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HomeMy WebLinkAbout2019-220 20190540 Southern Oregon communications LLC • SERVICES AGREEMENT PROVIDER: Southern Oregon Communications, LLC CITY 0 F PROVIDER'S CONTACT: Keith Reinwald ASHLAND 20 East Main Street ADDRESS: 747 Summer Glen Drive. Medford, OR 97501 Ashland, Oregon 97520 Telephone: 541/488-5587 PHONE: 541-864-0143 Fax: 541/488-6006 This Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Southern Oregon Communications, LLC, ("hereinafter "Provider"), for providing all of the labor and equipment needed to install fiber optic cable for the Harfst project located at 1970 Ashland Street. 1. PROVIDER'S OBLIGATIONS 1.1 Provide Labor and equipment needed to install City of Ashland provided aerial fiber optic cable for the Harfst project at 1970 Ashland Street.The scope includes but is not limited the following: Traffic control plans, naggers, permits (ODOT, COA, Railroad, etc.), aerial boom trucks, lashing equipment, guy anchors, etc. 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 Page 1 of 5: Agreement between the City of Ashland and Southern Oregon Communications, LLC • 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. 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. Provider 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$4,000.20 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$4,000.20 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 Southern Oregon Communications,LLC • • 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. 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 estimate dated 5/6/2019. 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. Page 3 of 5: Agreement between the City of Ashland and Southern Oregon Communications, LLC • • 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 July 30, 2019, unless sooner terminated as provided in Subsection 6.2. • 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 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—Ashland Fiber Network Attn: Donald Kewley, AFN Operations Manager 20 E. Main Street Ashland, Oregon 97520 Phone: (541) 552-2316 • With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541) 488-5350 If to Provider: Southern Oregon Communications, LLC Attn: Keith Reinwald, Owner 747 Summer Glen Drive Medford, OR 97501 Phone: 541-864-0143 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. Page 4 of 5: Agreement between the City of Ashland and Southern Oregon Communications,LLC 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider, for a period of no fewer than six (6) calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (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: Southern Ore to• '- uni >. (PROVIDER): By: By: /l71�..// Signature ignature K611y Madding /,M, , Keith Reinwald Printed Name Printed Name �ra I- City Administrator Owner Title Title June June 1, 2019 S 2Y 2alg Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. QZe ' ( ® �T Page 5 of 5: Agreement between the City of Ashland and Southern Oregon Communications,LLC f FW:. Fiber job quote � a Chad Sobotka Tue 5/21/2019 9:41 AM To Donald Kewley <Donald.Kewley @ashland.or.us>; From: Richard Holbo [mailto:holbor @hunterfiber.com] Sent: Tuesday, April 30, 2019 1:02 PM To: Chad Sobotka Subject: Re: Fiber job quote Engineering came back with the following: ' 54400 for either one.. $4200 without permit. !I 41♦ X`,e Ot 01- ( (-• 4 e - from Micah - U r4 o They are both about the same amount of time, so the price is the same for us. I included two hours for me to get the ODOT permit; omit if they will provide the permit. The "2220 Ashland to Faith St" version crosses the RR tracks.. so if there are other issues surrounding that... (permits etc....) Let's avoid that one if possible. We can't make it by the 15th as crews are booked out, but could do it on the 29th, but let us know soon so we can get you on the schedule. /rh On Tue, Apr 30, 2019 at 11:17 AM Chad Sobotka<chad @ashlandfiber.net> wrote: Richard, We have a small fiber job that we would like a quote on. Attached is a KMZ of the job site. The customer address is 1970 Ashland St. There are two options for the fiber path and we would like a separate quote for each: Option 1: We have a splice case located at the corner of Ashland St and Normal Ave. We want a slack loop at that pole (Pole 1 A) and another slack loop at Pole 4A. We need fiber run to the End Pole (the blue push pin) and a slack loop at that location. Finally, we need fiber run from the End Pole to Pole 8B (across the street from Faith Ave) P y n h r slack loo and a of a ac loop at that location. Option 2: From the splice case in front of the paint store to the End Pole with a slack loop at Pole 1B and 6B. Materials: We will handle the splicing. We will also provide the fiber and the hanging brackets. We will also be responsible for the drop cable to the building (the pink line). ' Timeline: • The customer has requested a completion date of May 15th. However, I may try and push that back to May 29th. If there is a price difference based upon the completion date, please let me know. Chad Sobotka Senior Network Engineer Ashland Fiber Network 541-552-2402 littwjhumashiand Richard Holbo Hunter Communications Network Operations 541.414.1365 Southern Oregon Communications,LLC 747 Summer Glen Dr. Medford, OR 97501 US (541) 821-2948 rebecca @socomllc.org ESTIMATE ADDRESS ESTIMATE# AFN-1297.E.Bid A F N Data-Ashland Fiber DATE 05/06/2019 Network 90 N Mountain Ave Ashland, OR 97520 United States JOB# 1970 Ashland St- Path B ACTIVITY QTY RATE AMOUNT ADSS FIBER AFN 1,470 1.56 2,293.20 Place Self Support Fiber FIBER LOOP AFN 2 104.00 208.00 Install Fiber Storage Loop (same trip aerial)/ Each Flagger Hourly 14 28.50 399.00 Flagger Rate Sales 1 200.00 200.00 Railroad Crossing Sales 1 200.00 200.00 Extra Signs and Cones Sales 1 200.00 200.00 Traffic Control Plan Sales 1 500.00 500.00 Permits if innerduct is placed over railroad,we will need to charge for innerduct,2 anchors and down guys. This estimate is for Fiber and Storage Loops only. Drop Fiber will be TOTAL $4,000.20 charged additionally at$1.04/ft for the building entrance. Accepted By Accepted Date I AC OR D� A DATE(MWDDITYYY)06/1MO19 CERTIFICATE OF LIABILITY INSURANCE 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 poilcy(los)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 court Vincent Girolaml _ Girolaml Insurance Agency Inc NAME: 209 NE 120th Ave Suite A PHONE 360.326.8219 FAX 360 989 1180 Vancouver WA 98684- _IEBJC.Lo,EXU' (ac Na): ADDRESS:GlAgencylnc @gmail.com __ INSURERS)AFFORDING COVERAGE_ __,__- _ . _ ?um II __ INSURERA:Capital Specialty ins Corp . INSURED Southern Oregon Communications LLC � INSURER8_,WestChester Surplus Lines Insurance Comp ' 747 Summer Glen Dr Medford OR 97501 INSURER C:______ „ __ __ ___- _ _ - - -. INSURER D: INSURER E: INSURER F: 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. INSRr IADOLSUBRr r POLICY EPP I POLICY EXP LTRI TYPE OF INSURANCE NSDI}}IYY✓YYQQ'I POLICY NUMBER IMMIDOIYYYYI I IMMIDDreyn'I LIMITS ote COMMERCIAL GENERAL LIABILITY j�I- ,1 I EACH OCCURRENCE _ 51,000,000 PRS(Caoc rre C ,PREMISES(Ea occurrence)A 'PERSONAL8.ADVINJURY 51.000,000 GENT-AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE 53,000,000 POLICY C2 Tgi fl LOC I i PRODUCTS.COMP/OP AGG 8 3,000,000 I OTHER: ,5 AUTOMOBILELULBILITY iU ui I COMDINED SINGLE LIMIT S I I r(Ea 0acid0111)_---ANY AUTO i 1 ROOILY INJURY(Per person) 5 '--' OWNED —^SCHEDULED AUTOS ONLY AUTOS I BODILY INJURY(Per accident) 5 - HIRED NON-OWNED I PROPERTY DAMAGE 5 _ AUTOS ONLY AUTOS ONLY I (Per acddenU S UMBRELLALIAB — OCCUR 1-11-11 I EACH OCCURRENCE _9 - EXCESS LIAR CLAIMS.MAOE i AGGREGATE __ _ .5 OED RETENTIONS I I I S AND EMPLOYERS'L ABILITY YIN