvices Clffiee, lr~., with its permission. Page 2 of 1~ (1) the Limits of Insurance shown in amount stated in the Decla- Section B. Limits of Insurance, 1. Employee 8enefrt Liabil rations as applicable to Ca`►e~ge acrd the rules beI ~w Each Empbyee. The limits fo< the most we win pay regard- of insurance shoo not be re- less of the number of: doted by the amount of this deductibm. (a} insureds; (b) The deductib~ amount (b} bro ms made or "sins" atatled in the Declarations ght; pp s to all damages sus- (c) Persons or organ¢ations ~ e" ~ . a~ ,o~ "em- makrng claims or bringing emQb' ~~clu deg such suits"; y~ pendents and beneficiaries, because (d} Acts, errors or omissions; or of all acts, errors or omis- sions to which this insur- (e) Benefits included in your ante appi~s. "empbyee benefit program". (c) The terms of this insurance, SeectioAggregate Limit shown in including those with respect n B. limits of insurance, to; 1. Employee Benefit Liability 1} Our right and duty to Coverage of this endorsement is defend the insured the most we will pay for all darn ages because of acts, errors or against any "suits" omissions negligently committed seelang dtose dam- in the "administration" of your a9es► and "empbyee benefit program". Your duties, and the ~3) Subject to the limit described in duties of any other in- (2} above, the Each Employee voh~ed insured, in the Limit shown in Section B. Limits event of an act, error or of Insurance, 1. Employee omission, or claim, Beneftt Llabiliq+ Coverage of apply irrespective of the ap- this endorsement ~s the most we plication of the deductible will pay for all damages sus- amount tamed by any one "employee", including damages sustained by We maY paY a~' Aar or all such "employee's" dependents of the deductible amount to and beneficiaries, as a result of; effect settlement of any claim or "suit" and, upon no- (a} An act, error or omission; or tification of the action taken, Eb} A series of related acts, er- you shall promptly reim- rors or omissions, re ard- bursa us for such part of the less of the amount ofgtime deducb~e amount as we that Lapses between such have paid. acts, errors or omissions, d. Additional Conditions negligentlyy committed in the As respects Employee Benefi# Li- "administration" of your "'em- ability Coverage, SECTION IV - playee benefit program". COMIMERCiAI. GENERAL LIABIL- However, the amount aid under ITY C©hIDIT10flIS is amended as fol- p lows: this endorsement shall not ex- ceed, and wfil be subject to the (1} Item 2. Duties in the Event of limits and restrictions that apply Occurrence, Offense, Claim or to the payment of benefits in any Surt rs deleted m Its entirety and Alan included in the "employee replaced by the folbwing: benefit program", Duties in the Event of an Deductible Amoun# Act, Error or Omission, or (a) Our obligation to pay darr}- Claim or Suit ages on behalf of the in- a. You must see to it that cured applies only to the we are notified as soon amount of damages in ex- as practicable of an act, cess of the deductible error or omission which Includes copyrighted material of Insurance GA 233 OR 0910 Services Office, Inc., with Its permission. Page 5 of 19 may result in a claim. surance may also To Cite extent possible, aPPIY• notice should include: d, Na insured will, except (~t~ What the act, error at that insured's own ar om~sion was cost, voluntarily make a and when it oc- payment, assume any curved; and obligation, or incur any {~j The names and seennt without our addresses of any- one who may suf (~j Item 5, Other Durance is de- fer damages as a tared in its entirety and replaced result of the act, by the following: error or omission. 5. tither Insurance b. If a claim is made or if other valid and collectible "suit" is brought against insurance is available to the any insured, you must: insured for a loss we cover (1) Immediately re- under this Coverage Part, cord the specific our obligations are limited of the claim or as follows: "suit" and the date received; and a. Primary Insurance (Zj N~ily us as soon This bsurance is Ari- as practicable. many except when c. below apples. if this in- You must see to it that surance is pdmary, our we receive written no- obligations are not of lice of the claim or fectied un~ss any of the "sub' as soon as Avoca- other insurance is also cable, primary. Then, we will share with ap that other c. You and any other in- insurance by the vohred insured must: method described in b. (~j Immediately send bebw. us copies of any b. Method of Sharing demands, notices, summonses or ie- If all of the other insur- gal papers re- ance perms contribu- ceived in sonnet- tion by equal shares, tion w~h the claim we will follow this or "suit"; method ado. Under this (2) Author¢e us to ob- approach each insurer contributes equal fain records and amounts until is has other information; paid its applicable limit (3j Cooperate with us of insurance or none of in the investigation the bss remains, ar settlement of whichever comes first. the claim or de- If any of the other in- fense against the surance does not per- "suit~; and mit contribution by Assist us, upon equal shares, we wit! our request, in the contribute by limits. enforcement of Under this method, any right against each insurer's share is any person or or- based on the ratio of its ganixaaiion which applicable limit of in- may be liab~ to surance to the total ap` the insured be- Pliable limits of insur- cause of an act, ance of all insurers. error or omission c. No Coverage to which this in- Includes copyrighted material of Insurance ~ 23~ t~R 4~ ~Q Services C)ffice, Inc., with its permission. Pale 6 of tfi This insurance shall not providing some or all of the cover any loss for following benefits to "em- whichthe insured is en- playees", whether provided tided to recovery under through a "cafeteria plan or any other insurance in otherwise: force previous to the of festive date of the a. Group life insurance; Coverage Part. group accident or e. l~ddltlonal Deflniflons heath insurance; den- . tat, vision and hearing As respects Employee Benefit Li- plans; and flexible ability Coverage, SECTION y . spending accounts; DEPINfTIt~NS is amended as fob provided that no one lows: other than an "em- ployee" may subscribe (1} The following definitions are to such benefits and added: such benefits are made 1. "Administration" means: generals available to those employees wire a. Providing information to satisfy the plan's eligi- "ernployees", ~cluding b~~y requirements; their dependents and b. Profit sharing plans, beneficiaries, with re- employee savings specs to eligibility for or plans, employee stock scope of "employee ownership plans, pen- benefitprograms"; Sion plans and stock b• Interpreting the "em. subscription plans, pro- ployee benefit p~ vided fat no one other grams"; than an "employee" may subscribe to such c. Handling records in benefits and such connection with the benefits are made gen- "employee benefit pro- erally available to ail grams"; or "employees" who are d. Eftectin , continuin or eligible under the plan g 9 for such benefits; terminating any "em- ployee's" participatron c. Unempbyment insur- in any benefit included once, social security in the "employee bens- benef~s, workers' com- fitprogram". pensation and d~ability However, "administration" benefits; and does not ~clude d. Vacation plans, includ- Nandiing payro~ deduc- ing buy and sell pro- s. grams; leave of ab- t~~; or sense programs, in- b. The failure to effect or ciuding military, mater- maintain any insurance nay, family, and civil ar adequate limits of leave; tuition assistance coverage of insurance, plans; transportation including but not limited and health club subsi- to unemployment in- dies. surance, social security (aj The following defrni6ans are de- benefits, workers' coin- feted in their entirety and re- pensation and disability placed by the following: benefits. 