Loading...
HomeMy WebLinkAbout2022-054 PO 20230034- Pump Pipe & Tank Services LLC r ..!., Purchase Order ic .CEC3RQER Vila ': Fiscal Year 2023• Page: 1 of: 1 BCity of Ashland --...-Ni._ _ _=rW I=- - -- ATTN: Accounts Payable LI 20 E. Main Purchase 20230034 Ashland, OR 97520 Order# T Phone: 541/552-2010 0 Email: payable@ashland.or.us V H C/O Facilities Maintenance Div. E PUMP PIPE &TANK SERVICES, LLC 1 90 North Mountain Ave N PO BOX 146 p Ashland, OR 97520 O TALENT, OR 97540 Phone: 541/488-5358 R T Fax: 541/552-2304 - g7IV— I mb$r' ;` a )AttrEiti$e li `a'i{ad -€ s 7 -- Y 1`$'i" lj 7=_C'0 (541) 535-6542David Arnold tlu==dlt7El�7i2t�-13t�imFlR7fo-'v.gj: ;.-----�� 7 "�^;;2F' aa Ott mr�r tcVis-}7, -; i _ -Ds v�9T-lz a._��i�g x"-= - - i 06/10/2022 468 FOB ASHLAND OR City Accounts Payable -_-—.__ -'_: _ 1 1 Uro• vi--,-__—_-g_A _mai } Fuel System Mgmt FY 23 1 Fuel system management and repairs for FY 23 1.0 $10,000.00 $10,000.00 Goods and Services Agreement($35,000 or Less) Completion date: 06/30/2023 Project Account: *************** GL SUMMARY*************** 088400-602400 $10,000.00 • By: Date: 9 Z ���{ _� Authorized Si ture � '= g, t 10 000.00 FORM.#3 CITY OF . ASHLAND Are 'nest for a Purchase ' �� 5 REQUISITION . Date of request: 5/24/2022 Required date for delivery: • Vendor Name - Pump, Pipe&Tank Services, LLC • Address,City,State,Zip PO Box 146.Talent, OR 97540 • Contact Name&Telephone Number • Addie McHenry 541-535-6542 addie@pumppipetank.com Email address SOURCING METHOD • ❑ Exempt from Competitive Bidding 0 Invitation to Bid r 0 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 ❑ 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. • , Date approved 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 , ❑ 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 ❑ Written.quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: • Valid until: (Date) Description of SERVICES Total Cost Fuel system management and repairs for FY23 $ 10,000.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost 1 $0 $0.00 • $0 $0.00 • $0 $0.00 ❑ 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 with departmentto a e all hardware and software purchases: IT Director ' Date Support-Yes/No . By signing this requisiti ify th the Cit(/ it s pu ' contracting requirements have been satisfied. Employee: / Department Head: vim or greatee z r than$5,000) Department ManagerlSupervisor: City Manager: • (Greater than?fit� _ Funds appropriated for current fiscal year: �/ NO � Fina ce Direc or-(Equal to or greater than$5,000) Date Comments: Fomi#3-Requisition . . , GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Pump, Pipe&Tank Services,LLC • CITY OF PROVIDER'S ASHLAND CONTACT: Ryan McHenry • 20 East Main Street Ashland,Oregon 97520 ADDRESS: "PO Bok 146 Telephone: 541/488-5587 Talent,OR 97540 Fax: 541/488-6006 PHONE: 541i-535. 6542 This Goods and Services Agreement (hereinafter "Agreement ) is entered into by a4d between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Pun*, Pipe & Tank Services, LLC, (a domestic/foreign business corporation) ("hereinafter"Provider"), for fuel system,management and repairs. 1. PROVIDER'S OBLIGATIONS 1.1 Provide fuel system management and repairs for FY-23 as Set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING. DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same Manner as herein provided for authority to exceed the maximum compensation, The services defined and described it 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 ofliability 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. 12.1 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. 1.22 Each policy of such insurance shall be on an"occurrence" and not a"claims form,411d • 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 froth.the first dollar Of liability; • Provider Shall MimediatelY 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 Page 1 if Gpoctsad gretheiitbëtween the City of Ashlandepd Pun Pipe&Tank Services,LLC . , • • 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 050.917, which requires 'subject employers to provide workers' compensation coverage for All of its subject workers. • 1.4 Provider agrees that no pettOn shall, Oil 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 o 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 tinder ORS 200.055, in awarding subcontracts as required by ORS.279A.110. 