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HomeMy WebLinkAbout2023-037 PO 20230310- Carlson Construction CITY RECORDER Purchase Order Fiscal Year 2023 Pager 1 of: 1 _3 �1a B City of Ashland I ATTN: Accounts Payable20 E. Main Purchase L Ashland, OR 97520 Order# 2023031. 0 T Phone:541/552-2010 O Email: payable@ashland.or.us V H CIO Electric Department E CARLSON CONSTRUCTION • ' I 90 North Mountain Ave N PO BOX 1503 p Ashland, OR 97520 • D MEDFORD, OR 97501 Phone: 541/488-5357 R T Fax: 541/552-2436 e: i� z _•s= r9 fie) 1 = .a_3t: ) __ —e_ =f i Fr1�;�- 1 1'' ..[ = flT#1 _E- I = t l��_.-z— err• '-inF-d= Rick Barton • 6vt®(`Foe 04/25/2023 1669 FOB ASHLAND OR/NET30 City Accounts Payable EiNg_(_ �_ ,r—.�- - 1 -U aF_ �Ei•.t 65.E F_�S S 2 _ _ � .�€.eLdC �_�_��_a__= Directional Drill 304 N. Main • • 1 Directional Drill 304.N. Main Street 1.0 • $4,800.00 $4,800.00 Per attached proposal dated 03/22/2023 Project Account: E-000824-999 ***************GL.SUMMARY*************** 111800-602400 $4,800.00 I I • • • • • • • • BY: l I� Date: /1/1) ••- . -r Authorized Signature _ $4,800.00 • FORM#3 • CITY OF A 6 equest fora Pe rchase OR , , 6) �� �5 H LAN D. REQUISITION iDate of request: 03/24/2023 • Required date for delivery: _ Vendor Name Carlson Construction Address,City,State,Zip . PO Box 1503, 1234 Corona Ave.Medford,OR 97504 • Contact Name&Telephone Number Brent Carlson, 1-541-773-3035 Cell: 1-541-601-3849 • Email address • bcarlsonconstruction@hotmail.com ' • SOURCING METHOD . ❑ Exempt from Competitive Bidding ❑ .Invitation to Bid ❑ Emergency • • . 0 Reason for exemption: Date approved by Council: 0 Form#13,Written findings and Authorization. ❑ AMC 2.50 _(Attach copy of council communication) 0 Written quote or proposal attached • O Written quote or proposal attached . _(If council approval required,attach copy of CC) ' ❑ Small Procurement 0 Request for Proposal Cooperative Procurement • Not exceeding$5,000 Date approved by Council: 0 State of Oregon Al Direct Award _(Attach copy of council communication) Contract# ' ❑ Verbal/Written bid(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington . Date approved by Council: Contract# ' • . _(Attach copy of council communication) • - 0 Other government agency.contract Intermediate Procurement 0 Sole Source Agency GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 .' 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids&solicitation attached 0 Form#4,Personal Services$5K to$75K Agency • PERSONAL SERVICES Date approved by Council: . 0 Annual cost to City does not.exceed$25,000. Greater than$5,000 and less than$75,000 Valid until: - Date Agreement approved by Legal and•approved/signed by O Less than$35,000,by direct appointment 0 Special Procurement City Administrator.AMC 2.50.070(4) O (3)Written proposals&solicitation attached' 0 Form#9,Request for Approval 0 Annual post to City exceeds$25,000,Council ❑ Form•#4,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) • Date approved by Council: Valid until:_ Date Description of SERVICES • TOTAL COST • Per Carlson bid proposal,dated 03/22/2023:provide directional drill for streetlight circuit per map. • Exhibit B(304 N.Main St.) 4 800.00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost ❑ Per attached quotelproposal TOTAL COST $ - Project Number 0 0 0 8 2 4. 9 9 s Account Number 1 1 1 8 0 0.6 0 2 4 0 0 • . 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 requi •ion form,l cerci that the•City's public contracting requirements'have been satisfied. . Employ• e Department Head: .,j t/ •/ ual to or g 6at2S 2.5 000) • Department Manager/Supervisor: City Manager: (Greater than$35,000) Funds appropriated for current fiscal year: YES/NO. Finance Director-(Equal to or greater than$5,000) Date Comments: • • Form#3-Requisition • r GOODS AND SERVICES AGREEMENT (LESS THAN $35,000) CONTRACTOR: Carlson Construction • CITY OF - CONTACT: Brent Carlson ' AS H LAND ADDRESS: PO Box 1503 (Mailing),Medford, OR 97501 • 20 East Main Street 1234 Corona Avenue,Medford,OR 97504 Ashland,Oregon 97520 Telephone: 541/488-5587 PHONE: . 541-773-3035 1~ax:. 