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HomeMy WebLinkAbout2022-052 PO 20230031- Don's Lock LLC Purchase Order prACITY RE_ O E Fa& Fiscal Year 2023 Page: 1 of: 1 City of Ashland ATTN: Accounts Payable Purchase L 20 E. Main 20230031 Ashland, OR 97520 Orden# T Phone: 541/552-2010 0 Email: payable@ashland.or.us V H C/O/Facilities Maintenance Div E DON'S LOCK LLC I 90 North Mountain Ave N 2940 N PACIFIC HWY p Ashland, OR 97520 MEDFORD, OR 97501 Phone: 541/488-5358 R T Fax: 541/552-2304 =�.�•==!€€e'-I�� ts1EC-�=�ar.,l=��s� 3C e e. S �__,.=�_�e�-1°F`�e-i€ii==�Ei:cfs�l-i�r� :.�--:�_: �� _ Y�'ji s�gT_:a_ _gt�li!-iet _ _..-��=���David Arnold . _ —==Vi=1= i;j5 €,i=1-1_�'--'_z' "� E_ts3�l= ' '_.`�-S i�l_IIa`l !1' - r .a -- --af_ *Tl;_ ,1�i 3 € sem__ �.- � 5 _� k.a i €�1�T{c!��le' a 06/10/2022 6411 FOB ASHLAND OR/NET30 Ci Accounts Payable _ f 1i� __"'- :i•w` —.H�eT L .L.: :x-"A.yc _ _ k ..� £A �-ci"— Lock and Key Services FY 23 1 Lock and Key Services FY 23 1.0 $2,000.00 $2,000.00 Goods and Services Agreement($35,000 or Less) Completion date: 06/30/2023 , Project Account: ***************GL SUMMARY.*************** 088400-602400 $2,000.00 I I • By: R//I j Date: A Auth. Sig a ure • _£ 2 000.00 . FORM #3 CITY OF A. request for a Purchase CA/ ,--P ". .62-. 9 ( • ASHLAND REQUISITION • Date of request: 5/9/2022 ' • Required date for delivery: Vendor Name Don's Lock LLC Address,City,State,Zip . 2940 N. Pacific Highway, Medford, OR 97501 Contact Name&Telephone Number Yvonne Sweet/Amber Taylor 541-776-2154 ' Email address SOURCING METHOD • ❑ Exempt from Competitive Bidding ❑ Invitation to Bid ❑ Emergency ❑ Reason for exemption: Date approved by Council: ❑ Form#13,Written findings and Authorization ❑ AMC 2.50 (Attach copy of council communication). , 0 Written quote or proposal attached ❑ 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 ® Direct Award - _(Attach copy of council communication) Contract# ❑.Verbal/Written quote(s)or proposal(s) 0 Request for.Qualifications(Public Works) 0 State of Washington Dateapproved by Council: Contract# (Attach copy of council communication) 0 Other government agency contract Intermediate Procurement 0 Sole Source Agency GOODS&SERVICES ❑ 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 and solicitation attached 0 Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: ❑ 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 ❑ Less than$35,000,by direct appointment 0 Special Procurement City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached ❑ Form#9,Request for Approval 0 Annual cost 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 Lock and key service for FY23 • $2,000:00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost 1 $0 $0.00 • $0 $0.00 $0 $0.00 1=1 Per attached quotelproposal TOTAL COST Project Number: _ _ _ Account Number: 088400-602400 $$0.00 • *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration withdepartment to approve all hareftware purchases: IT Director Date Support-Yes/No By signing this requisitiform,I certify that the City's public contracting requirements/ have been satisfied. Employee: -de' — / Department Head: • y4tt2Z r greater than$5,000) Department ManagerlSupervisor: City Manager: • . (Greater than$39,000)._ • . Funds appropriated for current fiscal year:IP NO r_1¶ ''�� Finance Director-(Equal to or greater than$5,000) Date ' Comments: • Form#3-Requisition • • • GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) • PROVIDER: Don's Lock LLC „' • c TY OF PROVIDER'S AS CONTACT: Amber Taylor 20 East Main Street • . r Ashland,Oregon 97520 ADDRESS: 2940 N. Pacific Highway. , • - Telephone: 541/488-5587 Medford, OR 97501 . , • Fax: 541/488-6006 • . , PHONE: 541-776-2154 . . 4 • • • • r • 1 • This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Don's Lock LLC, (a domestic/foreign business corporation) ("hereinafter"Provider"), for lock and key service. 1. PROVIDER'S OBLIGATIONS 1.1 Provide lock and key service for FY23 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;;WaiSrers or extension of such deadline may be authorized except in the same manner as herein provided for authority' to exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." • • • 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder,a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than.$2,000,009,(t*o, million dollars)per occurrence for Bodily Injury and Property Damage. • ,' • 1.2.1 The insurance required in this Article shall include the following coverages: • • Comprehensive General or Commercial General Liability, including -perSonal, injury, contractual liability,and products/completed operations coverage, and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an"occurrence" and not a"claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents:and employees" with respect to claims arising out of the provision of Work under ;this Agreement; . • • Apply to.each named and additional named insured as though a separafe'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.thai4w6 or more such policies are intended to "layer" coverage and, taken together,AeY.proVide total coverage from the first dollar of liability; • • - • Provider shall immediately notify the City of any change in insurance coverage . 6 • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City: ; Page 1 of 6: Goods and Services Agreement between the City of Ashland and Don's Lock LLC 1.3 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance;with ORS • 656.017, which requires subject employers to provide workers' compensation coverage;for'all.of its subject workers. • . 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability,:sexual orientation, gender identity or source of income, suffer discrimination in the performance :of this Agreement when employed by Provider. Provider agrees to comply with all applicable`requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider;agrees° not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business.enterprise, certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5In all solicitations either by competitive bidding or negotiation made by Provider for-::work*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 11 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: Provider 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. 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 betweenthe assignee or subcontractor and the City. 2. CITY'S,OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective 5/2/2022 as specified in the ' SUPPORTING, DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this,Agreement'exceed• the sum of$2,000 (this is maximum, not to exceed amount of ENTIRE Agreement)'without express; written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization;from the responsible official must be in writing. Provider further acknowledges that any Work.delivered.or expenses incurred without authorization as provided herein is done at Provider's .own risk'.and as a volunteer without expectation of compensation or reimbursement. " 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers inits'sole discretion. Page 2 of 6: Goods and Services Agreement between the City of Ashland and Don's Lock LLC 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 Agreements, 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.shal.14 '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 arid agents • from and against any and all claims, suits, actions, losses, damages, liabilities, costs;and expense's';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 ordelay 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 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; . Page 3 of 6: Goods and Services Agreement between the City of Ashland and Don's Lock LLC 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 Provider's complete written Rate Sheet dated May 2,2022. • 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 iri'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 m 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 withinany 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 mya `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, 2023,.unless`.'sooier 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'c�:prior written notice if the cause is not cured within that fourteen'(14) day period:after written notice.'". Such termination is in addition to and not in lieu of any other remedy at law or equity • 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such'notice shall be given,in ; writing to the other party by personal delivery, by sending via a reputable commercial overnight Courier,,`or; by mailing using registered or certified United States mail, return receipt requested, postage prepaid,.'to . address set forth below: If to the City: Page 4 of 6: Goods and Services Agreement between the City of Ashland and Don's Lock LLC _ • City of Ashland=Facilities Maintenance Department • : Attn: David Arnold 20 E. Main Street • : ° ' • • Ashland, Oregon 97520 Phone: (541) 552-2292 . With a copy to: • City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541)488-535'0 If to Provider: Don's Lock LLC Attn: Amber Taylor 541-776-2154 . t 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;3,05.620.and ORS • chapters 316, 317, and 318; ; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws`.of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement; Further,. any violation of Provider's warranty, as set forth in this Article 9, shall constitute.a niaterial breach•;of . • this Agreement. Any material breach of this Agreement shall entitle the City to terminatethis Agreement and to seek damages and any other relief available under this Agreement,at law,or,in equity. Page 5 of 6: Goods and Services Agreement between the C'ty of Ashland and Don's Lock LLC 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: Don's Loc, - e RO 1E10: By. By: .1t4.21. _ e /Jr' •Signature Seer" 0tR..euz-y 017fle Leer ' Printed Name Printed Name :• Pt au` wot+ts tr-strc__ Title "tie • • • Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. r Page 6 of 6: Goods and,Services Agreement between the City of Ashland and Don's Lock LLC , _ Don's Lock • 2940 N Pacific Hwy, Medford, OR 97501 P: 541-776-2154 F: 541-779-2913 May 2, 2022 Dear Nicole, This letter is for the information you requested on our rates to create a Goods and Service Agreement. Our service call and labor will remain consistent. However, the materials are harder due to changes with the supply companies that are out of our • control. In addition, we would need a list of every piece of hardware you have to make a proper list. We can give an estimate on any job, and we guarantee the cost of goods for 30 days. In general, the rates are as follows. Commercial service call $75 Day time scheduled calls Commercial after hours and weekends $100 Mileage $2.50 per mile Only if outside city limits Hourly labor $100 Single sided keys $3.25 each Plastic head $4.50 Double sided keys S $4.25 each Plastic head $5.50 Do Not Duplicate keys $4.25 each S Thank you, Amber Taylor Shop Manager/Dispatcher , • , ' • . - . , . , „ • • •• /....71!/W . . . • DATE(IVIMIDDNWY) ACCPRO 'CERTIFICATE Or LIABILITY INSURANCE , ‘,......--- . . 95/96/2022 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 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(les)must be endersed. 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 Hell of such endorsement(s). . . , . . _ . . . . • PRODUCER • ' . ' CONTACT BILL JOHNSON BILLJOHNSON@ALLSTATE.COM JOHNSON INSURANCE"tGENCY,'PCNo • . PHONE 503-873-8181 ' FAX - 503-873-8122' • (AIC t: ' .• 210 OAK ST . . kinds: SERVICE:. MELISSATONGA@ALLSTATE.COM ' • • SUITE 1 INSURERIS)' INSU,S)AFFORDING COVERAGE . . . . URIC II . SILVERTON OR.97381 ' • INSURER A: ALLSTATE INS GRP • . . . • - • INSURED ' " INSURER B: HARTFORD ACCIDENT AND INDEMNITY CO • DON'S LOCK;LLC' • INSURER C: • • 2940 N pACIFIC HWY . INSURERD: : • . . INSURER E: • , - , ... . • . , MEDFORD , OR 97501 INSURER F: .• • , _. : • • • i 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 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR .ADDL SUBR . _ POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR wyp . POUCY'NUMBER NTD/YYYTI (MIWODIYYTY) _ UNIT'S . . GENERAL LIABILITY EACH OCCURRENCE $. _ 1.000;000 • X COMMERCIAL GE4ERAL LIABILITY (E $. - : DAMAGE TO RENTED • PREMISES a occornineel50,000_ . . . . ' CLAIMS-MADE ri OCCUR MED EXP(Any one person)• .$ 10,000 , A Y 648745787: 02/01/2022 0.2/0112023 pERSONAL a ADV INJURY• S 1,000,000 . .. . . - -- , GENERAL AGGREGATE $ 2,000,000 GENT.AGGREGATE UMIT ApPUES PER: - PRODUCTS-COMP/OP AGG •$ _ _ 2,000,900_ • . • POU CY nIJR9r" -.1-1 LOC $ . . • • . , . . . . .. . , . AUTOMOBILE LIABILITY • , COMBINEeD SINGLE L4 IMIT - 500,000 accidnt) • . ANY AUTO ' • BODILY INJURY(Per oersen) $ A AL":31/413) X 1?-illesqLED Y 648747558 02/28/2022 92/28/2023 BODILY INJURY(Per accident) $ • -" AUTOS . NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS . . . .$ (Per accidemt) . . ' _ , • • • " . .•_. „ • . . . . , . . UMBRELLA UAB ..,., CU.•R • EACH OCCURRENCE- $ _ EXCESS um CLAIMS-MADE (.., . AGGREGATE - $ ' • DED RETENTIONS • $ ' WORKERS COMPENSATION WC STATU- • 0114• - - •' ' . AND EMPLOYERS'LIABILITY YIN • . ' . , ,f• TORY LIMITS ER • • ., ANY PROPRIETOR/PARTNERIMECUTIVE r--1 EL EACH ACCIDENT § . _ 500,000. B oFFIcEamEmsiutexcluppor 1 I NIA . 01 WEC ZH473Ci .. 02/05/2022 02/05/2023. (Mandatory In NH) . • EL DISEASE-EA EMPLOYEE$ „ _. 500,000 • . urdaragi'uomERA-tioNi below . _ . E.L bISEASE-POUCY unit v 500,000 . ._ _„ • _ . ... . . _ . . ... . .. _ ' -- - - • • • , • . • • . • DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACOFID1B1,•AddItiortal Remarks Schedule,if more space Is required) CITY OF ASHLAND IS LISTED AS ADDITIONAL INSURED ON THE GENERAL LIABILITY COVERAGE PER FORM BP 0448 0?13.ATTACHED TO THE 'POLICY. ' CITY OF ASHLAND IS LISTED AS ADDITIONAL INSURED ON THE AUTOMOBILE LIABILITY COVERAGE PER FORM CA 26 46 19 13 ATTACHED TO THE POLICY. ,.., , . • . . • . . • • '• . . CERTIFICATE HOLDER, . - . • . . CANCELLATION . _ . ... . . . .. . , SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CEIY OF.ASHLAND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2o,g..mAIN sT . ° ACCORDANCE WITH THE POLICY PROVISIONS. • • • • AUTHORIZED REPRESENTATIVE. 'ft- ASHLAND • OR 97529, ' ,• _ • ..1 / L v ' ACORD 25(2010105)- .— - . '' ' —--- T' ' - "' ''' ''@ 19884010 ACORD CORPORATION. 'All rig 'reserved ' TheACORD name and logo are registered marks of ACORD . . . , . . ,, . . . •,-„. . . . . POLICY NUMBER 64 87457 8 7 BUSINESSOWNERS BP 04 48 07 13 • THIS ENDORSEMENT CHANGES THE-POLICY. PLEASE READ fl.PAREFULLY. • _ • ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION • This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM ' SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): CITY OF ASHLAND • • ' Information required to complete this Schedule,if not shown above will be shown in the Declarations. Seddon II Liabny is amended as follows: B. With respect to the insurance afforded to these A. The following is added to Paragraph C.Who Is An additional insureds, the following is added to Paragraph D. Liability And Medical Expenses Insured: Units Of Insurance: 3. My person(s)or organization(s) shown in the Schedule is also an additional insured,but only If coverage provided to the additional insured is - with respect to liability for 'bodily injury", required by a contract or agreement, the most we "property damage"or"personal and advertising willpay on behalf of the additional insured is the injury".daused, in whole or in part,by your acts • amount of insurance. Or omissions or the acts or omissions of those 1. Required by the contract or agreement;or :acting on ;your:behalf in the performance of 2. Available under the applicable Limits Of your ongoing operations or in connection with Insurance Shown in the Dedlarations; your premises owned by or rented to yoU. virhiCheiver ie less. However: This endorsement shall not increase the applicable a The insurance afforded to such additional Limits Of Insurance shown in the Declaratiopu. :Merited only applies to the extent permitted• by law;and b. if coverage provided to the additional insured is required by a contract or • agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract • • or;agreement to provide for eirdh additional insured.. • • • BR 0448qp ©Insurance Services Office,Inc 2012 . Page I -- • Insured Full Copy • • r, • • • • • • • POLICY NUMBER:64 8 7 47 5 58 • COMMERCIALAUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE • This eridotsernent Modffies 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 tiniest modified by this endorsement This endorsement identifies person(s) or organization(s)who are Insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. • Named Insured: DON'S LOCK LLC Endorsement Effective Date: 02-28-2022 SCHEDULE . . _ ,• Name Of Person(a)Oi'Organizalkm(s); CITY OF ASHLAND . • 20 E MAIN ST ASHLAND OR USA 975201814 Information required to complete this Schedule,if not shown above,will be shown in the Declarations. • Each person or organization shoWn in the Schedule is an Insured"for Covered Autos Liability Coverage, but only to the extent that persen or Organization qualifies. as an Insured" under the Who Is An Insured • provision contained in Paragraph Al.of Section II— Covered Autos Liability Coverage in the Busineds • Auto and Motor carrier Coverage Forms. and Paragraph D.2. of Section. I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA20 4810 13 Insutance Seritices Offide,Inc.,2011 Page i of 1 inured Full Copy •