IJf USTATUTE I ICR - _____ ____^ IANYPROPRIETOWPARTNERIEXECUTNE n N/A ' E.L.EACH ACCIDENT $ IOFFICEWMEMSEREXCLUDEDI 1 /(Mandatory In NH) I EL DISEASE-EA EMPLOYEE_5 II yes.dsscnbe under 'DESCRIPTION OF OPERATIONS blow I I EL DISEASE-POLICY LIMIT S B I Contractor's Pollution Liability boo G46857987001 01/16/2019 10111612020 Each pollution Condition 2,000,000 DC, i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Romano Schedule.may be attached II more space Is required) Endorsements CG 20 01 Primary and Noncontributory ;CG 20 33 Additional Insured;CG 20 04 Waiver of Subrogation ' Certificate holder named as additional insured. CERTIFICATE HOLDER CANCELLATION Ashland Fiber Network(AFN) ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Ashland THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR,97520 AUTHORIZED REPRESENTATIVE zL ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web Software.www.FormeBoss.com(c)Impressive Publishing 000-208.1D71 I / 1 rK DATE(MMlDDlYYYYI ACORN CERTIFICATE OF LIABILITY INSURANCE 44.....--„- 05/31/2019 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 Dana State Farm Rachael Spoon,Agent PHONE 541-884-6265 i FAX 541-883-8080 IAIG,_N.a.Eutl:— i- -------- INC,No): 2316 S.6th Street Suite B EMAIL ADDRESS: dana @spooninsurance.cOm • INSURER(S)AFFORDING COVERAGE NAIC 8 Klamath Falls OR 97601 INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED INSURER e: Southern Oregon Communications LLC INSURER C: _ 747 Summer Glen INSURER D: INSURER E: Medford OR 97501 INSURER F: 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. WO ADDL SUBR { POLICY EFF POLICY EXP ' LTR i TYPE OF INSURANCE /Vn POLICY NUMBER (MMIDDENYY) (MM ODIYYYYI LIMITS i COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES fEa RENTED S MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER ! GENERAL AGGREGATE S PRO- .1E0: LOC PRODUCTS-COMP/OP AGG S POLICY I OTHER S AUTOMOBILE LIABIUTY X X 325 3755-A02-37B-9ZZ 01/02/20191 01/02/2020 IEOMa II rNdEEDt SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) S 1,000,000 ' X OWNED \� SCHEDULED BODILY INJURY(Per accident) $ 1,000.000 AUTOS ONLY AUTOS HIRED NON-OVF1ED PROPERTY DAMAGE S 1,000,000 AUTOS ONLY � AUTOS ONLY I (Per accident) i S i UMBRELLA LIAB '! OCCUR EACH OCCURRENCE E _ EXCESS(JAB 1 CLAIMS-MADE AGGREGATE S DED RETENTION S { S WORKERS COMPENSATION I STATUTE I W- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? I I N I A ( N ) (Mandatory in NH E.L.DISEASE-EA EMPLOYEE S R yes IPTION under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more apace is required) Other certificate conditions for the above named;A waiver of subrogation on all policies.This insurance is primary and non-contributory with respects to claims arising out of the operation of the described vehicle CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street AUTHORIZED REPRESENTATIVE /-, Ashland OR 97520 .---sue >/7���- , ©1988-2015 ACORD CORPOF111f46N. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ✓✓ 1001488 132849.12 03-16-2016 • • www.saif.com Oregon Workers' Compensation Work. Certificate of Insurance sail Oregon. The policy of insurance listed below has been issued to the insured named below for the policy period indicated.The insurance afforded by this policy is subject to all the terms,exclusions and conditions of such policy;this policy is subject to change or cancellation at any time. Insured Producer/contact Southern Oregon Communications LLC Gtw Insurance LLC 747 Summer Glen Dr Gtw Insurance LLC Medford, Or 97501-4500 636.296.9000 gatewayins @gmail.com Issued 06/18/2019 Limits of liability Policy 875182 Bodily Injury by Accident $1,000,000 each accident Period 08/01/2019 to 08/01/2020 Bodily Injury by Disease $1,000,000 each employee Cancel 08/01/2019 Body Injury by Disease $1,000,000 policy limit Description of operations/locations/special items Important This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the policies above.This certificate does not constitute a contract between the issuing insurer,authorized representative or producer and the certificate holder. Authorized representative • Kerry Barnett President and CEO 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.584.9812 Policy_OLCA_CertificaleOfl nsu rance CITY OF -ASHLAND PROJECT ACCOUNTING REQUEST FORM PROJECT NUMBER / t( (Public Works Only,otherwise Accounting will assign project number) PROJECT TITLE I Harfst Fiber Installation PROJECT DESCRIPTION Install/Place Fiber Cable along Ashland Street as needed to provide services for the Harfst project Department Ashland Fiber Network Department Head Supervisor Donald Kewley Project Manager Chad Sobotka Type of Project(Check One) Type of Domain(Check One-Electric Only) []Cost Allocation Plan(i.e.,To capture the revenues and expenditures of a program) nNew Services Construction Project IILine Upgrades EGrants 00ther Estimated Project Begin Date. 05/21/2019 Estimated Project End Date: 06/28/201 9 BUDGET INFORMATION FY FY FY Estimated Cost per Fiscal Year Revenue Account(s) Expenditure Account(s) Types of Revenues(Check all the Apply) Types of Expenditures (Check all that Apply) E100-Grants n 100-Design n 375-Internal Labor-Matching 200-Loans El 120-Construction IN 400-Outside Labor 300-General El 150-Construction Mgmt E 425-Public Arts 400-SDC [] 170-Permits El 700-Material Costs-Matching El500-LID []300-Equipment Costs n 999-General Expenses 600-Donat .ns' 0 350-Internal Labor Project Number Requested By: / 05/21/19 (Emp . re) (Date) Entered By: (Accounting Signature) (Date) C\Users\oakleys\Desktop\Draft Project Accounting Request Form3.xlsx 3/92015 8:48 AM Fr All Purchase Order Fiscal Year 2019 Page: 1 of: 1 /� g B City of Ashland �_'s�, 1 7=na�►Ei ®87 � �e� L 20 E.ATTN: Accounts Payable Purchase L AshlandaiOR 97520 Order# 201 90540 T Phone: 541/552-2010 0 Email: payable @ashland.or.us V H C/O Ashland Fiber Network E SOUTHERN OREGON COMMUNICATIONS LLC I 90 North Mountain Ave N 747 SUMMER GLEN DR - p Ashland, OR 97520 MEDFORD, OR 97501 Phone: 541/552-2222 O T Fax: 541/552-2436 R O Ma McCla 07/09/2019 4776 FOB ASHLAND OR/NET30 Cit Accounts Pa able Install Fiber Loop 1 Install fiber storage loop per Exhibit C (Estimate# 1 $4,000.2000 $4,000.20 AFN-1297.E.Bid) Services Agreement Completion date: 07/30/2019 Project Account: E-000711-999 • ***«*#**** **** GL SUMMARY 024700-704100 $4,000.20 By Vl Date: I ( ___�= Authorized Signature F[ fai= _ - $4,000.20 '- FORM Wc_e_ e.-`( ���-6 CITY OF ASHLAND REQUISITION h Date of request: 14.1) /26/2019 Vendor Name SOUTHERN OREGON COMMUNICATIONS, LLC 01" Address,City,State,Zip 747 SUMMER GLEN DR. MEDFORD,OR Contact Name REBECCA -/ Z- Telephone Number 541 821.2948 Email address rebeccaa_socomllc.orq 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#_ _(Attach copy of council communication) ❑ State of Washington ❑ Verbal/Written quote(s)or proposal(s) g 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#Intergovernmental Agreement PERSONAL SERVICES ❑ Special Procurement ❑ Agency _ $5,000 to$75,000 ❑ Form#9,Request for Approval Date original contract approved by Council: ❑ Less than$35,000,by direct appointment ❑ Written quote or proposal attached (Date) ❑ (3)Written proposals/written solicitation Date approved by Council: _(Attach copy of council communication) ❑ Form#4, Personal Services$5K to$75K Valid until: (Date) Description of SERVICES Total Cost Install Fiber Storage Loop per exhibit C(quote AFN-1297.E.Bid) $ 4,000.20 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ Project Number 0 0 0 7 1 1 . 9 s s Account Number 0 2 4 7 0 0- 7 0 4 1 0 0 $_,_ _ _,_ _ _ _ _ , • 4 00020 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: .14,W Department Head: (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: Fnrm in_Rantiicitinn