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HomeMy WebLinkAbout2017-159 Contract - Accustat Sports Timing Contract for GOODS AND SERVICES Small Procurement Less than $5,000 CITY o F INDEPENDENT CONTRACTOR: Accustat Sports Timing Inc ~1SH LAN D CONTACT: Eric Larpenteur 20 East Main Street ADDRESS: 8748 Glisan St. Portland, OR 97220 Ashland, Oregon 97520 Telephone: 5411488-6002 Fax: 5411488-5311 TELEPHONE: (503) 803-9377 FAX: N/A BEGINNING DATE: 5!1117 COMPLETION DATE: 811/17 COMPENSATION: $2500 for up to 833 runners for the 2017 4th of Jul Run. $2.50 per runner after 833. GooDS AND SERVICES To BE PROVIDED: Database management and chip preparation services for the 4th of July Run. In the event of conflicts or discrepancies among Contract Documents, this standard form of the City of Ashland Contract will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with this standard form City 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 ihto this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Ownership of Production: All documents, materials or items produced by Contractor pursuant to this contract shall be the property of City. 4. Statutory Requirements: ORS 2796.220, 2796.225, 2796.230, 2798.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 5. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from those losses, expenses, or other damages resulting from injury to any person or damage to property arising out of or incident to the negligent performance of this contract by Contractor its employees, or agents. Contractor shall not be held responsible for any losses, expenses, or other damages, directly, solely, and proximately caused by the negligence of City. 6. Termination: City's Convenience. This contract may be terminated at any time by the City. 7. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 8. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. 9. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 10. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work. 11. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 12. Default. The Contractor shall be in default of this agreement if Contractor commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract. 13. Insurance. Contractor shall at its own expense provide the following insurance: a. a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers. Worker's compensation insurance is required if work is performed by employees, subcontractors, or volunteers. BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES UNDER PEN OF LAW THAT THE WORK REQUIRED BY THIS CONTRACT SHALL BE PERFORMED SOLELY BY THE UNDERSIGNED: b. General Liability insurance with a combined single limit, or the equivalent, f 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 500,000 for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applica COA Initial 14. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in ac a ce with the laws of the State of Oregon 15. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. Certification. Co ractor shall e certification attached hereto as Exhibit A and herein incorporated by reference. Contras r: ; , City of As Ian By ~ ~ ~ By Signature rtment ea 1~ IL- • L~f~~ ~ Print Name Print me Title Date ~ W-9 One copy of a W-9 is to be submitted with the signed contract. PUrChaSe Order N0. Revised io-28-14 Page 1 of 2 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 contra documents, ai d has check~~d 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. V 2 Commercial advertisin or business cards or a trade association membership are purchased for the g business. t~ (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,thebor or services to be provided. ~q fo- / Ala l ~ ~ Contractdr (Date) f Revised 1o-28-i4 Page 2 of 2 A~~ ® DATE (MMIDDIYYYYI CERTIFICATE OF LIABILITY INSURANCE 12/14/2016 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 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Clnd Cromwell NAME: y Elliott Powell Baden and Baker Inc . No Ext ; (503) 227-1771 AIC No ; (503) 274-7644 1521 S.W. Salmon Street a ~RIESS:ccromwell@epbb.com INSURER(S) AFFORDING COVERAGE NAIC # Portland OR 97205-1783 INSURERA:Continental Casualt Com an 20443 INSURED INSURER B ACCUSTAT SPORTS TIMING INSURER C :f 8748 NE GLISAN ST INSURERD: INSURER E PORTLAND OR 97220 INSURER F COVERAGES CERTIFICATE NUMBER:17-18 GL REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN WV POLICY NUMBER MMIDD/YYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1, 000 , 000 A