HomeMy WebLinkAbout2018-041-Contract for Goods and Services Liquivision
Contract for GOODS AND SERVICES less than $25,000
CITY OF CONTRACTOR: Liquivision Technology Incorporated
-AS H LAND CONTACT: Sherri Trigg
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 711 Market Street - Klamath Falls, Oregon
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: (800) 229-6959
DATE AGREEMENT PREPARED: 1-5-2018 FAX: 541-883-1361
BEGINNING DATE: 1-22-18 COMPLETION DATE: 5-31-18
COMPENSATION: Scope of services and fees attached as exhibit "C" not to exceed $3,575
GOODS AND SERVICES TO BE PROVIDED: Clean and inspect Ashland's Granite Street Reservoir using
potable water equipment and methods compliant with ANSI/NSF 61 and all applicable AWWA standards.
ADDITIONAL TERMS: Cleaning and inspection must be completed on or before May 31 2018
In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take
precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a
manner that will not conflict with the said rima 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
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 279B.220, 27913.225, 2796.230, 2796.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $20,688.86 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. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not 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.
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 art, effective upon delivery of
Contract for Goods and Services Less than $25,000, 06/19/2017, Page 1 of 5
written'notice to Contractor, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach, may at any time terminate
the whole or any part of this contract if Contractor fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. 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 QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
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, $2.000.000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage.
C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property e,
Contract for Goods and Services Less than $25,000, 06/19/2017, Page 2 of 5
including coverage for owned, hired or non-owned vehicles, as applicable.
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. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Con tor: City of Ashland
By 'U By
17
Signature Department Head
Print Name Print Name
C,Plw ~rnt (ylAi 1 4F C 16 .44 Zo If
Title Date
W-9 One cop 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
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, 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
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
year.
(6) 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.
R1
Contractor (Date)
Contract for Goods and Services Less than $25,000, 06/19/2017, Page 4 of 5
CITY OF ASHLAND, OREGON
EXHIBIT B
City of Ashland
LIVING
WAGE
per hour effective June 30, 2017
(Increases annually every June 30 by the
Consumer Price Index)
portion of business of their 401 K and IRS eligible
employer, if the employer has cafeteria plans (including
ten or more employees, and childcare) benefits to the
has received financial amount of wages received by
assistance for the project or the employee.
For all hours worked under a business from the City of
service contract between their Ashland in excess of : Note: "Employee" does not
employer and the City of $20,688.86. include temporary or part-time
Ashland if the contract employees hired for less than
exceeds $20,688.86 or more. If their employer is the City of 1040 hours in any twelve-
Ashland including the Parks month period. For more
For all hours worked in a and Recreation Department. details on applicability of this
month if the employee spends policy, please see Ashland
50% or more of the In calculating the living wage, Municipal Code Section
employee's time in that month employers may add the value 3.12.020.
working on a project or of health care, retirement,
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
-ASHLAND
Contract for Goods and Services Less than $25,000, 06/19/2017, Page 5 of 5
T C
UQUiViSiON TECHNOLOGY
DIVING SERVICES
e14 _ Office P,lailirg :ogre;; Phore: 800, cc5-P5E5 Fax: ;E41~883-18?' XcBterr OFfraticra
711 hla&et Street liDLivisicr(gaivirgservioes.=r 835 P:larvet Street
' Klamath Falls, OR 97E01 ,rvw.aivicgseroioes.rr Klarrath Falls, OR 97801
Steve Walker 1/3/2018
City of Ashland Wk: 541-552-2326
90 N. Mountain Ave. Em: walkers@ashland.or.us
Ashland, OR 97520 'OR501077R1T_
We are pleased to provide you the following firm quotation and outline of the conditions of our services.
Tank Type Dia. Hgt. Maximum Surface Price for Price for Price for
or (Feet) Calculated Area Diver Diver Additional
LxW Capacity (S.F.) Inspection Cleaning & Sediment
Feet Gallons Only Inspection Per Hour
Mobilization Charge - Flat charge to mobilize and demobilize to your location. $450 $430
1. Granite Street OG Concrete 134 26 2,741,476 14,095 $3,050
I I
I
i
Dechlorination is billed at a flat rate. $75
Filter bags are billed at $200 per bag
Subtotal $3,575
Total 'Plus sales tax if applicable $3,575
Scope of Work:
Removal of accumulated sediment from the floor of the tank. The effluent will be disposed of at the districts direction. A final
and comprehensive inspection will be performed documenting the condition of the entire structure and recorded on DVD.