1.5 In all solicitations either by competitive bidding Of negotiation Made by Provider for work to 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 CMJ Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreenient.is $22,310A6 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 Agreeinent. Provider is also required to post the notice attached hereto,a8"Eithibit A"predominantly in areas where,it will:N.0bn by alLemployees, ' 1:7 Assignment: Provider shall not as-sigi'i 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 SUbebutraetsfu:and the City. 2. CITY'S OBLIGATIONS. 2.1 City shall pay-Provider the hourly rates effective April 7, 2022 as specified in the SUPPORTING DOCUMENTS. 2.2 In no eventshall PrOvider!S total of all compensation and roiinbutsdiiidntinidor this Agreement exceed the sum of$10,000 (this is maximum,not to exceed amount of ENTIRE Agreement) without express, written approval from the City official whose signature appears below, or such official's stetessor in Offite. Provider expressly acknowledges that no Other:person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from . the responsible official must be in writing. Provider hither acknowledges that any Work delivered or • . • expenses incurred without authorization as provided herein is.done at Provider's own risk-and as a Volunteer without expectation Ofeorriperitation or reiroburaelnent. 3.' GENERAL PROVISIONS 3,1 This is a non=exclusive Agreement City is not obligated to procure any specific amount of Work from Provider and is free to procure sumlar types of goods and services from other providers in-its sole discretion, Rage °hods and Services Agreethenthetween the City Of 4$hiandatid Paw,Pipe:8i Tank gerviaes, • • '1 • 3,2 Provider-4S Itilhdeljeidderit dintradtceand not an employee or,agent of the City for any purpose 33 Provider is not entitled to,and expressly waives all claims to City benefits such.as health and disability insurance,paid leave,and retirement 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 Agetineht. 3;6 The following laws of the State of Orogen are hereby incorporated by reference into this Agreement ORS 279B.220,279B230 ancP79B,235„ 3.7 This Agit onent,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-inairitaiii an action under this Agreement in.nny 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'Cho*of Venire. 3.8: Provider shall defend,save,hold harmless and itiddiniiify'the City and its 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 tinder 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 notaffect the other provisions, but'.S.Y911-warotod010 ptoviaion,aliall:t ,deemed Modified to the extent necessary to render it enforceable, preserving tç.the fullest extent permitted the intent of Provider and the City set forthin this Agreement 3,1i Deliveries will bea0.B destination Provider shall pay all transportation and handling charges for the Goods,Provider is responsible and liable forlossor damage until final inspection And acceptance ad* Goods by the City: -Provider remains liable for latent defects,fraud, and Warranties. 3,12'-Tho City may inspect and test the OoodS. The City may reject non-conforming Goods and require Provider to'correct them without charge or deliver them at are-diked price, as negotiated. IfProvider .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 theuniforincontnet dial Code,ORS Chapter 72 fUtc). . . _ Page 3'0'0; plc*afict..$0-06.4 Agfeeitight bet-weep the City of Aihiand and Pup,Pipe•,?41,e0 SO-Vieea,IW • , , 3.13 PrOVider represents and warrants that the Goods are. new, Mont, and 'fayWarranted 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. SITOPORTING DOCVIVANTS 4.1 The tfollowing .documents are; by this reference, expressly incorporated in this Agreement, and are collectively referred to inthis Agreement as the "SUPPORTING DOCUMENTS " . The Provider's edifupteteWritten Rate Sheet.datedAptil 7,2022. 44 This Agreement and the SUPPORTING DOCUMENTS shall be ootiontodto be mutually complimentary and Supplementary wherever possitole„ 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: -Kent 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 Agitotheht and at law Orin equity,mcluding,but not limited to!, 5.1,1 Termination of this Agreement, • 5 1 2 Withholding all moniep,due for the Work that Provider has failed to deliver withiniany 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, ) $.1A These remedies are cumulative to the extent the reinedies are not inconsistent,and City may pursue • any(teniedy or remedies singly,collectively,successively or in any order*hatsoevet, 52 In no event shall City be liable to Provider fot.40rovenstsidlacd to termination of this Agreement or for.anticipated ptofits. If previous amounts paid to Provider exceed theadlount due,Provider shall Pay Inunediatelr any excess.tocity upou written demand provided.. 