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HomeMy WebLinkAbout2017-209 Addendum to Contract-Hays Oil Company ADDENDUM TO CONTRACT FOR FUEL ASHLAND PARKS & RECREATION Addendum made this 10TH day of Jam, 2017, between the City of Ashland ("City") and Hays Oil Company ("Contractor"). Recitals: A. On 07/18/2016, City and Contractor entered into a "Contract for Fuel - Ashland Parks & Recreation" (further referred to in this addendum as "the agreement"). B. The parties desire to amend the agreement to extend the date of completion. City and Contractor agree to amend the agreement in the following manner: 1. The date for completion as specified in Paragraph 3 of the agreement is extended to July 17, 2019. 2. Except as modified above the terms of the agreement shall remain in full force and effect. C0N~R A C OR: ASHLAND PARKS & RECREATION " BY / BY jt4l 6~,= epart~t- Head Its Date DATE '-(a l 1111 ~7 07 Purchase Order # Acct. No.: r~ f C~ Addendum to Contract for Fuel - Ashland Parks S Recreation, Page 1 of 1 .'Faxmodeml (3/10) 06/26/2017 03:58:45 PM -0700 ~CERTIFICATE OF LIABILITY INSURANCE °A2"o 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(les) 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(a). PRODUCER O Palo Wimme2 NAM - Elliott Powell Baden and Baker Inc. P (AIC No ES-1- (Ar- HONE (503).227-1771 FAX Na : (503) 274-7944 An ISO Network Member ~~,pwimmer@epbb.com 1521 SW Salmon Street INSURERS AFFORDING COVERAGE NAICI Portland OR 97205-1783 INSURER AContinental Western Insurance Co. 10804 INSURED INsutmn a Great Divide Insurance Co. 25224 AIR Bays Co, DBA: Hays Oil Company INSURERCCertain Underwriters at Lloyds Hays Randolph LLC. INSURER o Endurance American Specialty Ins -Co 41718 PO Box 1220 INSURER E: Medford OR 97501 INSURER F: COVERAGES CEFMFlCATENUMBER:17-18,GL,AL,Vm s Excess 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. I~ R TYPEOFINSURANCE POLICY NUMaER P LICDV FJF POU YEKP (MMMDfVYYn LIMITS X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE S 1,000,000 A CLAIMS-MADE OCCUR p M $ 300,000 X CPA2938039 7/1/2017 7/1/2018 MED EXP (Anyone moI $ 10,000 PERSONAL&ADV INJURY $ 1,D00,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERALAGGREGATE $ 2,000,000 X POLICYDjEp& 0LOG PRODUCTS -COMPIOPAGO $ 2,000,000 b OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE UMrr $ 1,000,000 (ER "ddoffl) B X ANY AUNT BODILY INJURY For Pelson) $ ALLOWNED SCHEDULED 8007123 7/1/2017 7/1/2018 BODILY INJURY (Per uddem) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY AMAGE $ X CA 6948 $ UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 6,000,000 C X E(CESS LIAR CLAIMS-MADE AGGREGATE $ 6,000,000 DEO RETENTION 17-RZM=600053101967 7/1/2017 7/1/2018 $ WORKERS COMPENSATION PEAq ER AND EMLOVERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTNE ❑ NIA EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL DISEASE - EA EMPLOYE $ IIyes derv U,We, OESGRIPTION OFOPERATIONS below. E.L. DISEASE - POLICY UMIT $ D ELiability LR030000382500 7/1/2017 7/3/2018 LIm84,000,000 So o¢/agg A Property in Transit CPA2936039 7/1/2017 7/1/201$ Umll 100.000 DESCMPOON OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addl6enal Remake S&odNe, may be a shed If mars apace la mcmrsc) Be: Delivery of Fuel. Form CL CG 04 92 09 16 is attached. CERTIFICATE HOLDER CANCELLATION (541)488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POUGES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 N Mountain Ave ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Pam Wimer/LJ ~Tcw+~u-La p`(~~t~wlX./~J 01988.2014 ACORD CORPORATION. All rights reserved. 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'rye aginaad 6w, Minurrrce vvs0+r >su#i at VOW 'S a* rnei .th grist =ate dt it>avireinae ~ :~li'itri~rty ek oss, c oritlt gehi or >eeAOrv~xy is Y ti<~►r soh perlulpetx 014 any ot#W #bwb. any payta- ntab y ~ rnrtll. oBi a r*, t`ht v irrer:pop"$: ~ 1d1I~1nt P#r~$ 4#f Seca*S t1! p~ersors(ay or > om~~~ct' a th # :snnrt»i~tat.teral:l:tab~tt::co#r#>EOr>.. wrath rnacf pr9[nICiFlht ! Thus; ;t r a ",OK'Op 'fit tNr ~ rar-~xi ~rrta~ t~ ~aie~r aers~tt~sd Nag a !1€ ,:scat psrsc i At tttjgme E is iitigite~y is ww al1.,*A*pat : Ow 'W tr at. rip- -Ot l u : wt is i€ eai to Qi 00.04,z 4% ttS MeV+'~h l AWS Mt l"Oit'a liltttti.lf~q>3rtilt§i;9ikKk As~`q Purchase Order ti o - Fiscal Year 2018 Page: 1 of: 1 3 R E GREo THIS PO NUMBER-MUST APPEAR ON ALL B Ashland Parks Commission 1NVOIGE AND SHIPPING_DOCUMENTS ATTN- Accounts Payable Purchase v L 20 E. Main 20180887 Ashland, OR 97520 Order # T Phone: 541/552-2010 p Email: payable@ashland.or.us V H C/O Oak Knoll Maint Shop E HAYS OIL COMPANY I 3070 Hwy 66 N PO BOX 1220 P Ashland, OR 97520 D MEDFORD, OR 97501 Phone: 541/488-5340 O O Fax: 541/488-5314 R Vey PhbmN mbar ndWT EWWN um = Jeff McFarland - D~tQ =Ordered ~Idr=~l-= en Ce atrQn 07/19/2017 35 FOB ASHLAND OR/NET30 Parks Accounts Payable Jtm# -e - SEEM e_d Prt_e_ Parks bulk fuel 1 Parks bulk fuel (Unleaded and B5 Bio Diesel w/additive) to be 1 EACH $7,000.0000 $7,000.00 delivered as needed to Oak Knoll Maintenance Shop Contract Addendum Extending contract to July 17, 2019 PENDING COUNCIL APPROVAL 08/01/2017 Project Account: $7,000.00 GL SUMMARY 125500 - 602120 $7,000.00 Bye Date: Pal oriz -Signature _ - $7,000.00 FO1M#3 CITY OF -ASHLAND REQUISITION Date of request: Required date for delivery: Vendor Name Address, City, State, Zip Contact Name & Telephone Number 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 Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached _ Attach co of council communication If council approval required, attach co of CC ❑ Small Procurement ❑ Request for Proposal (Copies on file) Cooperative Procurement Less than $5,000 ❑ State of Oregon Date approved by Council: ❑ Direct Award -(Attach copy of council communication) Contract # ❑ Verbal/Written 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 $5,00016 $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 Intergovemmental Agreement $5,000 to $75,000 ❑ Form #9, Request for Approval El Agency ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Written proposals/written 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 $ Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST Per attached quote/proposal $ "kf Project Number _ _ _ _ _ _ - _ _ _ Account Number - Account Number Account Number *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. ITDirector/n collaboration with department to approve all hardware and software purchases IT Director Date Support -Yes / No By signing this requi lion form, l certify t the City's public contracting requiQments ha ve been satisfied. ri Employee: partment Head: J (Equal to or greater than $5,000) 74 Department ManagerlSupervisot 1 City Administrator: (Equal to or greater than $25,000) l: f Funds appropriated for current fiscal year. ~Y, E l NO <FinanceDirect©r-'(Equaltoorgreaterthan $5,ooo) Date Comments: Form #3 - Requisition