HomeMy WebLinkAbout2019-209 20190535 Johnson Controls, Inc. GOODS & SERVICES AGREEMENT ($25,000.00 or less)
PROVIDER: Johnson Controls Inc.
CITY OF PROVIDER'S CONTACT: Michael Hernandez
ASHLAND
20 East Main Street ADDRESS: 4011 SE International Way Suite 605
Ashland,Oregon 97520 Milwaukie, OR 97222-8826
Telephone: 541/488-5587
Fax: 541/488-6006 PHONE: (866) 635-1302
This Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an
Oregon municipal corporation (hereinafter "City") and Johnson Controls, a domestic business corporation
("hereinafter"Provider"), for air conditioning unit for Wastewater Treatment Plant centrifuge.
1. PROVIDER'S OBLIGATIONS
1.1 Provide air conditioning unit for Wastewater Treatment Plant centrifuge 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 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 Johnson Controls
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1.3 Provider shall,at its own expense,maintain Worker's Compensation insurance in compliance with ORS
656.017, which requires subject employers to provide workers' compensation coverage for all of its
subject workers.
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.
1.6 Living Wage Requirements: If the amount of this Agreement is $21,127.46 or more, Provider 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 A"predominantly in areas where it will be seen by all employees.
2. CITY'S OBLIGATIONS
2.1 City shall pay Provider the sum of$8,300.00 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$8,300.00 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.
Page 2 of 5: Agreement between the City of Ashland and Johnson Controls
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.
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 Proposal dated 05/23/2019.
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.
Page 3 of 5: Agreement between the City of Ashland and Johnson Controls
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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 August 15, 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.
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.
Y Y
7. NOTICE
Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in
writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or
by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the
address set forth below:
If to the City:
City of Ashland—Public Works Department
Attn: Dave Gies
20 E. Main Street
Ashland, Oregon 97520
Phone: (541) 488-5587
With a copy to:
City of Ashland—Legal Department
20 E. Main Street
Ashland, OR 97520
Phone: (541) 488-5350
If to Provider:
Johnson Controls
Attn: Michael Hernandez
4011 SE International Way Suite 605
Milwaukie, OR 97222-8826
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:
Page 4 o$5: Agreement between the City of Ashland and Johnson Controls
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(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;
(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: JOHNSON CONTR S (PROVIDER):
By: '' / By:
Signature — Signature
444.4.4 c 6 u,,1 0 1-1U/17--
-
Printed Name !Printed Name
Title Title
7 Ju/J Zo /j 6/2/26/,
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 Johnson Controls
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Proposal JOHNSON CONTROLS PORTLAND
MEDFORD OR CB-ON58
4011 SE INTERNATIONAL WAY STE 605
MILWAUKIE OR 97222-8826
PH: (866)635- 1302
FAX: (503)654- 1158
TO: CITY OF ASHLAND Date: 05/23/2019
20 EAST MAIN STREET Quote Ref: 1-13RTCJAJ
ASHLAND OR Project Name: CENTRIFUGE#1 NC REPLACEMENT
USA 97520 Site: CITY OF ASHLAND WASTE WATER
TREATMENT PLANT
1295 OAK ST
ASHLAND OR 97520-1058
ATTN: RON POLACH
We propose to furnish the materials and/or perform the work below for the net price of:$8,300.00
For the above price this proposal includes:
REPLACE THE A/C UNIT
START UP SYSTEM.
This proposal DOES NOT include:
1. Labor or material not specifically described above is excluded from this proposal.
2. Unless otherwise stated, any and all overtime labor is excluded from this proposal.
3. Applicable taxes or special freight charges are excluded from this proposal.
Important: This proposal Incorporates by reference the Terms and Conditions attached
This proposal is hereby accepted and
Johnson Controls is authorized to proceed This proposal is valid through: 06/20/2019
with the work,subject to credit approval by
Johnson Controls, Inc. Milwaukee,WI.
This quote was prepared for your review by: Michael Hemandez
CITY OF ASHLAND Johnson Controls Inc.
Signature: Signature:
Name: Name:
Title: Title:
Date: Date:
PO:
Johnson 1'
si-
(IMPORTANT):This proposal incorporates by reference the terms and conditions which are attached to this document.All work is to be performed Monday
through Friday during normal JCI business hours unless otherwise noted.This proposal,or any accepted alternates,are hereby accepted and Johnson Controls is
authorized to proceed with the work;subject,however,to credit approval by Johnson Controls,Inc.,Milwaukee,Wisconsin.
