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2019-217 20200041 Amps Ashland Medford Pllumbing
SERVICES AGREEMENT PROVIDER: Ashland Medford Plumbing, Inc. CITY OF PROVIDER'S CONTACT: Jon Janakes ASHLAND 20 East Main Street ADDRESS: PO Box 8494 Ashland, Oregon 97520 Medford, OR 97504 Telephone: 541/488-5587 Fax: 541/488-6006 PHONE: 541-734-3236 This Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Ashland Medford Plumbing Inc., a domestic business corporation("hereinafter"Provider"), for on call plumbing services related to the water distribution division for fiscal year 2020. 1. PROVIDER'S OBLIGATIONS 1.1 Provide on call plumbing services related to the water distribution division 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 Page 1 of 5: Agreement between the City of Ashland and Ashland Medford Plumbing • • Be evidenced by a certificate or certificates of such insurance approved by the City. 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$4,999.99 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$4,999.99 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. Page 2 of 5: Agreement between the City of Ashland and Ashland Medford Plumbing • 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, 2798.230 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 rate sheet. 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. Page 3 of 5: Agreement between the City of Ashland and Ashland Medford Plumbing • 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, 2020, 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. 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: Steve Walker 20 E. Main Street Ashland, Oregon 97520 Phone: (541)488-5353 With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541)488-5350 If to Provider: Ashland Medford Plumbing, Inc. Attn: Jon Janakes PO Box 8494 Medford, OR 97504 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: Page 4 of 5: Agreement between the City of Ashland and Ashland Medford Plumbing 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 ( ) Y bm p P Y 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: ASHLAND DFORD PLUMBING,INC. (PROVIDER): By: A% —e, By: CIELeas Signature Si: ature f4441.4. G Or2au/.) _ Printed Name Printed Name A' 1)10-6erc2_ Title Title zoo' 6 - as- 1� Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. 'et ( Page 5 of 5: Agreement between the City of Ashland and Ashland Medford Plumbing P Ashland Medford Plumbing and Excavation Services PO Box 8494; Medford, OR 97501 • Phone: 541-734-3236 • Fax: 541-732-0092 City of Ashland Contract Fiscal Year 2019/2020 Rate Sheet July 1, 2019 —June 30, 2020 April 16, 2019 Billing on a Time and Material Basis —to be paid within 30 days of billing. Plumbing Service Regular Rates Mon-Fri 8am — 5pm Regular Labor Rates (Plus Materials) PER HOUR 1 Plumber $100 1 Plumber and 1 Helper $165 2 Plumbers $185 Camera Lines $250 (1st Hour,$100 hour after) Jetter Lines $250 (1st Hour,$100 hour after) After Hour Rates $150 an hour(2 hour min) Holiday Weekend Rates $20o an hour(2 hour min) Excavation Service Rates Mon — Fri 8am — 5pm MACHINE WITH OPERATOR PER HOUR EX LG EXCAVATOR $120 MINI EXCAVATOR $100 DUMP TRUCK $95 SKID STEER $100 BACK HOE $100 BULL DOZER $100 ROLLER $100 LABOR PER HOUR FOREMAN $100 LABOR CLASS 1 $85 LABOR CLASS 2 $75 ROCK PER TON 3/4" ROCK $11.50 4" SHALE / ROCK $10.50 peeitalizing in Plumbing. Iltvl •td. Rgdronicx. Radiant. Geothermal I Full.Service Excavation Ashland Medford Plumbing and Excavation Services PO Box 8494; Medford, OR 97501 • Phone: 541-734-3236 • Fax: 541-732-0092 Exclusions: Bonds, permits and fees, site security, dumpsters, crane, forklift, saw cutting and concrete removal, concrete pour back, items not identified on plans, responsibility for damage to installed materials. No surveying is included — All surveying required for grid line installation is the responsibility of the general contractor. No footings shall be installed before rough in plumbing. All installed footings that are damaged due to the underground plumbing shall be the responsibility of the general contractor. Escalator Clause: Due to the recent fluctuation in commodity pricing AMP can only hold this price for 15 days. Material pricing may increase without a notification within that time. Hazardous Materials Disclaimer: Ashland Medford Plumbing will be held harmless in the discovery and manipulation of any and all hazardous materials. It is the job owner's responsibility to meet all requirements in handling such materials at no cost to Ashland Medford Plumbing. Ashland Medford Plumbing will go on standby time or redirect work until such situation is resolved. Owner will be responsible for all cost involved, including wages and equipment rental. Ashland Medford Plumbing will not lose work time due to delays generated by such discoveries. All materials are guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements are contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado,flood and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurance. A late payment service charge of 2%per month will be charged on accounts 30 days past due from date of billing. The service charge is an annual percentage rate of 24%. Minimum service charge is$100.00,plus the reasonable cost of collection, including but not limited to attorney and legal fees. I agree that my liability for the charges is not waived and I agree to be held personally liable for such charges. Authorized Signature Jon Janakes Date Apn(16, 2019 Acceptance of Proposal/Contract—The above price,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made 20%Down and Final Payment Upon Completion. Signature Date of Acceptance Specializing in Plumbing. Mechanical. IIydronie.. Radiant. Geothermal I Full.S'errice Excavation FEDERATED . 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: ciientcontactcenter @fedins.com Thank you for your business! Client Contact Center Enclosed: Certificate Document(s) fi MISC-0829 (04-13) • ACCORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/27/2019 j 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 FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER F PHONE HOME OFFICE: P.O.BOX 328 (A/C,No,Ext):888-333-4949 A/C,No) :507-446-4664 ![ 1 EMAIL OWATONNA,MN 5506 0 ADDRESS:CLIENTCONTACTCENTER aFEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED 358-611-2 INSURER B: ASHLAND MEDFORD PLUMBING INC INSURER C: PO BOX 8494 INSURER D: MEDFORD,OR 97501-0894 INSURER E: kI INSURER F: COVERAGES CERTIFICATE NUMBER:124 REVISION NUMBER:4 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 SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYYL (MMIDDIYYYY) : X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 { DAMAGE TO RENTED $100,000 CLAIMS•MADE I X I OCCUR PREMISES(Ea occurrence) MED EXP(Any one person) EXCLUDED C A N N 9337481 03/20/2019 03/20/2020 PERSONAL&ADV INJURY $1,000,000 Y GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY , PROT ll- I I LOC PRODUCTS•COMP/OP AGG $2,000,000 I JEC OTHER: I i AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 E (Ea accident) X ANY AUTO BODILY INJURY(Per person) -SCHEDULED A OWNED AUTOS ONLY AUTOS N N 9337481 03/20/2019 03/20/2020 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 I A EXCESS LIAB CLAIMS-MADE N N 9337482 03/20/2019 03/20/2020 AGGREGATE $2,000,000 e DED I RETENTION WORKERS COMPENSATION .PER STATUTE ER L AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT t OFFICERIMEMBER EXCLUDED? I I NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE f If yes,describe under E.L DISEASE•POLICY LIMIT E{EE DESCRIPTION OF OPERATIONS below F E DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached((more space Is required) 1 POLICY COVERAGE AS OF 03/26/2019 I 1 j CERTIFICATE HOLDER CANCELLATION € 358-611-2 124 4 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND,OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. i AUTHORIZED REPRESENTATIVE )4A"_./ © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD BBS! 304350 A Human Resource Management Company March 25, 2019 ASHLAND MEDFORD PLUMBING INC 5555 N MEDFORD INDUSTRIAL RD CENTRAL POINT, OR 97502-9400 Re: Barrett Business Services, Inc. ("BBSI") Letter of Self-Insurance for Workers'Compensation Coverage As the named addressee of this Letter, your company's required workers' compensation coverage is provided through BBSI's state approved Self-Insured Workers' Compensation Plan by way of your co-employment contract with BBSI. Additional information is as follows: � II State: Oregon Workers'Compensation Limits: Employer Liability Limits: Self Insurance Certification#: 1068 Statutory $5,000,000.00 Each Accident $5,000,000.00 Disease Coverage Limit by Client $5,000,000.00 Disease; Each Employee Other Comments (place an"X"if applicable): X Named"Letter Holder": City of Ashland 20 East Main St Ashland, OR 97520 X Other: RE:All Operations. Contract effective 9/17/12, renewed through 9/30/19. Subject to 30 days'notice of cancellation. Additionally, BBSI's self-insured program is further supported by an excess workers'compensation insurance policy with ACE American Insurance Co.. Copy of certificate is available upon request. For additional information, please contact your local BBSI office at: MEDFORD (541)772-5469 3512 Excel Drive Suite 107 Very truly yours, Medford, OR 97504 Michael L. Elich President and Chief Executive Officer doc:LOSI-2 6 Pr _ Purchase Order 'a Fiscal Year 2020 Page: 1 of: 1 B City of Ashland I ATTN: Accounts Payable Purchase L 20 E. Main L Ashland, OR 97520 Order# O T Phone: 541/552-2010 O Email: payable @ashland.or.us V H C/O Public Works Department E AMPS, ASHLAND MEDFORD PLUMBING I 51 Winburn Way N P 0 BOX 8494 p Ashland, OR 97520 MEDFORD, OR 97504 Phone: 541/488-5347 O T Fax: 541/488-6006 R O Paula Brown 07/10/2019 372 FOB ASHLAND OR/NET30 Ci Accounts Pa able On-call Plumbing Services 1 On-call plumbing services for FY 20 1 $4,999.9900 $4,999.99 Services Agreement Completion date: 06/30/2020 Project Account: GL SUMMARY *************** 081800-602400 $4,999.99 By: 1lt-_v1A6 Date: I 13 f II L___ Authorized Signature _-- - $4 999.99 r)( } FORM #3 212) /7 f CITY OF • ASHLAND r e q u e s t A for fl Purchase ' REQUISITION Date of request: 06/25/2019 Vendor Name Ashland Medford Plumbing Address,City,State,Zip PO Box 8494 Medford,OR 97504 Contact Name Jon Janakes Telephone Number 541-734-3236 Email address 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 ❑ 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 government 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: ❑ (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) 1 Description of SERVICES Total Cost Misc.plumbing services as requested for fiscal year 2020 $ 4,999.99 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quote/proposal $ Project Number Account Number o 8 1 8 0 0.6 0 2 4 0 0 $_,_ _ 4 ,9 9 9 .9 9 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,I certify that the City's public contracting requirements have been satisfied. Employee.'��,d�vs`"JQ Department Head: 9.4.'1-Y o<9 (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 than$5,000) Date Comments: Form#3-Requisition