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HomeMy WebLinkAbout2022-007 PO 20220261- Cut N Break Construction Inc Purchase Order mei VMS LT.d 6 nicuLyn Li d Fiscal Year 2022 Page: 1 of: 1 By City of Ashland ATTN:Accounts Payable � 20 E. Main Purchase 20220261 Ashland, OR 97520 Order# T Phone: 541/552-2010 O Email: payable@ashland.or.us ✓ S C/O Parks Department E CUT N BREAK CONSTRUCTION INC H Admin Office N PO BOX 1455 l 340 South Pioneer D MEDFORD, OR 97501 P Ashland, OR 97520 R I Phone: 541/488-5340 O Fax: 541/488-5314 4 (541) 779-1482 Michael Black lTA 02/04/2022 475 FOB ASHLAND OR City Accounts Payable AU-7'a _ _ . � ' ��ss L-. .,�'1 _--_- ---- � --... Remove and replace concrete - 1 Remove and replace concrete at Lithia Park(Park& Rec Building) 1.0 $2,980.00 $2,980.00 Goods and Services Agreement(Less than $25,000) Completion date: 04/30/2022 Project Account: ***************GL SUMMARY*************** 121200-704001 $2,980.00 - _ By: Date: P Au horize Signature .2 980.00 • • FORM #3 CITY OF A request f®r a Purchase Ordo., ASHLAND REQUISITION Date of request: 01/22/2022 Required date for delivery: Vendor Name Cut N Break Addre§s,City,State,Zip PO Box 1455 Medford,OR 97501-0108 Contact Name&Telephone Number . John Lawton, President Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency O Reason for exemption: ❑ Invitation to Bid 0 Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached _(Attach copy of council communication) _(If council approval required,attach copy of CC) 0 Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: , • ❑ State of Oregon ❑■ Direct Award _(Attach copy of council communication) Contract# 0 Verbal/Written bid(s)or proposal(s) ❑ Request for Qualifications(Public Works) 0 State of Washington Date approved by Council: Contract# _ _(Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement ❑ 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 ❑ Form#4,Personal Services$5K to$75K Agency • PERSONAL SERVICES 0 Special Procurement 0 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 0 Written quote or proposal attached City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached Date approved by Council: ❑ Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services$5K to$75K Valid until: (Date) approval required.(Attach copy of council communication) Description of SERVICES Total Cost • 2,980:00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost O Per attached quote/proposal TOTAL COST Project Number _ _ _ Account Number 1 2 1 2 0 0.7 0 4 0 0 1 $2980 00 Account Number - Account Number - *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form, I certify that the City's public contracting requirements have been satisfied. Employee: /a-a-/V- -e Department Head: (Equal to or greater than$5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than$25,000) Funds appropriated for current fiscal year: YES /NO Finance Director-(Equal to or greater than$5,000) Date Comments: Form#3-Requisition l i 1 i' GOODS AND SERVICES AGREEMENT(LESS THAN$25,000) r ii i; p,-0PROVIDER: Cut N Break Construction Inc. ji. .t..sS a PROVIDER'S CONTACT: John Lawton,President iS r" 174-: e-.'. . '• ' ADDRESS: PO Box 1455 I. 20 East Main Street Medford,OR 97501-0108 '' IT • Ashland,Oregon 97520 • PHONE; (S41)7.79-1482 Telephone: 541/488-5340 I- Fax: 541/552-5314 f' F This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of . Ashland, an Oregon municipal corporation(hereinafter "City") and Cut 'n Break Inc. ("hereinafter"Provider"), for removal and replacement of concrete at Lithia Park Sports Courts. I. PROVIDER'S OBLIGATIONS ff 1.1 Provide core drilling of 8—16"diameter core drills in concrete at Litha Park Tennis Courts 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 ra SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized 5. except in the same manner as herein provided for authority to exceed the maximum compensation. The l 1 . services defined and described in the SUPPORTING DOCUMENTS, shall hereinafter be collectively 5 referred to as"Work." G 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. i j, 1.2.1 The insurance required in this Article shall include the following coverages: O Comprehensive-General or Commercial General Liability, including personal injury, ,}. ii contractual liability,and products/completed operations coverage; and s il o Automobile Liability. 1.2.2 Each policy of such insurance shall be on an"occurrence" and not a"claims made"form, and shall: 1 o 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 P Agreement; r. a Apply to each named and additional named insured as though a separate policy had been I issued to each,provided that the policy limits shall not be increased thereby; O Apply as primary coverage for each additional named insured except to the extent that two Jr' or more such policies are intended to "layer" coverage and,taken together, they provide If total coverage from the first dollar of liability; P G. Provider shall immediately notify the City of any change.in insurance coverage t{ O Provider shall supply an endorsement naming the City,,its officers, employees and agents i as additional insureds by the Effective Date of this Agreement; and k Page 1 of 5: Goods and Services Agreement between the City of Ashland and Cut'n Break Construction i l fi r i , II il i o Be evidenced by a certificate or