TERMS AND CONDITIONS
By accepting this proposal,Purchaser agrees to be bound by the following terms and conditions:
1. SCOPE OF WORK This proposal Is based upon the use of straight time labor only. Plastering,patching,and painting are excluded. Disinfecting of chiller
condenser and cooling tower water systems and components for biohazards,such as but not limited to Leglonella, are excluded unless otherwise specifically
stated in this agreement.In-line duct and piping devices,including,but not limited to valves,dampers,humidifiers,wells,taps,flow meters,orifices,etc.,if required
hereunder to be furnished by Johnson,shall be distributed and installed by others under Johnson's supervision but at no additional cost to Johnson.Purchaser
agrees to provide Johnson with required field utilities(electricity,toilets,drinking water,project hoist,elevator service,etc.)without charge.Johnson agrees to keep
the job site clean of debris arising out of its own operations. Purchaser shall not back charge Johnson for any costs or expenses without Johnson's written
consent Unless specifically noted in the statement of the scope of work or services undertaken by JCI under this agreement, JCI's obligations under this
agreement expressly exclude any language or provision of the agreement elsewhere contained which may authorize or empower the Purchaser to change,modify,
or alter the scope of work or services to be performed by JCI and shall not operate to compel JCI to perform any work relating to Hazards or Biohazards,such as
but not limited to Leglonella,without JCI's express written consent
2.INVOICE AND PAYMENTS.Johnson may Invoice Purchaser monthly for all materials delivered to the job site or to an off-site storage facility and for all work
performed on-site and off-site.Purchaser shall pay Johnson at the time purchaser signs this agreement an advance payment equal to 10%of the contract price,
which advance payment shall be credited against the final payment(but not any progress payment)due here in under and purchaser Johnson additional amounts
invoiced upon receipt of the invoice.Waivers of lien will agrees to pay be furnished upon request,as the work progresses,to the extent payments are received.If
Johnson's Invoice Is not paid within 30 days of its Issuance,it is delinquent - -
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3.MATERIALS.If the materials or equipment included in this proposal become temporarily or permanently unavailable for reasons beyond the control and without
the fault of Johnson,then in the case of such temporary unavailability,the time for performance of the work shell he extended to the extent thereof,and in the case
of permanent unavailability,Johnson shall(a)be excused from furnishing said materials or equipment,and(b)be reimbursed for the difference between the cost
of the materials or equipment permanently unavailable and the cost of a reasonably available substitute therefore.
4.EQUIPMENT WARRANTY.Johnson Controls,Inc.(JCI)warrants that equipment manufactured or labeled by Johnson Controls,Inc.shall be free from defects
In material and workmanship arising from normal usage for a period of one year.Only if JCI installs or furnishes a piece of equipment under this Agreement,and
that equipment is covered by a warranty from a manufacturer other than JCI, JCI will transfer the benefits of that manufacturer's warranty to Customer. All
transportation charges Incurred in connection with the warranty for equipment and/or materials not installed by JCI shall be borne by Customer.These warranties
shall not extend to any equipment that has been abused,altered, misused or repaired by Customer or third parties without the supervision of and prior written
approval of JCI,or If JCI serial numbers or warranty dale decals have been removed or altered.Customer must promptly report any failure of the equipment to JCI
in writing.
5. LABOR WARRANTY.Johnson Controls, Inc. (JCI)warrants its workmanship or that of its agents(Technicians)in relation to installation of equipment for a
period of ninety(90)days from date of installation.Customer shall bear all labor costs associated with replacement of failed equipment still under JCI's equipment
warranty or the original manufacturer's warranty,but outside the terms of this express labor warranty.All warranty labor shall be executed on normal business
days during JCI normal business hours-These warranties do not extend to any equipment which has been repaired by others,abused,altered,or misused in any
way, or which has not been properly and reasonably maintained. THESE WARRANTIES ARE IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR
IMPLIED,INCLUDING BUT NOT LIMITED TO THOSE OF MERCHANTABILITY AND FITNESS FOR A SPECIFIC PURPOSE.UNDER NO CIRCUMSTANCES
SHALL JCI BE LIABLE FOR ANY SPECIAL,INDIRECT,OR CONSEQUENTIAL DAMAGES ARISING FROM OR RELATING TO ANY DEFECT IN MATERIAL
OR WORKMANSHIP OF EQUIPMENT OR THE PERFORMANCE OF SERVICES.
6.IJABILITY.Johnson shall not be liable for any special,indirect,or consequential damages arising in any manner from the equipment or material furnished or the
work performed pursuant to this agreement.
