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HomeMy WebLinkAbout2018-023-Contract for Goods & Services- SME Solutions Contract for GOODS AND SERVICES less than $25,000 r l CITY OF CONTRACTOR: SME Solutions, LLC j ASHLAND CONTACT: Brad Weast 20 East Main Street Ashland, Oregon 97520 ADDRESS: 10107 South Tacoma Way #A2 Telephone: 541/488-6002 Lakewood, WA 98499 Fax: 541/488-5311 TELEPHONE: (253)572-3822 DATE AGREEMENT PREPARED: 9/26/2017 FAX: (253)572-0978 BEGINNING DATE: July 1, 2017 COMPLETION DATE: June 30, 2018 COMPENSATION: Per fee schedule attached as Exhibit C. GOODS AND SERVICES TO BE PROVIDED: Repair, maintenance and testing of fuel islands and tanks. 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 primary 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 into this contract now represents, that any personnel i assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 27913.220, 279B.225, 2798.230, 279B.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 Exhibit B predominantly in areas where it will be seen by all employees. 8. Indemnffication: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 9. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. s b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of i written notice to Contractor, or at such later date as may be established b City under an of the following Contract for Goods and Services Less than $25,000, 06/19/2017, Page 1 of 5 conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are f no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Contractor to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Contractor may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Contractor's performance of each and every obligation and duty under this contract. City by written notice to Contractor of default or breach, may at any time terminate the whole or any part of this contract if Contractor fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. 10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any requirement of ORS 279A.110 or the administrative rules implementing the Statute. 12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor has qualified as a GRIP for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 16. Insurance. Contractor shall at its own expense provide the following insurance: 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 b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000,$500,000,$1,000,000,$2,000.00 0 or Not Applicable for each occurrence for Bodily Injury and Property Damage. I L C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. _ Contract for Goods and Services Less than $25,000, 06/1912017, Page 2 of 5 d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to the City. e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies, excluding Workers' Compensation, required herein but only with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or 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, suit or } proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 19. Nona pprop riations 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. Contract City of Ashlar By ~ By Signature Depart ent Head Pam, C~•, rK_E.-`fir ~ Sc~F 1r~ ~2y Print Name Print Name C,dycc, ~ ` Y 1I2/ t*~, Title at W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. Contract for Goods and Services Less than $25,000, 06/19/2017, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: 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, it is an independent Contractor as defined in the contract documents, it is authorized to do business in Oregon, it is authorized to act on behalf of the City, and Contractor has checked four or more of the following criteria that apply to its business. (1) 1 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 N4, purchased for the business. r, (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) 1 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. VZ Con i ctor (Date) Contract for Goods and Services Less than $25,000, 0611912017, Page 4 of 5 _ 'r.,, , y ` •1- ,..V f. CITY OF ASHLAND, OREGON EXHIBIT B City of Ashland LIVING I I WAGE per hour effective June 30, 2017 (Increases annually every June 30 by the Consumer Price Index) • - • . business of their and IRS eligible cafeteria employer, if the employer plans (including has ten or more childcare) benefits to the employees, and has amount of wages received financial received by the For all hours worked assistance for the project employee. under a service contract or business from the City between their employer of Ashland in excess of ➢ Note: "Employee" does and the City of Ashland if $20,688.86. not include temporary or the contract exceeds part-time employees $20,688.86 or more. ➢ If their employer is the hired for less than 1040 City of Ashland including hours in any twelve- ➢ For all hours worked