6. TERM.AND-TERMINATM 61 Tata This Agreement shall be effective from the date of execution on behalf of the City ras.set forth below (the "Effective Date"), and shall continue in full force-and effect until June 30,2023,'Unless sooner terminated asprovided in:Subsection 6,2. 02 'Termination 62,1"Tho City and Provider may this Agreement by mutual agreement at any tiine. 612 The City may,upon not ess than thirty(3Q) dais'prior written notice,terminate this Agreement for any reason deemed appropriate in its sole discretion. 623 Either party may terminate this Agreement,With cause,by not less than fourteen(14)daysiptiOt written notice if the cause is not cured withinthat icitirteen (14) day.period after writtql140tiee. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7# *AVE 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 dejivery, by sending via a reputable commercial'overnight tondo; Of . . _ itif"0,;' 9004 and Servid6 Agreement between the City Aihtatial hdNI* 84:Einle:ReriitestILC • by mailing wing registered or certified United States niáil,returitrieceipt requested,postage prepaid, V) tlie address set forth beloW: If to,tire City: City of Ashland Maintenance Department lath! David Arnold 20 E. Main Street Ashland, Oregon 97520 , •- . Phone: 041)552-2292 With a copy to; City ofik§hlaiid.--Legal Department 20 E.Main Street Ashland,OR 97520 Phone; (541)0.85350. If to Provider: Pump,Pipe&Tank Services,LLC Attn: Ryan McHenry 541=535-6542 WATVER OF 13REACII: • • _ • 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 Agree-Ment 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 0,1 PreVider repteSents and warrantsto the City that: 9,14 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, p.4:13gi; (ii) Any tax provisions imposed hy a political subdivision of the State of Oregon applicable to Provider,and (in) Any rules,regulations, charter provisions, or ordinances that lin Oen-tent or enforce any of 'the foregoing tax laws or provisions: • 9:1.2 PinVidet,for a period Otho 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, mcludmg but not limited to ORS 305 620 and ORS Chapters 316,317, and.318, Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and Any rules,regulations, charter provisions, or ordinances that implement or enforce any of 'the foregoing tax laws or proyisions, • 92 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 shallcop,s.tipttc arnatetial breach ofthi§Agreethea. Father; atW.violation of Provider's warranty, as set in this Article 9, shall constitute a material breach of this Agreopept, Any material breach of this Agreeinent shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or iii equitY. l'age 5:0(6: Goods and Services-Agreement between the City land and Anti;pilikOcjankServices;LLC y ri IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly antorized representatives as of the dates set forth below: CITY OF ASHLAND_: Pump;-pip Tank Services;L'LC (PROVIDER): By _ . Signa a Signature - s tr .y Ryi /�?crP e„ Printed Name Pr-inted.Nane. • pu t - wod4r.S otit£4fa__ Title Title Date Date is to be,submitted with•this signed Agreement) Purchase Order No;:_ _ _ _ Page 6.of6 Goons andServices Agreernentbetween the;City of Ashlar d anti Pump,Pipe 8c Tank Services,LL , FORM#2 CITY OF ' ASHLAND INVITATION TO BID INTERMEDIATE PROCUREMENT Release date: 31 Mar 2022 • Requested by: David Arnold,Facility Maintenance Representative Tel: 541-552-2292 Fax: 541-552-2304 • David.Arnold(a�ashland.or.us • Bids are due prior to: 2:00 PM,Monday, 18 Apr 2022 Project name: Fuel Pump Maintenance Location: Service Center Fuel Island,90 N.Mountain,Ashland,OR 97520 Bids may be faxed,emailed or hand delivered.Contractors shall submit bid on their company letterhead. Informal email bids and/or late bids will not be accepted.Terms or discounts which are conditioned upon payment within a certain time will not be considered for purposes of comparison of bids.The successful contractor will be required to enter into a contract , with the City for the services and provide insurance certificates in their own name for General Liability,Automobile and Workers' Compensation. Subcontracting will not be