21. "Suit" means a civil pro- Cafeteria pins" means seeding in which money bpl~an authorized, by appGcap damages because of an act, law to albw employees error or omission to which to elect to pay for certain this insurance applies are benefits with pre-tax dollars. aieged. "Suit" includes: "Employee benefit pro- a• An arbi~ation proceed- grams" means a program ing in which such dam- lncludes copyrighted material of Insurance GA ~3~ OIL 0910 Services Office, Inc., with its permission. Page~ofl~ ages are claimed and The exclusions under SECTION to which the insured I -COVERAGES, COVERAGE must submit or does A. BODILY INJURY AND submit with our con- PROPERTY DAlVIAGE L1AB1L- sent; ITY, 2. Exclusions, other than i. b, An other a~ernative ~Ilar and the Nuclear Enemy y Liabilit~► Exclusion, are deleted dispute resolution pro- and the following are added: seeding in which such damages are claimed This insurance does not apply to: and to which the in- (a) "Property damage"; sured submits with our consent; or Assumed in any con- c. An appeal of a civil pro- trail; or seeding. 2) toss caused by or re- "Empbyee" means a person suking from any of the actively employed, formerly following: employed, on leave of ab- a) Wear and tear; sense or disabled, or re- tired. "Employee" includes a b) Rust, corrosion, "leased worker". "Employee" fungus, decay, de- does not include a"tempo- teriaration, hidden racy worker'. or latent defec# or 2. unintentional Failure to Disclose Hax- any quality in aids property that causes it to dam- SECTION IY - COIdMERCIAI C~NERAl. age or destroy it- UABILITY CONDITIONS, 1. Represen- self; lotions is hereby amended by the addi- c) Smog; tion of the foilow~g: Based on our de endence u on ur re - d) Mechanical break- P P Yo P down including resentations as to existing hazards, if un- rupture or bursting intentionally you show fail to disclose all caused by cen- such hazards at the inception date of your trifugal force; policy, we will not reject coverage under this Goverage Pact based solely on such e) Setting, cracking, failure. shrinking or ex- 3. Damage to Premises Rerded to You pansion; or a. The last Sub ara ra h of Para rah f) Nesting or infesta- P g P 9 P Lion, or discharge 2. SECTION I -COVERAGES, ar release of waste CO1lER~ReGE A. -BODILY INJURY products or secre- AND PROPERTY DAN6AGE, LI- lions, by insects, A811JTY Exclusions is hereby de- birds, rodents ar leted and replaced by the following: other animals. Exclusions c, through q. do not apply fib) loss caused directly or indi- to damage by fire, explosion, light- redly by any of the foliow- ning, smoke ar soot to premises ing: while rented to you or temporarily oc- cupied by you with permission of the f} Earthquake, volcanic owner. eruption, landslide or any other earth move- b. The insurance provided under SEC- ment; T10N I • COVERAGE, COItERAGE A. BODILY INJURY AND PROP- Water that backs up or ERTY DAMAGE LIABILITY applies overflows from a sewer, to "propert~r damage" arising out of drain or sump; water damage to premises that are bath rented to and occupied by you. 3j Water under the ground surface pressing on, or 41) As respects Water Damage l.e- flooring or seeping gal Liability, as provided in Para- through: graph 3.b. above: Includes copyrighted material of Insurance CA 233 OR 0~ 10 Services Office, Inc., with its permission. Page ~ of 16 b, Care, Custody or Control t.iability deductible amount as has been coverage paid by us. SECTION I -COVERAGES, COV- 7. 180 Day Coverage for Newly Formed or ERAGE A. BODILY 1111.JURY AND Acquired Organitatiions PROPERTY DAMAGE LIABILITY, Exciusiot~s, .Damage to Property► SECTION II -WHO tS AN INSURED is Sub ra ra ~s 3 , 4 and 5 do not amended as follows. Pa 9 p ~jl~ apply to "propertjr damage" to the Subparagraph a. of Paragraph is propert~+ of others described therein. hereby deleted and replaced by the fol- With respect to the insurance provided by lowing: this section of the endorsement, the fol- a, lnsurance under this provision is of lowing additional provisions apply: forded only until the 180th day after a. The Limits of Insurance shown in the you acquire or forth the organizaation C)eclarations are rep~ced by the lim- or the end of the policy period, its designated in Section B. Limits of whichever is earlier; Insurance, 6, Voluntary Property g, Waiver of Subrogation Damage and Care, Custody or Control Liability Coverage of this SECTION IV - COMMERCIAL. GENERA!. endorsement with