CLAIMS-MADE ~ OCCUR DAMAGE TO RENTED 300 , 000 PREMISES Ea occurrence $ X 5085898531 2/1/2017 2/1/2018 MED EXP (Any one person) $ 10, 000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 000, 000 X POLICY ❑ PRO ❑ LOC PRODUCTS - COMPIOP AGG $ 2 , 000 , 000 JECT Employment Practices Liability $ 10, 000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED i PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y 1 N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Please see attached SB146932E 06/11 endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Cindy Cromwell/SHELLY - - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 r~n~an1~ COMMENTSIREMARKS Certifcate holder is named as additional insured. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. PROGRESSIVE ~~Da~~~~~~~/~,, P.U. BOX 31260 TA1tif1PA, FL 33631 ,D/RECl,4ut~ Policy Number: 71548254 Underwritten by: Progressive Universal Insurance Co February 3, 2017 ERIC J L~RPENTEUR Polity! Period t~~1ar ?01~+ - yep 2~~17 8748 NE GLISAN ST PORTLAPJD, OR 97224 Faye 1 of 3 progressive.com Qnline Service Make payments, check billing activity, update policy information or check status of a claim, Auto Insurance 1-s0o.~~s~~3~ Fc~~r customer service and claims service, ~o~rera a ~u n1 Z4 hours a day, ? days a Week. ~ rY This is cur R~n~~ral ~QCl~rati~ns P~ ~ The ouu~era~es, lim i~ 3rd policy period sh~.n~~rln apply only if you pay fur ~,~is policy to rerle~~~~l~ Your coverage begins on Nlarth 3, 2017 at 12:01 a~m , This policy expires on September 3, 1G 1 r at 1Z:G1 a.rn, Your insurance polit~l and arly policy endorsements contain a full explanation of your to~Uerge, Tne policy limits ~lo~~rn for a ~~ehide may not be combined ~~vith the limits for the same coUerage cn ana~er ~~ehitle~ Tne polity contract is form 9611D OP ~08~15}, Tne contract is m odified by forms 2357 ~01~07} and 4884 ~ 1008}, Drivers and resident relatives ~dU~>7c~>ai Iz,f~maac~r~ Eric)Larpenteur ,,.~,..,PJ3rnerJ ins~_~red...,.,. Outline of coverage 2003 FORD EC~N~/CLUB WGN E150 SPORT VAN UIN:1 FDRE11W03HB71527 Garaging ZIP Code: G7Z2G Primary use of ~~e vehicle: Commute LIf111[5 D~'l~Uftltil~' ~'i~J`IIUJiTI Liability ToOtf~ers ,.,C~odily Injur~+ and Propert)~ Damage Liabilitl'~,,,,,,,,,,,,, ~S~GG,GGG tom b'ir~ed ~~,Igle limit each acader~t,,,,,,,,,,,,.,,.,,,,,.,,.,,.,,.,,.,,.,,.,,, Personal Injury Protection ~ $25,600 $G 40 UninsuredjUnderinsured f~~otorist.~~.~~.,,.,,.,~..,.,..,,..~.~SGG,GOG combined single limit each acadent ...................3,1 Uninsured Motorist Properly Damage 1~$SG,GGG ead~ accident $2GG 5 $306 hits run Comprehensive Actual CashUalue ~~.~~.11.~~.~~.~1.~~.~1.~~.~~~$SGG .......................1G 1 ..................J L „ „Atrtual CashUalue ..................................................OC}. Collision ll Total premium for 2663 FORD,,,,,,,,,,,,,,,,,,,,.,,.,..,,.,,.,..~,.,,....,,.,,.,..,,....~~.,..,,.,,.,,.,,.,,.,,.,~.,,....,,.,,.~,.,..,~.~,.,,.,,.,~.,,.,,..~348 C~nonJ~ ~i ~ _ s, T ~ ~r -~--'i Accustat S orts Timin ~ g Live Race Services Proposal to: City of Ashland Parks and Recreation 41 st Annual Ashland 4th of July Run 2017 CHRONO3~°,~~rc : ~ ~ w i.. ~ s h. J„nprr„ 7 e..r~...h i~ . ~ non a.# .w~.. A , .;i. About Us Customers Say Accustat Sports Timing Inc. is a team of sports enthusiasts Accustat has hit the mark every year dedicated to improving the race experience for Race Directors We've used them. When They talk about being "Race Spackle" and filling and Participants. We have the newest chip timing equipment in the gaps they aren't kidding. Great to the Northwest and the professional staff to make your event work with! outstanding. Louise Long, Race Director Chip timing is primarily about database management. Without Seattle Marathon accurate data, the timing results are flawed or useless which leads to unhappy participants, At Accustat Sports Timing, Inc we spend the majority of our time behind the scenes before the event making sure that your event day runs smoothly. We can help you with your event by creating the registration database (including data entry), packet pickup, scoring, posting results online, course management, equipment rentals, and promotions. Timing Services Overview Utilizing the latest timing technology, our Chronotrack system has been used at Portland Marathon, Bloomsday, Seattle Marathon, Eugene Marathon, and a hundred other events. The same system is used at 24 of the 26 largest races in the USA. Chips are fastened to the bibs for runner convenience and greater