7.TAXES.The price of this proposal does not include duties,sales,use,excise,or other taxes,unless required by federal,state,or local law.Purchaser shall pay,
in addition to the stated price, all taxes not legally required to be paid by Johnson or, alternatively, shall provide Johnson with acceptable tax exemption
certificates.Johnson shall provide purchaser with any tax payment certificate upon request and after completion and acceptance of the work.
8.DELAYS.Johnson shall not be liable for any delay in the performance of the work resulting from or attributed to acts of circumstance beyond Johnson's control,
including but not limited to;acts of God,fire,riots,labor disputes,conditions of the premises,acts or omissions of the Purchaser,Owner,or other Contractors or
delays caused by suppliers or subcontractors of Johnson,etc.
9.COMPLIANCE WITH LAWS.Johnson shall comply with all applicable federal,state,and local laws and regulations,and shall obtain all temporary licenses and
permits required for the prosecution of the work.Licenses and permits a permanent nature shall be procured and paid for by the Purchaser.
10.PAYMENT.Customer shall pay all invoices whon due In accordance with the payment terms provided for in the Agreement,and such payment is a condition
precedent to Johnson Controls'obligation to provide products or perform services under the Agreement.In issuing any purchase order related to or arising out of
this proposal and notwithstanding any language to the contrary therein,Customer acknowledges and agrees that any and all Johnson Controls invoices for an
amount greater than$25,000 shell be paid via wire transfer,check or money order,and that Customer shall not make,nor will Johnson Controls accept,payment
In excess of$25,000 In the form of a credit card,debit card,or other similar payment device.
11.DISPUTES.All disputes involving more than$15,000.00 shall be resolved by arbitration In accordance with the rules of the American Arbitration Association.
The prevailing party shall recover all legal costs and attorneys fees incurred as a result Nothing here shall limit any rights under construction lien laws.
12.INSURANCE.Insurance coverage in excess of Johnson's standard limits will be furnished when requested and required.No credit will be given or premium
paid by Johnson for Insurance afforded by others.
13.INDEMNITY.The Parties hereto agree to Indemnify each other from any and at liabilities, claims, expenses,losses or damages,including attomey's fees
which may arise In connection with the execution of the work herein specified and which are caused,by the negligent act or omission of the indemnifying Party.
14.OCCUPATIONAL SAFETY AND HEALTH.The Parties hereto agree to notify each other Immediately upon becoming aware of an Inspection under,or any
alleged violation of the,Occupational Safety and Health Act relating in any way to the projector project site.
15.ENTIRE AGREEMENT.This proposal,upon acceptance,shall constitute the entire agreement between the parties and supersedes any prior representations
or understandings.
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16.CHANGES.No change or modification of any of the terms and conditions stated herein shall be binding upon JCI unless accepted by JCI in writing. ���
Johnson ''/JJ,�p
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to
JAHNKE HEATING &
AIR CONDITIONING, INC.
P.O.BOX 660 TALENT,OREGON 97540
112 SOUTH PACIFIC HWY. TALENT,OREGON 97540
(541) 779-8496 (541) 5354470 (541)479-3600 FAX(541)535-9916 CCB456243
PROPOSALSUBMITTTATO: City of Ashland Waste Water PRONE: 530-391-4783 DATE 3-13-19 •
STREET: 90 N.Mountain Ave.
CITY,STATE AND ZIP CODE Ashland,OR 97520 JOB LOCATION:1195 Oak St.Ashland,OR 97520
To fattish labor and materials to remove existing air conditioning unit and install a new air conditioner writ in its place.
I XP2(12,000 BTU)Air conditioner by 10E QUBE
Includes:
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-Stainless cabinet
-Coated coil
-Nematype 3R14X hazardous locution
230v
I Hook to existing:
-Electrical wiring
I Permit(electrical and mechanical,does not include flood plain permits if necessary)
1 Haul away old equipment
1 Labor to install
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Installed price:S 13,720.00
*Received Oregon right to lien(signature):
We propose hereby to tbmish material and labor-complete In accordance with above specifications,for the sum of:
dollars(S )
Payment to be made as follows: •
1/2 down deposit,balance due anon completion orlob
All medial Is guaranteed to beastpeiard.All work to be completed armwoitnanlite manor according to suudord
predicts.Any aherminoor deviation from above Specifications iaaiMagamcaasflbe executed o yupenmiaco Authorized
orlon,and will become to earn ssv gemaoed abate All abneaoeobemmngemd open alA4d.accdents, Signature f
ordetaysbeyom ourcmaml.Owner locony are,tornado,end other necessary bse m
mnce.Our ore fully coveted
Or
by Worked Campensatioatosudnca.
