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2019-072 20190115 West Coast Appliances
f GOODS & SERVICES AGREEMENT PROVIDER: West Coast Appliances CITY OF PROVIDER'S -1S H LAND CONTACT: Linda Lindsey 20 East Main Street Ashland, Oregon 97520 ADDRESS: 6439 Crater Lake Highway Telephone: 541/488-5587 Central Point, OR 97502 Fax: 541/488-6006 PHONE: (541)826-7644 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and West Coast Appliances, a domestic business corporation ("hereinafter "Provider"), for appliance service and repair. 1. PROVIDER'S OBLIGATIONS 1.1 Provide appliance service and repair for FY19 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." 1.2 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 $2,000,000 (two million dollars) per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, 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 West Coast Appliances 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.I 10. 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. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject 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 27913.220, 27913.230 and 27913.235. 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 Page 2 of 5: Agreement between the City of Ashland and West Coast Appliances 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 dated June 18, 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. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. Page 3 of 5: Agreement between the City of Ashland and West Coast Appliances 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 - Facilities Maintenance Department Attn: David Arnold 90 North Mountain Avenue Ashland, Oregon 97520 Phone: (541) 552-2292 With a copy to: City of Ashland - Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541) 488-5350 If to Provider: West Coast Appliances Attn: Linda Lindsey 6439 Crater Lake Highway, Central Point, OR 97502 (541)826-7644 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. 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; Page 4 of 5: Agreement between the City of Ashland and West Coast Appliances (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. i CITY OF ASHLAND: West Ap c RO DER): By; Z444~~-- B Signature Si ature P~ Atz.9 Vj,) -"Co Printed Name Pr nt Name Title Ti le Ile Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. Page 5 of 5: Agreement between the City of Ashland and West Coast Appliances APPLIANCES FURNITURE • MATTRESSES June 18, 2018 SC SERVICE CALL 79.95 SC2 SERVICE CALL2 89.95 SC3 SERVICE CALL3 99.00 SC4 SERVICE CALL 4 119.95 SC5 SERVICE CALL 5 139.95 All service calls are for trip charge and initial diagnosis. All Parts and labor are in addition to initial service call. We use Blue Book service rates. Below are the current service rates. BLUE BOOK LABOR RATES: f G1 34.95 IF12 74.90 J13 104.65 `L14 134.95 - - A- _ iIN15 162.70 t~ 16 199.75 23.95 ------^.-I 817 j269.75 U18 l N119 317.95 ----I X20 1569.95 -I Rates are based on individual repair needs. Regards, Linda R. Lindsey Like us on Facebook and Get Special Offers Linda R. Lindsey Accounts Receivable I West Coast Appliance and Furniture Office 541.826.7644 ext 1081 fax 541.826.5649 www.westcoastapplianceandfurniture.com facebook.com/westcoastapplianceandfurniture 6439 CRATER LAKE HIGHWAY • CENTRAL POINT, OR 97502.541-826-7644 • FAX 541-826-5649 INSURANCE7 Dear Policyholder, Thank you for choosing Federated Insurance to handle your insurance and risk management needs. The attached certificate document(s) have been issued or updated. Please feel free to contact us with any additional changes, additions or deletions that may be needed by contacting the Federated Client Contact Center at: Phone: 1-888-333-4949 Fax: 507-446-4664 E-mail: clientcontactcenter@fedins.com Thank you for your business! Client Contact Center Enclosed: Certificate Document(s) MISC-0829 (04-13) AC "R" ® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/13/2018 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 endorsements . PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER HOME OFFICE: P.O. BOX 328 A CNNo Ext :888-333-4949 I a/c No : 507-446-4664 OWATONNA, MN 55060 A E-MAIL INSURER(S) AFFORDING