permitted. SCOPE OF SERVICES The Facility Maintenance Department is requesting proposals for Fuel System services for fuel tanks and pumps • and firm prices for these services to be guaranteed from July 1,2022 to June 30,2023.This contract may be extended for an additional year for a maximum term of two years. Inspections as required and in accordance with the Oregon EPA UST State and Federal Requirements Repairs on an as needed basis with same day response time as requested by City of Ashland staff. Suggest Preventive Maintenance to prevent future maintenance issues. Please provide an official proposal on your company letterhead,including the following information: 1. Firm prices for the following items: a. Annual Inspections in accordance with EPA Requirements b. Use of Quality Parts and Labor Practices c. Hourly Rate for Service Calls during normal business hours d. Hourly Rate for Service'Calls during after normal business hours • e. Hourly Rates for Travel ' f. Milage Charge Per Mile • g. Hazardous Material Disposal Fees • 2. Written confirmation that you are willing to enter into a contract to provide these services from July 1,2022 to June 30,2023 and provide insurance certificates for general liability,automobile and Workers'Compensation,including the City of Ashland as the additional insured. Due date and time for submitting quotes is 2:00 PM,Monday 18 April 2022.Late quotes will not be considered. If you have any questions and/or need additional information,please contact David Arnold at 541-552-2292. Thank you. • Method of Award:ORS 279B.070 Intermediate Procurements. (4)If a contract is awarded,the contracting agency shall award the contract to the offeror whose quote or proposal will best serve the interests of the contracting agency, taking into account price as well as considerations including,but not limited to,experience,expertise,product functionality,suitability for a particular purpose and contractor responsibility under ORS 279B.110. • 1 Form#2—Intermediate Procurement,Invitation to Bid,Trade Services,Page 1 of 3,4/8/2022 • Pump Pipe & Tank Services, LLC CCB#197390, CA#569114 PO Box 146 Talent, OR 97540 E-mail:servicerequest@pumppipetank.com Phone: 541-535-6542 or Toll Free:1-844-450-2503 Fax: 541-535-5557 April 7,2022 ATTN: David Arnold Facility Maintenance Representative 90 N. Mountain Ashland,OR 97520 David:Arnold@ashland.or.us/PH:541-552-2292 FUEL PUMP MAINTENANCE: . CITY OF ASHLAND SERVICE CENTER FUEL ISLAND 90 N. MOUNTAIN,ASHLAND,OR 97520 la. Annual Inspections in accordance with the DEQ/.EPA requirements; - • • Annual Line Tightness Testing-$275.00 Annual Leak Detector Testing-$85.00 Annual Overfill Equipment Testing-$50.00 •Annual Release detection/Tank Monitor Equipment Testing-$50.00 lb. Yes,we do use quality parts and labor practices. 1g.' Hazardous Material and Disposal Fees Vary: Used Filter Disposal Set price$3.80 per filter. Our Misc./Job/Supplies,Safety supplies/Haz. Disposal etc./Per job fee$25.00 Please see rate sheet below for Items c,d,e,f • CUSTOMER RATES PPT RATES Labor hourly rate $90.00 • Travel hourly rate $0.00 Overtime Labor $135.00 Overtime Travel $0.00 Weekend Labor Rate $180.00 Weekend Travel $0.00 Holiday Labor Rate $255.00 Holiday Travel $0.00 • Mileage $0.00 • No Mileage or Travel in the Medford/Ashland area. S:\City of Ashland\City of Ashland 2022 BID.doc . 2 • • • • Pump Pipe&Tank Services, LLC is willing to enter into a contract to provide these services from July 1,2022 to June 30,2023 and provide Insurance Certificates for General Liability,Automobile and Workers Compensation, including the City of Ashland as additional insured. Pump Pipe&Tank Services, LLC is Licensed with the below Departments to do all required work: Oregon CCB: 197390 Department of Environmental Quality: Decommissioning License: 10442 Installation/Retrofit License: 10441 • Tank Tightness Testing License: 11264 UST Service Provider License: 10606 • Thank you, • • Ryan McHenry Service Manager—Owner ryan@pumppipetank.com/PH:541-535-6542 • • • S:\City of Ashland\City of Ashland 2022 BID.doc 3 • I I Basir 66.0621 • • • May 16,2022 y . • PUMP PIPE&TANK SERVICES LLC 5446 S PACIFIC'-WY Oft 97.535-6608 • Re: Barrett Business Services, Inc: ("BBSI") • Letter of SelOnsurerice for Workers'Compensation Coverage As the named addressee of this.Letter, your company's required workers' compensation coverage is provided through 131381's state approved Self=lrured Workers' Compensation Plan by way Of your co-employment Contract With BB'S!. ,Additional infOrrnation is as follows: • State: Oregon Workers'Compensation Limits:. Employer Liability Limits: Self Insurance Certification#: 10-58 Statutory -$5,000,000.0b Each Accident $5,000,K10.00 Disease Coverage Limit by Client 0:,000,000i00 Disease; Each Employee bther Comments(place an'!X"if appliCable): Waiver Of SUbtOgation: BBSI and PUMP PIPE.