541/488-6006 CELL: 541-601-3849 EMAIL: bcarlsonconstruction@hotmail.com • This Goods and Services Agreement (hereinafter "Agreement") is entered into.by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Carlson Construction ("hereinafter "Contractor"),for directional drilling at-304 N.Main Street(200'). 1. CONTRACTOR'S OBLIGATIONS 1.1 Provide directional drilling at 304 N. Main Street (200') as set forth in the "SUPPORTING DOCUMENTS" attached as Exhibit B,hereto and, by this reference,incorporated herein. Contractor 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 asherein provided for authority to exceed the maximum compensation. The services defined and describedin the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 1.2 Contractor 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;and . • Workers' Compensation. . 1.2.2 Each policiof 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 Worlkunder 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; ' • Contractor shall immediately notify the City of any change in insurance coverage. Page 1 of 5: Goods and Services Agreement between the City of Ashland and Carlson Construction • Contractor shall supply an endorsement naming the City,its officers,employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. 1.3 Contractor 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 Contractor 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 Contractor. Contractor agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations, Further, Contractor agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman- owned business,a business that a service-disabled veteran owns,or an emerging small business enterprise certified under ORS 200.055,in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Contractor 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 Contractors of the Contractor's obligations under this Agreement and Title VI of the Civil Rights Act of 1.964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $24,050.68 or more, Contractor 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. Contractor is also required to post the notice attached hereto as"Exhibit A"predominantly in areas whereit will be seen by all employees. 1.7 Assignment: Contractor shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor artd the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Contractor the sum of$4,800.00 as provided herein as full compensation for the Work as specified in the SUPPORTING DOCUMENTS. • -2.2 In no event shall Contractor's total of all compensation and reimbursement under this Agreement exceed the sum of$4,800.00 (four thousand eight hundred dollars) without express, written approval from the City official whose signature appears below, or such official's'successor in office. Contractor 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. Contractor further acknowledges that any Work delivered, or expenses'incurred without authorization as provided herein is done at Contractor's own risk and as a volunteer without expectation of compensation or reimbursement. Page 2 of 5: Goods and Services Agreement between the City of Ashland and Carlson Construction ti • 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Contractor and is free to procure similar typesof goods and services from other Contractors in its sole • discretion. • 3,2 Contractor is an independent contractor and not an employee or agent of the City for any purpose., • 3.3 Contractor is not entitled to,and expressly waives all claims to City benefits such as health and disability insurance,paid leave,and retirement. 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 27.9B.220,279B 230 and 279B.235. 