certificates of such insurance approved by the City. '! i 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, li familial status or domestic partnership, national origin, age, mental or physical disability, sexual i orientation, gender identity or source of income, suffer discrimination in the performance of this ii Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of if 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 11 business, a business that a service-disabled veteran owns or an emerging small business enterprise i<. certified under ORS 200.055,in awarding subcontracts as required by ORS 279A.110. k 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be wj performed under a subcontract, including procurements of materials or leases of equipment, eachI[i 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.. - 15 1.6 Living-Wage Requirements: If the amount of this Agreement is $22,0.02.43 or more, Provider is l 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 j attached hereto as"Exhibit A"predominantly in areas where it will be seen by all employees. ,_ 'I 1.7 Assignment: Provider shall not assign this Agreement or subcontractany portion of the Work to be' i provided hereunder without the prior written consent of the City. Any attempted assignment or 11 subcontract without written consent of the City shall be void. Provider 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 ,i or subcontractor and the City. It. r 2. CITY'S OBLIGATIONS 11 2.1 City shall pay Provider the sum of$2,980(two thousand nine-hundred and eighty dollars)lump sum if as provided herein as full compensation for the Work as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed I the sum of$2,980 (two thousand nine-hundred and eightydollars)this is maximum,not to exceed ` li amount of ENTIRE Agreement without express,written approval from the City official whose signature i 11 appears below, or such official's successor in office. Provider expressly acknowledges that no other , il person has,authority to order or authorize additional Work which would cause this maximum sum to be iS 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 rzli done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement, 3i 3. GENERAL PROVISIONS is 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. - - l Page 2 of 5: Goods and Services Agreement between the City of Ashland and Cut'n Break Construction K I€f i i , 1 9i 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. ., t 3.3 Provider is not entitled to,and expressly waives all claims to City benefits such as health and disability E ri insurance,paid leave,and retirement. li li 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject t matter hereof. It supersedes all prior agreements, negotiations,and representations between the parties, i whether written or oral. i y 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: jy ORS 279B.220,27913.230 and 27913.235, 1.1 is i` 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws j principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the i. Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, i in which case exclusive venue shall be in the federal district court fqr the district of Oregon. Each party + expressly waives any and all rights to maintain an action under this Agreement in any other venue, and i 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. V, 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents 11 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, i= employees,contractors,or agents under this Agreement. l 11 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance f: 11 caused by acts of God,strikes,lockouts,accidents,or Other events beyond the control of the other or the 13 other's officers,employees or agents. ii1 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, DI 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 I intuit of Provider and the City set forth in this Agreement. R il 3,11 Deliveries will be F.O.B destination.Provider shall pay all transportation and handling charges for the 0 Goods.Provider is responsible and liable for loss or damage until final inspection and acceptance of the E, 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 reducedprice, as negotiated. If Provider II g g 1 does not cure any defects within a reasonable time, the City may reject the Goods•and cancel this j ii 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(UCG). f i 1 _ Page 3 of 5: Goods and Services Agreement between the City of Ashland and Cut'n Break Construction_ 1.1 .i i I¢ 1 i ; c f 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. 1 E. 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:" - I 1 R o The Provider's complete written quote dated February 19,2020. 3 ; 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 t remedies available to it under this Agreement and at law or in equity,including,but not limited to: j 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; 1 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or r t injunctive relief; I 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue t 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 i for anticipated profits. If previous amounts paid to Provider exceed the amount due,Provider shall payii immediately any excess to City upon written demand provided. 