&TANK SERVICES LLC agtee to Waive their right of - - subrogation for the benefit bf:,. Beneficial Electrial AssoCiates, Inc.at All Operations • ri Named"Letter Holder: City of Ashland 20 EOSIN*St Ashland, OR 97520 • El Other This letter Of self-insurance for workers'compensation replaces Acord form 25.Contract effective .51112Q12, renewed thrOugh 4/30/2023. SObject to 30 days'notibe Of Additionally, BBSI's self-insured program is tither supported by en excess workers'compensation insurance policy with ACE American Insprance bo Copy of certificate is available upon request For additional inkibiatiokpleate'contact yoUi lOöal BBSI office at: SOUTHERN OREGON (541)77275469 2045 Cardinal Way Suite 100 Very truly yours, Medford, OR 97504 Gary Krasner president and ohiefExectitive Officer • 40q;Lo•-strz • • • PUMPP-1 OP ID:AD AC-CPRE"," CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `..---:--- 05/23/2022 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(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER • 817-640-5035 NAMEACT Jim Beam,CIC Monroe&Monroe Insurance PHONE 817-640-5035 I FAx 817-640-0131 Agency, Ltd. {ac,N",Ext): (A/C,No): 2921 Galleria Dr., Suite 102 E-MAIL Arlington,TX 76011 ADDRESS' Jim Beam,CIC • INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Mid-Continent Casualty Co. 23418 INSURED INSURER B:The Hanover Insurance Group 22292 Pump Pipe&Tank Services LLC Robert McHenry dba Pump Pipe& INSURERC: - Tank Services • Petroleum Pump Supply • INSURER D: PO BOX 146 INSURER E: ' Talent,OR 97540 , 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 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.' INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MMIM/YYYY) (MMIIIf)IYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 04GL1070345 11/15/2021 11/1512022 DAMAGE TO RENTED 100,000, X X PREMISES(Ea occurrence) $ X Pollution Liab MED EXP(Any one person) $ -0 X Professional LiabPERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,600,000 POLICY X jIN-F LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000, (Ea accident) $ X ANY AUTO X X AWDA75436206 • 10/15/2021 10/15/2022 BODILY INJURY(Per person) $ . OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ _ X HIRED X NON WNED PROPERTY DAMAGE AUTOS ONLY AUTO ONLY (Per accident) $ $ . A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1'000'000 ,X EXCESS LIAB ' CLAIMS-MADE 04XS222016 11/15/2021 11/15/2022AGGREGATE $ 1,000,000 DED X RETENTION$ -0- $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTEH ER ' YIN OFFIR/ EPROPRIETOR/PARTNER/EXECUTIVE N"/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under • DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Equipment Floater 04CIM23251 11/15/2021 11/15/2022 Owned Equ 31,875 . DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required), The General Liability and Commercial Auto policies include a blanket • additional insured and'waiver of subrogation endorsement which provides • additional insured and waiver of subrogation status to the City of Ashland, , Oregon,its officers,agents and employees only when there is a written "insured contract"as defined by the ***SEE NOTES*** • • CERTIFICATE HOLDER CANCELLATION CITASHI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Facility Maintenance Dept. 90 North Mountain Ave. • Ashland,OR 97520 AUTHORIZED REPRESENTATIVE Iev._ 25(2016/03) - ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • NOTEPAD. HOLDER CODE CITASH1 PUMPP-1 PAGE 2� INSURED'S NAME Pump Pipe&Tank Services LLC OP ID:AD Date 05/23/2022 • policy, between the named insured and the certificate holder which requires such status. The General Liability policy contains a special endorsement with "primary and noncontributory" wording. e • c q, • Policy No. 04-GL-001070345 • MID-CONTINENT CASUALTY COMPANY ML 13 57 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • ADDITIONAL INSURED --OWNERS, LESSEES, OR CONTRACTORS This endorsement modifies insurance provided under the following: • COMMERCIAL GENERAL LIABILITY COVERAGE PART • • • SCHEDULE Name of Person or Organization: ? �' City of Ashland • 1. WHO IS AN INSURED(Section 11)is amended to indude as an insured the person or organization shown in the Schedule,but only with respect to liability caused,in whole or in part,by your performance of"your work"for that insured.However: A. The insurance afforded to such additional insured only applies to the extent permitted by law;and B. If coverage provided tothe additional insured is required by written Insured contract', the insurance afforded to such additional insured will not be broader than that which you are required by the written Insured contract"to provide for such additional insured. 