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HomeMy WebLinkAbout2019-280 20200262 Noel Lesley Event Services GOODS AND SERVICES AGREEMENT LESS THAN $25,000 PROVIDER: Noel Lesley Event Services Inc. CITY OF PROVIDER'S CONTACT: John Lochner -ASHLAND 20 East Main Street ADDRESS: POB 360 Phoenix, OR 97535 Ashland, Oregon 97520 Telephone: 541/488-5587 PHONE: 541-482-1982 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 Noel Lesley Event Services Inc. ("hereinafter "Provider"), for a 10 foot by 20 foot frame tent at the Ashland Rotary Centennial Ice Rink. 1. PROVIDER'S OBLIGATIONS 1.1 Provide delivery, set up and take down of a 10 foot by 20 foot Western Frame Tent covering the walkway and transaction window area of the operation at the Ashland Rotary Centennial Ice Rink as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder, a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars) per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each, provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 5: Agreement between the City of Ashland and Noel Lesley Event Services Inc. 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.I 10. 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 $21,507.75 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 $2,470 ($1,235 due before set up and $1,235 due at conclusion of agreement) as provided herein as full compensation for the Work as specified in the SUPPORTING DOCUMENTS. Ashland Parks and Recreation will also provide one dasher board advertisement and two separate Recreation Playguide advertisements 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 $2,470 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 Noel Lesley Event Services Inc. 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 27913.220 27913.230 and 27913.235. 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. 3.11 Deliveries will be F.0.13 destination. Provider shall pay all transportation and handling charges for the Goods. Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects, fraud, and warranties. 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor, material and manufacture. Provider shall transfer all warranties to the City. 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:" Page 3 of 5: Agreement between the City of Ashland and Noel Lesley Event Services Inc. • The Provider's complete written quotation dated October 25, 2019. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including, but not limited to: 5. 1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief, 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent, and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due, Provider shall pay immediately any excess to City upon written demand provided. 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 February 17, 2020, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30) days' prior written notice, terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement, with cause, by not less than fourteen (14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: Ashland Parks and Recreation Department Attn: Lonny Flora 1195 E. Main Street Ashland, Oregon 97520 Phone: (541) 552-2250 With a copy to: City of Ashland - Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541) 488-5350 Page 4 of 5: Agreement between the City of Ashland and Noel Lesley Event Services Inc. If to Provider: Noel Lesley Event Service Inc. Attn: John Lochner POB 360 Phoenix, OR 97535 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; (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. Page 5 of 5: Agreement between the City of Ashland and Noel Lesley Event Services Inc. CITY OF ASHLAND: (PROVID By: By: Signature S nature , tb AXE A , ~/-t ~G Printed Name rinte ame 0 1 ~c ' V I Title Title 6&1 (7 /1// Date at (W-9 is to be submitted with this signed Agreement) Purchase Order No. Page 6 of 5: Agreement between the City of Ashland and Noel Lesley Event Services Inc. Noel Lesley Event Services, Inc. QUOTE NOEL P.O. Box 360 306 South C Street LESLEY EVENT Phoenix, OR 97535 Phoenix, OR 97535 SERVICES Ph: 541-482-1982 Fax: 541-512-9597 Delivery Quote to: Address: Job #5289231 Ashland Parks & Recreation Commission Ashland Rotary Centennial Ice Rink Order Status: Quote Only 1 195 East Main St 85 Windburn Way Ashland, OR, 97520 Ashland,OR 97520 Sales Person: John Lochner Email: johnk: noellesley.com Contact: Lonny Flora Room: Customer #1172098 Phone: (541) 552-2250 On-Site Contact: Lonny Flora Cell: (541) 324-1473 Phone: (541) 552-2250 Terms: Due Upon Receipt Email: lonny.flora@ashland.or.us Order Date: 10/25/2019 Delivery Pickup Event Date: - 11 '22/2010 2%17/2020 - Event Name: Ice Rin k I x 20' Western Frame Tent 11 /22/19-2/17/19 Terms 'I his quote is valid for 30 dac, lion th ( )rdcr D,itc In order to schedule vour ccent on r. 1,, 11 jJ1j' r.nt coil hay C requested, please sign and return this quote with the 50% non-refundable deposit. A Visa, MasterCard, American Express or Discover card number is ttiquired at the time of order. 'Ihe balance will be invoiced and is due at the close of the event. The on file card will be charged if the balance is not paid within the invoice terms. All credit/debit card payments will be charged a 3% processing fee. Loading begins 14 days prior to the quoted delivery date. We charge in full for what we load. Ifyou are not onsite at the time of delivery/pickup, you agree to the equipment quantities/condition as stated in final invoice. Any equipment missing/damaged at the time of pickup/return will be billed to the customer. Subsequent changes in site condition may affect our ability to provide requested equipment at quoted rates. If the signed quote and/or deposit are received less than 4 days prior to the event setup and tent-staking is not possible due to incomplete locates, customer will be charged for use of ballast. By signing this quote, you accept full responsibility for all rental equipment from the time it is delivered/picked-up until pickup/retum and all terms included in the quote. Quantity Description Duration Price Subtotal 1 10' x 20' White Western Frame Tent (Ballast) 1 Days $220.00 $220.00 6 12" X 24" Sonotube Ballast - 450 lbs. 1 Days $50.00 $300.00 6 12" X 24" Sonotube Cover - INCLUDED 1 Days $0.00 $0.00 1 Tent Rain Gutter - 20' Regular 1 Days $20.00 $20.00 Delivery/Misc Quantity Description Price Subtotal 11 Extended Rental Weeks $270.00 $2,970.00 1 Ice Rink Dasher Board ($500.00) ($500.00) 1 APRC Playguide 1/4 page-Summer ($270.00) ($270.00) 1 APRC Playguide 1/4 page-Fall ($270.00) ($270.00) Page 1 of 2 Printed 10/31 /2019 10:17 AM Notes: Product Total: $540.00 Ice Rink Dasher Board and APRC Playguide 1/4 page Summer and Fall provided Service Charge: $0.00 by APRC. Damage Waiver: $0.00 Labor: $0.00 Delivery/Misc: $1,930.00 Tax: $0.00 Job Total: $2,470.00 Please read the Terms above prior to signing this quote. For Noel Lesley Event Services, Inc. Date Offer ccepted By Date Page 2 of 2 Printed 10/31/2019 10:17 AM I ® DATE (MM/DD YYYY) A Ill 1 CERTIFICATE OF LIABILITY INSURANCE 8/13/2019 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: Ward Insurance Agency Inc. PHONE FAX PO Box 10167 IA'C. o 541-687-1117 A/C 1541-342-8280 Eugene OR 97440 ADO"Ess: kim@wardinsurance.net INSURERS AFFORDING COVERAGE NAIC # INSURER A : Scottsdale Insurance Company 41297 INSURED NOELLES-01 INSURER B : Depositors Insurance Company 42587 Noel Lesley Event Services Inc PO Box 360 INSURER C Phoenix OR 97535-0360 INSURER D: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 111667125 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y BCS0037956 6/15/2019 5/15/2020 EACH OCCURRENCE $1,000,000 _ DAMAGE TO RENTED CLAIMS-MADE FT] OCCUR PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 1XI JECOT Ll LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER. $ B AUTOMOBILE LIABILITY Y Y ACP7575619769 5/15/2019 5/15/2020 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Per accident HAPD $ 250/500 Ded A UMBRELLA LIAR X OCCUR XLS0110545 6/15/2019 5/15/2020 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N STATUTE EERH ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N / A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of subrogation with respects to the general liability and auto liability with waiver as required by written contract per attached endorsements. Subject to policy limits, terms, conditions and exclusions. Re: Ashland Rotary Centennial Ice Rink Certificate Holder Includes: The City of Ashland, its elected officials, officers & employees. 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 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 A ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO AC 70 05 03 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO PROTECTION - GOLD This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A. Effect of This Endorsement B. Newly Acquired or Formed Entities C. Employees as Insureds - Nonowned Autos D. Additional Insured by Contract, Permit or Agreement E. Supplementary Payments - Bail Bonds F. Supplementary Payments - Loss of Earnings G. Personal Effects and Property of Others Extension H. Prejudgment Interest Coverage 1. Fellow Employee -Officer, Managers and Supervisors J. Hired Auto Physical Damage K. Temporary Substitute Autos - Physical Damage Coverage L. Expanded Towing Coverage M. Auto Loan or Lease Coverage N. Original Equipment Manufacturer Parts - Leased Private Passenger Types 0. Deductible Amendments P. Rental Reimbursement Coverage Q. Expanded Transportation Expense R. Extra Expense- Stolen Autos S. Physical Damage Limit of Insurance T. New Vehicle Replacement Cost U. Physical Damage Coverage Extension V. Transfer of Rights of Recovery Against Others To Us W. Section IV - Business Auto Conditions - Notice of and Knowledge of Occurrence X. Hired Car Coverage Territory Y. Emergency Lock Out Z. Cancellation Condition AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 7 with its permission ACP BAPD75-5-5619769 L782 17117 INSURED COPY AC7005031600 0001 47 0024870 COMMERCIAL AUTO AC 70 05 03 16 A. EFFECT OF THIS ENDORSEMENT If specifically required by the written contract or Coverage provided under this policy is modified agreement referenced in the paragraph above, by the provisions of this endorsement. If there any coverage provided by this endorsement to is any conflict between the provisions of this an additional insured shall be primary and endorsement and the provision(s) of any state- any other valid and collectible insurance avail- specific endorsement also attached to this poli- able to the additional insured shall be non- cy, then the provision(s) of the state-specific contributory with this insurance. If the written endorsement shall apply instead of the provi- contract does not require this coverage to be sions of this endorsement that are in conflict, primary and the additional insured's coverage to but only to the extent of the conflict, and only to be non-contributory, then this insurance will be the extent necessary to bring such provisions excess over any other valid and collectible insur- into conformance with the state requirement(s) ance available to the additional insured. contained in the provision(s) of the state-specific endorsement. E. SUPPLEMENTARY PAYMENTS - BAIL B. NEWLY ACQUIRED OR FORMED ENTITIES BONDS The Named Insured shown in the Declarations is Supplementary Payments of SECTION II - amended to include any organization you newly COVERED AUTOS LIABILITY COVERAGE is acquire or form, other than a partnership, joint revised as follows: venture, or limited liability company, and over (2) Up to $2,500 for cost of bail bonds (including which you maintain ownership or majority (more bonds for related traffic law violations) than 50%) interest; if there is no other similar in- required because of an "accident" we cover. surance available to that organization. Coverage We do not have to furnish these bonds. under this provision is afforded until the 1801h F. SUPPLEMENTARY PAYMENTS - LOSS OF day after you acquire or form the organization or EARNINGS the end of the policy period, whichever is later. C. EMPLOYEES AS INSUREDS - NONOWNED Supplementary Payments of the SECTION II - COVERED AUTOS LIABILITY COVERAGE is AUTOS revised as follows: The following is added to paragraph A.1. Who Is (4) All reasonable expenses incurred by the "in- An Insured of SECTION II - COVERED AUTOS sured" at our request, including actual loss LIABILITY COVERAGE: of earnings up to $500 a day because of d. Any "employee" of yours is an "insured" time off from work. while using a covered "auto" you don't own, G. PERSONAL EFFECTS AND PROPERTY OF hire or borrow in your business or your per- OTHERS EXTENSION sonal affairs. D. ADDITIONAL INSURED BY CONTRACT, 1. The. Care, Custody or Control Exclusion of PERMIT OR AGREEMENT SECTION II - COVERED AUTOS LIABILITY COVERAGE, does not apply to The following is added to A.1. Who Is An In- "property damage" to property, other than sured of SECTION II - COVERED AUTOS your property, up to an amount not exceed- LIABILITY COVERAGE: ing $250 in any one "accident". Coverage Any person or organization that you are re- is excess over any other valid and collectible quired to name as an additional insured in a insurance. written contract or agreement that is executed 2. The following paragraph is added to A.4. or signed by you prior to a "bodily injury" or Coverage Extensions of SECTION III - 11 property damage" occurrence is an "insured" PHYSICAL DAMAGE COVERAGE: for Covered Auto Liability coverage. How- c. We will pay up to $500 for your property ever, with respect to covered "autos", such that is lost or damaged as a result of a person or organization is an insured only to covered "loss", without applying a de- the extent that person or organization qualifies as an "insured" under A.I. Who is an Insured of ductible. Coverage is excess over any SECTION II - COVERED AUTOS LIABILITY other valid and collectible insurance. COVERAGE: Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc. AC 70 05 03 16 with its permission ACP BAPD75-5-5619769 L782 17117 INSURED COPY AC7005031600 0001 47 0024871 COMMERCIAL AUTO AC 70 05 03 16 H. PREJUDGMENT INTEREST COVERAGE substitute for a covered "auto" you own that The following paragraph is added to SECTION II is out of service because of its: - COVERED AUTOS LIABILITY COVERAGE, a. Breakdown; 2. Coverage Extensions, a. Supplementary b. Repair; Payments: c. Servicing; (7) Prejudgment interest awarded against the "insured" on that part of the judgment we d. "Loss"; or pay. If we make an offer to pay the appli- e. Destruction cable limit of insurance, we will not pay The coverage that applies is the same as any prejudgment interest based on that the coverage provided for the vehicle being period of time after the offer. replaced. 1. FELLOW EMPLOYEE - OFFICERS, MANAGERS, AND SUPERVISORS L. EXPANDED TOWING COVERAGE The Fellow Employee Exclusion in SECTION II 1. We will pay up to: - COVERED AUTOS LIABILITY COVERAGE is a. $100 for a covered "auto" you own of replaced as follows; the private passengertype, or A. "Bodily injury" to any fellow "employee" of b. $500 for a covered "auto" you own that the "insured" arising out of and in the course of the fellow "employee's" employment or is not of the private passengertype, while performing duties related to the con- for towing and labor costs incurred each duct of your business. This exclusion does time the covered "auto" is disabled. Howev- not apply to an "insured" who occupies a er, the labor must be performed at the place position as an officer, manager, or supervi- of disablement. sor. 2. This coverage applies only for an "auto" J. HIRED AUTO PHYSICAL DAMAGE covered on this policy for Comprehensive or If covered "auto" designation symbols 1 or 8 ap- Specified Causes of Loss Coverage and ply to Liability Coverage and if at least one "au- Collision Coverages. to" you own is covered by this policy for Com- 3. Payment applies in addition to the otherwise prehensive, Specified Causes of Loss, or Colli- applicable amount of each coverage you sion coverages, then the Physical Damage have on a covered "auto". coverages provided are extended to "autos" you M. AUTO LOAN OR LEASE COVERAGE lease, hire, rent or borrow without a driver; and 1. In the event of a total "loss" to a covered provisions in the Business Auto Coverage Form "auto", we will pay any unpaid amount due applicable to Hired Auto Physical Damage apply on the loan or lease, including up to a max- up to a limit of $100,000. The deductible will be imum of $500 for early termination fees or equal to the largest deductible applicable to any penalties, for your covered "auto" less: owned "auto" for that coverage. Any Compre- ensive deductible does not apply to fire or a. The amount paid under SECTION III - hensi PHYSICAL DAMAGE COVERAGE of lightning. K. TEMPORARY SUBSTITUTE AUTOS - this policy; and b. Any: PHYSICAL DAMAGE COVERAGE The following is added to paragraph C. Certain 1) Overdue lease/loan payments at the Trailers, Mobile Equipment And Temporary time of the "loss"; Substitute Autos of SECTION I - COVERED 2) Financial penalties imposed under a AUTOS: lease for excessive