accuracy. Beyond the technology, it's our crew that makes AST the leader in the Pacific Northwest. Energy, Experience, and Enthusiasm are our hallmarks! Live Services Overview In addition to standard timing services we can offer your athletes and participants ways to engage with your event through online, mobile and social race experiences, including: • Real-time online results • Mobile results • On-site computer results • Athlete updates on Facebook, Twitter and SMS • Athlete finisher video • Digital photography CHRONO~ ~ ^ k` ,y l' ~ ~ • K 1 ~Si~ 1 - ~ , il. w ~m ,ss:. ~ t v' . , J. 1. Timing Services Overview We can handle events of any size. For our large races we offer chip timing featuring ChronoTrack race solutions. For our growing races we're a great alternative for race directors who want professional results at reasonable rates. Timing Services Costs and Inclusions: Disposable BibTag or D-Tag Timing - $2500 minimum fee, covers up to 833 registrants $2.50 Per Registered Runner thereafter Equipment: • Start and Finish line timing included • Split point on 10k course • Timing tags • $750 per additional split time requested Travel and Staff: • Lodging and Mileage included • Staff member on-site for expo/registration race day This Includes: • Finish line setup: Start arch, cones, LED clock, 1300 watt PA System • Database management • Bib prep, preassignment and labeling or dynamic assignment on site • On-site registration • Computer Kiosk for Registration and Live Results • Generators for wherever we need power • Smiles and Enthusiasm Available: • Athlete video • Digital Photography • Registration Setup CHRONO~ ~i ~f 3 j ~ ~ i ~ ~}jk r- f $ f { Se 4 J ~ J 1. ~ i l 1 x t C J f 1 N 'ten') _ r" ~ i 'f ~""n^ ~ t R f a 1 ~ r~' ,F s x ^ t,ti~r a,tik ~u rh yFl.~} i~'~W ~ r J ~ ~ 1 ;;a, a~~ ,d ~~A, P y,,. <Y'< r,.~:~5 ~ ~ 1'." .~ti ~y A r r~L ~~~r1.. ?tW . to F4 ~ ~ ~ . E 17 ~~.f f,A w ~ Live Race Services: Real-time online, mobile and social race experiences that are engaging for spectators and athletes and increase your event exposure Check the box of services you wish to use ~..a. , ~ ❑ Real-time results online and at your event: • Results come off the course in real-time m~~ • Online results page is branded for your event and easily ' shared on Facebook and Twitter • On-site computer results so athletes can scan bib and view results immediately ❑ Mobile results: • Provide real-time leaderboard, athlete splits, pace and . , ~ ~ ~ finish times • Can promote available on site and through QR codes ~~`h`.~U. Cangiata;uions+ RICH;ARSON crossed.=;n.,h 8roaght ro you ~v Providence Nealth P!tn, ❑ Facebook, Twitter & Text Athlete Updates • Real-time updates from the course --,~-~oE~~E ~ • Athletes can set up during registration and we give you the tools to promote to spectators • Event exposure to participants social network 'x~,~'.x',,.:,'~~ ;~me~ WQaTi~e rtic . ~:;n.; %r ❑ Athlete Video ,~°~x~r.~~;~w~r~~~ • Athlete video crossing various splits on the course ❑ Digital Photography ..r ~ • Digital photography packages for sale through results interface • ChronoTrack coordinates photographers, sell photos and ` manages photography support _ ~ cHRONO~~,~A.~~~., i. ~ . ^~t~t, r ~ 5. ~,v-~<{fib;.. , e'S , a R s, ~ ',i.?Y ; .(4 S. Ay ,m!., . p 7 Jt lx', S:x~j, s J; . ~ ,t„ ) l.. `n7' ,i ti :E.F e ,.,,,~..a,a~ M u ...„vex .,c `,'.H.,~ Race Management Services Check the box of services you wish to use ❑ChronoTrack Registration (By checking this box you are ~ ~ ~ xous~on~ ~.~F~~sF[h29;,o~E~z ~a indicating you would like ChronoTrack to contact you to set up ~ ~ "°°~`°N~`" registration. This will be contracted directly with ChronoTrack) Namc,genA",da.~ofa,<<~~ First Name • Customized registration form - Lasl Nama • Social sharing options enable athletes to refer friends on Su Fe~ae Mae Facebook and Twitter • Combined with on-site race check i,n services and you _ Tom; »,6 , can keep registration open to the start of your event ~ ~ ❑On-Site Registration & Race Check In • Go green and eliminate data entry with paperless on-site registration on computers • Race check in conducted on computers eliminating pre- race packet assembly and bib assignment • Allows you to keep registration open to the start of the race Signed by: Name Organization Date Contact: Eric J Larpenteur 503.803.9377 eric@accustatsportstiming.com cHRONO~~~ n <i ~ it E ; ~ j~n~'~ ".F a.y~ y q~ "t , r t k' y t ~9 6 c rtry 9 } ~ N f .g^a-.