COVERAGE NAIC INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 339-397-2 INSURER B: FEDERATED SERVICE INSURANCE COMPANY 28304 HUMPHRIES FAMILY ENTERPRISES INC, WEST COAST APPLIANCE INSURER C: 6439 CRATER LAKE HWY CENTRAL POINT, OR 97502-8405 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 45 REVISION NUMBER: 0 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR INSR WVD MMIDD/YYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE ❑X OCCUR PREMISES DAMAGE ( Ea RENTED occurrence $100,000 MED EXP (Any one person) EXCLUDED B Y N 9284866 03/01/2018 03/01/2019 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑JECT PRO- -1 LOC PRODUCTS - COMPIOP AGG $2,000,000 NOTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) OWNED AUTOS ONLY SCHEDULED B AUTOS N N 9284866 03/01/2018 03/01/2019 BODILY INJURY (Per accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000 B EXCESS LIAB CLAIMS-MADE N N 9284867 03/01/2018 03/01/2019 AGGREGATE $2,000,000 DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ER X PER STATUTE OTH- ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $500,000 A OFFICER/MEMBER EXCLUDED? NIA N 9334540 10/01/2017 10/01/2018 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF ASHLAND IS ADDITIONAL INSURED ON GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 339-397-2 450 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 90 N MOUNTAIN AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND, OR 97520-2014 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4~ © 1968-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD f¢tce Gopy . PO CY NUMBER: 9284858 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED a OWNERS, LESSEES OR z CCONTRACTORS 6 SCHEDULED PERSON ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART i SCHEDULE i Name Of Additional Insured Person(s) Or Organizations: Location(s) Of Covered Operations ~-ITY OF ASHLAND ;ANY COVERAGE PROVIDED BY THIS 90 N € OUN7AIN AVE iEN€ ORSEMENT APPLIES ONLY WHILE HUMPHRIES ASHLAND OR fJ7520 EAMILr` ENTERPRISES INC: IS SERVICING, (INSTALLING, OR DELIVEHRING APPLIANCES WHILE IN THEIR CARE, CUSTODY, OR k~:ONTROL) TO OR FOR THE ADDITIONAL !INSURED/CERTHOLDER. Information required to complete this Schedule, if not shown above, will be shown in the Declarations- A, Sections Il s Who Is An Insured is amended to 13, With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional oryar:iyation(s) shown in the Schedule: but otzly exclusions apply: with respect to liability for "bodily injury" This insurance does not apply to "bodily injury" or "property damage" or "personal and advertising "property damage" occurring after: injury" caused, in whole or in part, by: 1. All work, including mt:terials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for oil behalf of the additional insitred(s) at the the additional insured(s) at "the locatiort(s) location of the covered operations has been designated above. completed: or However: 2, That portion of "your work" out of which the injur; or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organisation law; and only applies to tEte extent permitted by other than another contractor or subcontractor lair; an gaged in performing operations for a 2. If coverage provided to the additional insured principal as a part of the same project. is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. HUMPHRIES FAMILY ENTERPRISES I NC 6439 CRATER LAKE I-IWY CENTRAL POINT OR 97502 t1 insurance Services Office, Inc., 2012 Page I of 2 CG 2 0 10 04 13 Poiicy Number: 9284-868 Transaction Effective Date: 07-12-2018 i -We' rpy . C. With respect to the insurance afforded to these 2. Availab?e under the applicable 11-innits of additional insureds, the following is added to insurance shown in the Declarations; Section Ill - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement. the most we applicable t_i;nits of Insurance shown in the will pay on behalf of the additional insured 1s the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance SerAces Office, Inc., 2012 CG 20 10 'x4 13 Policy Plumber: 9284866 Transaction Effective Date: 07-12-2018 BWNDHBS 339-397-2 45 XWXW0021 XXXXXXX5# BEOOO.01.0015 CITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND OR 97520-2014 I E i I Additional Insured Copy POLICY NUMBER: 9284866 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: t COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations: Location(s) Of Covered Operations CITY OF ASHLAND ANY COVERAGE PROVIDED BY THIS 90 N MOUNTAIN AVE ENDORSEMENT APPLIES ONLY WHILE HUMPHRIES ASHLAND OR 97520 FAMILY ENTERPRISES INC IS SERVICING, INSTALLING, OR DELIVERING APPLIANCES (WHILE IN THEIR CARE, CUSTODY, OR CONTROL) TO OR FOR THE ADDITIONAL INSURED/CERTHOLDER. nformation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", This insurance does not apply to "bodily injury" or "property damage" or "personal and advertising "property damage" occurring after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its insured only applies to the extent permitted by intended use by any person or organization other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured principal as a part of the same project. is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. HUMPHRIES FAMILY ENTERPRISES INC 6439 CRATER LAKE HWY CENTRAL POINT OR 97502 © Insurance Services Office, Inc., 2012 Page 1 of 2 CG 20 10 04 13 Policy Number: 9284866 Transaction Effective Date: 07-12-2018 Additional Insured Copy C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 Policy Number: 9284866 Transaction Effective Date: 07-12-2018 Third Party Copy gCBWNDHBS Ao001001- 0245 ENTPRTOWATXXXX4## ITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND, OR 97520 i F014M#3 CITY OF ASHLAND REQUISITION _ ? I J Date f request: 7/17/2018 ~Required date for delivery: Vendor Name West Coast Appliances Address, City, State, Zip 6439 Crater Lake Highway, Central Point, OR 97502 Contact Name & Telephone Number Linda Lindsey (541)826-7644 Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization Date approved by Council: ❑ Written quote or proposal attached ❑ AMC 2.50 ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ® Direct Award Date approved by Council: Contract # ❑ VerbalNVrltten quote(s) or proposal(s) ❑ State of Washington Contract Intermediate Procurement El Sole Source # agency contract GOODS & SERVICES El Applicable Form (#5,6, 7 or 8) El Other Agency 5,000 to $100,000 El Written quote or proposal attached o ~ Contract # ❑ (3) Written quotes and solicitation ❑ Form #4, Personal Services $5K to $75K Intergovernmental Agreement attached ❑ Agency PERSONAL SERVICES ❑ Special Procurement $5,000 to $75,000 ❑ Form #9, Request for Approval Date original contract approved by Council: ❑ Less than $35,000, by direct ❑ Written quote or proposal attached (Date) appointment Date approved by Council: ❑ (3) Written proposals/written solicitation ❑ Form #4, Personal Services $5K to $75K Valid until: (Date) Description of SERVICES Total Cost Provide appliance service and repair for FY19 $ 2,500.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quotelproposal Project Number _ _ _ _ _ _ - _ _ _ Account Number 082400-602400 *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. lT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support -Yes / No By signing this requisition form I certi th t the City's public contracting requirements have been satisfied. Employee Signature: Department Head Signature. /d°✓trG e / (Equa to or greater than $5,000) City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year YES / NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition Purchase Order Fiscal Year 2019 Page: 1 of: 1 ~I EMM SflR 1 N--AL B City of Ashland - - - I L 20 E. ATTN: Accounts Payable Purchase L Ashland, Main Order # 20190115 OR 97520 T Phone: 541/552-2010 O Email: payable@ashland.or.us V H C/O Facilities Maintenance Div E WEST COAST APPLIANCE & FURN 1 90 North Mountain Ave N 6439 CRATER LAKE HWY P Ashland, OR 97520 D CENTRAL POINT, OR 97502 Phone: 541/488-5358 O T Fax: 541/552-2304 R O 541 826-7644 David Arnold 07/19/2018 2093 FOB ASHLAND OR/NET30 City Accounts Pa able On call Applicance - Facilties 1 On call appliance service and repair for FY 19 -City Facilities 1 EST $2,500.0000 $2,500.00 Goods and Services Agreement Completion date: 06/30/2019 Project Account: GL SUMMARY 082400 - 602400 $2,500.00 By:f Date: Authorized Signature - $2,500.001