HomeMy WebLinkAbout2019-036 20190300 Terrasurvey, Inc
Contract for Personal Services less than $35,000.00
CONSULTANT: Terrasurvey Inc.
CITY OF
-AS H LA N D CONTACT: Fred A. Franz, P.L.S.
20 East Main Street ADDRESS: 274 Fourth Street
f Ashland, Oregon 97520 Ashland, OR 97520
I Telephone: 541/488-6002 _L(541) 482-6474
Fax: 541 /488-5311 FAX'S.
EMAIL::
i
EFFECTIVE DATE: 11 8 COMP TION DATE: 6/30119
COMPENSATION: to Exceed (NTE) $30,OgD,
SERVICES TO BE I OVIDED: Misc a eous on call professional land surveying services on a time and
materials basis. Re rence exhibi Terra surveying fee schedule.
ADDITIONAL TERMS:
In the event of a conflict or discrepancy among the contract documents, this City of Ashland Contract for Personal Services will be primary and take
precedence, and any exhibits or ancillary 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.
FINDINGS:
Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and
i determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor
resources to perform the services; (3) the statement of work represents the department's plan for utilization of such
personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient
to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints
3 provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein
is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings I Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
i 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service 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.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service 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.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
j City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $20,688.86 or more, Consultant 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 service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Consultant 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
i 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 Consultant (including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations,
actions, costs, judgments, or other damages, directly, solely, and proximately caused b the ne li ence of City.
Contract for Personal Services less than $35,000.00, 06/19/2017, Page 1 of 6
10. 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 part, effective upon delivery of
written notice to Consultant, 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 Consultant 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 Consultant 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 Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant 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
e 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, Consultant shall immediately cease all activities under
i this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Consultant 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 Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant 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. Consultant 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.
13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant 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.
14. Insurance. Consultant 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
i provide Oregon workers' compensation coverage for all their subject workers
b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$250,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
C. 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.
d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$100,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property e,
J
Contract for Personal Services less than $35,000.00, 06/19/2017, Page 2 of 6
including coverage for owned, hired or non-owned vehicles, as applicable.
e_ 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 Consultant or its insurer(s) to
the City.
f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies, excluding Professional
Liability and Workers' Compensation, required herein, but only with respect to Consultant's services to be provided
under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance
coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to
commencing work under this contract. 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 Consultant shall be financially responsible for all
pertinent deductibles, self-insured retentions and/or self-insurance.
15. 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 Consultant 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. Consultant, 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.
16. 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.
CONSULTANT, 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.
it. 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. Consultant
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 Consultant, with no further
liability to Consultant.
18. Certification. Consultant shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
19. Consultant's compliance with Oregon Tax Law:
(1) Consultant represents and warrants to the City that Consultant 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 Consultant; and
;i (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or
provisions.
(2) Consultant represents and warrants that, for a period of no fewer than six (6) calendar years preceding the Effecti
of this Agreement, it 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 Consultant; and
(iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax I
provisions.
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Contract for Personal Services less than $35,000.00, 06/1912017, Page 3 of 6
Consultant: Cil of shland
By B
Sig atu ' Department Head
J A A/ I -Z-
Print Name Print Name
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Title Date
(W-9 is to be submitted with the signed contra
Purchase Order No.
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Contract for Personal Services less than $35,000.00, 0611912017, Page 4 of 6
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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
i
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
ii
i!
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.
i
i
v (1) 1 carry out the labor or services at a location separate from my residence or is in a
i 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.
~r (5) Labor or services are performed for two or more different persons within a period of one
f
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.
i
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Contractor (Date)
Contract for Personal Services less than $35,000.00, 06119/2017, Page 5 of 6
AC LIP CERTIFICATE OF LIABILITY INSURANCE 11/u17/2 n12 DA1 018
L~
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 -
NmE;
Hall'& Company PHONE Alex Johnson Fax
19660 10th Ave NE INC. N.. 360.626-2957 aC Hal. 360.598-3703
PDulsbo WA 98370 ADDRESS: a'ohnson hallandcom a .corn
INSURERS AFFORDING COVERAGE NAICa
INSURER A: RLI INSURANCE COMPANY 13056
INSURED 1073
Terrasurvey, Inc INSURER B:
274 Fourth Street INSURERC:
Ashland OR 97520 INSURERD:
INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1562186354 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,.
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTR TYPE OF INSURANCE ADOLS BR POLICYNUMBER PIvtnnYEFF MWDD YY UMITS
COMMERCIAL GENERALLIABIUTV EACH OCCURRENCE $
CLAIMS-MADE ❑ OCCUR DrUMAUL REN ED
PREMISES lEa ence $
MED EXP (An one Person) $
PERSONALS ADV INJURY $
GEM-AGGREGATE LIMITAPPLIES PER GENERALAGGREGATE $
POLICY PHI 0 LOC PRODUCTS -COMPIOP AGO $
-0THER $
AUTOMOBILELIABILITY COMBINED SINGLE LIMIT $
Ea accident
H ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY Penarcident $
AUTOS ONLY AUTOS ( )
HIRED NON-OWNED PROPERTYDAMAGE
AUTOS ONLY AUTOS ONLY ramidenl $
$
UMBRELLALIAB OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DEO RETENTIONS g
WORKERS COMPENSATION PER 0TH-
. AND EMPLOYERS' LIABIUTY YIN STATl7rE ER
ANYPROPRIETORIPOFFICER/MEMBEREXCTLEUOED7 EID?ECUnvE NIA ELEACHACCIDENT $
(Mandacr NH) EL. DISEASE-EA EMPLOYE $
U ySCRIP escubR, e antler E- DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS below
A 'Pmfesaicnal Uab: Claims Made RDP0027606 2/812017 2/812019 $1,ODO.OMPer Clalm
52,000,000 Aggregate
DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES/ (ACORD ICI; Additional Remarks Schedule, may be atlached Kmom space is roqulmd)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVEDESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS..
20 E Main St
Ashland OR 97520 AUTHORDEDREPRESENTATIVE
United States
llkcYn:n P~„~
U 01988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
DATE 14121 8
A`Q a® CERTIFICATE OF LIAEILITY INSURANCE 1`11/]4/2018
THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW: THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE DR PRODUCER; AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or he endorsed.
If SUBROGATION 119 WAIVED, suh]ectfothe terms and conditions of the policy, certain policies may'requirean endorsement A statement on
this Gertifmcate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER cONTADT Julie Asher
NAME
1
Ashland In'surancehic PHONENo (541) 482-0831 (AIC No): (641)488-585
NC Ed!
585ASbeetSultel Apgp~s; )asher@ashlandinsumnce.com
P. O. BOX 680 INsUResis)WORDINGCOVERABE NAICY
Ashland OR 97520 INSURER A: Foremosllnsurarice Co 11185
INSURED yN$u g: Ohio Security' Insurance Co. 24082
TERRASURVEY; INC INsuRERc: SAW Corporation
2744TH STREET INSURERO; ENA Surety
INSURER E
ASHLAND OR 97520-2044 INSURER FL
COVERAGES CERTIFICATE NUMBER: CL185308120 REVISION NUMBER:
THIS ISTO CERTIFY THATTHE 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 ANYCONTRACT DR OTHER DOCUMENT WITH RESPECTTO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESGR15M HEREIN IS SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS. OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY. PAID CLAIMS.
LICY"P
LTR TYPE OF. INSURANCE INSD WVD POUCYNUMBEft MEOEIUDCYEF MMNurYYYY Umns AUUL
X1 COMMERCIALGENFAALLiABIUTY . EACHOCCURRENCE S 1,000,000
CLAIMS-MADE rx] OCCUR PREMISES Eavcwrtens s-1,000,D00
MEDFJ(P(Anybnepersbn) 5 10,000
.A Y' Y` PAS&M57319 - 05!1012070 05/1012019 PERSONAL a ADV INJURY t A'000,00)
GEN'LAGGREGATEUMITAPPUES PER:.. GENERALAGGREGATE S 2,000,000
x POLICY❑yM 0LGC PRODuCTS-CDMP/OPAGG $'2,000,000
.OTHER:, - s
AUMOMOBILEUABILITY COMBI ED SI GLE LIMIT s 1,D00,00D
Ea a¢ tlanl
ANYAU 3 BOOILYINJURY(Pxperwn) 5
B OWNm x SCHEDUlEO Y Y' BASS6788482 1013012018 10/3011019 BODILY INJURY(Perecddent) $
HIRED' NON-0wNED Pier.RdYOAMAGE S
AV10$ONLY AIITOSONLV erartltleM
UnInsured'Riatorist s 1,000;000
UMBRFLLII WB OCCUR FACHPCCURRERCE, $
EXCESS Use CL4IMSMADE A(3CiREGATE, $
OED REIEkMbN S E
WORKERS COMPENSATION XI PER O1H-
A DO ;,LOYsmrumeluny YIN STATUTE ER
ppNNyy-PROPmEIORrRARTHERIEXECUME EL EACH ACCIDENT E 1,OOD;g00
0 OFFTCERrt!WHEREXCLUDEDP NIA 858530 0310112018 03101/2019 _
pdandatery in NH) el-.DISEASE- EAEMPLOYEE g 1,000,000
HYegtlesaibe dndv 1,000,000
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY WIT $
Statutory Public Wiirks Bond'
D 69670529' 06!01/2018 06/01@019 Llmd 530000
MSC "P OFOPFAARONS/LOCATIONS/VEHICLES (ACOR01m,AddBiondMmarl¢s ulymaybeenechedifinemxpacelsrequimdl
Cettflcate holder is included as Additional Insured for General Uabirity coverages vdth written tnnbacL Waiver of Subrogation applies. This form Is'subfecito
policy terms, conditions and exclusions.
CERTIFICATE' HOLDER CANCELLATION
SHOULD ANY OF THE ABOVEDESCRIBED POLICIES BECANCELLEO BEFORE
THE EXPIRATION. DATE THEREOF, NOTICE WILL Be DELIVEREMIN
Cifyof Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
20 E. Main SL
AITTHOR® REPRESENTATIVE
Ashland OR 97520
(D 1988.2015 ACORD CORPORATION. All rights reserved.
ACO@025 (2016103) The ACORD name and logo are registered marks of.ACORD
Terrasurvey, Inc.
Charge out rates
DRAFTING $ 90/HR
CLERICAL $ 80/HR
PROFESSIONAL $ 120/HR
FIELD $ 180/HR
Purchase Order
Fiscal Year 2019 Page: 1 of: 1
THIS PO UMBEh MUST APPEAR ON ALL y
B City of Ashland MVOI Ew AND SHIPPING DOCUMENTS
ATTN: Accounts Payable Purchase
L 20 E. Main 20190300
Ashland, OR 97520 Order #
T Phone: 541/552-2010
O Email: payable@ashland.or.us
V S C/O Parks Department
E TERRASURVEY, INC H Admin Office
N 274 FOURTH STREET 340 South Pioneer
D ASHLAND, OR 97520 P Ashland, OR 97520
O T Phone: 541/488-5340
R O Fax: 541/488-5314
TIM
541 482-6474 Michael Black
rrrer-lfrs_
Rum art 11/29/2018 404 FOB ASHLAND OR Parks Accounts Pa able
On-call Surveying Services
1 Miscellaneous on call surveying on a time and materials basis. 1 $4,500.0000 $4,500.00
Contract for Personal Services less than $35,000.00
Completion date: 06/30/2019
Project Account:
GL SUMMARY
121200 - 604100 $4,500.00
i
B Date: ` 3 d
authorized Signature $4,500.00
FORM c >I T Y OF
r ASHLAND
REQUISITION Date of reque ; 11126/2018
Vendor Name Terrasurve , Inc
Address, City, State, Zip 274 Fourth Street, Ashland OR 97520 r 5
Contact Name Fred A. Franz PLS
Telephone Number 541 482-6474 a
Email address xjh
SOURCING METHOD
r
❑ Exempt from Competitive Bidding ❑ Emer enc
❑ Invitation to Bid
~ Aut ati
❑ Reason for exemption: Date approved by Council: ❑ W,,,0rrnquote 3)Writt finding,~tache
AMC 2.50 ❑ o pr ~a'f E] -(Attach copy of council communication) p ❑ Written uote or ro osal attached co ieil a roval/f uiretl c,
C~
❑ Small Procurement ❑ Request for Proposal Cooperative Procurement
Not exceeding $5,000 Date approved by Council: ❑ State of Oregon I/
❑ Direct Award _(Attach copy of council communication Contract # It )f~ i 11
-b v
❑ Verbal/Written quote(s) or proposal(s) ❑ Request for Qualifications (Public Works) ❑ State of Washington
Intermediate Procurement Date approved by Council: Contract # ~14'
GOODS & SERVICES (Attach copy of council communication) ❑ Other government agency contract
Greater than $5,000 and less than $100,000 ❑ Sole Source Agency
❑ (3) Written quotes and solicitation attached ❑ Applicable Form (#5,6, 7 or 8) Contract #
PERSONAL SERVICES ❑ Written quote or proposal attached Form Intergovernmental Agreement
Greater than $5,000 and less than $75,000 ❑ Form #4, Personal Services >$5K & <$75K Agency
9 Direct appointment not to exceed $35,000 does not exceed $25,000,
El Special Procurement ❑ Annual cost to City
❑(3) Written proposals/written solicitation El Form #9, Request for Approval Agreement approved by Legal and approved/signed by
OR Form #4, Personal Services >$5K & <$75K City Administrator. AMC 2.50.070(4)
❑ Written quote or proposal attached
Date approved by Council: E] Annual cost to City exceeds $25,000, Council
Valid until: (Date) approval required, (Attach copy of council communication)
Description of SERVICES Total Cost
Miscellaneous on call surveying on a time and materials basis. Reference Exhibit C fee schedule.
$ 4,500.00
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
0 Per attached quotelproposal TOTAL COST
Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. 4500.00
Project Number _ _ _ _ _ _ _ Account Number 1 2 1 2-D0- - Le 0 $
Project Number _ _ _ _ _ _ _ Account Number _ _ _ _ _ _ _ $
Project Number Account Number $
IT Director in collaboration with department to approve all hardware and software purchases:
By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. IT Director Date Support -Yes /No
Employee: Gt L' Department Head:
(Equal to or greater than $5,000)
Department Manager/Supervisor: 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: