HomeMy WebLinkAbout2022-014 PO 20220257- Greenway Spray LLC Purchase Order
,as Fiscal Year 2022 Page: 1 of: 1
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B City. of Ashland C� rl 7111
ATTN: Accounts Payable Purchase
L Ashland, OR 97520 Order# 20220257
T Phone: 541/552-2010
0 Email: payable@ashland.or.us
V H C/O Public Works Department
E GREENWAY SPRAY LLC I 51 Winburn Way
N 3155 OLD-STAGE ROAD p Ashland, OR 97520
O CENTRAL POINT, OR 97502 Phone: 541/488-5347
R T Fax: 541/488-6006
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02/02/2022
3093 FOB ASHLAND OR/NET30 City Accounts Payable
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Herbicide Pavement Airport
1 Routine herbicide application for pavement protection at Ashland 1.0 $4,950.00 $4,950.00
Municipal Airport
Goods and Services Agreement(Less than $35,000)
Completion date: June 30, 2022
Project Account:
*************** GL SUMMARY***************,
085700-602353 $4,950.00 I
---
By: Date: %, A4-
Authorized Signature $4,950.00
r
FORM #3 • CITY OF
A request fors Purchase Order ASHLAND
-REQUISITION Date of request: 1J
33: 0'22%2
Required date for delivery:
Vendor Name Greenway Spray LLC
Address,City,State,Zip 3155 Old Stage Rd, Central Point, OR 97502
Contact Name&Telephone Number Greg Stewart (541) 662-9949
Fax Number greg@greenwayspray.com
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergency
❑ Reason for exemption: 0 Invitation to Bid (Copies on file) ❑ Form#13,Written findings and Authorization
O 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)
® Small Procurement 0 Request for Proposal (Copies on file) Cooperative Procurement
Less than$5,000 Date Raequest by Council: ❑ State of Oregon
® Direct Award Contract#
_(Attach copy of council communication)
® VerbalMritten quote(s)or proposal(s) 0 State of Washington
Intermediate Procurement 0 Sole Source Contract#
GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) ❑ Other government agency contract
$5,000 to$100,000 0 Written quote or proposal attached Agency
❑ (3)Written quotes and solicitation attached ❑ Form#4, Personal Services$5K to$75K Contract#
PERSONAL SERVICES 0 Special Procurement Intergovernmental Agreement
$5,000 to$75,000 ❑ Agency
❑, Form#9,Request for Approval
❑ Less than$35,000,by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3)Written proposals/written solicitation Date approved by Council:_ (Date)
• ❑ Form#4, Personal Services$5K to$75K Valid until: (Date) —(Attach copy of council communication)
Description of SERVICES Total Cost
Routine herbicide application for pavement protection at Ashland Municipal Airport
$49500"
0
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
XXX
XXX
XXX -
T.OTAL,'COST
® Per attached quote/proposal
Project Number Account Number 085700.602353
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( 1t,?,
form,I certify that the City's public contracting requirements have been satisfied.
a'Y c
Employee: 4A,1171,0 kluge Department Head: >-1 113 It 2122
W1k, qua o or greater than$5,000)
Department ManagerlSupervisor: 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
GOODS AND SERVICES AGREEMENT (LESS THAN $35,000)
PROVIDER: Greenway Spray LLC
CITY o_ F PROVIDER'S CONTACT: Greg Stewart
ASHLAND
20 East Main Street ADDRESS: 3155 Old Stage Way
Ashland,Oregon 97520 Central Point, OR 97502
Telephone: 541/488-5587 PHONE: 541-622-9949
Fax: 541/488-6006,
This Goods and Services Agreement (hereinafter "Agreement") is entered,into by and between the City of
Ashland, an Oregon municipal corporation (hereinafter "City") and Greenway Spray LLC, a domestic business
corporation) ("hereinafter "Provider"), for Routine herbicide application for pavement protection at Ashland
Municipal Airport.
1. PROVIDER'S OBLIGATIONS
1.1 Provide Routine herbicide application for pavement protection at Ashland Municipal Airport 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 toexceed 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; and
• Workers' Compensation:
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;
Page 1 of 6: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC
• 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.
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 a,n 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 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 $22,310.46 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.
1.7 Assignment: Providershallnot 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. 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
or subcontractor and the City.
2. CITY'S OBLIGATIONS
2.1 City shall pay Provider the sum of$4,950.00 (four thousand nine-hundred fifty dollars) 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
the sum of$4,950.00 (four thousand nine-hundred fifty dollars)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.
Page 2 of 6: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC
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.
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 279B.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 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.O.B 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
Page 3 of 6: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC
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 •
4.1 The following documents are, by this reference, expressly incorporated in this Agreement, arid are
collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:"
• The Provider's complete written Estimate dated January 8,2022.