Written documentation with digital pictures, descriptions of the images and any recommendations will be provided to the district
on a USB flash drive.
Our bids are based on a variety of factors that pertain to the length of time it takes to accomplish our work. The main
consideration is the amount of sediment that has to be removed, 4" of normal sediment is included in this bid.
Initials Please initial the line items below to verify that you have reviewed them.
Entry hatch on top of the tank is at least 18" diameter.
The water level is kept within ten (10) feet of the top of the tank.
Tank dimensions are correct.
Scope of work is correct.
1. Placement and disposal of effluent removed from the tank is done at the direction of the Customer.
2. Quotes for cleaning assume that the sediment is normal material (such as silt, flocculated material, insects,
manganese, rust, etc.) found in potable water tanks that is easily removed by our vacuum system. If the sediment is
difficult to remove such as large amounts of concrete chips, gravel, sand, rocks, detached coating debris, etc., then
our hourly rate shall apply for each hour (over the first hour) for removing this material.
a
711 Market Street
Klamath Falls, OR 97601
Fax: (541) 883-1361
LIQUIVISIONTECHNOLO-G'Y Phone: (541) 883-6473
3. Unless specified in quote detail we clean all submerged horizontal and angled berms or sloped surfaces 35 degrees
or less. Surfaces exceeding this angle such as the walls can be cleaned but must be listed separately in the quote
detail or estimated by the divers upon inspection. We do not clean surfaces that are out of the water.
4. If any information provided to us is incorrect or if any problems exist that inhibit our ability to complete the job on a timely schedule,
then we will notify you of the problem and reserve the right to add on to the quote based on our estimate of the additional time it will
take to complete the work. Charges for time delays are $200 per hour. This paragraph only applies to any problems that are your
responsibility (i.e. rescheduling with less than 2 business days notice, set up and start of work before cancelation, etc.) Charge for
going remote (if required and not addressed in advance) is $430 per hour.
5. For coating repair in steel tanks we use a two part underwater epoxy. Each rust nodule or area of coating defect is
wire brushed to bare metal and epoxy is applied over the area. The epoxy chemically bonds to the steel, displaces
water, and remains intact with a greater bond than the original coating. All of our repair, sealing and coating materials
meet or exceed NSF 60 & 61 standards. Repairs are done at the districts direction for the rate of $430 per hour and
$35 per tube of Manus or epoxy. i
6.. If dechlorination is required it will be charged at $15.00 per hour. If filtration is required then the filter bags will be
charged at $200.00 per bag. Unless specified LVT does not remove the bags they become the districts responsibility
to dispose of.
7. If payment is not made within sixty days of the date of the invoice, an interest charge of 3% shall begin to accrue each
month on the unpaid balance. This interest will continue to accrue each month until the balance is paid in full. To
avoid any interest charges, payment must be received or postmarked within the sixty days following the date of the
invoice. Statements will be sent each month to reflect the new balance.
Our cleaning procedure is accomplished utilizing our proprietary vacuum cleaner, the "LiquiVacTm" (Patented). The
LiquiVacTm pumps an average of 200 gallons per minute. It has a rotating soft bristle brush that scrubs the floor clean and
removes all sediment without creating turbidity in your tank. This is the onlyway to ensure that all biofilm is removed from the
interior surfaces without getting any of it mixed into the water column. This system also enables us to clean walls.
In a conscious effort to preserve our nations natural resources LVT will provide our reports to the district on USB flash
drives. If you require a printed and bound copy of the reports please notify our office staff. There will be an additional fee of $125
per copy.
In over 20 years of providing diving services we continue to treat every customer as if they were our only customer. We are
dedicated to accomplishing every job with the utmost professionalism, safety and efficiency.
Please sign this quote and FAX both pages back to us with an approximate time frame of when you would like the work
done. If you have any questions please give us a call. We look forward to working with you.
Quote is valid for 90 days. Upon signature the work shall be accomplished at a mutually acceptable date within one year.
Sincerely, I find the above and preceding page of contingencies and procedures
acceptable.
Accepted by: Date:
Patty Bowers
General Manager Signature: Title:
I
FtBEt d CERTIFICATE OF LIABILITY INSURANCE DATE `"MI°°""'"'
01/08/3018
RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
ATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
THIS CERTIFICATE OF INSURAN CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
ENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED previsions 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 endorsemen s .
PRODUCER TA T nary
Great easier Insurance Janice - FAX
PO Boat 69 PHONE Ext)m (541) 882-5507 fa o.
E-MAIL
anice.s ebasin.com
Klamath Falls OR 97601 ADDRESS: INSURER AFFCRDDIGCOVERAGE NAIC0
INSURERA:LM inaarance Ca 33600
INSURED (561) 883-6473
BHS
Liquiviaioa Technology Inc. and Arrow URERe:Btarstoae Nntiosai Inanraace C 95496
Manufacturing Inc. UISURERc:weat American Insurance 44393
711 Market at. INSURER 0: Great American Insurance Group 16691
Klamath Falls OR 97601 INSURER E:
a
COVERAGES CERTIFICATE NUMBER: cart SD 1447 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.
LTR SR TYPE OF INSURANCE ~I POLICYNUMBE POUCYEFF POUwhM LIMITS
W
D X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 3 1,000,000
MRAW TO RENTED
CLAIMS-MADE Fx-IOCCUR Y OMM205785 09101/2017 09/01/2018 p
S 50,000
MEDEXP An one puraw) S 5,000
X Limited Pollution-1Z CHH2205785 09/01/2017 09/01/2018 PERSONAL SADVINJURY_ S 1,000 000
GERL AGGREGATE UMIT APPLIES PER' . GENERALAGGREGATE 3 2,000,000
x POLICY El JECT ❑ LOC PRODUCTS- COMPIOPAGG 3 1,000 000
OTHER: S
AUTOMOBILELIABILITY COMBINED SINGtF UMIT 3 1,000,000
C X ANY AUTO Y aMW5711437117 011/01/2017 08/01/2018 -BODILY INJURY (Per pcmw) 3
OWNED SCHEDULED BODILY INJURY (Per acciderll) S
AUTOS ONLY AUTOS
HIRED NONOWNEO PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY - a 3
a
e UMBRELLA LIAB X OCCUR Y 4 4 6 3 9216 0ANA 0910112017 09/01/20111 EACH OCCURRENCE S 9,000,000
X EXCESSLIAS CLAIM&MADE AGGREGATE S 5,000 000
OED RETE N S
WORKERSCOMPENSATION P R OTH
A AND EMPLDYERSLIABUJTY 41N WC5-398-319580-0215 10/01/2017 10/01/2018 X
ANYPROPRIETCRIPARTNERIEXECVnVE E.L. EACH ACCIDENT S 1,000,000
OFFICEWMEM NIA
(Mawktory in NH)
(Manda
E.LDISEASE-EAEMPLOYEE S 1,000,000
U as. descg* under
SCRIPTIONOFOPERATIONS below E.L. DISEASE-POLICY UMIT S 11000,000
s
s
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, AddWanal Remarks Schedule, nay be Ob 0 moo space is required)
City of Ashland, 0rogon is an additional iaourad per the attached ]Policy endorsement forms.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EVIRA71ON DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of ,Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
90 N. Mountain Avo. AUTHORIZED REPRESENTATIVE
Ashland OR 97520
®1888.2015 ACORD CORPORATION. All rights reserved.
ACORO 25 (2016103) The ACORD name and logo are reglstered marks of ACORD
Page 1 of 1
03 " 08/28/2017.OMH 2205785 02 Great American Insurance Company
0161456
GAI 2381 (Ed. 0616)
MARINE COMMERCIAL LIABILITY
BLANKET ADDITIONAL INSURED ENDORSEMENT
We agree that this policy shall Include as Additional Insureds any person or organization to whom the Named Insured has
agreed by written contract or written agreement to provide coverage, but only with respect to operations performed by or
on behalf of the Named Insured and only with reaped to an 'occurrence':
1. Otherwise covered by this policy; and
2. That occurred subsequent to the making of such written contract or written agreement_
All other terms and conditions of this policy remain unchanged.
i
GAI 2391 (Ed. 06/16) (Page 1 of 1)
COMMERCIAL AUTO
CA 88 10 01 10
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified
by the endorsement.
