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HomeMy WebLinkAbout2019-121 20190424 Bugs Northwest GOODS & SERVICES AGREEMENT PROVIDER: Bugs Northwest CITY OF PROVIDER'S -ASH LAN D CONTACT: Dave Mays 20 East Main Street Ashland,Oregon 97520 ADDRESS: 551 SW G Street Telephone: 541/488-5587 Grants Pass,OR 97526 Fax: 541/488-6006 PHONE: (541)472-5003 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Bugs Northwest, a domestic business corporation("hereinafter"Provider"), for pest control. 1. PROVIDER'S OBLIGATIONS 1.1 Provide pest control for FY 19 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 Bugs Northwest 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$3,535 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$3,535 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 279B.220, 279B.230 and 279B.235. Page 2 of 5: Agreement between the City of Ashland and Bugs Northwest 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 dated March, 2019. 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 Page 3 of 5: Agreement between the City of Ashland and Bugs Northwest 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 P arty 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: Bugs Northwest Attn: Dave Mays 551 SW G Street, Grants Pass, OR 97526 (541)472-5003 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: Page 4 of 5: Agreement between the City of Ashland and Bugs Northwest (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: Bugs Nor • ' = •VI► ' By: '�` B Signature Signa re /a4-001 ifxr-,K43 4 )Ain /////$4,!! Printed Name Printed Name Title Title / ,97/2 i9 3— —1 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. a7 Page 5 of 5: Agreement between the City of Ashland and Bugs Northwest A 0 CERTIFICATE OF LIABILITY INSURANCE DATE"MMJ°DAMY) 9/10/2018 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 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 LIPCA Inc. ccnoa"1E DT LIPCA, Inc. PO Box 80663 PHONE 25 927.3283 FAX Baton Rouge,LA 70898 INC Ito Ent ( ) Lacs)) (225)927 295 ADDRESS: info @IIpCd.00 INSURER(S)AFFORDING COVERAGE NAIL G INSURER A; Gemini Insurance Company 10833 INSURED Green Line Corporation INSURER B: Bugs Northwest INSURER C 551 SW G St Grants Pass,OR 97526 INSURER D: INSURER E: INSURER F: COVERAGE CERTIFICATE NUMBER: 67337 REVISION NUMBER: 20180910 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 ABb-LBIERW POLICY EFF POUCY ENP LIMITS LTR INSR YND POUCY NUMBER (MMIDOfYYYY) (MWDDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ LGLOD0075905 9/10/2018 9/10/2019 PREMISES- (TEaoccurrence) s 100,000 CLAIMS-MADE ✓ OCCUR MED Ex,(Any one person) S 5,000 A Deductible 1.000 PERSONAL S ADV INJURY S 2,000,000 GENERAL AGGREGATE S 4,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 -' I Poucy P]JECOT El LOC S - AUTOMOBILE LIABILITY COMBINED SINGLE UNIT ,LEaan@eenll ANY AUTO BODILY INJURY(Per person) S ALL OWNED ■ SCHEDULED BODILY INJURY(Per accident) S AUTOS N N-0WNED PROPERTY DAMAGE HIRED AUTOS ■ AUTOS Peraccidenl) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I RETENTIONS $ WORKERS COMPENSATION [ _,__- i�T�1_ AND EMPLOYERS'LIABILITY YIN 11t11U1L—LC¢ ANY PROPRIETORIPARTNER/EXECUTNE NIA E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Pest and Wildlife Services City of Ashland Is Included as an additional insured including waiver of subrogation on a primary&non-contributory basis with respect general liability per endorsement CG 78 27 0213 when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Ashland 20 E.Main St SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ashland,OR 97520 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2014101) ©1988-2014 ORD C RPORTION.All rights reserved. The ACORD name and logo are registered marks of ACORD AC GO a DATE(MMIDD/YYYYi CERTIFICATE OF LIABILITY INSURANCE 03/28/2019 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 House Account NAME : Siskiyou Insurance Marketplace. Inc. PHONE No.Exd: (541)479 6672 FAX No): (541)474-6632 E-MAIL 704 Sw 4th Street ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Grants Pass OR 97526 INSURER A: Saif Corporation 203 INSURED INSURER B: Green Line Corporation INSURER C: DBA, Bugs North West INSURERD: 551 Sw G Street INSURER E: _ Grants Pass OR 97526 INSURER F: II 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. INSR ADDL SUBR POUCY EFF POLICY EXP TYPE OF INSURANCE LIR INSO 1NVo POLICY NUMBER (MMIDD/YYYY) IMIWDDIYYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGETO CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JERC LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA UAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE -ER A OFFICER/MEMBERIEXCLUDED'?PROPRIETOR/PARTNER/EXECUTIVE Y/N NIA N 747737 04/01/2019 04/01/2020 EL.EACH ACCIDENT $ 500,000 (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!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. MAIN ST. AUTHORIZED REPRESENTATIVE ( I Ashland OR 97520 Fax: Email: ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AUTO INSURANCE DECLARATIONS COUNTRY Mutual Insurance Companyx P.O.Box 14151,Salem,Oregon 97309-5069 Preferred Plan POLICY NUMBER POLICY TERM PAYMENT PLAN INS.OFFICE/AGENT A36A4937883 6 MONTHS SEMI-ANNUAL 36003 SOREG/05571 To report a claim or for roadside assistance any ACCOUNT NUMBER 0009988087 time day or night,call 1-866-COUNTRY(1-866-268-6879) Policy period beginning Oct 11,2018 INSURED 12:01 a.m.standard time at your address ending Apr 11,2019 12:00 a.m. MAYS DAVID ADAM & KRISTINA M Declarations reason: 225 LINCOLN RD RATED DRIVER AGE CHANGE GRANTS PASS OR 97526-5834 Effective Oct 11,2018 12:01 a.m.standard time at your address. Your policy consists of the policy booklet, applications,declarations pages and any endorsements. Please keep them together. 0000 0000 TOTAL PREMIUM $1,594.17 PREMIUM CHANGE NONE DO NOT PAY THIS AMOUNT. ANY BALANCE DUE WILL BE LISTED ON A SEPARATE INVOICE. VEHICLE VEHICLE,USE AND DRIVER INFORMATION 2004 FORD A84765 TRUCK 1 TON AND UNDER, BUSINESS, 30-64 2009 FORD 871843 TRUCK 1 TON AND UNDER, PLEASURE, 30-64 2009 FORD A51076 TRUCK 1 TON AND UNDER, PLEASURE, 30-64 2009 FORD A54631 TRUCK 1 TON AND UNDER, PLEASURE, 30-64 POLICY COVERAGE LIMITS EACH PERSON EACH OCCURRENCE LIABILITY-BODILY INJURY 250,000 500,000 PROPERTY DAMAGE - 100,000 UNINSURED MOTORISTS 250,000 500,000 UNDERINSURED MOTORISTS 250,000 500,000 2004 FORD 2009 FORD 2009 FORD 2009 FORD Terr 005 Terr 005 Terr 005 Terr 005 VEHICLE COVERAGE LIMITS PERSONAL INJURY PROTECT EACH PERSON 100,000 100,000 100,000 100,000 COLLISION-ACTUAL CASH VALUE LESS DED 500 500 500 500 COMPREHENSIVE-ACTUAL CASH VALUE LESS DED 250 250 250 250 ROAD SERVICE YES ENDORSEMENTS UNINSURED MOTORISTS PROPERTY DAMAGE COV YES YES YES YES AMENDATORY END-OR YES YES YES YES SAFETY GLASSFULLCOV YES YES YES YES PREMIUMS LIABILITY-BODILY INJURY 194.10 148.84 148.84 148.84 PROPERTY DAMAGE included included included included FOR SERVICE CALL YOUR FINANCIAL REPRESENTATIVE DEBBRA DERENSKI AT(541)479-0362. 11302OR(01-06/16) FILE COPY Page 1 AUTO INSURANCE DECLARATION COUNTRY Mutual Insurance Company. P.O.Box 14151,Salem,Oregon 97309-5069 Preferred Plan POLICY NUMBER POLICY TERM PAYMENT PLAN INS.OFFICE/AGENT A36A4992326 6 MONTHS SEMI-ANNUAL 36003 SOREG/05571 To report a claim or for roadside assistance any ACCOUNT NUMBER 0007268315 time day or night,call 1-866-COUNTRY(1-866-268-6879) Policy period beginning Nov 23,2018 INSURED 12:01 a.m.standard time at your address ending May 23,2019 12:00 a.m. MAYS DAVID ADAM & KRISTINA M Declarations reason: 225 LINCOLN RD RATED DRIVER AGE CHANGE GRANTS PASS OR 97526-5834 Effective Nov 23,2018 12:01 a.m.standard time at your address. Your policy consists of the policy booklet, applications,declarations pages and any endorsements.Please keep them together. 0000 0000 TOTAL PREMIUM $378.62 PREMIUM CHANGE NONE DO NOT PAY THIS AMOUNT. ANY BALANCE DUE WILL BE LISTED ON A SEPARATE INVOICE. VEHICLE VEHICLE,USE AND DRIVER INFORMATION 2010 FORD A35512 TRUCK 1 TON AND UNDER, PLEASURE, 30-64 POLICY COVERAGE LIMITS EACH PERSON EACH OCCURRENCE LIABILITY-BODILY INJURY 250,000 500,000 PROPERTY DAMAGE - 100,000 UNINSURED MOTORISTS 250,000 500,000 UNDERINSURED MOTORISTS 250,000 500,000 2010 FORD Intentionally Left Blank Intentionally Left Blank Intentionally Left Blank Terr 005 VEHICLE COVERAGE LIMITS PERSONAL INJURY PROTECT EACH PERSON 100,000 COLLISION-ACTUAL CASH VALUE LESS DED 500 COMPREHENSIVE-ACTUAL CASH VALUE LESS DED 250 ROAD SERVICE YES ENDORSEMENTS UNINSURED MOTORISTS PROPERTY DAMAGE COV YES AMENDATORY END-OR YES SAFETY GLASS FULL COV YES PREMIUMS LIABILITY-BODILY INJURY 147.35 PROPERTY DAMAGE included UNINSURED MOTORISTS 40.28 UNDERINSURED MOTORISTS included PERSONAL INJURY PROTECT 50.46 FOR SERVICE CALL YOUR FINANCIAL REPRESENTATIVE DEBBRA DERENSKI AT(541)479-0362. 