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HomeMy WebLinkAbout2019-237 20200135 Thermo Fluids inc i GOODS & SERVICES AGREEMENT PROVIDER: Thermo Fluids, Inc. CITY OF PROVIDER'S Lee Michael -AS H LA N D CONTACT: Account Manager 20 East Main Street Ashland, Oregon 97520 ADDRESS: 535 Industrial Circle Telephone: 541/488-5587 White City, OR 97503 Fax: 541/488-6006 PHONE: 503-849-1211 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Thermo Fluids, Inc., a foreign business corporation ("hereinafter "Provider"), for retrieval, hauling, and recycling of used oil. 1. PROVIDER'S OBLIGATIONS 1.1 Provide for the retrieval, hauling, and recycling of used oil as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The goods and services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 12 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 $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 5 of 5: Goods and Services Agreement between the City of Ashland and Thermo Fluids, Inc. Page 5 of 5: Goods and Services Agreement between the City of Ashland and Thermo Fluids, Inc. 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. Eachparty 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. 3S 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, to the extent caused by the negligence or willful misconduct of Provider. Neither party shall be liable to the other for indirect, incidental, consequential, or special damages, including loss of use or lost profits. 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 "Service Agreement" dated January 7, 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. 52 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. Page 5 of 5: Goods and Services Agreement between the City of Ashland and Thermo Fluids, Inc. r I 62 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 - Facilities Maintenance Department Attn: David Arnold 90 North Mountain Avenue Ashland, Oregon 97520 Phone: (541) 552-2292 With a copy to: City of Ashland - Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541) 488-5350 If to Provider: Thermo Fluids, Inc. Attn: Lee Michael 541-830-1100 With a copy to: Thermo Fluids, Inc. 42 Longwater Drive, Norwell, MA 02061 Attn: General Counsel (Urgent Contract Matter) 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision, term, condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach, whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; Page 5 of 5: Goods and Services Agreement between the City of Ashland and Thermo Fluids, Inc. (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. 92 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. 10. Non-Conforming Waste: If the Work involves the transportation and disposal of waste, City shall provide Provider with a description of said waste ("Waste Profile"). Upon approval by Provider, the Waste Profile shall be incorporated into and become a part of this Agreement. Waste materials discovered by Provider to be non- conforming, if in Provider's possession, shall be prepared for lawful transportation by Provider and returned to City within a reasonable time after rejection by Provider, unless the parties agree to an alternative and lawful manner to dispose of the waste materials. City shall pay Provider at agreed rates for the handling, loading, preparing, transporting, storing and caring for and, if applicable, disposing of such non-conforming waste materials. The waste material shall be considered non-conforming if the waste materials contain constituents or have characteristics or properties not disclosed on the Waste Profile. IN WITNESS WHEREOF the parries 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: THERMO FLUI S, IN (C NSULTANT): By: By: Signature Si nat e r4U 44 C- Orf.-W-J / Printed Name PAnted Name ✓lw 0✓rLC--c-Ta2 S ~t~ ~,o ~w~i off S' Title Title AvG 20 9 Z/t, Z l ot Date ate (W-9 is to be submitted with this signed Agreement) Purchase Order No. Page 5 of 5: Goods and Services Agreement between the City of Ashland and Thermo Fluids, Inc. Service Agreement THERMO f FLUIDS- The Responsible Solution 1.800.350.7565 www.thermofluids.com Company Guaranty Chevrolet v Address ° City/State/Zip Junction City o Contact a Phone a Fax Mobile w Multiple Locations ESTIMATED PRICING or UNITS EFFECTIVE DATE SERVICE ANNUAL VOLUMES (PAYMENT)' INTERVAL Collection Services Used Oil Collection (Bulk) (Max. 1%water) FIXED INDEXED xx 7,100 $ 0.300 gallon 01-01-19 Used Oil Collection (Drums) drum Used Oil Filter Collection DRUMS X BIN: $ 73.000 dribin Non-RCRA Waste Antifreeze Collection $ 0.720 gallon Absorbent Collection GRANULAR SOCK/PAD drum Other - TYPE: each Commercial & Industrial Wastewater and/or Vacuum Truck Services Oily Water Collection PROFILE COMPLETE gallon Sludge Collection gallon Truck Time hour N Technician Time hour Other - TYPE: each o Parts Washing Services & Equipment z 0 16 Gallon Solvent Tank COMS LEASE each m w 30 Gallon Solvent Tank COMS LEASE each U Aqueous Based -TYPE: each z H Equipment Sales - TYPE: each a Other - TYPE: gallon Coolant & Other Products N v Pre-mix Conventional LT DUTY AUTO HW DUN DIESEL $ 3.680 gallon o Pre-mix Extended Life LT DUTY AUTO Hw DUTY DIESEL $ 4.830 gallon Washer Fluid - TYPE: gallon Other - TYPE: Waste AF Lab Analysis Analytical Testing PW SOLVENT OILY WATER each Field Halogen Test USED OIL OILY WATER each Other - TYPE: each NOTES and/or OTHER SERVICES/PRODUCTS This Agreement is governed by and subject to Thermo Fluids Inc.'s Terms & Conditions. 'Fuel charges may apply. Thermo Fluids Representative Customer Representative Print: Lee Michael Print: a Signature: Signature: Z y Title: Account Manager Title: Date: 07-01-19 Date: w NAC Account: no Dispatch Upon Receipt: N w Account Manager: Lee Michael New Custc x Local TFI Office: EUGENE Change Order: ° Vertical Market: AUTO DEALERSHIP voeio a Page 1 of 2 DATE (MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 08/16/2019 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 NAME: Willia of Massachusetts, Inc. PHONE 1-877-945-7378 PAX 1-868-467-2378 c/o 26 Century Blvd A/ No, A/C No E-MAIL P.O. Box 305191 ADDRESS: certificates@willis.com Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAICIf INSURER A : ACE American Insurance Company 22667 INSURED INSURER B : ACE Property L Casualty Insurance Company 20699 Thermo Fluids Inc. 42 Longwater Drive INSURER C: Indemnity Insurance Company of North Ameri 43575 Norwell, MA 02061 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W12307596 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM DD YYYY MM/ DYYYY WVD LTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 T--1 CLAIMS-MADE I X 1; OCCUR PREM EN 500,000 'PREMIS PREMISES Ea occurrence $ A X XCD MED EXP (Any one person) $ 5,000 X Contractual y Y li HDOG71209581 11/01/2018 11/01/2019 PERSONAL 8 ADV INJURY $ 2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRO- CT LOC PRODUCTS - COMP/OP AGO $ 4,000,000 R POLICY 1XI E OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 5,000,000 Ea accident) i_ ANY AUTO BODILY INJURY (Per person) $ A X OWNED SCHEDULED Y AUTOS ONLY AUTOS ISAH25271865 11/01/2018 11/01/2019 BODILY INJURY (Per accident) $ X i HIRED IX NON-OWNED PROPERTYDAMAGE $ &TqO ONLY AUTOS ONLY Per accident X $ B X { UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 '.EXCESSLIAB CLAIMS-MADE G4682586A 002 11/01/2018 11/01/2019 AGGREGATE $ 10,000,000 DED X RETENTION $ 0 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY Y/N STATUTE ' ER _ C ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 2,000,000 OFFICER/M EMBER EXCLUDED? No N/A WLRC65228610 (AOS) 11/01/2018 11/01/2019 - - (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under 2, 000, 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Workers Compensation WLRC65228658 (AE, CA, MA) 11/01/2018 11/01/2019 E-L. Each Accident $2,000,000 6 Employers Liability E.L. Disease -Pol Lm $2,000,000 Per Statute E.L. Disease Each Emp $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addhlonal Remarks Schedule, may be attached If more space Is required) Scope of Work: All Operations of the Insured. SEE ATTACHED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE Attn: David Arnold 90 North Mountain Ave Ashland, OR 97520 vYl"- ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 18396294 BATCH: 1329437 AGENCY CUSTOMER ID: LOC ACoR" ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Willis of Massachusetts, Inc. Thermo Fluids Inc. 42 Longwater Drive POLICY NUMBER Norwell, KA 02061 See Page 1 CARRIER NAIL CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance The City of Ashland, Oregon, its officers, agents and employees are named as Additional Insureds for General Liability and Auto Liability as their interests may appear if required by written contract but only with respect to liability arising out of operations of the Named Insured. It is further agreed that the General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insureds. It is understood and agreed that the company waives its right of subrogation which may arise by reason of a payment of claim under the General Liability policy as required by written contract. INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 POLICY NUMBER: COO G27416603 004 EFF DATE: 11/01/2018 EXP DATE: 11/01/2019 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Contractor's Pollution Liability Each Claim $10,000,000 All Claims $10,000,000 SIR $250,000 INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 POLICY NUMBER: COO G27416603 004 EFF DATE: 11/01/2018 EXP DATE: 11/01/2019 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Professional Liability Each Claim $10,000,000 All Claims $10,000,000 SIR $250,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 18396294 BATCH: 1329437 CERT: W12307596 Tami Campos From: David Arnold Sent: Thursday, July 25, 2019 11:35 AM To: Tami Campos Subject: Contract/Oil Separator/Rate Sheet/Requests/Results Hi Tami, The following is a description of the companies I requested rate sheets from and the results: Thermo Fluids: Received 30 Apr SafetyKlean: Refused to Submit 26 Jun Sister Company of ThermoFluids Western States Environment: No Response 27 Jun & 16 Jul Sequential: Refused to Submit 16 Jul Not in Their Field Please contact me if you have any further questions, Dave Dave Arnold, Facility Maintenance City of Ashland - Public Works 90 North Mountain Ave Ashland, OR 97520 541 552 2292 FAX: 541 552 2304 david.arnold@ashland.or.us This email transmission is official business of the City of Ashland, it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at (541) 552 2292. Thank you. 1 Legal Department Review DOCUMENT TRANSMITTAL AND CONTROL This form will accompany the document through the drafting, review, and signature processes, and will be kept with the City's final executed copy of the document. Required fields are indicated in gray scale. I Document: Thermo Fluids FY20 (Include names of parties to the document) Type of Document: Contract Lease ❑ Easement ❑ Deed ❑ IGA ❑ Other (Specifv) Dept Contact: Tami De Mille-Campos ACTION REQUESTED: Dept: Public Works Phone: Ext 2920 lil Review Draft Date submitted to Legal: 117i2112019 ❑ Approve final and forward to: Draft due by: ASAP (Unless in(licated, Legal will return document to you) Return Requested by: Tami De Mille-Campos Complete this section ONLY the first time this form is filled out: Has this document been previously worked on by the Legal Dept Staff? ® No ❑ Yes If yes, by whom? LEGAL DEPT First Date Received by Legal Date:; By: , USE ONLY Returned to Dept. for Revision Date: By: Received for additional review by Legal Date: By: Returned to Dept. for Revision Date: By: Received for additional review by Legal Date: By: Returned to Dept. for Revision Date: By: Received for Additional Review by Legal Date: By: Returned to Dept for Revision Date: By: Final Logged out by Legal Date: ~ Z- ° By: Comments from LEGAL to DEPARTMENT: Comments from DEPARTMENT to LE AL: ❑ See Attached. P' fIe Return original executed document to City Does this document need to be recorded? Recorder for safekeeping? ❑ No lJ. Yes Z No ❑ Yes CITY ADMINISTRATOR / DEPARTMENT HEAD Please do not sign the attached document until this forT has-been ap1proytd by the Legal Dept below: FINAL LEGAL DEPARTMENT APPROVAL:' Date: 2 G:AIegaltDEPARTMEVTS\Contracting\FORMS\Legal Doc Transmittal - KLB.docx Purchase Order Fiscal Year 2020 Page: 1 of: 1 I i t•':IS ISO NUMBEF~ ".iUST APPEAR CN ALL INVOICES. AND SHIPPING DOCUMENTS. j B City of Ashland I I ATTN: Accounts Payable Purchase L 20 E. Main 20200135 Ashland, OR 97520 Order # T Phone: 541/552-2010 O Email: payable@ashland.or.us V S C/O Facilities Maintenance Div E THERMO FLUIDS INC. H 90 North Mountain Ave N PO BOX 7170 D PASADENA, CA 91109-7170 P Phone: 541/488-5358 O O Fax: 541/552-2304 R 888 834-2228 David Arnold 09/05/2019 807 FOB ASHLAND OR Cit Accounts Pa able Recycling Used Oil 1 Recycling used oil for FY 20 1 $10,000.0000 $10,000.00 Goods & Services Agreement Completion date: 06/30/2020 Project Account: GL SUMMARY 082400 - 602400 $10,000.00 it By: tL~ E~ F~ Date: L ! " Authorized Signature $10,000.00 C~. - - . ' u FORM#3 CITY OF ASHLAND REQUISITION `5;,a of request: 8/23/2019 -90 Required date for delivery: Vendor Name ThermoFluids Address, City, State, Zip 535 Industrial Circle White City OR 97503 Contact Name & Telephone Number Lee Michael 503-849-1211 Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached Attach co of council communication If council approval required, attach co of CC ❑ Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding $5,000 Date approved by Council: ❑ State of Oregon ❑ Direct Award -(Attach copy of council communication) Contract # ❑ Verbal/Written quote(s) or proposal(s) ❑ Request for Qualifications (Public Works) ❑ State of Washington Date approved by Council: Contract # Attach co of council communication ❑ Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS & SERVICES ❑ Applicable Form (#5, 6, 7 or 8) Contract # Greater than $5,000 and less than $100,000 ❑ Written quote or proposal attached Intergovernmental Agreement H (3) Written quotes and solicitation attached ❑ Form #4, Personal Services >$5K & <$75K Agency PERSONAL SERVICES ❑ Special Procurement ❑ Annual cost to City does not exceed $25,000. Greater than $5,000 and less than $75,000 ❑ Form #9, Request for Approval Agreement approved by Legal and approved/signed by ❑ Direct appointment not to exceed $35,000 ❑ Written quote or proposal attached City Administrator. AMC 2.50.070(4) ❑ (3) Written proposals/written solicitation Date approved by Council: ❑ Annual cost to City exceeds $25,000, Council ❑ Form #4, Personal Services >$5K & <$75K Valid until: Date approval required. (Attach copy of council communication) Description of SERVICES Total Cost [Recycling Used Oil for FY20 $ 10,000.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost ❑ Per attached quote/proposal TOTAL COST Project Number _ _ _ _ _ _ _ Account Number 082400-602400 '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 a rove all hardware and software purchases: IT Director Date Support -Yes /No By signing this requisition form, i certify that th ity's public contracting requirements have been satisfied. Employee: Department Head: Z tlf"16 zor (Equal to or greater than $5,000) Department Wnager/Supervisor: City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year.'E / NO t f k (A Deputy Finance Director- (Equal to or greater than $5,000) Date Comments: P- fiz - Rona 6i ifi-