respect to cover- LIABILITY CONDITIONS, 9. Transfer of age provided by this endorsement Rights of Recovery Against Others taa These limits are inclusive of and not Us is hereby amended by the addition of in addition to the limits being re- the following: placed. The Limits of Insurance shown in Section B. Limits of incur- We waive any right of recovery we may ante, 6. Voluntary Properrt~►► Dam- have because of payments we make for age and Gare, Custody or Control injury or damage arising out of your ongo- _ ing operations or "your work" done under Liab~li~jo Coverage of this endorse meat ftx the most we will pay in any a wr~ten contract requiring such waiver one "occurrenceN regardless of the with that person or organization and in- niimhs~r rrf~ eluded in the "product-completed opera- ~a} The written or oral contract or use of equipment leased ar agreement is: to you by such persan~s) ar argari~zations{s}. Nawever, Currentljr in effect ar this insurance does not ap- becarnes effective dur- per to any "occurrence" ing the policy period, which takes place after the and equipment lease expires. 2) Executed prior to an ~c) Any person or arganitatian "occurrence" or offense (referred to below as ven- to which this insurance dor3 with whom you have wain aPPIY~ and agreed per Paragraph fib) They are nat spec~cally 9.a.{1) alive to provide in- named as an additions! in- surance, but only w~h re- spect to "badilyy mjur~" or cured under any other pro- "property damage" artsmg vision af, ar endorsement aut of'~rour products" which added ta, this Coverage are distributed ar sold in the Part. regular course of the ven- C1nly the fallowing persons or or- dot's business, subject to gan¢ations are additional incur- the following additional ex- edsunder this endt~rsement, and clusions: insurance coverage provided to The insurance afforded such additional insureds is lira- the vendor does not iced as provided herein: apply to: ta} The manager or lessor of a a) "Bodily injury" or prem~es leased to ynu with "property damage" whom you have agreed per for which the ven- Paragraph g,a.~"I) above to dot ~ ©bligated to provide insurance, but only pay damages by with respect to liability aril- reason of the ac- ing out of the ownership, sumption of liab~ity maintenance or use of that in a contract ar part of a premises leased to agreement This you, subject to the fallowing exclusion does not additional exclusions: apply to liability for This insurance does not ap- damages that the ply to: vendor would have in the absence of 1} Any "occurrence" which the contract or takes place after yc~u agreerner~; cease to be a tenant in that premises. b} Any express war- ranty unauthorized Structural alterations, by you; new construction or demalitivn operations c} Any physical Qr performed by or an be- chemical change half of such additional in the product insured. made intentionally by the vendor; (b} Any person or arganizatian from which yc~u lease d} Repackaging, ex- equipment with whom you ceps when un- har~e agreed per Paragraph packed solely for 9,a,.~1) above to provide in- the purpose of ~n- surance. Such person(s) or spection, demon- organ¢ation~s) are insureds, strati~n, testing, or but only to the extent that the substitution of the liability for'bodily injury, parts under in- "property damage" or "per- structians from the sonal and advertising injury" manu#acturer, and is caused by your negli` then repackaged Bence, acts ar omissions in in the origins! con- the maintenance, operation tamer; Includes copyrighted material of Insurance C~ X33 0~ 091 5erv~ces t)ffice, Inc, with i~ permissran. Page ~1 of e} Any failure to Part with respect make such inspec- to wch products. lions, adjustments, Any state or political subdi- tests or servicing vision with which you have as the vendor has agreed per Paragraph agreed to make or normally under- 9.a.~1} above to provide in- takes to make in surance, subject to the fol- theusualcourse of lowing additional provision: business, in con- This insurance applies only nedion with the with respect to the folbwing distribution or sale hazards for which the state of the products; or political subdivision has f} Demonstration, in- issued a permit in connec- stallation, servicing tion with premises you awn, or repair opera- rent or control and to which bons, except such this insurance applies: operations per- 1) The existence, mainte- formed at the ven- Hance, repair, consUvc- dor's premises in tion, erection, or re- connection with moval of advertising the sale of the signs, awnings, cano- product; pies, cedar entrances, g} Products which, coal holes, driveways, manholes, mar uses, after distribution or hoist away openings, sale by you' have sideway vault, street been labeled or re- labeled or used as banners, or decorations a container, part or and similar exposures; ingredient of any or other thing or sulr Z} The construction, erec- stance by or for tion, or removal of ele- thevendor, or vators; or h) "Bodily injury" or 3) The ownership, main- "property damage" tenants, or use of any arising out of the elevators covered by negligence, acts or this insurance. omissions of the vendor, its em- fie) Any state or political subdi- ployees or anyone vision with which you have else acting on its agreed per Paragraph behalf. 9.a.(1) above to prove in- surance, subject to the fol- This insurance does not lowing provisions: apply to any insured person or organization: 1} This insurance applies only with respect to op- a} From whom you erations performed by have acquired you or on your behalf such products, or for which the state or any ingredient, polititicai subdivision has part or container, issued a permit. entering into, ac- companying ar This insurance does not containing such apply to "bodily injury', products; or "property damageu or b) Vl~hen liability in- "personal and advertis- ing rntur~" ansrng out of chided within the operations perfinrmed "products" for the state or political completed opera- subdivision. Lions hazard" has been excluded un- (f) For "your work" performed der this Coverage in Oregon, any person ar includes copyrighted material of Insurance G~ OR 0~ 9o Services Ofl'rce, Inc., with its permission. Page 12 of 16 organization with which you raj Subparagraphs (ej, and have agreed per Paragraph (gj do not apply to "bodily rrt- s.s.(7j above to provide ~n- " surance, jury' or Property damage" but °ny tti the ex- included within the "prod- tent that the liabil~y is acts-completed operations caused by 'your work" per- hazard"; formed for that additional in- sured and only to the extent (b) Subparagraphs (aj, (dj, (e) that such liab~ity is caused and (Qj do not apply to "bod- ne your negl~ence or the ily Nn~ry', "property dam- gl~gence of those acting age or personal and ad- on your behalf. A person or vertising injury' arising out organ¢atlon's status as an of the sole negligence or insured under this provision w~pu! misconduct of the ad- of this endorserrasnt contin- ditional insured or its "em- ues for only the period of ployees"; or time required by the writ#en contract or agreement, but (cj Subparagraph and (~j do in no event beyorxi the expi- not apply to "body injury', ratron date of this Coverage "property damage" or "per- Part. !f there is no written sonal and advertising injury" contract or agreement, or if arising out o~ no period of time is required ij The rendering of, or by the written contract or failure to render, an agreement, a person or or- professional services gar ~ bon's status as an in- by you or on your be- under endorse- had, but only with ce- ment ends when your op- sped to either or both erations far that insured are of the following opera- completed. bons: (gj IFor 'your work" performed aj Providing en i- the coverage temtory" veering, architec- but not in Oregon, any pet tarot or su 'n son or organ¢atian with ~ g which you have agreed per services to others; Paragraph g.a.