-~-^'~5~^`°T'° ~°~°°r '°'~°^x @n 1 ewe.. A { nt, x ~ x 1 r:a r h= ~adr X r r'f ~ i I~ ; R t ~ l ((,Q ae s h ~ V ~ ~ 1 ) y r-. sit S A€: ~ s v:• f.. i, t f.. i „ P ~ s J ~ Terms & Conditions .Remaining amounts to be billed via invoice post-event and are due within 20 days of invoice. 1.5% per month interest added to unpaid amounts. Bib printing is the responsibility of the Event and need to be delivered to AST no later than 2 weeks prior to the Event for preparation. ,~F s • ASHLAND PARKS AND RECREATION COMMISSION 340 S. PIONEER STREET ASHLAND, OREGON 97520 COMMISSIONERS: Michael Black Mike Gardiner Director Rick Landt Jim Lewis TEL: 541.488.5340 Stefani Seffinger ,r FAX: 541.488.5314 Vanston Shaw parksinfo@ashland.or.us MEM RANDUM T0: John Karns, City Administrator FROM: Rachel Dials, Recreation Superintendent DATE: April 12, 2017 SUBJECT: Contract for Goods and Services Less than $5000-4t" of July Run/Accustat Accustat will provide database management and chip preparation services for the 4t" of July Run. I am asking that the auto insurance requirement be lowered to $500,000 instead of the $1,000,000. Please initial the agreement where I have noted and call me at 541-552-2260 if there are any concerns about lowering the requirement for auto insurance to $500,000. The contractor is on-site the day before the event and the day of. Thank you. ~I. Home of Famous Lithia Park Asks ~ Purchase Urder ,o Fiscal Year 2018 Page: 1 of: 1 ~S R ECftEo'~yy = - ~ - B Ashland Parks Commission =.-ice=-= I L ATTN: Accounts Payable Purchase L 20 E. Main 20180873 Ashland, OR 97520 Order # T Phone: 5411552-2010 O Email: payable@ashland.or.us V H C1O Recreation Division (Grove E ACCUSTAT SPORTS TIMING INC I 1195 East Main Street p 8748 NE GLISAN ST P Ashland, OR 97520 O PORTLAND, OR 97220 Phone: 5411488-5340 R 0 Fax:5411488-5314 V~ndo~'PhQn~NumbQr = _ _ _ _ Rachel Dials _ Date Or~~r~d ._.~1~~~d~r~lurribQr_=_=~r._ = - _ _ - 07107/2017 2301 FOB ASHLAND OR/NET30 Parks Accounts Pa able July 4th Run Management 1 Database management and chip prep services for the 2017 July 1 $2,500.0000 $2,500.00 4th Run Contract for Goods and Services Small Procurement Less than $5,000 Beginning date: 0510112017 Completion date: 0810112017 Project Account: E-000003-999 $2,500.00 GL SUMMARY ~ ~ 125302 - 610260 $2,500.00 r'' . , , . By:~ Oate: Authorized Signature - = ~ w ~ ~ $2 500.00 ~~~M#3 CITY OF SHLAND REQU~SIT~I~IV Date of request; ~ ~ Required date for delivery: Vendor Name ~ ~ i al~,te~ Address, City, State, Zip ~ ~ a t~~6~ ; Contact Name & Telephone Number ~ ~ ~ , gr , , , Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2,50 Date approved by Gouncil; ❑ Written quote or proposal attached Written cote or ro osal attached _ Attach co of council communication If council a royal re uired, attach co of CC Small Procurement Gooperative Procurement Less than 5 000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon -.Direct Award Date approved by Council: Contract # VerballWritten quote(s) or proposal(s) -(Attach copy of council communication) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract $5,000 to $100,000 ❑ Written quote or proposal attached Agency ❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVIGES ❑ Special Procurement Inte~overnmental Agreement $5,000 to $75,000 ❑ Form #9, Request far Approval ❑ Agency ❑ Less than. $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council; ❑ (3) Written proposalslwrittensnlicitation Date approved by Council; (Date) ❑ Form #4, Personal Services $5K to $75K Valid until; Date - (Attach copy of council communication) Description of SERVICES Total Cost z Item # Quantity Unit Description of MATERIALS Unit Price Total Cost o~ ~b> ~ v~`~A~ r~..~~~~ TOTAL COST Per attached quotelproposal ~ ~ o~, $ ~.~s,~9~ Project Number _ _ _ _ ° _ _ Accau~t~l~m~er _ _.@~~-~_.~ _ _ AccountNumber___-__®__•__•______ AccountNumber___•__•_ • Expenditure must be charged to the appropriate account numbers for the financials fo accurately reflect the actual expenditures, lT Director in collabaration with department to approve all hardware and software purchases: s~~. IT Director Date Support -Yes / No By signing this ui~i~i fo , I certify that the `i 's publi contracting requirements have been satisfied, ~ Employee: ~ ' ~ ~ ~ Department Head: ~J (Equal to or greater than $5,000) Department ManagerlSupervisor: City Administrator: (Equal to or greater than $25,000) ~ , Funds appropriated for current fiscal year YES ~ NO ~ ~ - ~ ~ ~ ~ ' F Frrfance Dlrecf'~(Equal fa or greater Phan $5,000) Date Comments: - ~m- Form #3 -Requisition