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 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 June 30, 2022, 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
Page 4 of 6: Goods and Services Agreement between the City of Ashland'and Greenway Spray LLC.
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—Public Works Department
Attn: Kaylea Kathol
20 E. Main Street
Ashland, Oregon 97520
Phone: (541)488-5587
With a copy to:
City of Ashland—Legal Department
20 E. Main Street
Ashland, OR 97520
Phone: (541)488-5350
If to Provider:
Greenway Spray LLC
Attn: Greg Stewart
3155 Old Stage Way
Central Point,OR 97502
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.
Page 5 of 6: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC
•
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.
CITY OF ASHLAND: GREENWAY PRAY LLC (PROVIDER):
By: I By: �. ✓1 n
4b. atu e S'bn WI,re
Scall Ft..Euey . . GZ'l t1V`tZei
Printed Namle Printed Name
putaLte- ,.N\[ea_r. (ac cct i_ OLA.¼ /47/E444bM12,_
Title itle
L 12tl 2bi2 . 1 •`Ze
l Date Date ,
• (W-9 is to be submitted with this signed Agreement)
77
Purchase Order No.
Page 6 of 6: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC
•
(01, Greenway Spray LLC Estimate
3155 Old Stage Road
Central Point, OR 97502 Date Estimate#
1/8/2022 192
Name/Address
City of Ashland Public Works/Engineering
51 Winbum Way
Ashland.OR 97520
•
•
Project
Description • Qty Rate Total
Custom spray 18 acres of weeds at the Ashland Airport with pre and 18 275.00 4.950.00
post emergent herbicide.
Areas include: •
All taxiway asphalt cracks and edges. •
Unpaved areas between the hanger doors. •
6"- 12"swath that follows the vegetative swale on the taxiway and
runway shoulders.
•
•
Signs.lights and reflectors will be treated individually 2'in all -
directions with a rectangular spray pattern.
1-land spray entrance bark.6'chain-link fenceline and asphalt piles. •
•
•
•
•
•
•
•
•
•
•
"Thank you for.your business. • Total
54.950.00
•
• www.saif.com
SaiWork.
Ore.
Oregon Workers' Compensation Oregon.
Certificate of Insurance
Certificate holder:
CITY OF ASHLAND
20 EAST MAIN STREET
ASHLAND,OR 97520
The policy of insurance listed belowhas been issued to the insured named below for the policy period
indicated.The insurance afforded by this policy is subject to all the terms,exclusions and conditions.of
such policy;this policy is subject to change or cancellation at any time.
Insured Producer/contact
Greenway Spray LLC SAIF Corporation
3155 Old Stage Rd Portland Service Center
Central Point,Or 97502-1478 503;673.5283 servic@saif.com
Issued 01/30/2022 Limits of liability
Policy 857891 Bodily Injury by Accident $1,000,000 each accident
Period 02/01/2022 to 02/01/2023 Bodily Injury by Disease $1,000,000 each employee
Body Injury by Disease $1,000,000 policy limit
Description of operations/locations/special items
Important
This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate
does not amend,extend or alter the coverage afforded by the'policies above.This
:certificate does not constitute a contract between the issuing insurer,authorized representative or producer and the
certificate holder.
Authorized representative
eAt- L
Chip Terhune
President and CEO
•
400 High StreetSE
Salem,OR 97312
P:800:285.8525
F:503.584.9812
Policy_OLCACertiricateOtlnsurance
PROGRESSIVE°
TOWNE CENTRE INS COMMERCIAL
315 SE 7TH STREET
GRANTS PASS,OR 97526
1-541-476-3311 Policy number: 03967552
Underwritten by:
• Artisan and Truckers Casualty Co
MAIC Number:10194
January 30,2022
• Page 1 of 2
•
Certificate of Insurance
Certificate Holder •
•
Additional Insured
CITY OF ASHLAND
20 EAST MAIN ST
ASHLAND,OR 97520
Insured Agent
GREENWAY SPRAY LLC TOWNE CENTRE INS
3155 OLD STAGE RD 315 SE,7TH STREET
CENTRAL POINT,OR 97502 GRANTS PASS,OR 97526
This document certifies that insurance polides identified below have been issued by the designated insurer to the insured
named above for the period(s)indicated.This Certificate is issued for information purposes only. It confers no rights upon
the certificate holder and does not change,alter, modify, or extend the coverages afforded by the policies listed below.The
coverages afforded by the policies listed below are subject to all the-terms,'exclusions, limitations, endorsements,and
conditions of these policies. Liability coverage may not apply to all scheduled vehicles.