COVERAGEINDEX
SUBJECT PROVISION NUMBER
ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3
ACCIDENTAL AIRBAG DEPLOYMENT 12
AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 18
AMENDED FELLOW EMPLOYEE EXCLUSION 5
AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13
BROAD FORM INSURED 1
BODILY INJURY REDEFINED 21
EMPLOYEES AS INSUREDS (including employee hired auto) 2
EXTENDED CANCELLATION CONDITION 22
EXTRA EXPENSE - BROADENED COVERAGE 10
GLASS REPAIR - WAIVER OF DEDUCTIBLE 15
HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) 6
HIRED AUTO COVERAGE TERRITORY 20
LOAN / LEASE GAP 14
PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 16
PERSONAL EFFECTS COVERAGE 11
PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8
RENTAL REIMBURSEMENT 9
SUPPLEMENTARY PAYMENTS 4
TOWING AND LABOR 7
UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 17
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 19
SECTION II - LIABILITY COVERAGE is amended as follows:
1. BROAD FORM INSURED
SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include
the following as an insured:
d. Any legally incorporated entity of which you own more than 50 percent of the voting stock
during the policy period. However, "insured" does not include any organization that:
(1) Is a partnership or joint venture; or
(2) Is an insured under any other automobile policy; or
(3) Has exhausted its Limit of Insurance under any other automobile policy.
Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in
excess of this policy.
e. Any organization you newly acquire or form, other than a partnership or joint venture, of which
you own more than 50 percent of the voting stock. This automatic coverage is afforded only for
180 days from the date of acquisition or formation. However, coverage under this provision
does not apply:
(1) If there is similar insurance or a self-insured retention plan available to that organization;
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(2) If the Limits of Insurance of any other insurance policy have been exhausted; or
(3) To "bodily injury" or "property damage" that occurred before you acquired or formed the
organization.
2. EMPLOYEES AS INSUREDS
SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include
the following as an insured:
f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but
only for acts within the scope of their employment by you. Insurance provided by this endorse-
ment is excess over any other insurance available to any "employee".
g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract
or agreement in that "employee's" name, with your permission, while performing duties re-
lated to the conduct of your business and within the scope of their employment. Insurance
provided by this endorsement is excess over any other Insurance available to the "employee".
3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT
SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to Include
the following as an insured:
h. 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 in a written contract,
agreement, or permit issued to you by governmental or public authority, to add such person, or
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";
(2) Only for "bodily injury" or "property damage" caused by an "accident" which takes
place after you executed the written contract or agreement, or the permit has been
issued to you; and
(3) Only for the duration of that contract, agreement or permit
4. SUPPLEMENTARY PAYMENTS
SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para-
graphs (2) and (4) are replaced by the following:
(2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required
because of an "accident" we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the insured at our request, including actual loss of earn-
ings up to $500 a day because of time off from work.
5. AMENDED FELLOW EMPLOYEE EXCLUSION
In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to
the employer by the workers compensation exclusivity rule, or similar protection, the following
provision is added.
SECTION II - LIABILITY, exclusion 6.5. FELLOW EMPLOYEE does not apply if the "bodily injury"
results from the use of a covered "auto" you own or hire.
SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows:
8. HIRED AUTO PHYSICAL DAMAGE
Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended
by adding the following:
If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified
Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any
"auto" you own, then the Physical Damage coverages provided are extended to "autos":
a. You hire, rent or borrow; or
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b. Your "employee" hires or rents under a written contract or agreement in that "employee's"
name, but only if the damage occurs while the vehicle is being used in the conduct of your
business,
subject to the following limit and deductible:
A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of:
(1) $50,000; or
(2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or
(3) The cost of repairing or replacing the damaged or stolen property with other property of
like kind and quality, minus a deductible.
B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that
coverage.
C. Subject to the limit, deductible and excess provisions described in this provision, we will
provide coverage equal to the broadest coverage applicable to any covered "auto" you own.
D. Subject to a maximum of $750 per "accident", we will also cover the actual loss of use of the
hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an
actual financial loss.
E. This coverage extension does not apply to:
(1) Any "auto" that is hired, rented or borrowed with a driver; or
(2) Any "auto" that is hired, rented or borrowed from your "employee".
For the purposes of this provision, SECTION V - DEFINITIONS is amended by adding the following:
"Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual
cash value.
7. TOWING AND LABOR
SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition
of the following:
We will pay towing and labor costs incurred, up to the limits shown below, each time a covered
"auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis-
abled:
a. For private passenger type vehicles, we will pay up to $50 per disablement.
b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a
gross vehicle weight (GVW) of 10,000 pounds or less.
c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that
have a gross vehicle weight (GVW) of 10,001 - 20,000 pounds.
However, the labor must be performed at the place of disablement.
8. PHYSICAL DAMAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend-
ed to provide a limit of $50 per day and a maximum limit of $1,500
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9. RENTAL REIMBURSEMENT
SECTION 111- PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following:
a. We will pay up to $75 per day for rental reimbursement expenses Incurred by you for the rental
of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss"
under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for
those expenses incurred after the first 24 hours following the "accident" or "loss" to the
covered "auto."
b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many
cases may be substantially less than $75 per day, and will only be allowed for the period of
time It should take to re air or replace the vehicle with reasonable speed and similar quality, up
to a maximum of 30 days.
c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove
and replace your tools and equipment from the covered "auto".
d. This coverage does not apply unless you have a business necessity that other "autos" avail-
able for your use and operation cannot fill.
e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will
pay under this coverage only that amount of your rental reimbursement expenses which Is not
already provided under Paragraph 4. Coverage Extension.
f. No deductible applies to this coverage.
For the purposes of this endorsement provision, materials and equipment do not include "personal
effects" as defined in provision 11.
10. EXTRA EXPENSE - BROADENED COVERAGE
Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of
returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000.
11. PERSONAL EFFECTS COVERAGE
A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the
following:
If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that
"auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal
effects" stolen with the "auto."
The Insurance provided under this provision is excess over any other collectible Insurance.
B. SECTION V - DEFINITIONS is amended by adding the following:
For the purposes of this provision, "personal effects" mean tangible property that is worn or
carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money
or securities.
12. ACCIDENTAL AIRBAG DEPLOYMENT
SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow-
ing:
If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for
"loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag.
Any insurance we provide shall be excess over any other collectible insurance or reimbursement by
manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov-
erage or warranty.
13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu-
sions 4.c. and 4.d. is deleted and replaced with the following:
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i
Exclusion 4.c. and 4.d. do not apply to:
a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered "auto" at the time of the "loss" and such equipment is designed to be solely operated
by use of the power from the "auto's" electrical system, in or upon the covered "auto" and
physical damage coverages are provided for the covered "auto"; or
If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with
this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property
will be reduced by a $100 deductible.
14. LOAN / LEASE GAP COVERAGE
A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is
amended by adding the following:
The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any
one "accident" is the greater of the:
1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is
subject at the time of the "loss" less the amount of:
a. Overdue payments and financial penalties associated with those payments as of the
date of the "loss",
b. Financial penalties imposed under a lease due to high mileage, excessive use or ab-
normal wear and tear,
c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease,
d. Transfer or rollover balances from previous loans or leases,
e. Final payment due under a "Balloon Loan",
f. The dollar amount of any unrepaired damage which occurred prior to the "total loss"
of a covered "auto",
g. Security deposits not refunded by a lessor,
h. All refunds payable or paid to you as a result of the early termination of a lease
agreement or as a result of the early termination of any warranty or extended service
agreement on a covered "auto",
I. Any amount representing taxes,
j. Loan or lease termination fees; or
2. The actual cash value of the damage or stolen property as of the time of the "loss".
An adjustment for depreciation and physical condition will be made in determining the actual
cash value at the time of the "loss". This adjustment Is not applicable in Texas.
B. ADDITIONAL CONDITIONS
This coverage applies only to the original loan for which the covered "auto" that incurred the
loss serves as collateral, or lease written on the covered "auto" that incurred the loss.
C. SECTION V - DEFINTIONS is changed by adding the following:
As used in this endorsement provision, the following definitions apply:
"Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the
actual cash value.
A "balloon loan" is one with periodic payments that are insufficient to repay the balance over
the term of the loan, thereby requiring a large final payment.
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15. GLASS REPAIR - WAIVER OF DEDUCTIBLE
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the
addition of the following:
No deductible applies to glass damage if the glass is repaired rather than replaced.
16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE)
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the
addition of the following:
The deductible does not apply to "loss" caused by collision to such covered "auto" of the private
passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by
the manufacturer as maximum loaded weight the "auto" is designed to carry while it is:
a. In the charge of an "Insured";
b. Legally parked; and
c. Unoccupied.
The "loss" must be reported to the police authorities within 24 hours of known damage.
The total amount of the damage to the covered "auto" must exceed the deductible shown in the
Declarations.
This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or
organization engaged in the automobile business.
SECTION IV - BUSINESS AUTO CONDITIONS is amended as follows:
17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following:
If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the
inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this
policy will not be prejudiced.
However, you must report the undisclosed hazard of exposure as soon as practicable after Its
discovery, and we have the right to collect additional premium for any such hazard or exposure.
18. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the
following:
a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it Is
known to:
1. You, if you are an individual;
2. A partner, if you are a partnership;
3. Member, if you are a limited liability company;
4. An executive officer or the "employee" designated by the Named Insured to give such
notice, if you are a corporation.
To the extent possible, notice to us should include:
(1) How, when and where the "accident" or "loss" took place;
(2) The "insureds" name and address; and
(3) The names and addresses of any Injured persons and witnesses.
19. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.S., Transfer of Rights of Recovery
Against Others to Us, is amended by the addition of the following:
If the person or organization has waived those rights before an "accident" or "loss", our rights are
waived also.
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20. HIRED AUTO COVERAGE TERRITORY
SECTION IV - BUSINESS AUTO CONDITIONS,. paragraph B.7., Policy Period, Coverage Territory, is
amended by the addition of the following:
f. For "autos" hired 30 days or less, the coverage territory Is anywhere in the world, provided that
--the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the
United States, the territories and possessions of the United States of America, Puerto Rico or
Canada or in a settlement we agree to.
This, extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with
a driver.
SECTION V - DEFINITIONS is amended as follows:
21. BODILY INJURY REDEFINED
Under SECTION V - DEFiNTIONS, definition C. is replaced by the following:
"Bodily injury" means physical injury, sickness or disease sustained by a person, including mental
anguish, mental injury, shock, fright or death resulting from any of these at any time.
COMMMON POLICY CONDITIONS
22. EXTENDED CANCELLATION CONDITION
COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol-
lows:
If we cancel for any reason other than nonpayment of premium, we will mail to the first Named
Insured written notice of cancellation at least 60 days before the effective date of cancellation. This
provision does not apply in those states which require more,than 60 days prior notice of cancella-
tion.
1
r
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C
r--
Purchase Order
Fiscal Year 2018 Page: 1 of: 1
THIS PO NUMBER MUST APPEAR ON ALL
B City of Ashland INVOICES. AND SHIPPING DOCUMENTS.
I ATTN: Accounts Payable Purchase
L 20 E. L Ashland, Main OR 97520 Order # 2018117
8 T Phone: 541/552-2010
O Email: payable@ashland.or.us
V H C/O Water Division
E LIQUIVISION TECHNOLOGY 1 90 North Mountaiin Ave
N 711 MARKET STREET P Ashland, OR 97520
D KLAMATH FALLS, OR 97601 Phone: 541/488-5353
O T Fax: 541/552-2329
R O
Vendor Phone Number V . • l b ~tton NUA Reference all 800 229-6959 Steve Walker
Date; Ordered=- Venc~orlVum - a -squired= eightkJleeA__ Depart - nt/Lacation
01/19/2018 423 FOB ASHLAND OR City Accounts Payable
Item# = eacn On -a - - - - UQM tinit Price = Extended Price
Granite Street Reservoir
1 Clean and inspect Granite St. Reservoir 1 $3,575.0000 $3,575.00
Not to exceed $3,575.00
Contract for Goods and Services Less than $25,000
Beginning date: 01/22/2018
Completion date: 05/31/2018
Project Account:
GL SUMMARY
081800 - 602400 $3,575.00
I
By: -Date: .6orized S266 re PO Tota( $3,575.00
FORM1 #3 F / CITY OF
-AS H LA N D
REQUISITION' Date of request: 1-16-18
Required date for delivery: ASAP
Vendor Name Liquivision Technology Incorporated
Address, City, State, Zip 711 Market St. - Klamath Falls, Oregon 97601
Contact Name & Telephone Number Sherri Trigg (800) 229-6959
Email address
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 copy of council communication) _(If council approval required, attach copy of CC)
X Small Procurement Cooperative Procurement
Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon
X Direct Award Date approved by Council: Contract #
❑ Verbal/Written 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 SERVICES Special Procurement Intergovernmental Agreement
$5,000 to $75,000 ❑ Agency
❑ Form #9, Request for Approval
❑ 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
Clean and inspect Granite St. Reservoir $ 3,575
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
Per attached quote/proposal $
Project Number Account Number 081800.602400
Account Number Account Number
*Expenditure must be charged to the appropriate account numbers for the 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 requisition form, l certify that the City's public contracting requirements have been satisfied.
Employee: Department Head: lb ✓ o,✓~~
(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
Finance Director- (Equal to orgreater than $5,000) Date
Comments:
Form #3 - Requisition