5 6. TERM AND TERMINATION 6.1 Term t - This Agreement shall be effective from the date of execution on behalf of the City as set forth below 11 L. (the "Effective Date"), and shall continue in full force and effect until April 30, 2022, unless sooner 1 terminated as provided in Subsection 6.2. • F 6.2 Termination 1 il 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time, - t 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. I ii •Such termination is in addition to and not hi lieu of any other remedy at law or equity. ; Ii 7. NOTICE ii Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in 'x 11 writing to the other party by personal delivery,by sending via a reputable commercial overnight courier,or lPb mailing using registered or certified United States mail,return receipt requested,Posta postage prepaid, to the address set forth below: - '` 11 If to the City: Ashland Parks and Recreation Commission 1 Attn: Michael BIack 340 S.Pioneer St. 1 Ashland,Oregon 97520 t y-. 1> Page 4 of 5: Goods and Services Agreement between the City of Ashland and Cut'n Break Construction I li I 1 • 1 i Phone: (541)488-5340 With a copy to: City of Ashland—Legal Department 20 E.Main Street Ashland,OR'97520 i Phone: (541)488.5350 • If to Provider: Cut `n Break Construction Inc. Attn: John Lawton,President 1 PO Box 1455 Medford,OR 97501-0108 t It Phone: (541)779-1482 : 8. WAIVER OF gREACR 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 11 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 4 with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS b chapters 316,317,and 318; i (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. it 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: Ij (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 i (iii) Any rules,regulations, charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. G . 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, 9 any violation of Provider's warranty,as set forth in this Article 9,shall constitute a material breach of 3 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. i 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. r t4 i Page 5 of 5: Goods and Services Agreement between the City of Ashland and Cul 'n Break Construction-- F 1E 11 ' I CITY OF ASHLAND: Cut 'n Break Construction Inc. (PROVIDER): By: By: Signature 'ignature (,(/koL 4 ' 164til- ��-aprs Lam Printed Name Printed Name Are-`2'I - 1 41/2-& V e Pres tr t Title Title ii vv / ,7p- .2az Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. • • - I ' Page 6 of 5: Goods and Services Agreement between the City of Ashland and Cut'n Break Construction CUT 'N BREAK CONSTRUCTION INC. P.O. Box 1455 Medford, OR 97501-0108 CCB License #72046 541-779-1482/FAX 541-772-1913 John Lawton, President February 19, 2020 Ashland Parks&Recreation Att: Jason 541-552-2254 ' Jason.minica@ashalnd.or.us Job Site: Lithia Park(Park&Rec building) This is proposal is to remove and replace concrete as discussed. • 2- 6' x 5' section of curb and gutter with 3' landing ❖ Sawcut ❖ Excavate as needed and haul away ••• Install forms ❖ Install 3 minus base rock and compact as needed ❖ Install#3 rebar 2' on center each way ❖ Place and broom finish 3500 psi concrete EQUIPMENT,MATERIAL,AND LABOR: $2,980.00 When saw cutting, Cut IN Break Construction, Inc. is not responsible for any damage to anything in or below the concrete. This includes water lines, electrical line, sprinkler systems, etc. Your signature indicates that you have read this notice and fully understand the limits of Cut'N Break Construction, Inc. responsibility. Billing and Payment Procedures: Invoices are presented on completion of work. Invoices are due and payable upon receipt. Delinquent invoices are subject to 1 1/2% monthly on unpaid balance. We accept Visa and MasterCard for your convenience. Should you have any questions or need any additional information regarding the above proposal please do not hesitate to contact this office. THIS ESTIMATE IS GOOD FOR 30 DAYS! Signing one copy of this letter and returning it in the enclosed envelope indicates acceptance of this proposal. Thank you, • Travis Lawton Superintendent ACCEPTED By: Date: THIS ESTIMATE IS GOOD FOR 30 DAYS! Acio Q® DATE(A4IWDWWYY). CERTIFICATE OF LIABILITY INSURANCE 01/06/2022 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 POUCIES 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(les)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 CLIENT CONTACT CENTER • FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE:P.O.BOX 328 (A/C,No, Ext):888-333-4949 FAX ,No):507-446-4664 OWATONNA,MN 55060 • ADDRESS:CLIENTCONTACTCENTER(aIFEDINS.COM INSURER(S)AFFORDING COVERAGE . NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 171-997-0 INSURER B: '-CUT'N BREAK CONSTRUCTION,INC. INSURER C: - PO BOX 1455 MEDFORD,OR 97501-0108 INSURERS: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:110 REVISION NUMBER:3 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 POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ' ILTR 'TYPE OF INSURANCE 'NSR SjIVO POLICY NUMBER (MM/OIDIVFX) (MMR)D I LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE Eaom $100,000CLAMS-MADE n OCCUR ( erence) ( MED EXP(My one person) EXCLUDED A Y N _ . 9829854 04/13/2021 04/13/2022 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE $2,000,000 1X POLICY I I lag I LOC PRODUCTS-COMP/OP AGO - - $2,000,000 OTHER: _- - ---AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 (Eaxmldend X ANY AUTO BODILY INJURY(Per person) —OWNED AUTOS ONLY SCHEDULED A _AUTOS Y N 9829854 04/13/2021 04/13/2022 BODILY INJURY(Per acdden) HIRED AUTOS ONLY NON-OWNED PROPERTY ppAMAGE AUTOS ONLY (Per EILTIG - X UMBRELLA LIAR X OCCUR .EACH OCCURRENCE $4,000,000 A EXCESS LIAB CLAIMS-MADE Y N 9829855 04/13/2021 04/13/2022 AGGREGATE $4,000,000 DED I RETENTION • WORKERS COMPENSATION PER STATUTE ER• AND EMPLOYERS'LIABILITY Y/N - ANY PROPRIETORIPARTNERIEXECUTIVE fI .E.L EACH ACCIDENT OFP10ER/MEMBER EXCLUDED? I N I A (Mandatory in NH) EL DISEASE-EA EMPLOYEE If yes,describe under , DESCRIPTION OF OPERATIONS below EL DISEASE•POLICY UNIT • • • DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remade Schedule,may be attached if more space Is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION - 171-997-0 110 3 ASHLAND PARKS&RECREATION COMMISSION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 340 S PIONEER ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE 'DELIVERED IN ASHLAND,OR 97520-2729 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1J • J"'. ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: 171-997-0 • LOC ACORD® ‘....--- ADDITIONAL REMARKS SCHEDULE Page 1 o1 1 AGENCY NAMED INSURED FEDERATED MUTUAL INSURANCE COMPANY CUT'N BREAK CONSTRUCTION,INC. PO BOX 1455 POLICY NUMBER ) MEDFORD,OR 97501-0108 SEE CERTIFICATE#110.3 CARRIER NMCCODE SEE CERTIFICATE#110.3 EFFECTIVE DATE:SEE CERTIFICATE#110.3 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY'INSURANCE ADDITIONAL INSURED ALSO INCLUDES THE CITY OF ASHLAND, OREGON, ITS OFFICERS, AGENTS AND EMPLOYEES 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. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. _ INSURANCE PROVIDED BY.THE BUSINESS AUTO LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. } COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. • 1 ACORD 101(2008101) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD l COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage 'provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance B. The following is added to the Other Insurance Condition in the Business Auto Coverage Form Condition in the Auto Dealers Coverage Form and arid the Other Insurance - Primary And Excess supersedes any provision to the contrary: Insurance Provisions in the Motor Carrier This Coverage Form's Covered Autos Liability Coverage Form and supersedes any provision to Coverage and General Liability Coverages are the contrary: primary to and will not seek contribution from any This Coverage Form's Covered Autos Liability other insurance available to an "insured" under Coverage is primary to and will not seek your policy provided that: contribution from any other insurance available to 1: Such "insured" is a Named Insured under an "insured" under your policy provided that: such other insurance; and • 1. Such "insured" is a Named Insured under 2. You have agreed in writing in a contract or such other insurance; and agreement that this insurance would be 2. You. have agreed in writing in a contract or -primary and would not seek contribution from any other insurance- available to such agreement that this insurance would .be "insured". primary and would not seek contribution from any other insurance available to such "insured". CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 • 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 of his 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: 9829854 Transaction Effective Date:04-13-2021 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 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 LIQUOR 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 Condition and supersedes any provision to the or agreement that this insurance would be- contrary: econtrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. 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 • © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 01 12 19 Policy Number: 9829854 Transaction Effective Date:04-13-2021 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 or agreement that such person or organization be 1. "Bodily . injury", "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, 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 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: 9829854 Transaction Effective Date:04-13-2021 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 to its intended use by any person or whichever is less. 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. • 1 Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9829854 Transaction Effective Date:04-13-2021 1 _ J Kariann Olson From: Tara Kiewel . Sent Thursday,February 03,2022 10:01 AM To: - Kariann Olson Subject: PO Request-Cut N Break • Attachments: Cut N Break Contract signed.pdf;Cut N Break Cert E61844-0.pdf;Cut n Break quote.docx;Form#3-Cut N Break 1.21.22.pdf Good Morning, Attached is a PO Requisition for Cut N Break. Let me know if you need anything else. Thanks! r wxieAvei Administrative Analyst Ashland Parks&Recreation Commission 340 S.Pioneer St.,Ashland,OR 97520 Tel:541-552-2257 Fax 541-488-5314 www.ashlandparksandrec.org This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error,please contact me at 541-552-2257. Thank you. 1