in a the Parks and Recreation month period. For more month if the employee Department. details on applicability of spends 50% or more of this policy, please see the employee's time in ➢ In calculating the living Ashland Municipal Code that month working on a wage, employers may Section 3.12.020. project or portion of add the value of health care, retirement, 401 K For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF Contract for Goods and Services Less than $25,000, 06119/2017, Page 5 of 5 -AS` _ `""~A ' N D Tacoma, WA • 10107 S. Tacoma Way, Suite A-2 Lakewood, WA, 98499 E Portland, OR 2800 NW 31" Ave, Portland. OR 97210 r= M San Diego, CA 7257 Ronson Rd San Diego, CA 92111 800.348.8487 Fax 253.572.0978 Spokane, WA S M E SOLUTIONS, L LC Oregon CCB 11174332 6015 E Veileyway Ave, Spokane Valley, WA 99212 City of Ashland Labor Rates: t Hourly rates: Mechanical $90.00 Electrical $150.00 (lie 0j Over Time rates: Mechanical $135.00 Electrical $225.00 Paw Holiday rates: Mechanical $180.00 Electrical $300.00 Prevailing wage rates: Mechanical $125.00 Electrical $175.00 Prevailing wage OT: Mechanical $187.50 Electrical $232.50 Prevailing wage Holiday: Mechanical $250.00 Electrical $350.00 Travel: Hourly rates +,98 per mile Sub-Contractor: Cost + 15% Equipment Rental: Cost+ 30% Materials: Cost + 30% Safety-Service-Satisfaction Client: 335759 SMESOLUT ACORDTN CERTIFICATE OF LIABILITY INSURANCE 12/29 ° /2017 2017 12129 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(tes) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder In lieu of such endorsement(s). ONTACT Jake McCauley PRODUCER C NAME: US[ Northwest WC PA/C HOr1ENo Ext : 503 224-8390 610 362-8130 AIC No 700 NE Multnomah, Suite 1300 E-MAIL DD SS: lake.mccauley@usi.com Portland, OR 97232 INSURER(S) AFFORDING COVERAGE NAIC9 503 224-8390 INSURER A : SAIr coTora ion 36196 INSURED INSURER B : Zurich Anrencan Insurance Camp, 16535 SME Solutions, LLC INSURER C 680 Quinn Ave. San Jose, CA 95112 INSURER D: INSURER E: INSURER F : COVERAGES - CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE. POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR TYPE OF INSURANCE INSR MD POLICYNUMBER MWDDYEFF M IDOY LIMITS COMMERCIAL GENERAL LIABILITY EEAACCHHCCCCURRENCE $ CLAIMS-MADE ~ OCCUR PREMISES E R~ aEONrTEE.D nca $ MED EXP (Any one person) S PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- - POLICY ❑ JECT F-1 LOC PRODUCTS - COMP/OPAGG 8 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acGtlent $ ANY AUTO BODILY INJURY (Per person) 8 OWNED.. SCHEDULED BODILY INJURY (Peraedident) AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DELI RETENTIONS $ A WORKERS COMPENSATION - 992634 010112017 101011201 X PER OTH- AND EMPLOYERS' LIABILITY YIN ER ANY PROPRIETORJPARTNERIEXECUTIVW E.L. EACH ACCIDENT $1000000 OFFICERIMEMBER E%CLUDED? N NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1 000000 If yes, descdbs under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Workers' Comp. 8997923 010112017 101011201 1000/100011000 DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Repair, maintenance and testing of fuel islands and tanks CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 North Mountain Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S22230528/M21628626 JXMJT This page has been left blank intentionally. SMESOLU-CL DWATTS ~~R~e CERTIFICATE OF LIABILITY INSURANCE DATE(MMMD/YYYY) 12/14/2017 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT George Petersen Insurance Agency, Inc. PHONE 525.4150 FAX 707 525-4175 P.O. Box 3539 (A/C, No, EA); (707) (AIC. Net:( ) Santa Rosa, CA 95402 E-MAIL . info@gpins.com INSURERS AFFORDING COVERAGE NAIC N INSURER A: Homeland Insurance Company of New York 34452 INSURED INSURER B: Fireman's Fund Insurance Co. 21873 SME Solutions, LLC INSURER C: 10107 S Tacoma Way, Suite A-2 INSURER D : Lakewood, WA 98499 INSURER E NSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECTTO 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 ADOL SUBR pOLICV NUMBER POLICY EFF POLICY EXP LIMITS To iNen IM myi,nDfYyy`Y% A X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 7'000'000 CLAIMS-MADE ❑ OCCUR X 793.00-22-82-0003 06/1412017 0611412018 DAMAGE TO RENTED $ 50,000 PREMISES( --m-1 X Pollution & Professi MED EXP An one person) S 5,000 PERSONAL &ADV INJURY 7'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 7,000,000 POLICY ~ wof L-1 LOC PRODUCTS-COMP/OPAGG $ 7,000,000 OTHER' WA Stop Gap Cov S 5,000,000 B AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT $ 1,000,000 X ANY AUTO X MZX80976509 03115/2017 03115/2018 BODILY INJURY Per Person) S OWNED SCHEDULED AUTOS ONLY X AUT8~pSSyVN BODILY INJURY Per accident S X AUT OS ONLY AUTOS ONLY Parre ,r AMAGE S S UMBRELLA LINE OCCUR EACH OCCURRENCE S EXCESS LIAe CLAIMS-MADE AGGREGATE $ DED RETENTIONS S WORKERS COMPENSATION PER OTH-qTATIMF ER AND EMPLOYERS' LIABILITY