use, abnormal If Physical Damage Coverage is provided by wear and tear or high mileage; this Coverage Form, the following types of 3) Security deposits not refunded by a vehicles are also covered "autos" for Physi- lessor; cal Damage Coverage: 4) Costs of extended warranties, Credit Any "auto" you do not own while used with Life insurance, Health, Accident, or the permission of its owner as a temporary Disability insurance purchased with the lease; and AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 7 with its permission ACP BAPD75-5-5619769 L782 17117 INSURED COPY AC7005031600 0001 47 0024872 COMMERCIAL AUTO AC 70 05 03 16 5) Carry-over balances from previous No deductible applies to glass if the glass is re- leases. paired, in a manner acceptable to us, rather than 2. This coverage only applies to a "loss" which replaced. is also covered under this policy for Com- P. RENTAL REIMBURSEMENT COVERAGE prehensive, Specified Causes of Loss, or 1. This coverage applies only to a covered "au- Collision coverage. to" for which Physical Damage Coverage is 3. Coverage does not apply to any unpaid provided on this policy. amount due on a loan for which the covered 2. We will pay for rental reimbursement ex- "auto" is not the sole collateral. penses incurred by you for the rental of an N. ORIGINAL EQUIPMENT MANUFACTURER "auto" because of "loss" to a covered "auto". PARTS - LEASED PRIVATE PASSENGER Payment applies in addition to the otherwise TYPES applicable amount of each coverage you Under Paragraph C. Limit of Insurance of have on a covered "auto." No deductibles SECTION III - PHYSICAL DAMAGE apply to this coverage. COVERAGE, Section 4 is added as follows: 3. We will pay only for those expenses incurred 4. We will use new original equipment vehicle during the policy period beginning 24 hours manufacturer parts for any private passen- after the "loss" and ending, regardless of the ger type covered "auto" where required by policy's expiration, with the lesser of the the lease agreement which has a term of at following number of days: least six months. If a new original equip- a. The number of days reasonably ment vehicle manufacturer part is not in pro- required to repair or replace the covered duction or distribution we may use a like, "auto". If "loss" is caused by theft, this kind and quality replacement part. number of days is added to the number 0. DEDUCTIBLE AMENDMENTS of days it takes to locate the covered The following are added to the Deductible provi- "auto" and return it to you. sion of SECTION III - PHYSICAL DAMAGE b. The number of days shown in the COVERAGE: Schedule. If another policy or coverage form that is not an 4. Our payment is limited to the lesser of the automobile policy or coverage form issued by following amounts: this company applies to the same "accident", the a. Necessary and actual expenses following applies: incurred. 1. If the deductible under this coverage is the b. $75 for any one day or for a maximum smaller (or smallest) deductible, it will be of 30 days. waived: 5. This coverage does not apply while there 2. If the deductible under this coverage is not are spare or reserve "autos" available to you the smaller (or smallest) deductible, it will be for your operations. reduced by the amount of the smaller (or 6. If "loss" results from the total theft of a cov- smallest) deductible. ered "auto" of the private passenger type, If a Comprehensive or Specified Causes of Loss we will pay under this coverage only that Coverage "loss" from one "accident" involves amount of your rental reimbursement ex- two or more covered "autos", only the highest penses which is not already provided for un- deductible applicable to those coverages will be der SECTION III - PHYSICAL DAMAGE applied to the "accident," if the cause of the loss COVERAGE Coverage Extension. is covered for those vehicles. This provision only Q. EXPANDED TRANSPORTATION EXPENSE applies if you carry Comprehensive or Specified Paragraph AA.a. of SECTION III - PHYSICAL Causes of Loss Coverage for those vehicles, DAMAGE COVERAGE is replaced by the follow- and does not extend coverage to any covered "autos" for which you do not carry such ing: coverage. We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense in- curred by you because of the total theft of a Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc AC 70 05 03 16 with its permission. ACP BAPD75-5-5619769 L782 17117 INSURED COPY AC7005031600 0001 47 0024873 COMMERCIAL AUTO AC 70 05 03 16 covered "auto" of the private passenger type. ment manufacturer or other sources in- We will only pay for those covered "autos" for cluding non-original equipment manu- which you carry Comprehensive or Specified facturers and Causes of Loss Coverage. We will pay for tem- b. If a repair or replacement results in bet- porary transportation expenses incurred during ter than like kind or quality, we will not the period beginning 24 hours after the theft and pay for the amount of the net improve- ending, regardless of the policy's expiration, ment. when the covered "auto" is returned to use or we pay for its "loss". 5. If we offer to pay the actual cash value of the damaged or stolen property, we will R. EXTRA EXPENSE - STOLEN AUTOS value auto advertising wraps, paint customi- The following paragraph is added to Coverage zation, and similar business related advertis- Extensions of SECTION III - PHYSICAL ing modifications, in addition to the actual DAMAGE COVERAGE: cash value of the property. Auto advertising c. We will pay for up to $5,000 for the expense wraps, paint customization, and similar of returning a stolen covered "auto" to you. business related advertising modifications We will pay only for those covered "autos" will be valued at the cost to replace them for which you carry Comprehensive or Spec- with an adjustment made for depreciation ified Causes of Loss Coverage and physical condition. S. PHYSICAL DAMAGE LIMIT OF INSURANCE T. NEW VEHICLE REPLACEMENT COST Under SECTION III - PHYSICAL DAMAGE The following is added to the Limit of Insurance COVERAGE, Paragraph C., Limit of Insurance provision of SECTION III - PHYSICAL is replaced by the following: DAMAGE COVERAGE: C. Limit Of Insurance 5. The provisions of paragraphs 1. and 3. do 1. The most we will pay for "loss" in any one not apply to a covered "auto" of the private "accident" is the lesser of: passenger type or a vehicle with a gross vehicle weight rating of 20,000 pounds or a. The actual cash value of the damaged less which is a "new vehicle." or stolen property as of the time of the "loss", or In the event of a total "loss" to your new ve- hicle to which this coverage applies, we will b. The cost of repairing or replacing the pay at your option: damaged or stolen property. a. The verifiable "new vehicle" purchase 2. $1500 is the most we will pay for "loss" in price you paid for your damaged vehi- any one "accident" to all electronic equip- cle, not including any insurance or war- ment that reproduces, receives or transmits ranties purchased; audio, visual or data signals which, at the b. If it is available the purchase rice as price, time of "loss", is: negotiated by us, of a "new vehicle" of a. Permanently installed in or upon the the same make, model, and equipment covered "auto" in a housing, opening or or the most similar model available, not other location that is not normally used including any furnishings, parts, or by the "auto" manufacturer for the in- equipment not installed by the manufac- stallation of such equipment. turer or manufacturers' dealership; or . b. Removable from a permanently installed c. The market value of your damaged ve- housing unit as described in Paragraph hicle, not including any furnishings, 2.a. above or is an integral part of that parts, or equipment not installed by the equipment; or manufacturer or manufacturer's dealer- c. An integral part of such equipment. ship. 3. An adjustment for depreciation and physical We will not pay for initiation or set up costs condition will be made in determining actual associated with loans or leases cash value in the event of a total "loss". As used in this endorsement, a "new 4. The cost of repairing or replacing may: vehicle" means an "auto" of which you are a. Be based on an estimate which includes the original owner that has not been previ- parts furnished by the original equip- AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 7 with its permission ACP BAPD75-5-5619769 L782 17117 INSURED COPY AC7005031600 0001 47 0024874 COMMERCIAL AUTO AC 70 05 03 16 ously titled and which you purchased less a. Your obligation in the Duties in the Event than 365 days before the date of the "loss". of Accident, Claim, Suit or Loss Condi- tion relative to notification requirements U. PHYSICAL DAMAGE COVERAGE applies only when the "accident" or EXTENSIONS "loss" is known to: Under SECTION III - PHYSICAL DAMAGE (1) You, if you are an individual; COVERAGE, A. Coverage, Coverage Exten- (2) A partner, if you are a partnership; sions, b. Loss of Use Expenses is replaced by (3) A member, if you are a limited liability the following: company; or b. Loss of Use Expenses (4) An executive officer or insurance For Hired Auto Physical Damage, we will manager, if you are a corporation. pay expenses for which an "insured" be- b. Your obligation in the. Duties in the Event comes legally responsible to pay for loss of of Accident, Claim, Suit or Loss Condition use of a vehicle rented or hired without a relative to providing us with documents driver, under a written rental contract or concerning a claim or "suit" will not be agreement. We will pay for loss of use ex- considered breached unless the breach penses if caused by: occurs after such claim or "suit" is known (1) Other than collision if the Declarations to: indicate that Comprehensive Coverage (1) You, if you are an individual; is provided for any covered "auto"; (2) A partner, if you are a partnership; (2) Specified Causes of Loss only if the (3) A member, if you are a limited Declarations indicate that Specified liability company; or Causes of Loss Coverage is provided for any covered "auto"; or (4) An executive officer or insurance manager, if you are a corporation. (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto." X. HIRED CAR- COVERAGE TERRITORY However, the most we will pay for any Item (5) of the Policy Period, Coverage Territory expenses for loss of use is $50 per day, to a Gene ralConditionss replaced by the following: maximum of $1,500. The insurance provided (5) Anywheren theworldif a covered "auto" is by this provision is excess over any other leased, hired, rented or borrowed without a collectible insurance. driver for a period of 30 days or less; and V. TRANSFER OF RIGHTS OF RECOVERY Y. EMERGENCY LOCKOUT AGAINST OTHERS TO US We will reimburse you up to $100 for reasonable The following is added to the Transfer Of Rights expense incurred for the services of a locksmith Of Recovery Against Others To Us Condition: to gain entry into your covered "auto" subject to We waive any right of recovery we may these provisions: have against any person or organization to 1. Your door key, electronic key or key entry the extent required of you by a written con- pad has been lost, stolen or locked in your tract executed prior to any "accident" be- covered "auto" and you are unable to enter cause of payments we make for damages such "auto" , or under this coverage form. 2. Your keyless entry device battery dies and W. NOTICE OF AND KNOWLEDGE OF you are unable to enter such "auto" as a re- OCCURRENCE sult, SECTION IV - BUSINESS AUTO 3. Your key, electronic key or key entry pad CONDITIONS, Paragraph A is amended as has been lost or stolen and you have follows: changed the lock to prevent an unauthorized ; and 6. NOTICE OF AND KNOWLEDGE OF entry OCCURRENCE Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc AC 70 05 03 16 with its permission. ACP BAPD75-5-5619769 L782 17117 INSURED COPY AC7005031600 0001 47 0024875 COMMERCIAL AUTO AC 70 05 03 16 4. Original copies of receipts for services of a If we cancel for any reason other than non- locksmith must be provided before reim- payment of premium, we will mail or deliver bursement is payable. to the First Named Insured written notice of Z. CANCELLATION CONDITION cancellation at least 60 days before the ef- fective date of cancellation. This provision Paragraph A.2. of the COMMON POLICY does not apply in those states that require CONDITION - CANCELLATION applies more than 60 days prior notice of cancella- except as follows: tion. AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 7 with its permission ACP BAPD75-5-5619769 L782 17117 INSURED COPY AC7005031600 0001 47 0024876 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER:BCS0037956 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization with whom the insured has agreed to waive rights of recovery, provided such agreement is made in writing and prior to the loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 06 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract or agreement that such person or organization be 1. "Bodily injury", "property damage" or "personal added as an additional insured on your policy. and advertising injury" arising out of the Such person or organization is an additional rendering of, or the failure to render, any insured only with respect to liability for "bodily professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury" caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and behalf; specifications; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims against additional insured: any insured allege negligence or other wrongdoing 1. Only applies to the extent permitted by law; in the supervision, hiring, employment, training or and monitoring of others by that insured, if the 2. Will not be broader than that which you are "occurrence" which caused the "bodily injury" or required by the contract or agreement to "property damage", or the offense which caused provide for such additional insured. the "personal and advertising injury", involved the rendering of or the failure to render any A person's or organization's status as an professional architectural, engineering or additional insured under this endorsement ends surveying services. when your operations for that additional insured are completed. CG 20 33 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 2. "Bodily injury" or "property damage" occurring C. With respect to the insurance afforded to these after: additional insureds, the following is added to a. All work, including materials, parts or Section III - Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or b. That portion of "your work" out of which the 2. Available under the applicable Limits of injury or damage arises has been put to its Insurance shown in the Declarations; intended use by any person or organization whichever is less. other than another contractor or This endorsement shall not increase the subcontractor engaged in performing applicable Limits of Insurance shown in the operations for a principal as a part of the Declarations. same project. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 33 04 13 PgH`9 Purchase Order Fiscal Year 2020 Page: 1 of: 1 ~ 3 $ R E CRF. ,e ' fHIS PC) N( 1rLk i iUS rAPPEAR ON ALI_ B Ashland Parks Commission iNVOICEG; AND SHIPPENG-_D-0'_ WA1-NTS ATT. Accounts Payable 20200262 ~ 20 E. Main Purchase Ashland, OR 97520 Order # T Phone: 541/552-2010 O Email: payable@ashland.or.us V H C/O Recreation Division (Grove E NOEL LESLEY EVENT SERVICES, INC 1 1195 East Main Street N PO BOX 360 P Ashland, OR 97520 D PHOENIX, OR 97535 Phone: 541/488-5340 O T Fax: 541/488-5314 R O Lonn Flora 11/15/2019 4974 FOB ASHLAND OR/NET30 Parks Accounts Pa able Canopy for Ice Rink 1 Delivery, set up, take down of 10 x 20' canopy for ice rink trailer 1 $2,470.0000 $2,470.00 Goods and Services Agreement (Less than $25,000) Completion date: 02/17/2020 Project Account: E-000007-999 $2,470.00 GL SUMMARY 125302 - 610210 $2,470.00 -3 By: Date: Authorized Signature - ~ $2,470.00 FF70:R #3 CITY OF -ASHLAND Date of request: REQUISITION , Required date for delivery: Vendor Name p 1? 7,1 Address, City, State, Zip r jC Contact Name & Telephone Number f' / Email address n,,,N i 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 a royal required, attach co of CC Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding $5,000 Date approved by Council: ❑ State of Oregon _(Attach co of council communication Contract # ❑ Direct Award PY ) ❑ 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 Date approval required. (Attach copy of council communication) ❑ Form #4, Personal Services $51K to $75K Valid until: Description of SERVICES Total Cost jc Tx a ; on v~ t q 30 Item # Quantity Unit 'description of MATERIALS Unit Price Total Cost 51o ❑ Per attached quotelproposal TOTAL COST $~VT® Project Numbed ~ 07 -!9V Account Number ~m 1 • _ _ _ _ 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 Ciitt 's public contracting requirements have been satisfied. Employee: Department Head: (Equal to or greater than $5,000) Department Manager/Supervis , 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: #3 - Requisition