2. With respect to 1.above the following additional provisions apply: . 4. Other Insurance The insurance afforded by this Coverage Part is primary insurance and we will not seek contribution from any other insurance available to the insured unless the other insurance is provided by a contractor other than the above named additional insured. We shall be considered as excess insurance of any other insurance provided by a contractor other than the above named additional insured. This amendment applies only when you have agreed by written "insured contract" to designate the person or organization listed above as an additional insured subject to all provisions and limitations of this policy. All other conditions remain unchanged. ML 13 57 0413 Includes copyrighted material of Insurance Services Office, Page 1 of 1 Inc.,with its permission • , s ' • Policy No. 04-GL-001070345 MID-CONTINENT CASUALTY COMPANY ML 10 81 04 13 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR • CONTRACTORS --SCHEDULED PERSON.OR ORGANIZATION This endorsement modifies insurance provided under the following:• . COMMERCIAL,GENERAL LIABILITY COVERAGE PART - SCHEDULE Name of Person or Organization: Any person or organization for whom the named insured has agreed by written "insured contract" to designate as an additional insured subject to all provisions and limitations of this policy. (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS.AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability caused, in whole or in part, by your performance of ongoing operations for that insured. However. 1 The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. If coverage provided to the additional insured is required by written Insured-contract",the insurance afforded to • such additional'insured will not be broader than that which you are required by the written`insured contract"to • provide for such'additional insured. • • • • • • • • • • ML 10 81 04 13 Includes copyrighted material of Insurance Services Office, Page 1 of 1 Inc..with its permission • • Policy No. 04-GL-001070345 MID-CONTINENT CASUALTY COMPANY • ML 10 80 071.1 • • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US • This endorsement modifiesinsurance provided under the following: • COMMERCIAL GENERAL LIABILITY COVERAGE PART • PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: • Any person or organization for whom the named insured is operating under a written "insured contract" when such contract requires a waiver of transfer of rights of recovery against others. (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as . applicable to this endorsement) • The following is added to Paragraph 8.Transfer of Rights of Recovery Against Others To Us of Section IV— Conditions: We waive any right of recovery we may have against the person or organization shown.in the Schedule above because of payments we make for injury or damage arising out of"your work" done under a contract with that person or organization_ This waiver applies only to the person or organization shown in the Schedule above. • • • • • ML 10 80 0711 Includes copyrighted material of Insurance Services Office, Page 1'of l Inc.,with its permission L ,` 3 Bid Process Fu Company Contact Infrmation 31-Mar 31-Mar Action Results Action Emailed Meet& Greet KC to Submit Carson Invitation to Received carr@carsonteam.com 4 Apr Rate Sheet Bid KC 541 507 7656 Pump Pipe &Tank Emailed 8 Apr Plans to Submit Submitted Rat Addie Invitation Received Rate Sheet 541 535 6542 to Bid Sheet addie@pumppipetank.com SME Solutions Emailed Josh to forward 541 5077675 Invitation Received to Sales Rep Grants Pass to Bid iosh@sme-solutions.com ;ement FY22 Bids Due Date Letter of Letter of Action Action Results 18 Apr Acceptance Condolences Unable to Provide Bid Sent LOC within 28 Apr Scheduled Timeframe ,pr Confirmed Awarded :iept of Rate Contract Sheet