Policy Effective Date: Dec 8,2021 Policy Expiration Date: Dec 8,2022
Insurance coverage(s) Limits
Bodily Injury/Property Damage $1,000,000 Combined Single Limit
Hired Auto Bodily Injury/Property Damage $1,000,000 Combined Single Limit
Employer's Non-Owned Auto BIPD $1,000,000 Combined Single Limit
Uninsured/Underinsured Motorist $1,000,000 Combined Single Limit
Description of LocationNehicles/Special Items
Scheduled autos only
2005 DODGE RAM 2500 3D6VV526D05G832400
Uninsured Motorist Property Damage $20,000 w/$200 Ded($300 if Hit&Run)
Comprehensive $500 Ded
Personal Injury Protection $15,000
.Collision $500 Ded
Rental Reimbursement $30 Per Day($900 Max)
Roadside Assistance Selected w/$0 Ded
2015. HOMEMADE Trailer 99999999999999999
1992 FORD F250 1FTHX26G6NKB46378
Uninsured Motorist Property Damage $20,000 w/$200 Ded($300 if Hit&Run)
Personal Injury Protection $15,000
Roadside Assistance Selected w/$0 Ded
Continued
Policy number: 03967552
GREEN WAY SPRAY LLC
Page 2 of 2
2017 DNS TRLR BLDRS Trailer 1D9D1VC2XH031023
Stated Amount $2,600
Comprehensive $250 Ded
2017 FORD F350 1FTRF3B63HEE26630
Uninsured Motorist Property Damage $20,000 w/$200 Ded($300 if Hit&Run)
Comprehensive $500 Ded
Personal Injury Protection $15,000
Collision $500 Ded
Rental Reimbursement $30 Per Day($900 Max)
Roadside Assistance Selected w/$0 bed
,Please be advised that additional insureds and loss payees will be notified in the event of a mid-term cancellation.
•
•
Form 5241(05/16)
•
r
•
I�o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMI11DIYYYY)
ki..-----' 02/04/2021
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(los)must have-ADDITIONAL INSURED provisions or he elldorsocl.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the-policy,certain pollcies may require an endorsement. A statomorit on
this certificate dons not confer rights to the certificate holder In lieu of.such•endorsomont(s).. .
- PRODUCER Towne Centre Insurance Service,LLC CONTACT BRIAN SEAG_OE
315 SE 7th Street PHONE
:_ , _ _ _
Grants Pass OR 97526 AI^No.EaD:(541)47.6.3311 I FAx (541)476-5626 ,
(NC,No): j
IL
ADDRESS:Brian@tcis.biz ,
INSURERS)AFFORDING COVERAGE _ NAIC l;
INSURERA:Scottsdale Insurance Company
INSURED GREENWAY SPRAY LLC INSURER Et Truckers Casualty Company
3155-OLD STAGE RD _.---- ...-_.__ .�_ . .._ --- ._...
CENTRAL POINT OR 97502 INSURER C:
INSURER 0
INSURER E
INSURER F: •
COVERAGES . CERTIFICATE NUMBER: 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 WI IICI I Ti II
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL1. TI IE TERM.
EXCLUSIONS L_USIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS. „
/NSR A'OOLT8U8R1 ( POLICY EFF' POLICY EXP
LIR TYPE OF INSURANCE NSD ! POLICY NUMBER C(MMIOOIYYYYI (MMIDO(YYYYI I LIMITS
pr COMMERCIAL GENE_RALLIABILITY (fin ! EACH OCCURRENCE 51,000,000
A CLAMS-MADE ✓❑OCCUR CPS-7304245- , 1512021 2/15/2022 DAKUCGETO'RENTED•PREMISES.(ED_WVnance)_ I5 100,000
____-•--•--•. __.. MEDE(PAAnono.parson) I$5,000
PERSONAL&AMINJURY ;x.1,000,000
GENLAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 152,000,000
RPOLICYE ECT El LOC• I PRODUCTS•COMP/OP AL(, I:2,000,000
OTHER: I 1---- _ _....
AUTOMOBILE LIABILITY u'u {En BIsccNED _I)INOLE LIMIT l 5 1•,000,000 -'V-
B ANY AUTO _ '03967552,4 . 12/0812020 12/08/2021 BODILY INJURY(Per Fuson) 'S
�- OWNED SCHEDULED - — -
AUTOS ONLY ✓ AUTOS I I BODILY INJURY(Partladdgnl),s
HIRED ^ NON-OWNED j.PROPERTY DAMAGE
✓ AUTOS ONLY ' AUTOS ONLY ± j (Par.aoNdenl)
'UMBRELLA LIAB ✓ OCCURI f I EACH OCCURRENCE I,2,000,000
A V• EXCESS LIAR _CLAIMS-h1ADE 1 XBS-0133806 /1512021 2/15/2022 f gsGREGnTE ';:2,000.000
DED I I RETENTIONS 1
IWORKERS COMPENSATION II II - PER 0TH. V
ANDEAIPLOYERS'LIABILITY 1-1 I STATUTE,, ,Ill I
ANYPROPRIETORIPARTNERIEXECUTIVE Y(� NIAI I E.L_EACHACCIDENT 5
OFFICER/MEMBEREXCLUDF.D7 I I
'(Mandatory In NH) I' E.L.DISEASE.EA EMPL01Y(j S
If g'CS.r1a:Yfdw under ! - -
i DESCRIPTION OF OPERATIONS below 1 E.L.DISEASE-POLICY LIMIT 1 a
0 t I
El El '
DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Addlllonsi Remarks Schedule,mny be attached If more specs Is required)
CERTIFICATE HOLDER IS ADDED AS ADDITIONAL INSURED
CERTIFICATE HOLDER CANCELLATION
CITY.OFASHLAND . .. • 1
20 EAST MAIN ST . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ASHLAND,OR 97520 - THE EXPIRATION DATE THEREOF, NOTICEWILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
- @1988-2015 ACORD CORPORATION. All rights resi:rvecl.
ACORD 25(2016/03) The ACORD name and Togo are registered marks of ACORD
Produced using Forms Boss Web software.www.Formsaose.com;?Impressive Publishing 000.208.1977
ENDORSEMENT
Ijk SCOTTSDALE INSURANCE COMPAN ' NO.
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ATTACHED TO AND ENDORSEMENT ERECTIYE DATE
FORMING APART OP (I7;O1AM.STANDARD TIME) NAMED,INSURED - • AGENT NO,
POLICY NUMBER
CPS7304295 . 02/15/2021 GREENWAY SPRAY ILC 96006 ,
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
With respect to this endorsement, SECTION H—WHO IS a. All work, including materials, parts or equip-
AN INSURED is amended to include as an additional in- ment furnished in connection with.such work,
sured-any person or organization-whom you are required to on the project (other than service, mainte-
add as an additional insured on this policy under a written nance or repairs)-to be performed by or on
contract,written agreement or written permit which must be: behalf of the additional insured(s)at the lova •
-
a. Currently in effect or becoming effective during tion of the covered operations has been com
the tern of the policy;and Meted;or
in-
b. Executed prior to the-"bodily injury," "properly b. That portion of"your work"out of which the Jury or damage arises has been put to its in-
damage,"or"personal and advertising injury."
tended use .by any person or organization
The insurance provided to these additional insureds is Lim- other than another contractor or subcontract
ited as follows: • tor engaged in performing operations for a
1. That person or organization is.an additional insured principal as apart of the same protect,
only with respect to liability for "bodily Injury," , 3. The limits of insurance applicable to the additional
"property damage" or "personal and advertising insured are-those specified in the written contract,
injury"caused,in whole or in part,by: written agreement or written permit or in the Dacia-
- rations for this policy,whichever is less.These lim-
a.{ Your acts or omissions;or its of Insurance are Inclusive of, and,not in addition
b. The acts or omissions of those acting on your to, the Limits of Insurance shown in the Declare-
behalf. - - - tions for this policy.
A person's or organization's status as an addi- 4. Coverage is not provided for "bodily injury,"
tional insured under this endorsement ends when "property damage," or"personal and advertising
your operations for that additional insured are injury" arising out of the sole negligence of the
completed. additional insured,
2. With respect to the insurance afforded to these 5. The insurance provided to the additional insured.
additional insureds, the following exclusions are does not apply to°bodily injury;''property damage,"
added to item 2. Exclusions of SECTIO_N I- or"personal and advertising injury' arising out of
COVERAGES: an architect's, engineer's or surveyor's rendering
of or failure to render any professional services
This insurance does not apply to "bodily injury" including:
"property damage" or_"personal and advertising
injury'.occurring after;
Includes copyrighted material of ISO Properties,Inc.,with its permission,.
Copyright.ISO Properties;Inc.,2004 - •
GLS-150s(7-08) Page 1 of 2
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a. The preparing, approving or failing to prepare written contract specifically requires that this insur-
or approve maps,shop drawings,opinions, re- ance be primary.
ports, surveys, field orders, change orders or
drawings and specifications;and When this insurance is excess,we will have no du-
ty under SECTION I—COVERAGES to defend the
b. Supervisory, inspection, architectural or engi- additional insured against any"suit"if any other in-
neering activities, surer has.a duty to defend the additional insured
6. Any coverage provided hereunder will be excess against that 'suit" If no other insurer defends, we
over any other valid and collectible insurance avail- will undertake to do so,but we will be entitled to the
additional insured's rights against all those other
able to the additional insured whether primary, ex- insurers.
cess, contingent or on any other basis unless a
(
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AUTHORIZED REPRESENTATIVE DATE
includes copyrighted material of ISO Properties,Inc.,v•ith Its permission.
Copyright:ISO Properties,Inc.,2004
GLS-150s(7-08) Page 2 of 2