HomeMy WebLinkAbout2019-250 20200165 Knife River Materials
PUBLIC IMPROVEMENT CONTRACT
North Mountain Park Nature Play
Project No. 000646
This Public Improvement Contract (hereinafter "Contract") is entered into by and between the
CITY OF ASHLAND, an Oregon municipal corporation (hereinafter "City"), and LTM,
Incorporated dba Knife River (hereinafter "Contractor").
NOW THEREFORE, for good and valuable consideration, the sufficiency of which is hereby
acknowledged, the parties mutually covenant and agree as follows:
1. PROJECT MANAGER:
The City's Project Managers for this Contract are:
Jason Minica and Libby Van Wyhe Ashland Parks and Recreation Department.
2. WORK:
2.1 The Work under this Contract is for the North Mountain Park Nature Play Area, Project
No. 000646, as more fully described in the Contract Documents listed in Article 6 below.
Contractor shall complete all Work as specified in the Contract Documents. The Work is
generally described as follows: The construction of a Nature Play.
2.2 Contractor shall, at its own risk and expense, perform the Work described in the Contract
Documents and furnish all permits, labor, tools, machinery, materials, transportation, equipment
and services of all kinds required for, necessary for, or reasonable incidental to, performance of
the Work, that is, the construction of the North Mountain Park Nature Play Area Project No.
000646 Contractor shall secure all municipal, County, State, or Federal Permits or licenses
including payment of permit fees, license fees, and royalties necessary for or incidental to the
performance of the Work. The risk of loss for such Work shall not shift to the City until written
acceptance of the Work by the City.
3. EFFECTIVE DATE AND DURATION:
This Contract is effective as of the date of execution by the City (the "Effective Date"). All
Work under this Contract shall, unless otherwise terminated or extended, be completed within
ninety (90) calendar days following Contractor's receipt of the City's written Notice to Proceed.
4. CONSIDERATION
4.1 City agrees to pay Contractor, at the times and in the manner provided in the Contract
Documents, a sum not to exceed $157,235.00 (one hundred fifty seven thousand, two
hundred and thirty five dollars) for performing the Work required by this Contract, including
all allowable expenses. In no event shall this sum be be modified except by Change Order
approved in writing by the City. Any progress payments to Contractor shall be made only in
accordance with the schedule and the requirements as set forth in the Standard Terms and
Conditions.
4.2 City certifies that sufficient funds have been appropriated to make payments required by
this Contract during the current fiscal year. Contractor understands and agrees that City's
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payment of amounts under this Contract attributable to Work performed after the last day of the
current fiscal year is contingent upon City appropriations, or other expenditure authority
sufficient to allow City in the exercise of its reasonable discretion, to continue to make payments
under this Contract. In the event City has insufficient appropriations, limitations or other
expenditure authority, City may terminate this Contract without penalty or liability to City,
effective upon the delivery of written notice to Contractor, with no further liability to
Contractor.
5. CONTRACTOR'S REPRESENTATIONS
In order to induce City to enter into this Contract, Contractor makes the following
representations:
5.1 Contractor has examined and carefully studied the Contract Documents, and any
data and reference items identified in the Contract Documents.
5.2 Contractor has visited the Site, conducted a thorough, alert visual examination of the
Site and adjacent areas, and become familiar with and is satisfied as to the general, local,
and Site conditions that may affect cost, progress, and performance of the Work.
5.3 Contractor is familiar with and is satisfied as to all laws and regulations that may affect
cost, progress, and performance of the Work.
5.4 Contractor has carefully studied all drawings of physical conditions relating to existing
surface or subsurface structures at the Site that have been identified in the
Supplementary Conditions, especially with respect to Technical Data in such reports
and drawings, and reports and drawings relating to Hazardous Environmental
Conditions, if any, at or adjacent to the Site that have been identified in the
Supplementary Conditions, especially with respect to Technical Data in such reports
and drawings.
5.5 Contractor has considered the information known to Contractor itself; information
commonly known to contractors doing business in the locality of the Site; information
and observations obtained from visits to the Site; the Contract Documents; and the Site-
related reports and drawings identified in the Contract Documents, with respect to the
effect of such information, observations, and documents on (1) the cost, progress, and
performance of the Work; (2) the means, methods, techniques, sequences, and
procedures of construction to be employed by Contractor; and (3) Contractor's safety
precautions and programs.
5.6 Based on the information and observations referred to in the preceding paragraph,
Contractor agrees that no further examinations, investigations, explorations, tests,
studies, or data are necessary for the performance of the Work at the Contract Price,
within the Contract Times, and in accordance with the other terms and conditions of the
Contract.
5.7 Contractor is aware of the general nature of work to be performed by City and others at
the Site that relates to the Work as indicated in the Contract Documents.
5.8 Contractor has given City written notice of all conflicts, errors, ambiguities, or
discrepancies that Contractor has discovered in the Contract Documents, and the written
resolution thereof by City is acceptable to Contractor.
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5.9 The Contract Documents are generally sufficient to indicate and convey understanding
of all terms and conditions for performance and furnishing of the Work.
6. CONTRACT DOCUMENTS
6.1 The Contract Documents consist of the following:
A. This Public Improvement Contract (pages 1 to 81, inclusive).
B. Performance bond (pages 59 to 60, inclusive).
C. Payment bond (pages 61 to 62, inclusive).
D. Standard Terms and Conditions for Public Improvement Contracts, including all
exhibits thereto (pages 34 to 53, inclusive).
E. Project Specifications for North Mountain Park Nature Play Area Project No.
000646.
F. Construction Diagrams entitled "North Mountain Park Nature Play Area Proiect
Ya 000"6.11
G. Addenda (numbers 0 to 0, inclusive).
H. Contractor's Bid (pages 1 to 3, inclusive). I.
Certificate of Representation.
J. The following documents which may be delivered or issued on or after the Effective
Date of this Contract and are not attached hereto:
1. City's Notice to Proceed.
2. Work Change Directives.
3. Written Change Orders.
6.2 The documents listed in Subarticle 6.1. are attached to this Contract (except as expressly
noted otherwise above).
6.3 There are no Contract Documents other than those listed above in this Article 6.
6.4 The Contract Documents may only be amended, modified, or supplemented as provided
in the General Conditions.
7. INSURANCE
7.1 Workers' Compensation. Contractor shall obtain and maintain during the term of this
Contract and until City's final acceptance of all Work performed hereunder Workers'
Compensation insurance in compliance with ORS Chapter 656. All employers, including
Contractor and any subcontractors, that employ subject workers who perform any work under
this Contract in the State of Oregon shall comply with ORS 656.017 and provide the required
Workers' Compensation coverage, unless such employers are exempt under ORS 656.126.
Contractor shall ensure that each of its subcontractors complies with this requirement.
7.2 Commercial General Liability. Contractor shall obtain and maintain during the term
of this Contract and until City's final acceptance of all Work performed hereunder, a policy or
policies of liability insurance including commercial general liability insurance with a combined
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single limit, or the equivalent, of not less than $2,000,000 (two million dollars) per occurrence
for Bodily Injury, Death, and Property damage. Such insurance shall include coverage for broad
form contractual liability; broad form property damage; personal and advertising injury; owners
and contractor protective; premises/operations; and products/completed operations. Coverage
shall not exclude excavation, collapse, underground, or explosion hazards. Aggregate limits
shall apply on a per project basis.
7.3 Commercial Automobile Liability. Contractor shall obtain and maintain during the
term of this Contract and until City's final acceptance of all Work performed hereunder, a policy
or policies of commercial automobile liability insurance with a combined single limit, or the
equivalent of not less than $2,000,000 (two million dollars) for each accident for Bodily Injury,
Death, and Property Damage, including coverage for owned, hired, and non-owned vehicles.
7.4 Notice of Cancellation or Change. There shall be no cancellation, material change,
reduction of limits or intent not to renew the insurance coverage(s) required under this Contract
without thirty (30) days' prior written notice from the Contractor or its insurer(s) to the City.
This notice provision shall be by endorsement physically attached to the certificate of insurance.
7.5 Additional Insured. Each policy for the commercial general liability insurance and the
commercial automobile liability insurance shall name as additional insured, "the City of
Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of
Contractor's services to be provided under this Contract. This coverage shall be evidenced by
an endorsement physically attached to the certificate of insurance.
8. Governing Law, Venue
This Contract 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 Contract 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.
CONTRACTOR DATA, CERTIFICATION, AND SIGNATURE
Business Name (please print): LTM, Incorporated dba Knife River Materials
Contact Name: Nick Kapphahn Phone: (541) 770-2960 Fax:(541) 664-4567
Address PO Box 1145, Medford, OR 97501
Do Not Write Federal and State Tax ID Numbers on this Contract: One copy of W-9 is to be
submitted with the signed contract to be kept on file in the City of Ashland Finance Department.
Ashland Business License 002243 Construction Contractors Board 56603
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Citizenship: Nonresident alien Yes X No
Business Designation (check one): Individual Sole Proprietorship
Partnership X Corporation Government/Nonprofit
The above information must be provided prior to contract approval. Payment information will be
reported to the Internal Revenue Service (IRS) under the name and taxpayer I.D. number provided
above. (See IRS 1099 for additional instructions regarding taxpayer ID numbers.) Information not
matching IRS records could subject you to 31 percent backup withholding.
I, the undersigned, understand that the Standard Terms and Conditions For Public Improvement
Contracts (Exhibit A) together with Exhibits B through J together with all othe Contract Documents
as described in this Contract, and the separately bound Oregon 2018 Standard Specifications for
Construction, as amended by the City of Ashland's most recent Addenda to the 2018 Standard
Specifications are an integral part of this Contract and agree to perform the Work described in the
Contract Documents, in accordance with the terms and conditions contained therein. I further
understand the City is prohibited from entering into a contract when the contractor has neglected or
refused to file any return, pay any tax, or properly contest a tax, pursuant to ORS 305.385; I hereby
certify, under penalty of perjury and false swearing, that I/my business am/is not in violation of any
Oregon tax laws; I further certify that the certification and representations in Standard Term and
Condition #16 [CCB Registration Requirements] are true and correct, and further I certify that I am an
independent contractor as defined in ORS 670.600.
CONTRACTOR:
000~ra(14o,,, t el A hoos, anag er
S, ature/Title
Joe Soares
Printed name
9/4/2019
Date
CITY OF ASHLAND SIGNATURE
CITY:
Kelly Madding, City A istrator
(Z
Date
CERTIFICATE OF REPRESENTATION
Contractor, under penalty of perjury, hereby certifies that:
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(a) The number shown on this form is its correct taxpayer ID (or is waiting for the number to be issued to it;
and
(b) Contractor is not subject to backup withholding because
(i) it is exempt from backup withholding or
(ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding
as a result of a failure to report all interest or dividends, or
(iii)the IRS has notified it that it is no longer subject to backup withholding. Contractor further
represents and warrants to City that
(a) it has the power and authority to enter into and perform the work,
(b) the Contract, when executed and delivered, shall be a valid and binding obligation of
Contractor enforceable in accordance with its terms, and
(c) The work under the Contract shall be performed in accordance with the highest professional standards, and
(d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also
certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a
corporation authorized to act on behalf of the entity designated above and authorized to do business in
Oregon or is an independent contractor as defined in the contract documents, and has checked four or more
of the following criteria:
X (1) I carry out the labor or services at a location separate from my residence or is in a specific portion
of my residence, set aside as the location of the business.
X (2) Commercial advertising or business cards or a trade association membership are purchased for
the business.
X (3) Telephone listing is used for the business separate from the personal residence listing.
X (4) Labor or services are performed only pursuant to written contracts.
X (5) Labor or services are performed for two or more different persons within a period of one year.
X (6) 1 assume financial responsibility for defective workmanship or for service not provided as
evidenced by the ownership of performance bonds, warranties, errors and omission insurance
or liability insurance relating to the labor or services to be provided.
33
PERFORMANCE BOND
The undersigned LTM Incorporated dba Knife River Materials as principal,
further referred to in this bond as Contractor, and Liberty Mutual Insurance Company/Travelers Casualty and Surety Company of America
as surety, further referred to in this bond as Surety, are jointly and severally bound unto CITY OF
ASHLAND as obligee further referred to in this bond as City, in the sum of One Hundred Fifty-Seven Thousand Two
Hundred Thirty-Five and 00/100
Dollars 157,235.00
Contractor and City have entered into a written contract dated
for the following project: North Mountain Park Nature Play Area Construction Project.
This contract is further referred to in this bond as the Contract and is incorporated into this bond by this reference.
The conditions of this bond are:
1. If Contractor faithfully performs the Contract in accordance with the plans, specifications and
conditions of the contract within the time prescribed by the Contract, as required by ORS 279C. 380
through 279C.385 then this obligation is null and void; otherwise it shall remain in full force and effect.
2. If Contractor is declared by City to be in default under the Contract, the Surety shall promptly remedy
the default perform all of Contractor's obligations under the contract in accordance with its terms and
conditions and pay to City all damages that are due under the Contract.
3. This bond is subject to claims under ORS 279C.380 through 279C.390.
4. This obligation jointly and severally binds Contractor and Surety and their respective heirs, executors,
administrators, successors.
5. Surety waives notice of modification of the Contract or extension of the Contract time.
6. Nonpayment of the bond premium shall not invalidate this bond.
7. The bond number and the name, address, and telephone number of the agent authorized to receive
notices concerning this bond are as follows.
190043366 Liberty Mutual Insurance Company
Bond Number: 107097198 Travelers Casualty and Surety Company of America
Bond Agent: Propel Insurance
Address: PO Box 2940
Tacoma, WA 98401
Telephone: (253) 759-2200
SIGNED this 28th day of August 201iK9
59
PERFORMANCE BOND Page 2
WITNESS:
CONTRACTOR: LTM, corporated dba Knife River Materials
By:
(Corporate Seal) Title: a
Legal Address: PO Box 1145 _
Medford, OR 97501
Attest: Qj
J Corporate Secretary
WI S Liberty Mutual Insurance Company
SURETY: Travelers Casualty and Surety Company of America
Holli Albers, Witness for Surety C",
(Corporate Seal) By. -
Title: Christopher Kinyon Atto ey-in-Fact
Legal Address: 1001 4th Avenue, Suite 3700, Seattle, WA 98154
1501 Fourth Ave., Suite 1000, Seattle, WA 98101
Aft ~
Heather L. Allen, Witness for Surety
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PAYMENT BOND
The undersigned LTM Incorporated dba Knife River Materials as principal,
further referred to in this bond as Contractor, and Liberty Mutual Insurance Company/Travelers Casualty and Surety Company of America
as surety, further referred to in this bond as Surety, are jointly and severally bound unto CITY OF
ASHLAND as obligee further referred to in this bond as City, in the sum of One Hundred Fifty-Seven Thousand Two
Hundred Thirty-Five and 00/100
Dollars 157,235.00
Contractor and City have entered into a written contract dated
for the following proiect North Mountain Park Nature Play Area Construction Project.
This contract is further referred to in this bond as the Contract and is incorporated into this bond by this reference.
The conditions of this bond are:
1. If Contractor faithfully performs the Contract within the time prescribed by the Contract, and promptly
makes payment to all claimants as defined in ORS 279C.600 through 279C 620 then this obligation is null
and void; otherwise it shall remain in full force and effect.
2. If Contractor is declared by City to be in default under the Contract the Surety shall promptly remedy the
default perform all of Contractor's obligations under the contract in accordance with its terms and
conditions and pay to City all damages that are due under the Contract.
3. This bond is subiect to claims under ORS 279C.600 through 279C.620.
4. This obligation iointly and severally binds Contractor and Surety and their respective heirs executors
administrators, successors.
5. Surety waives notice of modification of the Contract or extension of the Contract time.
6. Nonpayment of the bond premium shall not invalidate this bond.
7. The bond number and the name address and telephone number of the agent authorized to receive notices
concerning this bond are as follows:
190043366 Liberty Mutual Insurance Company
Bond Number: 107097198 Travelers Casualty and Surety Company of America
Bond Agent: Propel Insurance
Address: PO Box 2940
Tacoma, WA 98401
Telephone: (253) 759-2200
SIGNED this 28th day of August 2019.
61
PAYMENT BOND Page 2
WITNESS:
CONTRACTOR: LTM, Inc orated dba Knife River Materials
By: 1-
(Corporate Seal) Title: 9MUc4i Nb RA a no M-r
Legal Address: PO Box 1145 _
Medford, OR 97501 _
Attest:
L ( -
Corporate Secretary
WITNE S: Liberty Mutual Insurance Company
SURETY: Traveler Casual and Sure Company America
Holli Albers, Witness for Surety
(Corporate Seal) BY'
Title: Christopher Kin on, Atto - act
Legal Address: 1001 4th Avenue, Suite 3700, Seattle, WA 98154
1501 Fourth Ave., Suite 1000, Seattle, WA 98101
Atte
XW~ Heather L. Allen, Witness for Surety
62
EXHIBIT D
CERTIFICATION STATEMENT
FOR CORPORATION OR INDEPENDENT CONTRACTOR
A. CONTRACTOR IS A CORPORATION
CORPORATION CERTIFICATION: I am authorized to act on behalf of the entity named below, and
certify under penalty of perjury that it is a cor ration.
LTM, Inc. dba Knife River Materials G C 9/5/2019
Entity Signature Date
B. CONTRACTOR IS INDEPENDENT.
Independent Contractor Standards. As used in various provisions of ORS Chapters including but not limited
to 316, 656, 657, and 701, an individual or business entity that performs labor or services for remuneration shall
be considered to perform the labor or services as an "independent contractor" if the standards of ORS 670.600
are met.
Contractor and Project Manager certifies that the Contractor meets the following standards:
1. Contractor is free from direction and control over the means and manner of providing the labor or services,
subject only to the specifications of the desired results.
2. Contractor is responsible for obtaining all assumed business registrations or professional occupation licenses
required by state law or local ordinances.
3. Contractor furnishes the tools or equipment necessary for the contracted labor or services.
4. Contractor has the authority to hire and fire employees to perform the labor or services.
5. Payment to the Contractor is made upon completion of the performance or is made on the basis of a
periodic retainer.
6. Contractor is registered under ORS chapter 701, if the Contractor provides labor or services for which such
registration is required.
7. Contractor has filed federal and state income tax returns in the name of the business or a business Schedule
C as part of the personal income tax return, for the previous year, for labor or services performed as an
independent contractor in the previous year.
8. Contractor represent to the public that the labor or services are to be provided by an independently established
business as four or more of the following circumstances exist.
(Check four or more of the following:)
X A. The labor or services are primarily carried out at a location that is separate from Contractors
residence or is primarily carried out in a specific portion of Contractors residence, which is set aside
as the location of the business.
B. Commercial advertising or business cards are purchased for the business, or Contractor has a
trade association membership.
X C. Telephone listing is used for the business that is separate from the personal residence listing.
X D. Labor or services are performed only pursuant to written contracts.
56
E. Labor or services are performed for two or more different persons within a period of one year.
F. Contractor assumes financial responsibility for defective workmanship or for service not
provided as evidenced by the ownership of performance bonds, warranties, errors and omission
insurance or liability insurance relating to the labor or services to be provided.
If any action is taken by a person or enforcement agency relating to Contractor's independent
contractor status in connection with this contract, Contractor shall defend, hold harmless and
indemnify the CITY OF ASHLAND, its elected and appointed officials, employees, volunteers and
agents from any such action, claim, judgment, fine, penalty, or order to pay. Contractor shall pay
any additional costs incurred by the City in defending such action or incurred as a result of such
action. This indemnification is in addition to any indemnification otherwise in this agreement.
9/5/2019
C tracto ignature Date
P oject Manager Signature Date
57
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutual, The Ohio Casualty Insurance Company Certificate No: 8200930-023049
SURETY West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Holli
Albers, Heather L. Allen, James B. Binder, Brandon K. Bush, Carley Espiritu, Jacob T. Haddock, Diane M. Harding, Brent E. Heilesen, Kyle Joseph Howat, Cynthia L.
Jay, Aliceon A. Keltner, Christopher Kinyon, Michael S. Mansfield, Jamie L. Marques, Erica E. Mosley, Annelies M. Richie, Sara Sophie Sellin, Donald Percell
Shanklin, Jr., Karen C. Swanson, Misti M. Webb, Eric A. Zimmerman
all of the city of Tacoma state of Washington each individually if there be more than one named, its true and lawful attorney-in-fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in
pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 17th day of April 2019
Liberty Mutual Insurance Company
%NSIJ ~Z( INSU a tNSUR The Ohio Casualty Insurance Company
JP OaPO tvlgt JQ 0R--tqI 9y GP ~oaP°RaTgt~ West American Insurance Company
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dvl~'S4CHU`''~aaa`l ZO~~NAMPSa~,aa~ ~s 'NOIAW, ,da3 By:
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David M. Carey, Assistant Secretary ~
Cal State of PENNSYLVANIA ~
a) n County of MONTGOMERY ss
N On this 17th day of April 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance O
o Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes
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N > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. v w
Z3 IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. E
C Cn PAS ~ OM
0O Q~SONVJ TF( COMMONWEALTH OF PENNSYLVANIA / Q 4
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OF Teresa Pastella, Notary Public CU
0 O Upper Merlon Twp., Montgomery County By: N
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0)(1) This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
o Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: o
ai ARTICLE IV - OFFICERS: Section 12. Power of Attorney. 42 2
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o Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or
the
-g President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety
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m ~ any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attomey,
shall L N
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such "OD
Z ~ instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact
under the 4L: ce) - 00
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. CC ,
0 C:)
ARTICLE All - Execution of Contracts: Section 5. Surety Bonds and Undertakings. v ~
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Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
I.
shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind
the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretaryto appoint such attomeys-in-
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of
the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force
and effect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 28th day of August , 2019
1NSU,P 'SY INSV a INSUq
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Cpl ssgeHase'rda 0 ~h'NA MPS da rS 'NOIANP da Renee C. Llewellyn, Assistant Secretary
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LMS-12873 LMIC OCIC WAIC Multi Co 062018
Travelers Casualty and Surety Company of America
~A► Travelers Casualty and Surety Company
TRAVELERS .1 St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St.
Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the
"Companies"), and that the Companies do hereby make, constitute and appoint Christopher Kinyon, of Tacoma, Washington, their true and lawful
Attomey-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in
the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts
and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 3rd day of February,
2017.
3 " W. a TIANTfOFY/, mt*~
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State of Connecticut '
By.
City of Hartford ss. Robert L. Raney, Se or Vice President
On this the 3rd day of February, 2017, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of
Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and
that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations
by himself as a duly authorized officer.
In Witness Whereof, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2021 TAR~~
* ~`os Marie C. Tetreault, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and
Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now in
full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any
Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and
Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with
the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a
bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke
the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice
President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation
is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional
undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior
Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant
Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by
one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more
Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice
President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power
of Attomey or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attomeys-in-Fact for purposes only
of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing
such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile
signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety
Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of
Attorney executed by said Companies, which remains in full force and effect.
Dated this 28th day of August 2019
LA 4J'~1V ANp a` R✓~
3 wrrtrcaAO I HARTFORD.
COINi. / $ CONN. I
~
t.✓. Hughes, Assistant Secretary
Kevin E
To verify the authentidty of this Power ofAttomey, please callus at 1-800-421-3880.
Please refer to the above-named Attomey-in-Fad and the details of the bond to which the power is attached.
■ SAIF Corporation 8/28/2019 10:29:46 AM PAGE 1/001 Fax Server
%N
www.saif corn
Oregon Workers' Compensation bti~a~1.
Gift.
Certificate of Insurance c~rz~n.
Certificate holder:
CITY OF ASHLAND, PARKS AND RECREATION
DEPARTMENT
340 S. PIONEER STREET
ASHLAND, OR 97520
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
Mountain View Paving Inc Ward Insurance Agency Inc
PO Box 508 Mike Godfrey
Talent, Or 97540-0508 541.687.1117 mike@wardinsurance.net
- - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Issued 08/28/2019 Limits of liability
Policy 496578 Bodily Injury by Accident $500,000 each accident
Period 10/01/2019 to 10/01/2020 Bodily Injury by Disease $500,000 each employee
Body Injury by Disease $500,000 policy limit
Description of o peratio ns/locations/s pecial items
Attn: All operations preformed by the named insured for the certificate holder in accordance with the policy terms and
conditions.
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.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN
ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO PROVIDE
WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE.
Authorized representative
)6~, P;~ak-
Kerry Barnett
President and CEO
400 High Street SL
Salem, DR 97312
P: 800.285.8525
F: 5D3.584.9812
Pdicy_OLCA_CerfificateOfInsurance
Council Business Meeting
September 3, 2019
Agenda Item Invitation to Bid North Mountain Park Nature Play Area Construction Project
From Michael Black APRC Director
Rachel Dials APRC Recreation Superintendent
Contact Michael.Black(a.ashland.or.us, Rachel. Dials(a ashland.or.us
SUMMARY
Approval is being requested to award and authorize the City Administrator to execute a contract for the construction
of North Mountain Park Nature Play Area.
POLICIES, PLANS & GOALS SUPPORTED
APRC BN 17-19 Commission Goal.
PREVIOUS COUNCIL ACTION
This project was approved in the 2019-21 Biennial budget process as a capital improvement project for Parks.
Council approved the donation of services from Clouser Drilling to Ashland Parks and Recreation for drilling a well
in preparation for the construction of the Nature Play Area on September 4, 2018
BACKGROUND AND ADDITIONAL INFORMATION
Since 2016, staff have been working to design, permit, fundraise, and contract for the Nature Play Area at North
Mountain Park.
The proposed Nature Play Area increases the community value of an underutilized area of North Mountain Park.
The area is not currently functioning as quality habitat as it is filled with annual grasses and only a few scattered
shrubs. However, the spot is near enough to the Beach Creek riparian area to convey a sense of wildness to visiting
children and families. In addition, the site is only a short walk from the most heavily used areas of the park and is
ADA accessible. This project will protect sensitive habitats by concentrating children's play into an appropriate
zone.
• GreenWorks PC, created the design and specifications (the same group responsible for
Westmoreland Park Nature Play Area in Portland)
• A Physical and Environmental Constraints Permit has been acquired from the City of Ashland.
• Staff have raised $184,455.07 in grants and donations for this project, and in-kind commitments
valued at $28,903.68
A formal competitive sealed bid (Invitation to Bid or ITB) was released on May 6, 2019 but did not receive
any bids. The Invitation to Bid was re-released on July 29, 2019. On August 21, 2019 the City of Ashland
received two (2) bids for the North Mountain Park Nature Play Area. LTM Inc. dba Knife River Materials
provided the low bid of $157,235.00. In accordance with AMC 2.50.080(C), the City Council acting as the
Local Contract Review Board is required to approve the award of public contract(s) resulting from a formal
competitive sealed bid. The bid tab is attached for your review. The City's intent is to award the North
Mountain Park Nature Play Area construction contract to the lowest responsive and responsible bidder LTM
Incorporated dba Knife River Materials.
Page 1 of 2
CITY OF
ASHLAND
The North Mountain Park Nature Play Area Construction Project Intent to Award is scheduled to go to
APRC Commission for recommended approval on August 26, 2019.
Name of Bidder LTM dba Knife Rive Materials Vitus Construction
Sum of Bid $157,235.00 $225,015.00
Name of Bonding Co Liberty Mutual Markel Insurance Co.
Amount of Bid Bond 10% 10%
FISCAL IMPACTS
APRC Staff have raised $184,455.07 in grants and donations for this project. In addition, in-kind commitments
valued at $28,903.68 have been received, and our own APRC team is providing in-kind support estimated at
$28,020.46 (not including the administrative and design costs already incurred). The complete budget for this project
is $238,330.00 The full funds for the project are currently available in the CIP. The apparent low bidder is LTM
Incorporated dba Knife River Materials in the amount of $157,235.00 see supporting documents.
STAFF RECOMMENDATION
Staff recommends approval of the contract award and authorization for City Administrator execution of the attached
contract.
ACTIONS, OPTIONS & POTENTIAL MOTIONS
1.) I move to approve the contract award for the construction of the North Mountain Park Nature Play Area with
LTM Inc. dba Knife River Materials.
2.) I move to deny the contract award the construction of the North Mountain Park Nature Play Area and direct staff
to...
REFERENCES & ATTACHMENTS
Attachment 1: Nature Play Bid Summary
Page 2 of 2
CITY OF
ASHLAND
A S )I
9y
z
~R .0
R E C REPS
r•
ASHLAND PARKS AND RECREATION COMMISSION
SUMMARY OF PROPOSALS
Project: North Mountain Park Nature Play Area
Project No.: 000646
Date of Bid Opening: August 21, 2019 - 2:00 p.m., at the Nature Center
No of Addendum: (0)
1 2 3 4 5
Kra R~.,e~ UI+LkS
Name of Bidder rVA C r C+\' ern
Sum of Bid 15-71235.00 S 225,~IS.oo
Name of A rAJk YVllLyv-Lk lrnstJLvane-
Bondin Co. Co
Amount of Bid
Bond
Addendum N/A N/A N/A N/A N/A
Acknowledged
LTM, Incorporated dba Knife River Materials
Bid Schedule
North Mountain Park Nature Play Area
City of Ashland Parks & Recreation
Project No. 000646
7/29/19
Budget Includes Design Related Unit Cost
Item # Page Spec.
1 Site Clearing Lump Sum
1.1 mobilization
1.2 erosion control LD1.0 1 31 2513
1.3 survey/staking L1.1 311000
1.7 excavation at play area L1.4 312000
1.8 excavation at sand play L1.4 312000
Sub-Total Site
Clearing oo
2 Earthwork Lump Sum
2.1 place on-site fill at boulder L3.2 5 31 2000
mound
2.2 rough grading L1.4 312000
2.3 finish grading L1.4 31 2000
Sub-Total
Earthwork S(J
3 Utilities Lump Sum
3.1 PVC perf drain pipe L3.0 2 / 33 4600
L3.1 1
3.2 4" PVC solid pipe L3.1 8 33 4600
3.3 6" PVC solid pipe L3.1 8 33 4600
3.4 overflow drain L3.1 8 334600
Page 1
LTM, Incorporated dba Knife River Materials
3.5 Cleanouts 33 4600
Sub-Total -
Utilities
4 Paving, Walls, Curbs Lump Sum i.
4.1 concrete pavers with L1.2 2 32 1400
memorial bricks
4.1a concrete header around L3.0 4 03 3100
memorial brick pavers _ - - - - I.
4.2 textured concrete at water L3.1 2 03 3100
4.3 seeded aggregate concrete L3.1 3 03 3100
water channels I'
4.4 concrete playground curb L3.0 2 03 3100
4.5 concrete curb at sand play L3.1 1/5 03 3100
log edging round and
4.6 horizontal L3.5 2 116800
4.8 ADA ramp L3.1 7 03 3100
4.9 reconstruct AC bike path L3.4 5 32 2125 j!
Sub-Total
Paving, Walls,
Curbs 7
5 Play Elements Lump Sum
5.1 boulder mound L3.2 5 11 6800
5.4 foundations and installation L3.2 3/4 116800
of climbing logs
5.5 foundations and installation L3.2 2 116800
of wood steppers
5.6 foundations and installation L3.1 2 - 116800
for log channels
5.8 willow tunnel L3.4 2 - 32 9113 - - -
5.9 fort building frame L3.4 1 116800
5.10 craft table L3.4 3 116800
5.11 Foundations and install L3.0 5 / 116800
sand play boulders L3.3 4
Page 2
LTM, Incorporated dba Knife River Materials
5.12 log round edges at sand L3.5 2B 116800
play area
5.13 wetland boardwalk L3.0 116800 y
7/8/9
Sub-Total Play
- Elements
6 Play Surfacing Lump Sum
6.1 engineered wood fiber L1.3 1 / - L3.0 2 32 1816
6.2 playground sand B.1 1 32 1816
6.5 drain rock base L3.0 2 32 1816
- it
6.6 geotextile fabric L3.0 2 32 1816
Sub-Total Play e
Surfacing f ~f , 7y(i
7 Site Furnishings Lump Sum
7.2 stone seat wall at sand play L3.1 1/4 03 3100
Foundations and installation
74 L3.5 1 116800
of log benches, horizontal
7.5 Foundations and installation LIS 2B 116800
of log seat rounds I
7.6 split rail fencing L3.0 6 12 9300
Sub-Total Site
Furnishings .6 7U
GRAND TOTAL
Contractor Signature:
Date: 8/21/2019
Page 3
i
Bid Schedule
North Mountain Park Nature Play Area
City of Ashland Parks & Recreation
F
Project No. 000646
7/29/19
Budget Includes Design Related
Item 4# Rage Spec. Unit Cost
- r is I ~ „•1f,; 5 s1 'l ay ~ i ~ F ~>t , - . ' f t 5 7
Site Cledrlnl1 Y
-t~e t 'it ~1.c~ i ?ty"~{k < iLu i'T]p Sum t ifnr .L ! tvf 1
V,\ Y. ^,'V.i .~.fir(. ^I ~ s r ~rY 1 i i ~ 1{ T!^,?;t .
1.1 mobilization
$9,313.00 a
1.2 erosion control LD1.0 1 312513
$5,533.00
1.3 survey/staking L1.1 311.000 $6,073.00
1.7 excavation at play area L1.4 312000 $9,313.00
1.8 excavation at sand play 1-1.4 312000
$7,153.00
Sub-Total Site
Clearing $37,385.00
2 Earthwork Lump Sum
2 1 place on-site fill at boulder L3.2 5 312000
mound $2,833.00
2,2 rough grading 1-1.4 312000 $2,293,00
2.3 finish grading L1.4 312000
$2,293,00
Sub-Total
Earthwork $7,419.00
3 Utilities . Lump Sum
3.1 PVC perf drain pipe 0 2 / 334600
1-3.1 1 $1,753.00
3.2 4" PVC solid pipe L3.1 8 334600 $1,105.00
3.3 6" PVC solid pipe L3.1 8 334600
$ 888.00
3.4 overflow drain L3.1 8 334600
$1,321.00
Page 1
3.5 Cleanouts 33 4600
$ 889.00
Sub-Total s
AY !P N A 7
Utilities $5,957.00
t ,
• ) 'li, '!l,'r f. y i~,, ~.}y .r i~-t r[l; S.j, -~v f 1x + r ? 'tr 1 iJ+,~(-f'..}~' .J 5
CUIbS`S tiC #tl Rr +'t r r Mf v ,L lrhl.` ry r K r h21 Fa.i.4. i;.l,~.'I
c a 1 Paving, Will
+et).~7 r+~~ Y I: h5 4 ~7 5;
. ti , f, Q . r-. ti i .r ~ , r ~ 1 ~ i~~t Lump ~ m ~ It}~+x X~{~-c~.c 1xa 1J
4.1 concrete pavers with
memorial bricks 1-1.2 2 32 1400
$3,373.00
4 1a concrete header around L3.0 4 033100
memorial brick pavers $4,129.00
4 2 textured concrete at water
play L3.1 2 03 3100
$3,157.00
4.3 seeded aggregate concrete
water channels L3.1 3 03 3100
$5,263.00
4,4 concrete playground curb L3.0 2 03 3100
$5,803.00
4.5 concrete curb at sand play 1-3.1 1/5 03 3100
$3,265.00
4 6 log edging round and
horizontal 1.3 .5 2 116800
$3,697.00
4.8 ADA ramp L3.1 7 03 3100 f
$1,105.00
4,9 reconstruct AC bike path L3.4 5 32 2125
$23,893.00 `
is
Sub-Total _ r.. `
Paving, Walls,
Curbs $53,685.00
a
5 Play Elements Lump
Sum'
5.1 boulder mound L3.2 5 11 6800
$14,497.00
5 4 foundations and installation
of climbing logs 1-3.2 3/4 116800
$6,829.00
5.5 foundations and installation
of wood steppers L3.2 2 116800
$6,397.00
foundations and installation
5.6 for log channels L3.1 2 116800
$6,397.00
5.8 willow tunnel L3.4 2 32 9113
$7,693.00
5.9 fort building frame 1-3.4 1 116800
$7,153.00
5.10 craft table 1-3.4 3 116800
$4,993.00
5.11 Foundations and Install L3.0 5/
sand play boulders 1-3.3 4 116800
$8,665.00
ii
Y
Page 2
i
CC
ppN
5.12 log round edges at sand
play area L3.5 2B 116800
$4,993.00
5.13 wetland boardwalk L3.0
7/a/s 116800 i
$11,149.00
Sub-Total Play
Elements 1$78,766,00
77 7-
I
' r Play Surfacng t ti tl r u ~r 4+ t f'
f' ! r lV 5 r t h 15
J 17
tc. t-x Y' it 1 a 't,. . i•-~ j i t t Svju ,:Y `rl+ey r1 Mfr vS^ t q','•:I
3,^ F .1.. i. ,r _ ti✓y i•~ mow. Lump'Surri, tJr`ft •},7 .•r'rf :I
6.1 engineered L1.3+ 1
wood fiber L3.0 2 321816 '
$10,123.00 j
6.2 playground sand L3.1 1 32 1816
$4,453.00
6.5 drain rock base 1.10 2 32 1816
$1,429.00
6.6 geotextile fabric L3.0 2 321816
$ 781.00
Sub-Total Play
Surfacing ti..•1:
$16,786.00
7 :Site Furnishings Lump Sum
7.2 stone seat wall at sand play 13.1 1/4 033100 $3,265.00 '
7.4 Foundations and installation
of log benches, horizontal ~'S 1 116800
$3,373.00
7.5 Foundations and installation
of log seat rounds L3.S 2B 116800
$4,777.00
7.6 split rail fencing L3.0 6 12 9300
$13,602.00
Sub-Total Site `
Furnlshings i
' $25,017.00
~i
GRAND TOTAL'
$225;015.00
Contractor Signature. I
r
i
Date: ugust 2 2019
'i
Page 3
i
i
1
,9 v
NS H` Purchase Order
Fiscal Year 2020 Page: 1 of 1
3 R t G Rio I
k HIS PC' N Jhr16ER, MU51 AYPE
R ON ALL
B Ashland Parks Commission I INVOICES AND SHIPPING DOCUMENTS
L 20 E. ATTN: Accounts Payable Purchase
L Ashland, Main 20200165
Aand, OR 97520 Order #
T Phone: 541/552-2010
O Email: payable@ashland.or.us
V S C/O Parks Department
E KNIFE RIVER MATERIALS H Admin Office
N PO BOX 1145 1 .340 South Pioneer
D P -Ashland, OR 97520
O MEDFORD, OR 97501 T Phone: 541/488-5340
R O 'Fax- 541/488-5314
541 779-6304 Michael Black
09/17/2019 774 FOB ASHLAND OR/NET30 Parks Accounts Pa able
N Mountain Park Play Area
1 Construction of North Mountain Park Nature Play Area 1 157,235.0000 $157,235.00
Public Improvement Contract
Completion date: "ninety (90) days following Contractor's written
Notice to Proceed"
Project Account: E-000646-120 $157,235.00
GL SUMMARY
123000 - 704200 $157,235.00
By: '~`~i 4 Date:
Authorized Signature $157 235.00
FFORM #3 CITY OF
-.SHL.AND
REQUISITION N` Date of request: 09/11/19
Required date for delivery:
Vendor Name Knife River Materials
Address, City, State, Zip PO Box 1145 MEdford OR, 97501
Contact Name & Telephone Number Nick Kapphahn (541)770-2960
Email address
nick.kapphahn@kniferiver.com
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergency
❑ Reason for exemption: Q Invitation to Bid ❑ Form #13, Written findings and Authorization
❑ AMC 2.50 Date approved by Council: 3 1 ❑ Written quote or proposal attached
,E] Written quote or ro osal 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 bid(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
❑ (3) Written bids & solicitation attached ❑ Form #4, Personal Services $5K to $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
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached City Administrator. AMC 2.50.070(4)
❑ (3) Written proposals & solicitation attached Date approved by Council: ❑ Annual cost to City exceeds $25,000, Council
❑ Form #4, Personal Services $5K to $75K Valid until: Date approval required. (Attach copy of council communication)
Description of SERVICES Total Cost
Construction of North Mountain Park Nature Play Area
$ 157,235.00
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
❑ Per attached quote/proposal TOTAL COST
$ 157,235.00
Project Number Account Number Z3~~ ~~!-QD
Account 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 contract' quirements have been satisfied.
Employee: l ~~-*~i~-_ Department Head:
( ual o gr aterthan 5,000)
Department Manager/Supervisor: City Administrator: c 2 It 5
(qual to or jgrea ha $25,0 0)
Funds appropriated for current fiscal year: {yENO Deputy Finance Director- (Equal to or greater than $5,000) ate
Comments: -
Form #3 - Requisition
CITY OF
FORM #12 ASHLAND
REQUEST FOR BUDGET REVIEW
To: Mark Welch, Finance Director
From: Michael Black, APRC
Date: April 24, 2019
Re: Request for Budget Review to Verify Adequate Funds Available
In accordance with AMC 2.50.080(A) for Formal Processes, the Finance Director must sign off that there are appropriate funds
for the project before the project is put out for bids. (Note: The department is to request by memo a budget review to the
Finance Director to ensure adequate funds are available prior to releasing the Invitation to Bid (ITB) or Request for Proposal
(RFP). If the amount of the successful bid or proposal exceeds the initial amount approved as a result of the budget review, the
department is to request by memo another budget review to ensure adequate funds are available for the additional amount prior
to the department requesting approval from the City Council to award and execute the intended public contract.)
REQUEST FOR BUDGET REVIEW PRIOR TO RELEASE OF ITB OR RFP:
Project name and number: North Mountain Park Nature Play Area 000646
Description of project: Construction and materials of a natural playground, facility at North Mountain
Park Nature Center.
Amount budgeted: $213, 000
Account Number(s) and amounts if multiple accounts: CIP Expense account # 123000. 704200
Project # E 000646
Timeline of intended project: (Beginning/completion dates) Begin 711119, Complete 9130119
Funds ropria r current fits "S / NO
Department Head
`7
iuance Director Date
Date
REQUEST FOR BUDGET REVIEW UPON CONTRACT AWARD IF ACTUAL
BID/PROPOSAL EXCEEDS THE INITIAL AMOUNT APPROVED ABOVE PRIOR TO
RELEASING ITB OR RFP:
Actual amount of bid/proposal: $
Funds appropriated for current fiscal year: YES / NO
Department Head
Finance Director Date
Date
Form #12 - Request for Budget Review to Verify Adequate Funds Available, Page 1 of 1, 4/25/2019
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.
Document: North Mountain Park Nature Play Area, Invitation To Bid
(Include names ofparties to the document)
Type of Document: Contract B Lease ❑ Easement ❑ Deed ❑ IGA ❑
Other (Specify) rrs
Dept Contact: LibbyvanNyhe ACTION REQUESTED:
Dept: Parka Phone: Ext 2471
0 Review Draft
Date submitted to Legal: 4l8n9
❑ Approve final and forward to:
Draft due by: Approxinately 4l25l19
(Unless indicated, Legal will retrIM document to you)
Return Requested by: Libby vanwyhe
Complete this section ONLY the first time this form is filled out:
Has this doctnuent been previously worked on by the Legal Dept Staff? 8 No ❑ Yes
If yes, by whom?
LEGAL DEPT First Date Received by Legal Date: L41 R' I ci By: _VA
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:
Retmned to Dept for Revision Date: By:
Final Lowed out b Legal Date: B :
Comments from LEGAL to DEPARTMENT: Comments from DEPARTMENT to LE
❑ See Attached. Hello.
J/ ~elN We would like to open this up to bid by May 1. and close the
i rs ~r~ bid process on May 30.
Ilk
Return original executed do ent to City D es this document need to be recorded?
Recorder for safekeeping? cu No El Yes No ❑ Yes
CIT'V ADMINISTRATOR / EPARTMENT HEAD
Please do not sign the attached document until this for ~ bee •oved by the Legal Dept below:
FINAL LEGAL DEPARTMENT APPROVAL: Date: Z z i