All pad dueaeco ntsltn bur;end Owed egret to pay,a service charged"mend one-half poem(I 112%)
per month morn doe dale Should suit.adios or othdpracecnng beinniMed to coned any amount due to Ababa Aaepaoe of Proposal-The ken pains,,pedaemom sad eandidone we
Heating and Al,coodatodng,Ono rheebyespreuly esetoto pay all wades,clads:don of debt.irshrdlo9hit specified,satisfactory l
^sY am hotcbyaaeplA YamemlbmhM doek the
not lit to,edledim agency feet,auomey re,,tad cows costs at the medal,aid,and appellate Inds,Owner agrees wort as Payments will be made as outlined above
to submit to come Inladuon r.amy,Oregon,hr the event elm/suit is ma
Signature: •
NOTE: This prmpmal nay tamVharcmn6r warn,tempted within Maly days Date of Acceptance:
"YOUR COMFORT IS OUR MISSION"
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1
Flf 7 Purchase Order
,al Fiscal Year 2019 Page: 1 of: 1
" UST''
B City of Ashland E Y )« =_°aT.D 5 (PAIN �J,a� �•r
ATTN: Accounts Payable Purchase
L
Ashland, OR 97520 Order# 20190535
T Phone: 541/552-2010
O Email: payable @ashland.or.us
V H CIO Wastwater Treatment Plant
E JOHNSON CONTROLS, INC. I 1195 Oak Street
N PO BOX 730068 p Ashland, OR 97520
O DALLAS, TX 75373-0068 Phone: 541/488-5348
R T Fax: 541/552-2364
O
425 398-6900 David Gies
06/21/2019 567 FOB AS HLAND OR/NET30 Ci Accounts Pa able
A/C Unit Centrifuge VFD
1 Air Conditioning Unit for Centrifuge VFD 1 $8,300.0000 $8,300.00
Goods and Services Agreement ($25,000.00 or less)
Completion date: 08/15/2019
Project Account:
GL SUMMARY
086100 -602400 $8,300.00
By C k\-14)AL Date: o L.
Authorized Signature $8,300.00
yi. c...,e t (IC 67,4, Ct:d2--_,)
FORM #3 • CITY OF
"40 ( D ASHLAND
REQUISITION I Date of request: ,5-_,2g-,2g -/ f
Vendor Name t,11 rl 5 t= n ~r.-,l I c)/S
Address,City,State,Zip
Contact Name
Telephone Number
Email address
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Invitation to Bid ❑ Emergency
❑ Reason for exemption: Date approved by Council: ❑ Form#13,Written findings and Authorization
El AMC 2.50 _(Attach copy of council communication)
❑ Written quote or proposal attached
❑ Written quote or proposal attached _(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) 0 Request for Qualifications(Public Works) ❑ State of Washington
Intermediate Procurement Date approved by Council: Contract#
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 ❑Wrien quote or proposal attached Form Intergovernmental Agreement
Greater than$5,000 and less than$75,000 Agency
❑ Form#4, Personal Services>$5K&<$75K
❑Direct appointment not to exceed$35,000 ❑Annual cost to City does not exceed$25,000.
❑ Special Procurement
0(3)Written proposals/written solicitation Agreement approved by Legal and approved/signed by
❑Form#4,Personal Services>$5K&<$75K ❑ Form#9,Request for Approval City Administrator.AMC 2.50.070(4)
❑ Written quote or proposal attached
Date approved by Council: ❑Annual cost to City exceeds$25,000,Council
Valid until: (Date) approval required.(Attach copy of council communication)
Description of SERVICES Total Cost
jiP G'cha/110AINS L,'/ / !'tct �'c"n :``I roe ts'� I'D �j `1J
Item# Quantity Unit Description of MATERIALS Unit Price Total Cost
11] Per attached quote/proposal
TOTAL COST
Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately.
''Proj ct Number - - - Account Number 0 S''61 Oo -6,-o c V $ , F3 c''.or
Account Number - $ ,
Project Number - _ Account Number - $ ,- - --- - -•- -
IT Director in collaboration with department to approve all hardware and software purchases:_
By signing this requisiti form,I certify at the City's public contracting requirements have been satisfied. IT Director Date Support Yes/No
Employee: f , �_ Department Head: �.,,_ /(1J uAJ W I7
(Equal to or greater than$5,000)
Department Manager/Supervisor: Ci ty Administrator.
(Equal to or greater than 525,000)
,. -rn r _-. A '.), Ter:r: YES / NO
.:e..e�4� -e.r��Jt.�.e.7,.,�: ...TSi i.d✓d&d ��:.8;Tear:
Finance Director-(Equal to or greater than$5,000) Date
Form#3-Requisition