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2019-170 20200078 OS Engineering Services Agmt
PERSONAL SERVICES AGREEMENT ($25,000.00 or less) CONSULTANT: OS Engineering g g CITY OF -ASH LAND ADDRESS: PO Box 70413 20 East Main Street Springfield, OR 97475 Ashland, Oregon 97520 Telephone: 541/488-5587 TELEPHONE: 541-393-3345 Fax: 541/488-6006 EMAIL: jeff.teel @os-engr.com This Personal Services Agreement (hereinafter"Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and OS Engineering, an assumed business name ("hereinafter"Consultant"), for Park Estates Pump Station Evaluation. NOW THEREFORE, in consideration of the mutual covenants contained herein, the City and Consultant hereby agree as follows: 1. Effective Date and Duration: This Agreement shall become effective on the date of execution on behalf of the City, as set forth below(the "Effective Date"), and unless sooner terminated as specifically provided herein, shall terminate upon the City's affirmative acceptance of Consultant's Work as complete and Consultant's acceptance of the City's final payment therefore, but not later than 09/30/2019. 2. Scope of Work: Consultant will provide a evaluation on the Park Estates Pump Station as more fully set forth in the Consultant's Proposal dated July 25,2019 which is attached hereto as"Exhibit A" and incorporated herein by this reference. Consultant's services are collectively referred to herein as the "Work." 3. Supporting Documents/Conflicting Provisions: This Agreement and any exhibits or other supporting documents shall be construed to be mutually complementary and supplementary wherever possible. In the event of a conflict which cannot be so resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the exhibits or supporting documents. 4. All Costs Borne by Consultant: Consultant shall, at its own risk,perform the Work described above and, unless otherwise specified in this Agreement, furnish all labor, equipment, and materials required for the proper performance of such Work. 5. Qualified Work: Consultant has represented, and by entering into this Agreement now represents,that all personnel assigned to the Work to be performed under this Agreement 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. Page 1 of 5: Personal Services Agreement with OS ENGINEERING 6. Compensation: City shall pay Consultant the sum of$3,800.00 (three thousand eight hundred dollars) as full compensation for Consultant's performance of all Work under this Agreement. In no event shall Consultant's total of all compensation and reimbursement under this Agreement exceed the sum of$3,800.00 (three thousand eight hundred dollars) without the express, written approval from the City official whose signature appears below, or such official's successor in office. Payments shall be made within thirty (30) days of the date of receipt by the City of Consultant's invoice. Should this Agreement be terminated prior to completion of all Work, payments will be made for any phase of the Work completed and accepted as of the date of termination. 7. Ownership of Work/Documents: All Work, work product, or other documents produced in furtherance of this Agreement belong to the City, and any copyright, patent, trademark proprietary or any other protected intellectual property right shall vest in and is hereby assigned to the City. 8. Statutory Requirements: The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220, 279B.230 and 279B.235. 9. Living Wage Requirements: If the amount of this Agreement is $21,127.46 or more, Consultant is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in that chapter,to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Consultant is also required to post the notice attached hereto as "Exhibit B"predominantly in areas where it will be seen by all employees. 10. Indemnification: Consultant hereby agrees to defend, indemnify, save, and hold City, its officers, employees, and agents harmless from any and all losses, claims, actions, costs, expenses,judgments, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this Agreement by Consultant (including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform Work or services attendant to this Agreement). However, Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs,judgments, or other damages, caused solely by the negligence of City. 11. Termination: a. Mutual Consent. This Agreement may be terminated at any time by the mutual consent of both parties. b. City's Convenience. This Agreement may be terminated by City at any time upon not less than thirty (30) days' prior written notice delivered by certified mail or in person. c. For Cause. City may terminate or modify this Agreement, 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 Agreement or are no longer eligible for the funding proposed for payments authorized by this Agreement; or Page 2 of 5: Personal Services Agreement with OS ENGINEERING iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this Agreement is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Consultant may terminate this Agreement in the event of a breach of the Agreement by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and its intent to terminate. If the party committing the breach has not entirely cured the breach within fifteen (15) days of the date of the notice, or within such other period as the party giving the notice may authorize in writing, then the Agreement 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 Agreement. City, by written notice to Consultant of default or breach, may at any time terminate the whole or any part of this Agreement if Consultant fails to provide the Work called for by this Agreement within the time specified herein or within 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 Agreement. 12. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City for any purpose. 13. Assignment: Consultant shall not assign this Agreement 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. 14. 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 under the 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 Agreement; or attempts to assign rights in, or delegate duties under, this Agreement. 15. Insurance. Consultant shall, at its own expense, maintain the following insurance: a. Workers' Compensation. Consultant shall obtain and maintain Workers' Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon Workers' Compensation coverage for its subject workers, unless such employers are exempt under ORS 656.126. If exempt under ORS 656.126, Consultant shall certify such exemption to the City. b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence. This is to cover any damages caused by error, omission or negligent acts related to the Work to be provided under this Agreement. c. 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, Death, and Property Damage. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 (one million dollars) for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. Page 3 of 5: Personal Services Agreement with OS ENGINEERING 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 thirty(30) days' prior written notice from the Consultant or its insurer(s)to the City. f. Additional Insured/Certifrcates 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 Agreement. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Agreement, the Consultant shall furnish acceptable insurance certificates and endorsements prior to commencing the Work under this Agreement. 16. Nondiscrimination: Consultant 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 any Work under this Agreement when employed by Consultant. Consultant agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Consultant 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. 17. Consultant's Compliance With Tax Laws: 17.1 Consultant represents and warrants to the City that: 17.1.1 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 (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 17.1.2 Consultant, 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 Consultant; and (iii) Any rules,regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 18. Governing Law; Jurisdiction: This Agreement shall be governed and construed in accordance with 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. Page 4 of 5: Personal Services Agreement with OS ENGINEERING Ili 19. Amendments. This Agreement may be amended only by written instrument executed by both parties with the same formalities as this Agreement. 20. THIS AGREEMENT AND THE ATTACHED EXHIBITS CONSTITUTE THE ENTIRE UNDERSTANDING BETWEEN THE PARTIES. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, EITHER ORAL OR WRITTEN,NOT SPECIFIED HEREIN REGARDING THIS AGREEMENT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS AGREEMENT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 21. Certification. Consultant shall execute the certification attached hereto as"Exhibit C" and incorporated herein by this reference. 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: OS ENGINEERING (CONSULTANT): By: Pow.* 134/g4,"/ By: c-C.A - Signature Signature /4Afcli.-7 C. ,r c.ie%..� Printed Name Printed Name f,✓ rLbcre... V:c c a/'G SI eI e 41- Title Title Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. Page 5 of 5: Personal Services Agreement with OS ENGINEERING GS ENGINEERING PROPOSAL FOR ENGINEERING SERVICES July 25, 2019 Proposal P19-0562-EN City of Ashland Public Works 20 East Main Street Ashland, OR 97520 Attn: Kevin Caldwell, Senior Project Manager RE: PROPOSAL FOR PARK ESTATES PUMP STATION EVALUATION Dear Kevin, Thank you for the opportunity to present this proposal to review and evaluate the control systems at your Park Estates Pump Station. Please find an outline of our proposal below. INTRODUCTION The City of Ashland has a new booster pump station with five pumps controlled by VFDs,which is backed up by a generator. There have been reliability concerns with this new station,which have led the City to seek a third-party evaluation of the pump station's control systems. This proposal describes the services that OS Engineering can provide in order to identify any deficiencies with the pump station and restore the City's confidence in its operation. SCOPE OF WORK OS Engineering will provide the following services as part of this project. Preliminary Review One of our engineers will review the pump station's drawing package and software to understand all the configuration details, and to document any concerns that we find that are related to reliability or safety. Site Inspection We will visit the site for an inspection to review the installation and to gather any additional information that we cannot obtain from the drawings or the software provided. During this visit, we will connect a laptop to each of the control devices so that we can ensure we have obtained PO Box 70413 • Springfield,OR 97475 • Phone(541)393-3345 • Fax(541)505-8917 the most current version of software in each device. We will also discuss