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arisingunder 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 Contractor shall_defend, save, hold harmless andindemnify 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 Contractor 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 Contractor and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination,Contractor shall pay all transportation and handling charges for the Goods. Contractor is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Contractor 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 the • Contractor to correct them without charge or deliver them at a reduced price,as negotiated.If Contractor does not cure any defects within' reasonable time, the City may reject the Goods and cancel this • Page 3 of 5: Goods and Services Agreement between the City of Ashland and Carlson Construction 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 Contractor 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.The contractor shall transfer all warranties to the City. 4. SUPPORTING DOCUMENTS 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:" • The Contractor's complete written bid dated 03/22/2023, project map, traffic plan map, and Right-of-Way Closure Permit are attached as Exhibit B. 4.2- This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Contractor 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 Contractor 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 the City be liable to the Contractor for any expenses related to'terminationof this Agreement or for anticipated profits.If previous amounts paid to the Contractor exceed the amount due, Contractor shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION . 6.1 Term This Agreementshall 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 05/30/2023, unless sooner terminated as provided in Subsection 6.2, 6.2 Termination 6.2.1 The City and Contractor 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. Page 4 of 5: Goods and Services Agreement between the City of Ashland and Carlson Construction • l 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery,by sending via a reputable commercial overnight courier,or by mailing using registered or certified United States mail,return receipt requested,postage prepaid, to the address set forth below: If to the City: • City of Ashland Electric Department Attn: Rick Barton • 90 N.Mountain Avenue Ashland,Oregon 97520 Phone: (541)488-5357 With a copy to: • City of Ashland—Legal Department 20 E.Main Street Ashland,OR 97520 - •• Phone: (541)488-5350 If to Contractor: • Carlson Construction . Attn:Brent Carlson •• PO Box 1503 • Medford,'.OR 97501 Phone:. (541)773-3035 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. CONTRACTOR'S COMPLIANCE WITH TAX LAWS • 9.1 Contractor represents and warrants to the City that: 9.1.1 Contractor 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 Contractor;and (iii) Any rules,regulations,charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Contractor, 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 Contractor; and • Page 5 of 5: Goods and Services Agreement between the City of Ashland and Carlson Construction • (iii) Any rules,regulations, charter provisions, or ordinances that implement or enforce"any of the foregoing tax laws or provisions. 9.2 Contractor'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 Contractor's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this • Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names . by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND: CARLSO► I NS RU I N: By: By:, , Signature Signature Printed Name Printed Name Title Title Y 2523 a a 0a3 Date � I Date • Purchase Order No. • (W-9 is to be submitted with this signed Agreement) • • • Page 6 of 5: Goods and Services Agreement between the City of Ashland and Carlson Construction • EXHIBIT A -0, CITY OF ASHLAND, OREGON City of Ashland LIVING Aft employers desaibed WAGE below must comply wilin City , of Ashland laws regulating payment of a living wage $17.04 per hour, affective June 30, 2022. 11III VMS The Living Wage is adjusted annually every June 30 by the Consumer Price Index. • Employees must be paid a pardon of the business•of of health care,retirement, living wagetheir emplom if the 401K,and IM eligible : etnPloyer has itsirl OT more cafeteria plans tincluormg employeac,and has received childcare)benefits to the For all hours worked under a financial assistance for the employee's amount of wages; project or business-from the senice contact ktrieen their City of Ashland over "fr. Note: For temporary and employer end the City of $24,050.68; part-time employees,the AsNarvd if the contrwt Living Wage does not apply. "ceeds ilt°5°18 T -Imre' '). if their employer is the Cty of to the fitst IND hours worked Ashland Trap:ring the Perks in any calendar year. For' For all hours worked in a • ' momployee end Foreation Department more details,please see • nk if the e . Ashland Munpal Code sPeids 5Q%°T Imre of the In calcubding theliving wage, Seilion 312.021 employee's time in that month a employers'may add the value wading on project or For additional information: . . Call Cie Ashland City Managers alfice at 541-438-6002 or write to the City Manager, • City Hall,20 East Main Street,Ashland,OR 97520,or%tit the Cities website atweirwashiand.orms. liotice to Employers: This notice must be posted in areas where it ran be seen by all empfeyees. • . • CITY Of • • ASHLAND • Page 7 of 5: Goods and Services Agreement between the City of Ashland and Carlson Construction Carlson Construction Mailing: PO Box 1503 Medford OR 97501 Office: 1234 Corona Avenue Medford, OR 97504 • 541-773-3035 Cell: 541-601-3849 CCB# 173889 Email:bcarlsonconstructio.n@hotmail.com BID PROPOSAL ' DATE SUBMITTED:3/22/2023; EXHIBIT B • Bid Proposal CONTRACT AMOUNT:$4,800.00 Page 1 of 4 • Required Deposit: $ • PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT:. Customer: City of Ashland Electric Address: 304 N Main St. Address: City:Ashland City: Phone: Phone: Rick Email: Thank you for allowing Carlson Construction the opportunity to bid this project for you.Our estimate is based on your plans and specifications. Please feel free to call and discuss this quote at any time. Bid is to directional drill from streetlight in front of 304 N Main St, heading south down the sidewalk about 200'to the ground box in the sidewalk at the next streetlight.We will remove any concrete needed to perform the drill.The city is responsible for all potholing of utilities that will be crossed during the drill for documenting depth.The city is responsible for repairing all asphalt and concrete.The city will supply all material and conduitfor job. *Note:The prices quoted above are subject to change after 14 days of this proposal. Delinquent accounts will be charged a minimum of 3%per week on all past due invoices.Payment is due within 14 days of invoice date.All material is guaranteed to be as specified.Any alteration or•deviation from above specifications involving additional extra costs will be executed only upon additional written orders and will become an additional extra on the project. All agreements are contingent upon accidents or delays beyond our control,this includes all city and or county inspection requirements. Liability Disclaimer:Carlson Construction is not responsible for unmarked utilities, irrigation, private water, private power, landscape repairs,and/or unforeseens. Repairs will be completed at the owner's expense and billed at time and material rates. Reasonable access to be provided for equipment unless discussed prior to job. Extra cost to complete job due to verbal changes,adverse weather,ground condition, rock,and/or unforeseens will be billed at time and material rates. ACCEPTANCE OF PROPOSAL The above prices,specifications,and conditions are satisfactory and are hereby,accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature " Date of Acceptance Page 1 of 2 •• • • `� �a5U4115b / • \ ;` i S5Q58275 Nrr '• /" ,a, • 446%; yp P�:g321 \ \ , vi 245 'L "-`n, ` r 3 /. P5041255 • 212 �\ �' . 7/ = / CO • 05058278 , ' • ;r #15-00 ''.1 i/,9 `, - ` `/ • r 75-A' �� �\ > 3' �/ ' .7 \ / \ / '176 / ./- s,-,..,„061 �J/ �\ '304'' -• • / / • 'u `.%. •• 231' / 317; - - " •\ • • Q 55058276 .. ' - . �� =' 311\, X. \ q v172 8------_,_ - 5P / r� . �`, / -, 229. •, �� 113 . � . ' \, � �7QJW (71•bt' O V•1l ^. 5505825,5 %' ;' \ / �` ' 05041251. .., \ \ ;; 11722 :. 172'.6-/-• / / 211I b •�.�: 172 1 6 I ro PVT SVC 7+ \\ • H #74 / P• 172.3 ' f .•:::•-/ r• n\ s. / - A."'� \\54.42 `i9vi \ -.1'✓ • UNK / r j� Q \Circa' ' \';_ P505827 D 4 172 5// //r // VJ/ / - ` �\ �. ; 1 4/ r. ;i,173. q \ 303 \ i 41%,... �` i r ... 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'9�� I p50411:0:2,.. `� I ! /' r , ‘,a k -• • J.(1.19,-,7„,,,,,i, !/ I a, /_ /,EEXHIBIT B ��a • \ _•,-, ,�; r .;r, / t �, •Project Map �` 55041103i/ , `i• • 265 \\ �s • \✓ 188 / �, ! ;Page.2 of 4 \` PQ P H5058126 / 1807 TEMP FEED �; Q: \, Q. P�04110q/ \ 1,72 • / ....,..,................,..„.... - '_ - - Yf 1 J.V V • - / Tpci,--s..,. . . P i: tom'- • _ \�X. � I i/ 176. E ~ ' ' ,,, -''- \ \\ :304 - • ,. �'1 . % . 231 / %`5 / S50582Z6 •,, - / �. „�: . ,`� • As .•! / ` \ Iw` 1��q 172 8 Al .� / �I` .- ! 229 ;;55058256" .• -— \\ ', O` 172'2 172 6 / •f % i ,1 r` •,,k-\‘ \ \ moo\ L,; •/ / r s; f \ •�o Q 1721 ! / ,,•, • :T�/�� :),t;''' � PVT SVC <�• \\ ._,rr C9',05` ., 172 3 _ , m � �.. . •• -307\ \\. �` Q #74'/ P ` /1 (--1:',-!•.,50-4 r\ft �\ • �\ \ J '� 1725i f -i — c,\ \, •P505827 N F IA1 -�'/ '• \• i ,- 303'1 \� • . ; 1i. �� . `'9 / r • h. \ . / _290 B 290 GA ` �� �� • / 229 1/2 / _ ` N. • ; /�`29•0A ;, `` Pj #669 /� • f % • 290 / - r --,._,�. • \\ J S ,� ��k,\;V1 ®A. ' .290.,D.:' :' f -�, ---.P, /254 i'63:: / cam. : 'Oil \..-------_ w`111\ 290 C `"' 7 ' 9,9 i / +< 159 r l' s / { :t L ,171. (1�.. = , ,.u:�3 ' \ .' 0, i / )' "' �., -w•-;---..` P•,` � 106 .. ' "v_.,-.9505:81.04 Z \\ :„.V • /� : / . � •"�/ �' '- `� '" . `®� \ ' 05812 /,.\� , _ - A `. t• • �\. v `\ g-,1, .•2x48 t. 147? •�/{1 ..` J 1,.„ P L' ,..-i. .•••••• \ J C- J 1 ` Ilt I`I •� ' ,\\ 2 >. `. 1 254 . t' / j . .� .„,/ . • \� . . / 254 A , -'..,I , i r, / 1,. ��' V ,/ . 1\ �\ ff 224 ,'ii.,....i / (A. � '`. t 0 \ (�OS 0A/k.® w \ 1 139 •` 1 �, - / z , --:-.-1 J i - :.: .\ ,. �,, P�50411011•.\ , .. _ .,-- : - , ., , „ 1. ',\ / -''s-,..:;.;; . 1/../: , '' '" ,/ • `. �. � /' /'/.-,.Z1 ..• %� .! i s • � \ / ra Y %i f!! 135 .�/ D EXHIBIT B , �'� F'Vis `�.._ 1/ ! . �!�'` ! • �, \\ • H5058127 ,C� ,i . r,,� Traffic Plan Map .. �� 'r'9�' ii/ / \ ,9 ",I 041102 ; ,'.r� , Page 3 of 4 , o :/ y, 196 ---/+f r ' CITY OF . Permit Fee* ASHLANDcost Sidewalk/Parking<72.hrs .$16 Fif., Sidewalk>72'hrs $74, Parking>72 firs: $74 Street/Alley $225 Application For: Permit# • Right-of-Way 'Closure Permit *Acceptance of fee does not deem the permit approved. • This permit covers the temporary closure of sidewalks, streets,alleys,parking spaces and,paths within the City of Ashland public right-of-way. Closures on federal highways, state highways or county roads may require additional permits through ODOT or Jackson County. The applicant must submit this application along with the written temporary traffic control plan at least 48 hours prior to the proposed closure.All traffic control plans shall conform to the ODOT Temporary Traffic Control Handbook, City of Ashland Engineering Standards and the Ashland Municipal Code.The applicant is responsible for notifying the Fire Department 541-482-2770,the Police Department 541-482-5211,911 Dispatch 541-488-2211 and the Ashland School District Transportation Department 541-482-3174 of all street closures.For more information call 541-488-5587. Owner Information .. Contractor Information Owner's Name Brent Carlson . Contractor's Name Carlson Construction Mailing Address. P.O. Box 1503 Medford,OR 97501 Mailing Address P.O.Box 1503 Medford, OR 97501 Phone Number 1-541-601-3849 Office/Cell Phone Number 1-54.1L773-3.035 CCB Number 173889 Applicant shall,,at the Applicant's own expense,at all times during the term of this Permit, maintain in force a comprehensive or commercial general liability policy including coverage for contractual liability for obligations assumed under this Permit. Applicant shall defend, indemni5Y and save City, its,officers, agents, and employees harmless from any and all claims, actions, costs,judgments, damages or other expenses resulting from injury to any person (including injury resulting in death,) or damage to property(including loss or destruction), of • whatsoever nature arising out of or incident to the negligent activities covered under the terms of this Permit. Applicant Name Rick Barton Applicant Signature 4.6 %�� If. Date 3/23/2023 • Applicant email bartonr@ashland.or.us . Site Information Site Address 304 N. Main St. Block(between X&Y Streets) Estimated Start Date/Time 4/20/2023 Estimated Closure Duration 8 Hrs. Project Information . 0 Street Sidewalk 0 Parking Space ❑Alley 0 Path ❑Other • Purpose:. Directional Drill 2" pvc.for Streetlight circuit. ' For Staff Use Only. Received by: Approved;by ... - Additional Conditions of Approval: 0 Pre-Qualified. Providetraffic control plan per MUTCD standards 0'Active Business.License DEPARTMENT OF PUBLIC WORKS EXHIBIT B 20 East Main St Fax:541-488-6006 • 11 Ashland,Oregon 97520 TTY: 800-735-2900 Right-Of-Way Closure Permit www.ashland.or.us G:Ipub-wrksleng101A Blank FormslCurrent Permit FormslJuly 2021 Page 4 of 4 • TE ADA CERTIFICATE OF LIABILITY INSURANCE 0/ t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is,an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement.on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). . PRODUCER CONTACT • FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER HOME OFFICE:P.O.BOX 328 A/C.No,Eel):888-333-4949 FAX No):507-446-4664 • OWATONNA,MN 55060 ADDRESS:CLIENTCONTACTCENTER(d(FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# • INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED 184-097-4 INSURER B: ' CARLSON CONSTRUCTIONINSURER C: PO BOX 1503 MEDFORD,OR 97501-0112 ' INSURER D: . • ' INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:8REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MMIODIYYYY) IMMIDDIYYWI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $1,000,000 CLAIMS-MADE n OCCUR DAM/WE REM SES(Ea RENTED $100,000• MED EXP(My one person) EXCLUDED AY N DV 9837473 10/06/2022 10/06/2023 PERSONAL Am $1,000,000 GE 'LAGGREGA E LIMIT APPLIES PER: OENERALAOOREOATE $2,000,000 PRO X pOUCV JECT- rI LOC PRODUCTS-COMP/OP AGO • $2,000,000 . OTHER: • AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $1,000,000 • Ws acddentl X ANY AUTO, BODILY INJURY(Per person) A OWNED AUTOS ONLY AUTOSULED Y N 9837473 • 10/06/2022 10/06/2023 BODILY INJURY(Per occident HIRED AUTOS ONLY NON-OWNEDPROPERTY DAMAGE AUTOS ONLY — Iyer eceidentl X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 — • A EXCESS LIAB CLAIMS-MADE Y N 9837474 10/06/2022 10/06/2023 AGGREGATE $5,000,000 DEC I I RETENTION WORKERS COMPENSATION - DTH- ' AND EMPLOYERS'LIABILITY. PER STATUTE ER • Y/N ANY PROPRIETORIPARTNERIEXECUTIVE - LL EACH ACCIDENT • OFFICERIMEMBER EXCLUDED? NIA . (Mandelory In NH) - E.L DISEASE•EA EMPLOYEE If yes.describe under , DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT • 1 ) , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES'(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) . • SEE.ATTACHED PAGE - • CERTIFICATE HOLDERCANCELLATION 184097-4 8 4 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E MAIN ST' • THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND,OR 97520-1814 ACCORDANCE WITH,THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE GGA % O 1988-2015 ACORD CORPORATION.A11 rights reserved. ACORD 25(2018103) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: 184-097-4 LOC I ACORD® • ADDITIONAL REMARKS SCHEDULE Page 1of 1 AGENCY - NAMED INSURED FEDERATED MUTUAL INSURANCE COMPANY CARLSON CONSTRUCTION POLICY NUMBER - PO BOX 1503 SEE CERTIFICATE#8.4 MEDFORD,OR 97501-0112 CARRIER NAIC CODE SEE CERTIFICATE#8.4 EFFECTIVE DATE:SEE CERTIFICATE#8.4 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM, • FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED'SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. • • • • • • ACORD 101(2008101) 0 2008 ACORD CORPORATION.All rights reserved. • The ACORD name and logo are registered marks of ACORD —' • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO.COVERAGE PART • With respect to coverage provided by this endorsement, the. provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for"bodily injury" and "property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto"with your permission. However,this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto".This exception does not apply if the covered "auto" is a "trailer"connected to a covered "auto"you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if'you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you,are a partnership), or a member (if you are a limited liability company) for a covered "auto" owned by him or her or a member ofhis or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are-required by the terms of the written agreement to add any insured, or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To "loss"which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented"auto"or the policy period ends,whichever occurs first. • • Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA-F-127 (03-03) Policy Number: 9837473 Transaction Effective Date:10/06/2022 COMMERCIAL GENERAL LIABILITY • CG.20 33 12 19 THIS ENDORSEMENT CHANGES,THE POLICY. PLEASE READ IT CAREFULLY. • ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN. A WRITTEN 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 1. "Bodilyinjury", or agreement that such person or organization be J rY "property damage" or added as an additional insured on your policy. "personal and advertising injury" arising out Such person or organization is an additional of.the rendering of, or the failure to render, insured only with respect to,liability for "bodily any professional architectural, engineering or ' injury", "property damage" or "personal and surveying services, including: advertising injury"caused, inwhole 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 additional insured: against any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring, and employment, training or monitoring of others 2. Will not be broader than that which you are by that insured, if the "occurrence" which required by the contract or agreement to caused the "bodily injury" or "property provide for such additional insured. ` damage", or the offense which caused the A person's or organization's status as an "personal and advertising injury", involved the additional insured under this endorsement ends rendering of or .the failure to render any when your operations for that additional insured professional architectural, engineering or are completed. surveying services. • • © Insurance Services Office, Inc., 2018 Page 1 of 2 CG 20 33 12 19 Policy Number: 9837473 Transaction Effective Date: 10/06/2022 • • 2. "Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring 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 2. Available under the applicable limits of b. That portion of "your work" out of which insurance;• • the injury or damage arises has been put whichever is less. to its intended use by any person or organization other than another contractor This endorsement shall not increase the or subcontractor engaged in •performing applicable limits of insurance. operations for a principal as a part of the same project. • • • • • • • • • • Page 2 of 2 © Insurance Services Office, Inc., 2018. CG 20 33 12 19 . Policy Number: 9837473 • Transaction Effective Date: 10/06/2022 4 ® � ACORN , CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) • ��, 4/24/2023 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 NAMCONE: John Ellot Protectors Insurance, LLC PHONE FAX P.O.'Box 4669 • (AIC.No.Extl:541-773-5358 (A/C,No):541-772-1906 • Medford OR 97504 • ADDRESS: •Johne@protectorsins.com • INSURER(S)AFFORDING COVERAGE NAIC# License#:8747880 INSURER A:SAIF Corporation 524113 INSURED CARLS-& INSURER B Brent Axel Carlson ' • Carlson Construction INSURERC: PO Box 1503 INSURERD: Medford OR 97501 • • INSURER E: INSURER F: • COVERAGES CERTIFICATE NUMBER:360550378 . REVISION NUMBER:. ' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, • EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. • INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ • DAMAGE CLAIMS-MADE OCCUR PREM SESO(Ea occu RENTED $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ • POLICY JET LOC PRODUCTS-COMP/OP AGG $ OTHER: • • $ AUTOMOBILE LIABILITY • COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO ' BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED • . PROPERTY DAMAGE $ ' AUTOS ONLY _ AUTOS ONLY • (Per accident) UMBRELLALIAB ' _ OCCUR EACH OCCURRENCE $ • EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ • $ A WORKERS COMPENSATION ' y 878937 • 12/1/2022 12/1/2023 X STATUTE ETH AND EMPLOYERS'LIABILITY Y/N / ANYPROPRIETORIPARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 • • OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EJB EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) • 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 ' '90 N Mountain Ave AUTHORIZED REPRESENTATIVE Ashland OR 97520. 5 laI ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD •