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HomeMy WebLinkAbout2019-028 20190327 Kocer Crane & Training LLC GOODS & SERVICES AGREEMENT PROVIDER: Kocer Crane & Training, LLC CITY OF PROVIDER'S -AS H LAND CONTACT: Levi Kocer 20 East Main Street Ashland, Oregon 97520 ADDRESS: PO Box 911 Telephone: 541/488-5587 Pleasant Hill, OR 97455 Fax: 541/488-6006 PHONE: 541-607-8715 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Kocer Crane & Training, Inc., a domestic business corporation ("hereinafter "Provider"), for crane inspections. 1. PROVIDER'S OBLIGATIONS 1.1 Provide annual crane inspections for FYI 9 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The goods and services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." L2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder, a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $x;986;98@ (two 011e- million dollars) per occurrence for Bodily Injury and Property Damage. * I, D00 Duo Z=AAF 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, t contractual liability, and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each, provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 5: Agreement between the City of Ashland and Kocer Crane & Training. LLC 4 1.3 All subject employers working under this Agreement are either employers that will comply with ORS 656.017 or employers that are exempt under ORS 656.126. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise, minority-owned business, woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of $2,500 as provided herein as full compensation for the Work as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of $2,500 without express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance, paid leave, and retirement. the subject 3.4 This Agreement embodies the full and complete understanding of the parties respecting ~ matter hereof. It supersedes all prior agreements, negotiations, and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220, 279B.230 and 279B.235. Page 2 of 5: Agreement between the City of Ashland and Kocer Crane & Training, LLC 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue, and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred, as appropriate, so as to effectuate this choice of venue. 3.8 Provider shall defend, save, hold harmless and indemnify the City and its officers, employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees, contractors, or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God, strikes, lockouts, accidents, or other events beyond the control of the other or the other's officers, employees or agents. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 4. SUPPORTING DOCUMENTS The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" • The Provider's complete written Rate Sheet received 10/29/2018. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including, but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent, and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due, Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2019, unless sooner terminated as provided in Subsection 6.2. Page 3 of 5: Agreement between the City of Ashland and Kocer Crane & Training, LLC i 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30) days' prior written notice, terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement, with cause, by not less than fourteen (14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: City of Ashland - Public Works Attn: Wes Hoadley 90 North Mountain Avenue Ashland, Oregon 97520 Phone: (541) 552-2355 With a copy to: City of Ashland - Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541) 488-5350 If to Provider: Kocer Crane & Training, LLC Attn: Levi Kocer PO Box 911, Pleasant Hill, OR 97455 541-607-8715 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision, term, condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach, whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. Page 4 of 5: Agreement between the City of Ashland and Koeer Crane & Training, LLC 9.1.2 Provider, for a period of no fewer than six (6) calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement, at law, or in equity. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND: Kocer Crane & Training, LLC (PROVIDER): By: By: ' Sign re Signature Y Wes, t L C k Oe. r- /~a c e r-- Printed N e Printed Name --~c~ 04Ve Tr-A-`1i9K- ~W 04- e- Y-- Title Title Date Date (W-9 is to be submitted with this signed Agreement) Q-7 Purchase Order No. Page 5 of Agreeinent between the City of Ashland and Kocer Crane & Training, ITC KOCER CRANE TRAINING, LLC Dear David Arnold or whoever it may concern. Kocer Crane & Training is currently charging $80 per hour for existing clients and $85 per hour for new clients. For the "City of Ashland" facilities plant sites having a collective number of (12) cranes/hoists in service as of 2017 spread between the Fleet Services, Waste Water Treatment Plant. Reeder Gulch Filtration Plant. and the Fire Department we consolidated to approximately $190 per hoist/crane. This includes time/labor as well as time/travel to and from all sites. The estimated cost for the 2018 annual overhead crane inspection as per (12) hoists/cranes comes to an end total of $2.280 as presented upon the quote provided prior. Respectfully. Levi Kocer Kocer Crane & Training. LLC. a~ P.O.BOX 91 I.Pleasant Hill. OR 97=155 PH. (541) 607-8715. FAX (5=11)607-0715 i RECEIVED CITY OF ASHLAND Memo DATE: 26 December, 2018 TO: Tami De Mille-Campos, Administrative Analyst FROM: David Arnold, Facilities Maintenance Worker RE: Low Risk, Less Stringent Insurance Coverage It is the intention of the Facilities department to contract with Kocer Crane to perform annual crane inspections for FY19. The FYI 8 contract included 1 million in insurance coverage and we feel this is justified. City Staff is on site to supervise and monitor activities. I Page 1 of 1 Ir, (-0 DATE (MMIDDNYYY) ACC) CERTIFICATE OF LIABILITY INSURANCE 12104/17 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 pollcy(les) 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). CONTACT PRODUCER NHMP__,___ PHONE COMPLETE EQUITY MARKETS INC (WCC,N ,E.1)-_(847)541-0900 _ is"c.Ncl (847)541.0444 EMAIL 1190 Flex Court EODRESS:_ Lake Zurich, IL 60047 INSURER(S)AFFORDING COVERAGE NAICO _ INSURER A: Underwriters at Lloyd's, London INSURED INSURERS Kocer Crane & Training LLC INSURER C: INSURER O: P O Box 911 INSURER E: _ Pleasant Hill. OR 97455 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 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. ILTA TYPE OF INSURANCE InO0L 5UBR POLICY NUMBER I MM OICVJEFF Mhei DJYYY LIMITS I X I COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE I5 1,000,000_ DIVI.INCETO FIRITED CLAIMS-MADE a OCCUR I PREhII$ESSEa_eccn!n...... 5 50,000 MED EXP (Anyone perspnl _S 5,000 A 412062 12109117 12/09118 _ERSONAL&ADVINJURY s 1,000000_ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE 52_000,000_. `X I POLICY ' I PRO- I ECT LOC i I PRODUCTS -COMPICP AGG S 1 000,000 OTHER: S COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY AI ag~4nnp_ S ANY AUTO BODILY INJURY (Per persm) 5 OWNED SCHEDULED BODILY INJURY (Per accitlenUl AUTOS ONLY AUTOS HIRED I NON-OWNED PROPERTY DAMAGE is . AUTOS ONLY I AU OS ONLY (Per ugdepl) I l ~ S UMBRELLA LIAB OCCUR EACH OCCURRENCE - Is EXCESS UAS I CLAIMS-MADE AGGREGATE 1 DED I RETENTIONS _ S WORKERS COMPENSATION STATUTE~ERH _ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE NIA E.L EACH ACCIDENT 5 OFFICERIMEMBER EXCLUDED'! (Mande wry in NH) EL DISEASE - EAEMPLOYE IIy s, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S I I Professional $1,000,000 A I 1176396 12104117 12104/18 Each Claim Liability Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORDIO[,AddlUOnal Remarks Schedule, may be attached If more sp..e is requlroC) Subject to the terms, conditions, exclusions, and endorsements of each respective policy. This insurance was procured and developed under the Oregon Surplus Lines laws. It is NOT covered by the provisions of ORS 734.510 to 734.710 relating to the Oregon Insurance Guaranty Association. If the Insurer issuingthis Insurance becomes insolvent, the Oregon Insurance Guaranty Association has no obligation to pay claims under this insurance. (SL Lic.4130205) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Informational Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE yn CL r-T• ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Fax Server loizaizu.LSS b:zu:aa em YHV L' Oregon Insurance Nationwide Identification Card Please detach your insurance card on the dotted lines, fold in center and place in your vehicle. If you lose your card or have any questions about its use, contact your Nationwide Agent. Cut Here Cu' Here - - Nationwide's On Your Sidet' tionwide Oregon Insurance, Nationwide' RI Na" Identification Card a Claims Guarantee means fast and fair handling of your claim. Policy Number Effective Date Expiration Date 24 Hour Claims 1.800.421.3535 7236) 016765 Aug 15, 2018 Fcb 1S, 2019 Report Claims anytime ^vwhe e i the U.S.A. Year Make/Model Vehicle Idertificatior Number 1998 CHEVi COR'VET 1G1YY22C32W5105737 When calling, please give these details: 7E 1. Policy number and zip rude 2. Make and model year 24 Hour Claims 1.800.421.3535 3. Location of accident, injuries and damages See the reverse side for more irforrnaUon. 4. other vehicles and persons involved RICHARD D KOCFR For questions abouL your policy, call your Nationwide Agent. NATIONWIDE SALES SOLUTIONS INC at 1.800.421.1444 Nationwide Insurance Company of America PO Box 8379 Canton, OH 44711-8379 NAIC Number: 25453 --------------t------------------ - F Nationwide's On Your Side" Nationwide' Oregon Insurance Nationwide' Claims Guarantee means fast and ; " Identification Card fair handling of your claim. y Policy Number Effective Date Expiration Date 24 Hour Claims 1.800.421.3535 7236) 015766 Aug 15, 2018 Feb 15, 2019 Report Cla-rrs arvti,ne, anvwhere in the U.S.A. Year Make/Model Vehicle Identification Number 1998 CHEV/CORVET 1G1YY22G2W5105337 When calling, please give these details TE 1, Policy number and lip code 2. Make and model year 24 Hour Claims 1.800.421.3535 3. Location of accident, inures and damages See'he reverse side for mere information, 4. Other vehicles and persons involved RICHARD D KOCER For questions about your policy. call your Nationwide Agent, NATIONWIDE SALES SOLUTIONS INC at 1.800.421.1444 Nationwide Insurance Company of America PO Box 8379 Canton. OH 44711-8379 NAIC Number: 25153 Cut Here Cut Here Important Notice... Evidence of insurance must be carried in the vehicle or otherwise available for display upon demand of a police officer. Failure to do so would be reasonable grounds for the officer to believe that the person is operating the vehicle in violation of ORS 806.010. Your ID card must be shown to any peace officer, judge or hearing officer if requested. In the event of an accident, your 'D card may be used to exchange information with other drivers. AID 101,10 0716 11/04/2018 01:09PM 5416070715 KOCER CRANE PAGE 02/03 KOCER CRANE TRAINING, LLC Wes Hoadley, Maintenance Safety Supervisor November 4, 2018 City Of Ashland Public Works 90 N. Mountain Ave, Ashland Oregon. Re: Oregon Workers Compensation. Dear Mr. Hoadley, After Calling the Oregon Department Of Insurance, Workers Compensation Division Regarding your need to carry workers compensation coverage. Mr. Ben Adams confirmed that as an LLC and the sole member/employee, you are not required to maintain Oregon Workers Compensation Coverage. Therefore, you will not have and EMR percentage. If needed, his direct line is (503) 947-7774. The Oregon Compliance Information would be found in section ORS 656.027. If you have any questions or if I can be of any further assistance, please let me know. Best Regards, Richard Kocer P.0.BOX 911,Pleasant Hill, OR 97455 PH. (541) 607-8715, FAX (541)607-0715 CERTIFICATION OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REQUIREMENTS Contractor is exempt from the requirement to obtain workers compensation insurance under ORS Chapter 656 for the following reason. Contractor is to initial the appropriate box as follows: SOLE PROPRIETOR ■ Contractor is a sole proprietor, and ■ Contractor has no employees, and ■ Contractor will not hire employees or subcontractors to perform this contract. CORPORATION - FOR PROFIT 1ria'.s~ ■ Contractor's business is incorporated; and ■ All employees of the corporation are officers and directors and have a substantial ownership interest* in the corporation, and ■ All work will be performed by the officers and directors; Contractor will not hire other employees or subcontractors to perform this contract. CORPORATION - NONPROFIT r:ir i!_ t ■ Contractor's business is incorporated as a nonprofit corporation, and ■ Contractor has no employees; all work is performed by volunteers, and ■ Contractor will not hire employees or subcontractors to perform this contract. PARTNERSHIP ■ Contractor is a partnership, and ■ Contractor has no employees, and ■ All work will be performed by the partners; Contractor will not hire employees or subcontractors to perform this contract, and ■ Contractor is not engaged in work performed in direct connection with the construction, alteration, repair, improvement, moving or demolition of an improvement to real property or appurtenances thereto.** -'V4 LIMITED LIABILITY COMPANY ■ Contractor is a limited liability company, and ■ Contractor has no employees. and ■ All work will be performed by the members; Contractor will not hire employees or subcontractors to perform this contract, and ■ If Contractor has more than one member, Contractor is not engaged in work performed in direct connection with the construction, alteration, repair, improvement, moving or demolition of an improvement to real property or appurtenances thereto.** I-V /J( gnature of Authorized Signer) (Date) ~1~Y1LaC f-~1ST~~*` (Signer'sTitle *NOTE: Under OAR436-50-050 a shareholder has a "substantial ownership" interest if the shareholder owns 10% of the corporation, or if less than 10% is owned, the shareholder has ownership that is at least equal to or greater than the average percentage of ownership of all shareholders. **NOTE: Under certain circumstances partnerships and limited liability companies can claim an exemption even when performing construction work. The requirements for this exemption are complicated. Consult with City Attorney's Office before an exemption request is accepted from a contractor who will perform construction work. l KOCER CRANE TRAINING, LLC 12/12/18 To: City of Ashland Dave Arnold, I am enclosing the additional insured certificate that you requested. (It took a little longer then we had anticipated) because you had never requested a additionally insured certificate before this year. As for the Auto insurance. We do not have a commercial carriers insurance due to the us of our vehicles. We do not use our vehicles in the course of services (OR- OSHA overhead crane inspections).We only use the vehicles to get to your parking lots, therefore we only need state required insurances. We have supplied you with proof of insurance certificates. But if you would like to call our auto insurance company in Portland Oregon. It is Nationwide Sales Solutions Inc. 1-888-821-0119. Policy Number PPNM0018224932-1 Please contact me if you have any questions or would like more information as you consider my request, Thank you, Levi Kocer, owner/operator Kocer Crane & Training, LLC. P.O.BOX 911.Pleasant Hill. OR 97455 PH. (541) 607-871. FAX (41)607-071 DATE (M"""Y' ,ac v«v" CERTIFICATE OF LIABILITY INSURANCE iv81201s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS INSURANCE DOES NOT NEGATIVELY A EXTEND BETWEEN OTHE ISSUING NSURER(S)TAUTHORIZED BELOW CATHIS CERTIFICATE AFFIRMATIVELY 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). CONTACT PRODUCER NAME PHONE FAX 847 541-0444 COMPLETE EQUITY MARKETS INC rPIC.No,Ext): .(84T)541-0900 - (A/C NO)` %_J5 E-MAIL 90 Flex Court E-MAIL Lake Zurich, IL 60047 INSURER(S)AFFORDINGCOVERAGE NAIC# INSURER A: Underwriters at Lloyd's, London INSURED INSURER B : Kocer Crane Sr Training LLC INSURERC: INSURER D : P O BOX 911 INSURER E : _ _ - - Pleasant Hill OR 97455 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSJRANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY RCCUIREVEN T TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCJMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR `.1AY PERTAIN, TrE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXC'_USIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHCWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN - -DD, SUBR POLICY EFF POLICY EXP LTR ItdMND'YYYYi IMM'DONYYY1 LIMITS 1NSR TYPE OF INSURANCE IA INSD~>r~'\D POLICY NUMBER t COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1.000.000 X _ Ors L Tbr,ENTE0 CLA'.MS-MADE OCCUR PRE*S=S iE. nc_drren;et - c 50,000 I MEDEXP(Ar one;:O"c l S 5,000 - - - , 412166 1 1219/2018 1219/2019 PCRC^ ' \L o ADV INJURY c 1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 _ 2,000,000 FRO - ! X POLICY JCCT LOC PR DUC'S • COMP/OP AGG 1,000,000 olF ER: COI-1131NEO SINGLE 1.11,11' AUTOMOBILE LIABILITY ~ ~ I SET acc:Cen~j. _ - ANN A~170 - i BODILY INJURY (Per person) $ Ori D SCHED'ULEC I BOD LY INJURY AUTFS (Per acrJden!) $ HiR D NON-OWNED C-'4-- - -OYE6 I 1 PRCP RTY UrVAGE H I LP c tlent_ AU OS vN-Y AUTOS ONLY I 7 UMBRELLA LIAR OCCUR EACH OCCURRENCE _ ; EXCESS LIAR C1_,r,1u5.6lADE GRECATF I DEC FEIEN1101:S I WORKERS COMPENSATION cR 0 F YIN STlTUTE AND EMPLOYERS' LIABILITY E.L. EACH ACCI7_E_NT ANY oRCPRIETOR ER,'EXECUTIVE -j NIA OFFICER ttEMSER EXCLU EXCLUDED? f (Mandato y to tiH) E.L. O SEAS EA E`nP~OYE= a C CRIP' E.L. DISEASE - POLICY!_INIT S ``IC' !)F EkAT:O':S !~r:c A Professional Liability 176611 12/412018 12/412019 Each Claim $1,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Subject to all policy terms, conditions, exclusions and endorsements of each respective policy. City of Ashland Is an additional insured only on the General Liability policy but only per the terms 8 conditions of the endorsement generated for each respective policy and subject to all policy terms, conditions, exclusions and endorsements. 30 Day Notice of Cancellation applies to the General Liability policy only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland Public Works AUTHORIZED REPRESENTATIVE 90 North Mountain Avenue Ashland, OR 97520a 7'F ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Purchase Order Fiscal Year 2019 Page: 1 of: 1 B City of Ashland - - - I ATTN: Accounts Payable Purchase 20190327 ~ 20 E. Main ' Ashland, OR 97520 Order# T Phone: 641/552-2010 O Email: payable@ashland.or.us V H C/O Facilities Maintenance Div N KOCER CRANE & TRAINING LLC 1 .90 North Mountain Ave D P O BOX 911 P Ashland, OR 97520 O PLEASANT HILL, OR 97455 T Phone: 1/488 2304-5358 R O Fax: 541 607-8715 David Arnold 01/0312019 289 FOB ASHLAND OR Ci Accounts Pa able - - _ - - ==e Annual Crane Inspections 1 Perform annual crane inspections for FYI 9 1 $2,500.0000 $2,500.00 Goods & Services Agreement Completion date: 06/30/2019 Project Account: . GL SUMMARY 082400 - 610400 $2,500.00 By:~~ i~ ~71+f1k Date: Autho ized Signature _ $2,500.00 FORM #3 CITY OF d r f 1 ASHLAND 1r"?]11~'c;, 1 $I '~t]PC"t7sli'D Si:~q, 6 ~ Date of request: 11/15/18 REQUISITION O(~~7 Required date for delivery: Vendor Name Kocer Crane & Trainino LLC Address, City, State, Zip PO Box 911, Pleasant Hill OR 97455 Contact Name & Telephone Number Levi Kocer 541-607-8715 FAX: 541-607-0715 Email address SOURCING METHOD F-1 Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid ❑ Form 413, Wdtten findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written uota or proposal attached Attach co of council communication If council approval required, attach co of CC ❑ Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding $5,000 Date approved by Council: ❑ Slate of Oregon ® Direct Award -(Attach copy of council communication) Contract # ® Verbal(Written quote(s) or proposal(s) ❑ Request for Qualifications (Public Works) ❑ State of Washington Date approved by Council: Contract # Attach cc of council communication ❑ Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS & SERVICES ❑ Applicable Form (#5, 6, 7 or 8) Contract # Greaterthan $5,000 and less than $100.000 ❑ Written quote or proposal attached Intergovernmental Agreement ❑ (3) Written quotes and solicitation attached ❑ Form A, Personal Services >$5K & <$75K Agency PERSONAL SERVICES ❑ Special Procurement ❑ Annual cost to City does not exceed $25,000. Greaterthan $5.000 and less than $75,000 ❑ Form #9, Request for Approval Agreement approved by Legal and approved/signed by ❑ Direct appointment not to exceed $35,000 ❑ Wdtten quote or proposal attached City Administrator. AMC 2.50.070(4) ❑ (3) Written proposals/written solicitation Date approved by Council: ❑ Annual cost to City exceeds $25,000, Council ❑ Form A, Personal Services >$5K & <$75K Valid until: Date approval required. (Attach copy of council communication) Description of SERVICES Total Cost Perform annual crane inspections forFY19 $ 2,500.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost ® Per attached quotelproposal TOTAL COST Project Number _ _ _ _ _ _ _ Account Number 082400.610400 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: ITUrector Date Support -Yes/No By signing this requisition form, I certify th the ity' public contracting requirements have been satisfied. Employee: / Department H _ r?*.,Jlb - ( u I to o greaterthan $5, 00) ~ Department Manager/Supervisor: City Administrator: ~v ,If (Equal to or gre;tt an$25,000) Funds appropriated for current fiscal year: YES / NO Finance Director- (Equalto orgreaterrhan $5,000) Date Comments: Form #3 - Requisition