YIN AFFICERPREMBEREXCWEED?ECUTIVE ❑ N/A E.L. EACH ACCIDENT (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may lea attached if more space is required) RE: Repair, maintenance and testing of fuel islands and tanks City of Ashland, Oregon, and its elected officials, officers and employees are named as Additional Insured with respects to General and Auto Liability per forms OBENV GE 301 (0211) & CA 70181014 , attached. Primary Wording applies per form OBENV GE 319 (0211), attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 90 North Mountain Ave. Ashland, OR 97520 AUTtIORIZED REPRESENTATIVE o~~^~~'f V U ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: 793-00-22-82-0003 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - FORM I This endorsement only modifies coverage provided tinder the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for which the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scope of insurance agreed to by the Named Insured. (f no entry appears above, information required to complete this endorsement will be shown In the Doclarations as applicable to this endorsement.) A. SECTION 11 - WHO IS AN INSURED is amended to Include as an insured the person or organization shown in the SCHEDULE above, but only with (aspect to liability arising out of your ongoing operations performod for that insured. B. With respect to the insurance afforded to these a1dillonal insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after: (a) All work, including materials, parts or equipment furnished in connection with Such work, on tho project (other than uervice, malnlenatlce or repairs) to be perforated by or on behalf of the additional insure9(s) at the site of the covered operations has been completed; or (b) Thal portion of your work out of which the Injury or damage arises has been put to its intended use by any persor or organization other Ihan another contractor or subcontractor engagod in performing operntlons for a principal as a part of the same project. All other terms and conditions remain the same. ou(z. Jv C.F 30'I (02 11) inouda5 copydgbled nlatodal31Insurance Servk S; OM,;% Inc. 1 of l Copyrlght 2011,0nG@eawo gtsurance Group I.-INSURED THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SECTION IV - CONDITIONS, 8. Other Insurance, is amended by adding the following paragraph: This insurance will be considered primary to, and non-contributory with any other insurance issued directly to a person or organization added as an additional insured under this policy, only if you specifically agree, in a written contract or agreement, that this Insurance must be primary to, and non-contributory with, such other insurance. All other terms and conditions remain the same. OBENV GE 319 (02 11) Includes copyrighled materiel or Insurance Services OIGce, Inc. 1 or l Copyright 2011, OneBeacon Insurance Group E-INSURED ' FleetCovero Endorsement - CA 70 18 10 14 Policy Amendment(s) This endorsement modifies insurance provided under the following: Business Auto Coverage Form Motor Carrier Coverage Form With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Broadened Named Insured Section 11 - Covered Autos Liahilit% Coverage, A. Coverage, 1. Who Is An Insured, the l'ollowing is added: Any organization you own on the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the policy period, majority ownership or majority interest will qualify as a Named Insured if: (1) There is no other similar insurance available to that organization: and (2) The first Named Insured shown in the Declarations of this policy has the responsibility of placing insur- ance for that organization: and (3) The organization is incorporated or organized under the laws of the United States of America. However: (a) Coverage tinder this provision is afforded only until the next occurring 12 month anniversary of the be- ginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier: and (b) Coverage under this provision does not apply to hodih injury or property damage that results from an accident that occurred before you acquired or formed the organization: and (c) No person or organization is an insured with respect to any current or past partnership, or joint venture that is not shown as a Named Insured in the Declarations; and (d) Coverage under A.(1), (2) and (3) above does not apply to any organization that is covered as an insured under any other automobile liability insurance policy whose limits of insurance have been exhausted or whose insurer has become insolvent. B. Broadened Who Is an Insured I. Form CA0001 (if attached to this policy). Section 11 - Covered Autos Liahilit• Coverage, A. Coverage. I. Who Is An Insured, item b.