113020R(01-06/16) FILE COPY Page 1 , . _ ,.. 4,,, , , -„,..,:e 4. ;,PE LT:ii%`_ BU!IS NorthWest City of Ashland, All Locations March, 2019 100438 Service Center: 90 N Mountain 530.00 100439 City Hall: 20 E Main 231.00 100440 Community Development: 51 Winburn 173.00 100457 Police Station: 1155 E Main 173.00 100491 Fire Station#1 455 Siskiyou Blvd 173.00 100493 Fire Station#2: 1860 Ashland St 173.00 101131 Ashland Airport Hangar/Skinner: 403 Dead Indian Mem Rd 405.00 101132 Ashland Airport Office 403 Dead Indian Mem Rd 210.00 101357 Mountain View Cemetery 440 Normal 290.00 101358 Ashland Airport Hangar,Surplus 403 Dead Indian Mem Rd 173.00 101463 Police Contact Station 33 N Main 158.00 101590 Skinner Airport Hangar, Fuel Shack 403 Dead Indian Mem Rd 48.00 101772 Justice Center 1175 E Main 173.00 TOTAL(includes 5%increase: $2,910.00 After Hours Additional Cost 625.00 $3,535.00 Service provided in each location: Treat Exterior Foundation Only for General pests. Treat Interior(Ext Walls Only)for General Pests w w w . b u g s n w . c o m 541 .472.5003 • 541 .770.2920 551 SW "G" Street • Grants Pass, OR 97526 CCB#200990 CITY RECORDER " Purchase Order 1,4 Fiscal Year 2019 Page: 1 of: 1 B City of Ashland 5-=®�rr_Ytaauto�s ®E. Main Purchase Payable L 20 Ashland, OR 97520 Order#e 20190424 T Phone: 541/552-2010 O Email: payable @ashland.or.us ✓ H C/O Facilities Maintenance Div E BUGS NORTHWEST I 90 North Mountain Ave 551 SW G STREET p Ashland, OR 97520 O GRANTS PASS, OR 97526 OT Phone: 552-230458 R E ;ae_in.:: David Arnold egf ,.t -E-A-- -27 nlsrrib i 3=.HE:' 04/02/2019 P FOB ASHLAND OR/NET30 Cit Accounts Pa able =1�c:in-1 a l�3sij__i'_.e F_ a_s •.n Pest Control City Buildings 1 Pest Control City Buildings FY 2019 1 $3,535.0000 $3,535.00 Per attached bid March, 2019 Goods &Services Agreement - Completion date: 06/30/2019 Project Account: ......«........GL SUMMARY........,,...... 082400-602400 $3,535.00 • // h 11 1 •By ate: _-=- D Aut ized Signature $3 535.00 FORM #3 CITY OF iii , ,_ 1 _ ASHLAND ( _ .r REQUISITION _Ate of request: 3/28/2019 fP• , ..-- f / Required date for delivery: v Vendor Name Bugs Northwest Address,City,State,Zip 551 SW G Street,Grants Pass,OR 97526 Contact Name&Telephone Number Dave Mays 541-472-5003 Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid ❑ 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) ❑ Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: ❑ State 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 copy of council communication) ❑ Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 ❑ Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written quotes and solicitation attached ❑ Form#4,Personal Services>$5K&<$75K Agency PERSONAL SERVICES ❑ Special Procurement ❑ Annual cost to City does not exceed$25,000. Greater than$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 ❑ Written 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#4,Personal Services>$5K&<$75K Valid until: (Date) approval required.(Attach copy of council communication) Description of SERVICES Total Cost Provide pest control for FY19(March 28,2019—June 30,2019) $ 3,535.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost I ❑ Per attached quote/proposal TOTAL COST $ Project Number _ _ _ Account Number 082400-602400 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 -•'rove all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form, I certify that th, City's, blic contracting requirements have been satisfied.l� / 1 Employee: � Department Head: f._ � i A'- Lew9 r,JV' (Equal to or greater than$5,000) Department Manager/Supervisor: City Administra • (E. • . .r greater than$25,000) Funds appropriated for current fiscal year: NO �I J ti') `) * ance Director-(Equal • •r greater than$5,000) Date Comments: Form#3-Requisition