(~ j above to and provide insurance, but only bj Providing, or hiring wig, respect to liabil~y aril- independent pro- ~~out of "your work" pet'- f~essiona~ to pro- ed for that add~onal tn- tide, engineering, sured by you ar on your be- architectural or ~ all. A person or organize- surveying services bn s status as an Insured in connection r~tth under this provision of this construction work endorsement continues far you perfiam~. only the period of time re- quired by the airritten con- Subject to Paragraph 3j tractor agreement, but in no beloua', professional event beyond the expiration services include; date of this Cav~erage Part if there is no written contract aj Preparing, approv- or agreement, or if no period ing, or #ailing io of time is required by the prepare or ap- written contract or agree- prove► maps, shop meat, aperson or organize- d~awings► opin- tmn s status as an insured s, reports, sur- under this endorsement vets, field orders, ends when your operations change orders, or for that insured are com- drawings and pleted. specifications; and (3j Any insurance provided to an bj Supervisory or in- addt~onal insured designated spectron activities under Paragraph S.a.(Zj: performed as part of any rested ar- Includes copyrighted material of Insurance GA X33 G~ p91~ Services Once, Inc., with itss permission. Ra a 73 of 1~ I~ chitectural ar engi- primary to other insurance veering activities. available to the additional insured excepfi 3} Professional services do not include services ~I) As otherwise provided within construction in SECTION N - means, methods, tech- COMMERCIAL GEN- piques, sequences and ERAL LIABILITY procedures employed CONDITIONS, 5. by you in connection Other Insurance, 6. with construction work Excess Insurance; or you per~arm. 1) For any other valid and (s~ Subparagraphs (f} and (g) collectible insurance do not apply to "bodi{y in- available to the addi- juryp or "property damage" tional insured as an ad- arising out of'~our work" for ditianal insured by at- which aconsolidated {wrap- tachment of an en- up) insurance program has darsement to another been provided by the prime insurance policy that is contractor /project manager written on an excess or owner of the construction basis. In such case, the project in which you are in- covefage provided un- volved. der this endorsement shall also be excess. b. Only with regard to insurance pro- vided to an additional insured desig- f~f Condition 11. Conformance to Hated under Paragraph g,a,(~) Sub- Specific Written Contract or paragraphs (f} and (g} above, SEC Apreemetrt ►s hereby added: TION III - LIMiITS OF INSURANCE is amended to include: 11. Conformance to Specific Wrr~en Contract or The lints applicable to the additional Agreement insured are those specified in the a, With respect to addi- written contract or agreement or in tional insureds de- the Declarations of this Coverage scribed in Paragraph Part, whichever are less. If no limits are specified m the written contractor g.a.(~}(~ above one: agreement, or if there is no wr~ten If a written contract or contract of agreement, the limits ap- agreement between plicab{e to the additional insured are you and the additional those specified in the Declarations of insured specfies that this Coverage Part. The limits of in- coverage for the addi- surance are incisive of and not in tional insured: addition to the limits of insurance shown in the Declarations. (1) Be provided by the Insurance Ser- c. SECTION Iv - CO~iMERCiAL GEN- vices Office addi- ERAL Lt~►BILtTY COI~nIT10WS is banal insured form hereby amended as follows: number CG 3~ 61, Condition 5.Other insurance is CG 3~ 6~ or CG amended to ~clude: 32 63; or 4a) vVhere required by a written (T} Include coverage contract or agreement, this for completed op- insurance is primary and ! or eraiions; or noncontributory as respects Include coverage any other insurance policy for "your workR; issued to the additional in- sured, and such other in- and where the limits or surance policy shall be ex- coverage provided to cess and 1 or noncontribut- the additional insured is ing, whichever applies, with more restrictive than this insurance. was specifically re- (b) Any insurance provided by quired in that written contract ar agreement, this endorsement shall be the terms of Para- Includes copyrighted material of Insurance GA X33 OR og 1 ~ Services C7ffice, inc., witfi its permission. Page 1~ of 16 graphs ~,a.(3}{a} or 9.b, agreement specfies above, or any combina- the Insurance Services tion thereof, shall be in- C3tTice additrona! in- terpreted as providing cured form number CG the limn or coverage ~0 i 0 but does not required by the terms of specify which edition, or the written contract or specifies an edition that agreement, but only to does not exist, Para- the event that such Gm- graphs 9.a.3.b. and its or coverage is in- 9,b, of this endorse- cluded within the terms meet shad not apply of the Coverage Part to and Paragraph which this endot~ement 9.a{3}(a} of this en- is attached. dorsement shall apply b, With respect to addi- 10. Broadened Conlrectual Liability -"Work banal insureds de- Within Sfl' of Railroad p~ scribed in Paragraph It is hereby agreed that Par raph f.1 of 9.a.{~}{g) above only: ag { } C~efinitian 1~. "insured contract" 4SEC- If awritten contract or TIGN Y - DEFINITIONS} is deleted. agreement between you and the additiona! 11. Property Damage t+c, BQrra~d Equip. insured specifies that merit coverage for the addi- a, -rn,e following is hereby added to Ex- tiona) insured elusion j, Damage to Property of a. Be provided by the TI ragraph 2., Exclusions of SEC- Insurance Ser QN I - C~IIE~RAGES, COVERAGE vices Otfiee addi- ~ B{~ILY INJURY AND PR4P- tional insured form ERA' pA[~AGE LIABILITY: number CG 20 1~q Paragraphs {3} and {4} of this exclu- or CG xQ Sion do not apply to tao~ or equip- {where edition meet loaned to y~au, provided they are sp~~hed}'' or not being used to perform operations b. Include coverage at the time of lass. for completed op- iNith respect to the insurance pra- erations; or vided by this section of the endarse- c. Include coverage merit, the fallowing additional provi- for "ycyurwork"; sans apply. and where the limits or {1} The limits of insurance shown in coverage provided to the Declarations are replaced by the additional insured is the lirni~ designirte►d in Section more restrictive than B. Lirnlfx cif Insurance, 11. of was specicficaliy re- this endorsement respect to quired in that written coverage provided by this en- contract or agreement, dorsement. These limits are in- the temps of Para- elusive of and not in addition to graphs g.a.{3}(s}, the limn being replaced. The g.a..{3}{bj or 9,b. above, Limn of Insurance shaven in ar any combination Section E, Limb a~ Insurance, thereof, shall be inter- 1't. of this endorsement ~ the prated as latov3ding the m©st we will pay in any one "oc- limits ar average re- currence" regardless afi the quired by the terms of number of the written contract ar {a} insureds; agreement, but only to the extent that such gym- {b} Claims made ar "suits" i~ ar coverage is in- brought; or chided wrth~n the terms of the Coverage Part to {c} Persons or organizations which this endorsement making claims ar bring is attached. )f, however, "suits°. the written contract ar includes copyrighted material of Insurance GA 233 OR 1g Services Offi'ice, )nc., with its permission. PacJe 15 of 16 Deductible Clat~e a, Nurses; {aj Our obligation to pay dam- b. Emergency Medical Technrcians; or ages on your behalf applies ,c, paramedics, ony to the amount of dam- ages for each "occurrence" in the jurisdiction where an "occurrence" whirh are in excess of the or offense to which this insurance applies Deductible amount stated in takes place. Section B. Llmlts of Insur- ance, 11, of this endorse- 13, Broadened Notice of Occurrence meat. The limits of insur- ance will not be reduced by Paragraph a. of Condition 2. Duties in the application of such De- the Event of Occurrence, OfFertse, ductible amour. CI$irn or Suit (SECTION N • COMMER- CIAL GENERAL LIABILITY CONDI- (b} Condition Duties in the ?IONS) is hereby deleted and replaced by Event of Occwrence, Of- the following: fense, Claim or Suit, ap- a, You must see to it that we are notified plies to each claim or "sub' as soon as practicable of an "occur- ~rrespective of the amount renceu or an offense which may result tc~ We may pay any part or ail in a claim. To the extent possibMe, no- of the deductible amount to rice should inchnie: effect settlement of any claim or "salt" and, upon no- ~1) How, when and where the "oc- tification of the action taken, currence" or offense took place; you shall prompty reim- t~) The names and addresses of burse us for such part of the any injured persons and wit- deductible amount as has nesses; and been paid by us. (3~ The nature and location of any 1~. Employees as Insureds -Specified injury or damage arising aut of Health Care Seances the "occurrence" or offense. ft is hereby agreed that Paragraph This requirement applies only when ~.a.(1}(d) of SECTION II -1~fH4 i5 AN the "occurrence" or offense is known INSURED, does not apply to your "em- to an "authorized representative". pbyees" who provide professional health care services on your behalf as day li- censed: Includes copyrighted material of Insurance GA 2~3 OR 03 I ~ Services Office, inc., with its permission. Page 16 of 16 Purchase Order _ ` ' ~ ~ Fiscal Year 2018 Page: 1 of: 1 v~ B City of Ashland - L ATTN: Accounts Payable Purchase 11Q Q L 20 E. Main Order # 2 O I V O V~ O Ashland, OR 97520 T Phone: 5411552-2010 0 Email: payable@ashland.or.us V H CIO Engineering Division E COPELAND CONSTRUCTION, LLC 151 Winburn Way D 321 PRUETT ROAD P Ashland, OR 97520 0 EAGLE POINT, OR 97524 Phone: 5411488-5347 R ~ Fax:5411488-6006 - - - - -~Vendor_ Ph~n~_Numb~~ 1~~n~~r~1u~~ ~~t - . - _ ~ - _ 541 826-2314 Kevin Caldwell Rath Or~er~d_ ~l~n~iQr~ N~rmb~r- _ ~te1air~= _~1--~- " ~ : - - _ ~ : ~ ~~r~_ _ 0710712017 742 ~ FOB ASHLAND ORINET30 Cit Accounts Pa able Item# _ - . - = _~e~~_r-I. t~~0~~~f _ = Y ~ : _ ~ = : _ _ = ~~fi~~~~~~~r~~: Pressure test waterline 1 Pressure test of 24 inch waterline per attached proposal (Exhibit 1 $5,000.0000 $5,000.00 C). Contract for Goods and Services Less than $25,000 Beginning date: July 1, 2017 Completion date: July 31, 2017 Project Account: E-201531-999 GL SUMMARY 081900 - 704200 $5, 000.00 ~ ~ O ~ - B o~~~~ ~ Date: ~ Y: Authorized Si~~ature _ - ~ - $5 000.00 _ ~ Date of request: Juiv 5, ?017 Required date far delivery: ASAP vendor ~:ame ~~ar~aastr~,~f~fln,.1LC-- Address, City, State, Zip ~~1 Pr;~tf Rai Eagle QZ,F~ - Contact Name & Telephone Number ~oJ~~ 541-82❑ 1y~4 Fax Number S~ - 5~~ _ ❑ Exempt from Competitive Biddin4 ❑ Emer env ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file} ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved toy Council ❑ Written quote or proposal attached ❑ Written uote or ro osal attached Attach co of council communication _ If council a rovaM required, attach copy of C~__ ❑ Small Procurement cooperative Procurement ' Less than $5,400 ❑ Request far 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 Vhashington Intermediate Procurement ~ ❑ Sole Source Contract # A livable Farm #5,5, 7 ar 8 ❑ Other government agency contract GOODS & SERI~ICE5 ~ ❑ ..pp ( ) $5,000 to $100,000 ❑ Written quote or proposal attached Agency ®(3) Written quotes and so;icitatio ~ ed ❑ Form #4, Personal Services $5K to $75K Contract # PERSOh#AI. SERVICES Intergovernmental Agreement ❑ ~ecial Procurement ~ y $5,000 to $15,000 ❑ Fcrm #9, Request for Approval u Agenc ❑ 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) _ (A,ttach copy of council communication) ❑ Form #4, Personal Services $5K to $75K ,Valid until; (Date) , ~~~~r~p~~~~ f~~ a ~~s~ Pressure test of 24 inch waterline per attached Proposa! (Exhibit C) --T--------- -i f i I ~ ~T~~ s ® Pei attached ~uotelproposal $ Project Number 2015.31 Account Number 01900-704200 *Expendifure must be charged fo the appropriafe account numbers for the financials fo accurately reflect the actual expenditures, 1T Director in collaboration with depar<rrent fo approve all hardware and software purchases: _ IT Director Dafe Su~pcrf -Yes / No signing Phis requ,'sifiori form; l certify that the City's public confracfing requirements have been satisfied. ~ ~ Em la ee: - - De artment Head: pY p (Equal to or ter than $5,DOGj z, ~~w~, Department ManagerlSupervESO,r~_w W Cifiy Administrator: , , ~ (Equal t~ nr greater than $25;uu0) ~ ~ Funds appropriafed for currenf frseaf year: ~~`YEa~~~f~~ a ~ ~ ~~o. .=~~~Ffl]anCe Dlrecf ~~jEquaf fc or greaterthan X5,000) Date Comments: Fnrm #3 - Rani ii~rinn