(2) is deleted, and d. is added as follows: d. Your employee while using with your permission his owned auto, or an auto owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that auto. This Form must he attached to Change F.ndorsemcnt when issued alter the police i. written. One of the Fireman's Fund Insurance Companies as named in the Ixilicy CA7018 10-14 'C 2014 Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Page I of 2. Form CA0020 (if attached to this policy). Section 11 - Covered Autos Liability Coverage, A. Coverage. 1. Who Is An Insured, item b.(2) is deleted, and f. is added as follows: f. Your employee or agent while using with your permission his owned private passenger type auto, or a private passenger type auto owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that auto. C. Additional Insured Coverage and Waiver of Subrogation 1. Farm CA0001 (if attached to this policy), Section 11 - Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, the following is added as item e.; and form CA0020 (if attached to this policy), Section II - Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured; the following is added as item g.: Any person or organization with respect to the operation, maintenance, or use, of a covered auto, provided that you and such person or organization have agreed under an expressed provision in a written insured contract or written agreement, or a written permit issued to you by a governmental or public authority, to add such person, organization, or governmental or public authority to this policy as an insured However, such person or organization is an insured (1) Only with respect to the operation, maintenance, or use, of a covered auto; and (2) Only for bodily injury or property damage caused by an accident which takes place after: (a) You executed the insured contract or written agreement; or (b) The permit has been issued to you. 2. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, A. Loss Conditions, item 5.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, A. Loss Condi- tions, item 6.; the following is added: Waiver of Subrogation If required by a: a. Written insured contract or written agreement executed prior to the accident; or b. Written permit issued to you by a governmental or public authority prior to the accident'. we waive any right of recovery we may have against any person or organization named in such contract, agreement or permit, because of payments we make for injury or damage arising out of a covered auto. D. Auto Medical Payments - Increased Limit For each covered auto described in the Declarations or shown in the Schedule as having Auto Medical Pay- ments Coverage, the Medical Payments Limit of Insurance for those autos is revised to the greater of: I. $5,000; or 2. The limit shown in the Declarations. E. Hired Auto Physical Damage Coverage and Loss of Use Expenses Hired Auto Physical Damage Coverage It' Physical Damage Coverage is provided by this policy on your owned covered autos, the following applies: CA7018 10-14 C 2014 Fireman's Fund Insurance Company, Novato, CA. All rights reserved. Page 2 of 9 Any auto that you lease, hire, rent or borrow without a driver. will be covered under- this policy for Physical Damage Coverage. However, any such auto: 1. Will be covered only for the same Physical Damage Coverage that applies to your owned covered autos; 2. Will be subject to the same applicable deductible shown in the Declarations that applies to your most sirmlar owned covered auto, except any Comprehensive Coverage deductible does not apply to loss caused by fire or lightning; and 3. The most we will pay for any one loss in any one accident is the lesser of the following: a. Actual Cash Value of the damaged or stolen property as of file time of the loss as determined by us: or b. The cost of repairing or replacing the damaged or stolen property %vith other property of like kind and quality. In addition, we will pay costs and fees associated with such covered loss only for a maximum time period of seven days beginning with the date of loss, subject to a nlaxinlum of' S500. However: (1) If form CA0001 is attached to this policy, this coverage does not apply to autos you lease. hire, rent or borrow from any of your employees, partners (if you are a partnership). members (if you are a limited li- ability company) or members of their households; and (2) If fornl CA0020 is attached to this policy, this coverage does not apply to any private passenger hype auto you lease, hire, rent or borrow from any member of your household, any of your employees, partners (if you are a partnership), members (if you are a limited liability company), or agents or members of their households. Hired Auto Loss of Use Expenses Forn CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 4. Coverage Extension, b. Loss of Use Expenses; and fomt CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 4. Coverage Extension, b. Loss of Use Expenses, is deleted and replaced by the following: b. For Hired Auto Physical Damage, we will pay expenses for which an Insured becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: ( I ) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered auto; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss is provided for any covered auto; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered auto. However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of 51,000. F. Coverage Territory - Hired Auto 1. Form CA0001, (if attached to this policy), Section IV - Business Auto Conditions, B. General Conditions, 7. Policy Period, Coverage Territory, b.