in detail the specific events that have taken place, which have caused service interruptions to your rate payers. Recommendations Following the site visit and final review of all software and documentation, we will prepare a summary report to identify any deficiencies or recommendations that we find. Our recommendations will focus primarily on items related to safety or reliability, and not simply personal preferences. Optional Items Because this will be a time and materials effort, if any obvious deficiencies are noted while we are on site at the pump station, we will be prepared to correct them if desired and make note of them in our final report. COMPENSATION Based on the above Scope of Work,we propose to perform this work on a time and materials basis in accordance with our standard rates at a cost not to exceed $3,800 without written permission. SCHEDULE OS Engineering is prepared to begin and complete this work immediately. We will schedule the site visit once a contract is in place. STAFF We expect to assign Jeffrey Teel, P.E. or Brian McEnulty, P.E. to this project. CONCLUSION We look forward to expanding our existing relationship with the City of Ashland and appreciate your confidence in OS Engineering. Please let us know if you have any questions regarding this proposal or require any clarifications or additional information. Sincerely, 66(1ta Jeffrey Teel, P.E. OS Engineering Page 2 of 2 EXHIBIT B CITY OF ASHLAND, OREGON City of Ashland LIVING ALL employers described WAG E below must comply with City of Ashland laws regulating •a mentofalivin• wa•e. $15.12 per hour, effective June 30, 2018. � ► The Living Wage is adjusted annually every June 30 by the Consumer Price Index. Employees must be paid a portion of business of their 401K and IRS eligible wage: if the employer has cafeteria plans (including livin g ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. D For all hours worked under a business from the City of service contract between their Ashland in excess of D Note: For temporary and employer and the City of $21,127.46. part-time employees, the Ashland if the contract Living Wage does not apply exceeds $21,127.46 or more. D If their employer is the City of to the first 1040 hours worked Ashland, including the Parks in any calendar year. For D. For all hours worked in a and Recreation Department. more details, please see month if the employee spends Ashland Municipal Code 0 50/o or more of the D In calculating the living wage, Section 3.12.020. employee's time in that month g employers may add the value working on a project or of health care, retirement, For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520, or visit the City's website at www.ashland.or.us. (Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND Page 1 of I EXHIBIT B EXHIBIT C CERTIFICATIONS/REPRESENTATIONS: Consultant, by and through its authorized representative, 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) Consultant 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. Consultant further represents and warrants to City that: (a) it has the power and authority to enter into this Agreement and perform the Work, (b)the Agreement, when executed and delivered, shall be a valid and binding obligation of Consultant enforceable in accordance with its terms, (c)the work under the Agreement shall be performed in accordance with the highest professional standards, and(d) Consultant is qualified,professionally competent, and duly licensed (if applicable)to perform the Work. Consultant 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 Agreement, it is authorized to do business in the State of Oregon, and Consultant has checked four or more of the following criteria that apply to its business. (1) Consultant carries out the work or services at a location separate from a private residence or is in a specific portion of a private residence, set aside as the location of the business. ✓ (2) Commercial advertising or business cards or a trade association membership are purchased for the business. (3)Telephone listing is used for the business separate from the personal residence listing. ✓ (4)Labor or services are performed only pursuant to written contracts. (5)Labor or services are performed for two or more different persons within a period of one year. (6) Consultant assumes financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission(professional liability) insurance or liability insurance relating to the Work or services to be provided. Cont tant's si a a e 7/Z9/2oi9 Date Page ag EXHIBIT C ,4`COR off® CERTIFICATE OF LIABILITY INSURANCE DATE 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 Marsh USA Inc. NAME:PHONE 1301 5th Avenue,Suite 1900 (A/C.No.Ext): A/C.No): Seattle,WA 98101 E-MAIL Attn:seattle.certrequest @marsh.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CN101923908-NAES-GAWUE-19- INSURER A:Zurich American Insurance Company 16535 INSURED INSURER B:American Zurich Insurance Co. 40142 Olsson Industrial Electric,Inc. 1180 NW Maple Street,Suite 200 INSURER C:N/A N/A Issaquah,WA 98027 INSURER D:Berkley Assurance Company INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-003623878-01 REVISION NUMBER: 3 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDYYY) A X COMMERCIAL GENERAL LIABILITY GL05574116-06 05/20/2019 05/20/2020 EACH OCCURRENCE $ 2,000,000 DAMAGE RENTED CLAIMS-MADE X OCCUR PREMISES O(Ea occurrence) $ 1,000,000 X SIR$200,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY JEC LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY BAP9830191-09 05/20/2019 05/20/2020 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X 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) COMP/COLL DED $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WC5574117-06(AOS) 05/20/2019 05/20/2020 X STATUTE I ER H- B AND EMPLOYERS'LIABILITY Y/N WC5574118-06(WI 05/20/2019 05/20/2020 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Professional Liability PCAB-5008685-0519 05/20/2019 05/20/2020 Limit: 2,000,000 SIR:$200,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Ashland,Oregon and its elected officials,officers and employees are included as additional insured where required by written contract and allowed by law with respect to the general liability and auto liability policies. This insurance shall be primary and non-contributory and limited to liability arising out of the operations of the named insured when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Greg Miller ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Business Registry Business Name Search New Search Business Entity Data 07-26-20 10 369 9 Entity Entity Registry Next Renewal Registry Nbr Type Status Jurisdiction Date Renewal Due? Date 935111-95 ABN ACT 05-03-2013 05-03-2021 Entity Name OS ENGINEERING Foreign Name Affidavit? N New Search Associated Names Type PPB PRINCIPAL PLACE OF BUSINESS Addr 1 1919 LAURA ST Addr 2 CSZ SPRINGFIELDIOR 197477 1 1CountrylUNITED STATES OF AMERICA The Authorized Representative address is the mailing address for this business. Type REP AUTHORIZED Start Date 05-03- Resign Date REPRESENTATIVE 2013 Name ERIC IE 'OLSSON I Addr 1 1919 LAURA ST Addr 2 CSZ SPRINGFIELDIOR 197477 1 ICountrylUNITED STATES OF AMERICA Type 'REGIREGISTRANT Of 162507- OLSSON INDUSTRIAL ELECTRIC, INC. Record 14 Addr 1 1180 NW MAPLE ST Addr 2 CSZ ISSAQUAH IWA 198027 1 1CountrylUNITED STATES OF AMERICA New Search Name History Business Entity Name Name Name Start End Date Type Status Date OS ENGINEERING EN CUR 05-03-2013 • Please read before ordering Copies. New Search Summary History Image Transaction Effective Name/Agent Available Action Date Date Status Change Dissolved By cRENEWAL OF 03-25-2019 FI REGISTRATION RENEWAL OF 03-24-2017 FI REGISTRATION RENEWAL 03-31-2015 SYS PAYMENT APPLICATION FOR 05-03-2013 FI Representative 'J -9 REGISTRATION P New Search Counties Counties Filed All Counties Filed. © 2019 Oregon Secretary of State. All Rights Reserved. Purchase Order ,Ma ; Fiscal Year 2020 Page: 1 of: 1 -41T tz-waa0-4'171-orr=7, B City of Ashland v�� 1 i1 Ff �gAa I ATTN: Accounts Payable Purchasea� L AshlandalOR 97520 Order# 20200078 T Phone: 541/552-2010 0 Email: payable @ashland.or.us V H C/O Public Works Department E OS ENGINEERING I 51 Winburn Way p PO BOX 70413 p Ashland, OR 97520 O SPRINGFIELD, OR 97475 Phone: 541/488-5347 R T Fax: 541/488-6006 541 373-3345 Paula Brown 08/05/2019 1338 FOB ASHLAND OR/NET30 Ci Accounts Pa able Park Estates Pump Evaluation 1 Review and evaluation of control systems at the Park Estates 1 $3,800.0000 $3,800.00 Pump Station per the attached proposal dated 07/25/2019. Personal Services Agreement ($25,000 or less) Completion date: 09/30/2019 Project Account: E-201204-999 ** * *** ***GL SUMMARY 081800 -704200 $3,800.00 By. 69„ A too Date 2 I J I ( Authorized Signature - $3,800.00 FORM #3 CITY OF A request for a Purchase Order ASHLAND REQUISITION ,&to 07 Date of request 07/2612019 Vendor Name OS Engineering Address,City,State,Zip PO Box 70413 Springfield,OR 97475 Contact Name Jeff Teel Telephone Number 541-393-3345 Email address ieff.teel nos-engr.com SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached (Attach copy of council communication) (If council approval required,attach copy of CC) ❑ Small Procurement Cooperative Procurement Less than$5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon 1:1 Direct Award Date approved by Council: Contract# ❑ Verbal/Written quote(s)or proposal(s) —(Attach copy of council communication) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract# GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) ❑ Other govemment agency contract $5,000 to$100,000 ❑ Written quote or proposal attached Agency ❑ (3)Written quotes and solicitation attached ❑ Form#4, Personal Services$5K to$75K Contract# PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5,000 to$75,000 ❑ Form#9,Request for Approval ❑ Agency ❑ Less than$35,000,by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: 1 ❑ (3)Written proposals/written solicitation Date approved by Council: (Date) ❑ Form#4, Personal Services$5K to$75K Valid until: (Date) —(Attach copy of council communication) Description of SERVICES Total Cost Review of control systems,programming and electrical hardware as described in attached proposal 3;800.00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost _TOTAL_COST_ ❑ Per attached quote/proposal $ Project Number 2 0 1 2 0 4. Account Number 0 a 1 8 0 0.7 0 4 2 0 0 $_, 3,8 0 0 ,0 0 Project Number _ _ _ Account Number - $_, Project Number •_ _ _ Account Number • $ , *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. . IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this��requisition^^form,,II cergr tthat the City's public contracting requirements have been satisfied. �/j/,� Employee:\;l(f t4O ()MAC/�`31Q Department Head: /24-54r---•r — / 4 2°(C (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 Deputy Finance Director-(Equal to or greater $5,000) Date Comments: Form#3-Requisition