(5) is deleted and replaced by the following: CA7018 10-14 2014 Fireman's Fund Insurance Company, Novato. CA. All rights reserved, Page 3 of 9 (5) Anywhere in the world if a covered auto of the private passenger type is leased, hired, rented or bor- rowed without a driver for a period of 180 days or less, 2. Form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, 13. General Conditions, 7. Policy Period, Coverage Territory, b.(5) is deleted and replaced by the following: (5) Anywhere in the world if a covered auto of the private passenger type is leased, hired, rented or bor- rowed without a driver for a period of 180 days or less, G. Communication Equipment Coverage Form CA0001 (if attached to this policy). Section 111 - Physical Damage Coverage, C. Limits of Insurance, Paragraph l.b.; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, C. Limits of Insurance. Paragraph Lb.: is deleted and replaced by the following: b. All electronic equipment that reproduces , receives or transmits audio, visual or data signals in any one loss is $1,500, it'. at the time of loss, such electronic equipment is: H. Tapes, Records, CDs and DVD Coverage The Physical Damage Coverage Section is amended as follows: I. The exclusion referring to tapes, records, discs, or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment does not apply. 2. Under Comprehensive Coverage - Form CA0001 (if attached to this policy), Section III- Physical Damage Coverage. A. Coverage; and form CA0020 (if attached to this policy). Section IV- Physical Damage Coverage, A. Coverage; the following is added: We will pay for loss to tapes, records, discs or other similar devices used with audio, visual or data elec- tronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data elec- tronic devices: a. Are your property. or that of a family member: and b. Are in a covered auto at the time of a loss. The most we will pay for loss is 5250. No deductible applies to this coverage. 1. Personal Effects Coverage Form CA0001 (if attached to this policy), Section Ill - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions: and form CA0020 (if attached to this policy). Section IV - Physical Damage Coverage, A. Cover- age, 4. Coverage Extension; item c. is added as follows: C. Personal Effects Coverage We will pay tip to $500 for loss for clothing items or other personal effects that are owned by an insured and are in a covered auto in the event of a covered loss. Personal Effects do not include audio visual or electronic devices, money, giftcards, securities, jewelry, or tools. This coverage is excess over any other collectible insurance. No deductible applies to this coverage. CA7018 10-14 B 2014 Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Page 4 of .I. Airbag Coverage Form CA0001 (if attached to this policy), Section Ill - Physical Damage Coverage, B. Exclusions, 3.a.; and form CA0020 (if attachcd to this policy), Section IV - Physical Damage Coverage, B. Exclusions, 3.a.; the following is added: However, mechanical breakdown does not mean the unintended discharge of an airbag, provided that any loss covered under this provision is excess over any other collectable insurance or warranty designed to cover such unintended discharge. K. Rental Reimbursement Forni CA0001 (if attached to this policy), Section 111 - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Cover- age, 4. Coverage Extension; item d. is added as follo%ks: d. Rental Reimbursement or Transportation Expenses If loss occurs to a covered auto described or designated in the Declarations or. Schedule and covered for Physical Damage Coverage, we will pay for rental expenses for the rental of a similar replacement auto and additional transportation expenses, incurred by you. This payment applies in addition to the otherwise applicable amount of each coverage you have on the covered auto. No deductible applies to this coverage. However: ( I ) We will pay only for those expenses incurred by you that begin 24 hours after the covered loss. (2) We will cease paying for those expenses, regardless of the policy's expiration date, at the earlier of the Hallowing dates: (a) The number of days reasonably required to repair or replace the covered auto. If loss is caused by theft, this number of days is added to the number of days it takes to locate and return the covered auto to you. or (b) 45 days from the date this coverage begins. (3) Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred by you, or (b) 51,500. (4) This coverage does not apply while there are spare or reserve autos available to you for your oper- ations. (5) If loss results from the total theft of a covered private passenger type auto (if CA0020 is attached to this policy), or a covered private passenger auto (if CA0001 is attached to this policy), we will pay under this coverage only that amount of' your covered rental expenses or additional transportation expenses which are not already provided for under the Physical Damage Coverage Extensions. L. Extended Towing Coverage 1. Form CA0001 (if attached to this policy). Section 111 - Physical Damage Coverage. A. Coverage, 2. Towing, is deleted and replaced by the following: CA7018 10-14 0 2014 Fireman's Fund Insurance Company, Novato. CA. All rights reserved. Page 5 of 9 2. Extended Towitio We will pay tip to $750 per disablement For towing and labor costs you incur each time your covered auto is disabled. However: a. All labor must be performed at the place of disablement, and b. If the covered auto is of the private passenger type, no deductible applies; and c. If' the covered auto is not of the private passenger type, our obligation to pay will be reduced by a $250 deductible per disablement. d. If the covered auto is not of the private passenger type and the disablement results from a loss covered under Section 111 - Physical Damage Coverage, A. Coverage, Paragraphs 1, a., b., or c., there is no separate deductible for the Extended Towing Coverage. For purposes of this coverage, disablement means a breakdown of the covered auto including n1e- chanical breakdown, engine failure, or tire blowout, where repairs cannot be made roadside and a tow is required to remove the auto from the roadway and to seek additional services and repair. 2. Form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage. A. Coverage, 2. Towing - Private Passenger Autos, is deleted and replaced by the following: 2. Extended Towinc We will pay up to $750 per disablement for towing and labor costs you incur each time your coveted auto is disabled. However: a. All labor must be performed at the place of disablement; and b. If' the covered auto is of the private passenger type, no deductible applies; and c. If the covered auto is not of the private passenger type. our obligation to pay will be reduced by a $250 deductible per disablement. d. If the covered auto is not of the private passenger type and the disablement results from a loss covered under Section IV - Physical Damage Coverage, A. Coverage, Paragraphs 1. a., b.. or c.. there is no separate deductible for the Extended Towing Coverage. For purposes of this coverage, disablement means a breakdown of the covered auto including me- chanical breakdown, engine failure, or tire blowout, where repairs cannot be made roadside and a tow is required to remove the auto from the roadway and to seek additional services and repair. M. Cancellation - 120 Days Notice if we cancel this policy for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured at the last mailing address known to its, written notice of cancellation at least 120 days prior to the effective date of cancellation. N. Supplementary Payments - Increased Limits Section II - Covered Autos Liability Coverage, 2. Coverage Extensions, I. Supplementary Payments, items (2) and (4) are deleted and replaced by the following: (2) Up to 52,500 for the cost of bail bonds (including bonds for related traffic law violations) required because of an accident we cover. We do not have to furnish these bonds. CA7018 10-14 Cr. 2014 Fireman's Fund Insurance Company, Novato. CA. All rights reserved. Page 6 of 9 (4) All reasonable expenses incurred by the insured at our request, including substantiated loss of earnings up to 5500 a day, because of time off from work. 0. Duties In The Event Of Accident, Claim, Suit Or Loss - Amended Form CA0001 (if attached to this policy) Section IV - Business Auto Conditions, A. Loss Conditions, item 2. a.; and form CA0020 (if attached to this policy) Section V - Motor Carrier Conditions, A. Loss Conditions. item 2, a.; is deleted and replaced by the following: a. In the event of accident, claim, suit or loss, you must promptly notify us or our authorized representative when it becomes known to: (1) You, if you are an individual; (2) Your partner or member, if you are a partnership or joint venture; (3) Your member, if you are a limited liability company; (4) Your executive officer if you arc an organization other than a partnership, joint venture or limited li- ability company; or (5) Your authorized representative or insurance manager. Knowledge of an accident, claim, suit or loss by other persons does not imply that the persons listed above have Such knowledge. Notice should include: (a) [low, when and where the accident or loss occurred; and (b) The insured'sname and address; and (c) To the extent possible, the names and address of any injured persons and witnesses. P. Unintentional Failure to Disclose Hazards Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, B. General Conditions, item 2.: and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, B. General Conditions, item 2.; the following is added: However, if you unintentionally fail to disclose any hazards existing at the inception date of this policy, we will not deny coverage tinder this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. Q. Fellow Employee Coverage Section 11 - Covered Autos Liability Coverage. B. Exclusions, 5. Fellow Employee, the following is added: Ilowever, this exclusion does not apply if the bodily injury results from the use of a covered auto you own or hire, and provided that any coverage under this provision only applies in excess over any other collectible insurance. R. Limited Mexico Coverage WARNING AUTO ACCIDENTS IN MEXICO ARE. SUBJECT TO THE LAWS OF MEXICO ONLY - NOT THE LAWS OF THE. UNITED STATES OF AMERICA. THE REPUBLIC OF MEXICO CONSIDERS ANY AUTO ACCIDENT A CRIMINAL OFFENSE AS WELL AS A CIVIL MATTER. CA7018 10-14 2014 Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Page 7 of 9 IN SOME CASES THE COVERAGE PROVIDED HERE MAY NOT BE RECOGNIZED BY THE MEXICAN AUTHORITIES AND WE MAY NOT BE ALLOWED TO IMPLEMENT THIS COVER- AGE AT ALL IN MEXICO. YOU SHOULD CONSIDER PURCHASING AUTO COVERAGE FROM A LICENSED MEXICAN INSURANCE COMPANY BEFORE DRIVING IN MEXICO. THIS ENDORSEMENT DOES NOT APPLY TO ACCIDENTS OR LOSSES WHICH OCCUR OUT- SIDE OF 25 MILES FROM THE BORDER OF THE UNITED STATES OF AMERICA. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, B. General Conditions, item 7.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions. B. General Conditions, item 7.; the following is added: The coverage territory is extended to include Mexico, but only: (i) For accidents or losses occurring within 25 miles of the United States border: and (ii) For trips into Mexico of 10 days or less: and (iii) If the covered auto is principally garaged and principally used in the united States: and (iv) if the insured is a resident of the United States. If a loss to a covered auto occurs in Mexico, we pay liar such loss in the United States. If the covered auto must be repaired in Mexico in order to be driven, we will not pay for more than the actual cash value of Such loss as determined by us at the nearest United States point where the repairs can be made. Any insurance provided under this provision will be excess over any other collectible insurance. S. Extended Glass Coverage Form CA0001 (if attached to this policy), Section 111 - Physical Damage Coverage. A. Coverage, item 3.a.: and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, item 3.a.: is deleted and replaced by tile rollowing: a. Glass breakage. If glass must be replaced, the deductible will be SI00 or the deductible shown in the Declarations, whichever is less. If glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. T. Broadened Definition of Bodily Injure Form CA0001 (if attached to this policy). Section V - Definitions, item C.: and forni 0110020 (if attached to this policy). Section VI - Definitions, item C.; is replaced by the following: C. Bodily injury mcans bodily injury, sickness or disease sustained by it person including death or mental anguish resulting from any of these at anv time. Mental anguish means any type of mental or emotional illness or disease. U. Customer Lease or Loan Physical Damage Coverage Extension Form CA0001 (if attached to this policy). Section I11 - Physical Damage Coverage. C. Limits of insurance: and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, C. Limits of Insurance; item 4. is added as follows: 4. If your covered owned auto is: (1) Shown in the Schedule and designated as covered for Physical Damage Coverage: and (2) Shown in this policy as having a loss payee or additional insured-lessor: and CA7018 10-14 2014 Fireman's Fund Insurance Company, Novato. CA. All rights reserved. Page 9 of 9 I i (3) Incurs a covered total loss: we will pay the greater of: (a) The actual cash value, as determined by us, of the damaged or stolen property as of the time of the total loss, or (b) The outstanding indebtedness under the initial finance agreement for the covered auto and its equip- ment. As used here, outstanding indebtedness means the amount you owe on the finance agreement at the time of total loss: (i) Less any amounts representing taxes, overdue payments, penalties, interest, or charges resulting from overdue payments, additional mileage, excel, wear and tear, or lease termination fees: and (ii) Less any administrative costs or overhead fees assessed by the finance company who has leased the covered auto to you; and (iii) Less security deposits not returned by the lessor: and (iv) Less costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease: and (v) Less carry-over balances from previous loans or leases. V. Two or More Deductibles 1. Section III - Physical Damage Coverage D. Deductible. of farm CA0001 (if attached to this policy), the followinf; is added: If another Fireman's Fund Insurance Company policy or coverage form that is not an automobile policy or coverage form applies to the same accident or loss, the following applies: (1) If the deductible under this Business Auto Coverage Form is the lesser (or least) deductible, it will be waived. (2) If the deductible under this Business Auto Coverage Form is not the lesser (or least) deductible, it will be reduced by the amount of the lesser (or least) deductible. 2. Section IV - Physical Damage Coverage, D. Deductible of form ('A0020 (if attached to this policy), the following is added: If another Fireman's Fund Insurance Company policy or coverage form that is not an automobile policy or coverage form applies to the same accident or loss, the following applies: (1) If the deductible under this Motor Carrier Coverage Form is the lesser (or least) deductible, it will be waived. (2) If the deductible under this Motor Carrier Coverage Form is not the lesser (or least) deductible, it will be reduced by the amount of the lesser (or least) deductible. All other terms and conditions of the policy remain unchanged. CA7018 10-14 V. 2014 Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Page 9 of 9 I (31 TY tq" Purchase Order Fiscal Year 2018 Page: 1 of. 1 ~aTHIS-~HIJMBE€~7NtI~RPPE4-,~QN RCL-=_ B City of Ashland ATTN: Accounts'Payable O 1T64 ~ 20 E. Main Purchase Ashland, OR 97520 Order# T Phone: 541/552-2010 O Email: payable@ashland.or.us V H C/O Facilities Maintenance Div SME SOLUTIONS, LLC 1 90 North Mountain Ave N 10107 SOUTH TACOMA WAY, STE A2 p Ashland, OR 97520 O LAKEWOOD, WA 98499 Phone: 541/488-5358 R TO Fax: 541/552-2304 ~ndo5~oneNum~re~yen~or_F~x~lumbe~~Gu~tror~L~7umEer _ ~n~rw~f~~efer~rrc~ 253 572 3822 f David Arnold 2 = - - - - Date>Orderea= Mentlo~fTum er _afaReq_oie:mileighn`l1?lathadlT~rms ~DgparimrPcatwr 01/03/2018 971 FOB ASHLAND OR Cit Accounts Pa able Item ~Desen ioartlVo ~~-Q31 1~Ln7iEpr7=-.Extetld~nce= Fuel Tanks Maintenance 1 Repair, maintenance and annual testing of fuel tanks and 1 $4,500.0000 $4,500.00 dispensers per attached contract. Contract for Goods and Services less than $25,000 Beginning date: July 1, 2017 Completion date: June 30, 2018 Project Account: E-000069-999 GL SUMMARY 082400 - 602400 $4,500.00 BDate: I 3 L - - 1Pat orize ignature P_~~D-: $4,500.00 i ~7 CITY OF FO ASHLAND reftc~~~~~~~ "UbrP a "urrcG"uasr~;; Order>v REQUISITION Date of request: 12/27/2017 Required date for delivery: Vendor Name SME Solutions LLC Address, City, State, Zip 10107 South Tacoma Way #A2, Lakewood, WA 98499 Contact Name & Telephone Number Brad Weast (253)572-3822 FAX: (253)572-0978 Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization Date approved by Council: El Written quote or proposal attached ❑ AMC 2.50 ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5.000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ® Direct Award Date approved by Council: Contract # ❑ Verbal/lNritten quote(s) or proposal(s) ❑ State of Washington Contract # Intermediate Procurement ❑ Sole Source ❑ Other government agency contract GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) Agency $5.000 to $100.000 ❑ Written quote or proposal attached Contract # ❑ (3) Written quotes and solicitation ❑ Form #4, Personal Services $5K to $75K Intergovernmental Agreement attached ❑ Agency ❑ Special Procurement PERSONAL SERVICES Date original contract approved by Council: $5.000 to $75.000 ❑ Form #g, Request for Approval (Date) ❑ Less than $35,000, by direct ❑ Written quote or proposal attached appointment Date approved by Council: ❑ (3) Written proposals/written solicitation ❑ Farm #4, Personal Services $5K to $75K Valid until: (Date) Description of SERVICES Total Cost Repair maintenance and annual testing of fuel island tanks and dispensers as per Exhibit C not to exceed $4,500 for FY18. $ 4,500M Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quotelproposal Project Number OL)sQ(-~P-5~-___ Account Number 082400 - 602400 Account Number Account Number `Expenditure must be charged to the appropriate account numbers forthe financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisite nfi rm, 1 e Ity that the City's public contracting requirements have been satisfied. Employee Signature: Department Head Signat I{~~tL T(, qua to or 3Ceater than $5,000) City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year., YES / NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition