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HomeMy WebLinkAbout2022-084 PO 20230117- Johnson Controls Inc Purchase Order prA,isi C® Ec l Fiscal Year 2023 Page: 1 of: 1 flIV2411 1.L4IMR5=81:4_*—PL1dN t B City of Ashland ' `; v I ATTN: Accounts Payable Purchase L 20 E. Main 20230117 L Ashland, OR 97520 . r Order* T Phone: 541/552-2010 O Email: payable@ashland.or.us V JOHNSON CONTROLS, INC. H C/O Facilities Maintenance Div EPO BOX 730068 I 90 North Mountain Ave N D DALLAS, TX 75373-0068 P Ashland, OR 97520 R Email: CARRIE.L.GALLAGHER@JCI.COM Phone: 541/488-5358 T Fax: 541/552-2304 - GI Of 11R1t3$ r Fd -Q t Bf E51 87oi i[}1ct 1€ (425) 398-6900 David Arnold Fifa QLd=—�/ercr tmEt = 7 f =ae' a — e 09/01/2022 567 FOB ASHLAND_OR/NET30 City Accounts Payable1-7:171 - Repair Chiller Comm Dev 1 Repair chiller at Community Development 1.0 $5,621.13 $5,621.13 Per attached Invoice 1-119703163685 Goods and Services Agreement • Completion date: 06/30/2023 r Project Account: ***************GL SUMMARY*************** 088400--602400 $5,621.13 I I = est q(IBy: Date: (/1y Authorized ignature _E1 $5,621.13 • ' FORM #3 CITY OF A request for .FIfl ) i ' i� ;t 'ASHLAND REQUISITION Date of request: 8/15/22 Required date for delivery: Vendor Name Johnson Controls Address,City,State,Zip 588 Parsons Drive Suite B,Medford,OR 97501 Contact Name&Telephone Number Kimberly Lewis 541-227-5710 kimberly.dawn.lewisAici.com Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Invitation to Bid 0 Emergency ❑ Reason for exemption: Date approved by Council: 0 Form#13,Written findings and Authorization ❑ AMC 2.50 _(Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached If council a..royal re•uired,attach co. 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 • Date approved by Council: Contract# (Attach copy of council communication) 0 Other government agency contract Intermediate Procurement ® 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: 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 Valid until: (Date) Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment 0 Special Procurement City Administrator,AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached 0 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: DM_ Description of SERVICES Total Cost Repair of chiller at Community Development :$6t.21,:11, : . Item# Quantity Unit Description of MATERIALS Unit Price Total Cost 1 • $0 $0.00 $0 $0.00 $0 $0.00 0 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 department to app all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition,I certify that the City's ublic ontracting requirements have been satisfied. Employee: / Department Head. �� St•3v• Z o Z t ( / Head... ....._ or greater than$5,000) Department Manager/Supervisor: C' Ma'a•er: j (Greater than$35A00 Funds appropriated for current fiscal year. i `/ r/NO q � lZ mance Director-(Equal to or greater than$5,000) Da e r / Comments: . Form#3-Requisition . FORM #s CITY OFASHLAND SOLE-SOURCE DETERMINATION AND WRITTEN FINDINGS GOODS AND SERVICES Less than $100,000 To: Scott Fleury,Public Works Director From: David Arnold,Facilities Maintenance Date: August 15,2022 Re: Sole Source Determination and Written Findings for Goods and Services In accordance with AMC 2.50.090(F),the Department Head shall determine in writing that there is only one provider of a product or service of the quality and type required available. Estimated total value of contract: $5,621.13 Project name: Chiller—Community Development Description of goods and services: Repair of chiller at Community Development Background: The City of Ashland Community Development,Water Treatment Plant and Wastewater Treatment Plant HVAC system utilizes Johnson Controls parts and equipment. Form#5-Sole Source—Goods and Services—Less than$100,000,Page 1 of 2,8/25/2022 • Findings: [The findings below must include factual information supporting the determination]. Market Research Overall finding: [In accordance with ORS 279B.07 5, these are the examples of findings that should be addressed. Select at least one of the findings and prepare the determination as it specifically relates to the goods or services being procured More than one finding can be addressed. The findings are as follows.j Pursuant to ORS 279B.075 (2)(a): Provide findings supporting your determination that the efficient utilization of existing goods requires the acquisition of compatible goods or services from only one source. . • The City of Ashland utilizes Johnson Controls HVAC control systems at the Community Development Building, Water and Wastewater Plants. All parts, equipment and service are proprietary and subject to Johnson Control warranties. All settings and calibrations must be implemented at time of service utilizing the operating software which is managed exclusively by Johnson Controls. Pursuant to ORS 279B.075 (2)(b): Provide findings supporting your determination that the goods or services required for the exchange of software or data with other public or private agencies are available from only one source. N/A • Pursuant to ORS 279B.075 (2)(c): Provide findings supporting your determination that the goods or services are for use in a pilot or an experimental project. N/A Pursuant to ORS 279B.075 (2)(d): Any other findings that support the conclusion that the goods or services are available from only one source. N/A • • • • • • Form#5-Sole Source—Goods and Services—Less than$100,000,Page 2 of 2,8/25/2022 • GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Johnson Controls CITY OF PROVIDER'S AS H LAN D CONTACT: Kimberly Lewis 20 East Main Street Ashland,Oregon 97520 ADDRESS: 588 Parsons Drive, Suite B Telephone: 541/488-5587 Medford, OR 97501 Fax: 541/488-6006 PHONE: 541-227-5710 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Johnson Controls, (a domestic/foreign business corporation) ("hereinafter"Provider"),for HVAC repair. 1. PROVIDER'S OBLIGATIONS . 1.1 Provide HVAC chiller repair at Community Development 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 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. 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; • 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 Page 1 of 6: Goods and Services Agreement between the City of Ashland and Johnson Controls • 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 an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by 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: 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 between the assignee or subcontractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective July 27, 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$5,621.13 (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 in its sole • discretion. Page 2 of 6: Goods and Services Agreement between the City of Ashland and Johnson Controls 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 districtcourt 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 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). • Page 3 of 6: Goods and Services Agreement between the City of Ashland and Johnson Controls 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, and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" • The Provider's complete written Proposal dated July 27,2022. 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, 2023, 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 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 Page 4 of 6: Goods and Services Agreement between the City of Ashland and Johnson Controls 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—FaciIities 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)488-5350 If to Provider: Johnson Controls Attn: Kimberly Lewis 541-227-5710 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. 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. Page 5 of 6: Goods and Services Agreement between the City of Ashland and Johnson Controls 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: Johnson Controls (PROVIDER): By: "14 By: ?ter rear Pihkur. 14T1;•ure Signature Eudz� Matthew Dunn Printed Name Printed Name purbc-ic_ s ,c.'c.r Branch Service Manager Title Title Q . xb. 2oZt, 8/15/22 Date Date (W-9 is to be submitted with this signed Agreement) e ' /( Purchase Order No. • • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Johnson Controls • art, JOHNSON CONTROLS Johnson ., Building Efficiency Controls Federal ID 39-0380010 ORIGINAL INVOICE Invoice#: 1-119703163685 Invoice Date: 07/2712022 PO#/Auth: DAVID ARNOLD Service Request: 1-119304699010 Customer WO#: SR Type: L&M • Customer Acct: 1352890 Branch Name: JOHNSON CONTROLS PORTLAND MEDFORD OR CB-ON58 Bill To: Service Site: CITY OF ASHLAND CITY OF ASHLAND COMMUNITY 20 EAST MAIN STREET DEVELOPEMENT ASHLAND OR 97520 51 WINBURN WAY, ASHLAND OR 97520-2735 Contractor/License Information : Requested By: DAVID ARNOLD Phone: 5415522292 Service Requested: BUILDING TOO HOT, NOT COOLING CHILLER DOWN Service Provided: CHILLER -7/12/22: -Chiller alarm (T-052)hard to move display LED curser indicator to reset the alarm. -Reset alarm by pressing display buttons with great force. -Ohmed compressor A2 motor windings. Bad motor. 7/13/22: -Arrived and building was 91 deg inside. Started chiller and overrode dampers 100%. Let run for 30 min. -Replaced the"Al"condenser fan motor. -Replaced the human interface display panel. -Tested operation. -Reset overrides in METASYS. -Checked all TU cfm set points. -Witnessed condenser fan motor one turn off. -When testing for voltage,fan started running again for another approximate 30 to 40 minutes. -Finally discovered a short circuiting MOV plug that was burning up, not seen on the electrical schematic. Suspect motor short damaging MOV protectors. -Removed MOV plug and bypassed power directly to VFD input terminals. • -Test ran unit operation normal. -Left a new 24 V contactor for TU Dash 22 upstairs at workstation. -Advised Dave Arnold. • Thank you for your business. Qty Description UOM Unit Price Sub Total Tax Net Price Labor 6 07/13/2022 Regular Mechanical Heavy Hour $160.50 $963.00 $0.00 $963.00 3 07/12/2022 Regular Mechanical Heavy Hour $160.50 $481.50 $0.00 $481.50 Sub-Total $1,444.50 $0.00 $1,444.50 Materials • 1 Fan Motor Each $1,994.26 $1,994.26 $0.00 $1,994.26 1 Display Panel - Each $1,945.17 $1,945.17 $0.00 $1,945.17 Sub-Total $3,939.43 $0.00 $3,939.43. Page 1 of 2 OVA JOHNSON CONTROLS Johnson �� Building.Efficiency Controls Federal ID 39-0380010 ORIGINAL INVOICE . Invoice#: 1-119703163685 Invoice Date: 07/27/2022 • PO#/Auth: DAVID ARNOLD Service Request: 1-119304699010 Customer WO#: SR Type: L&M Customer Acct: 1352890 Branch Name: JOHNSON CONTROLS PORTLAND MEDFORD OR CB-ON58 Fees 1 Disposal,Environmental&Usage Charge Each $45.00 $45.00 $0.00 $45.00 1 Ppe Supplies Each $10.00 $10.00 $0.00 $10.00 1 Fuel Surcharge Adjustment Each $35.00 •$35.00 $0.00 $35.00 Sub-Total $90.00 $0.00 $90.00 Mileage 80 • Mileage Each $1.84 $147.20 $0.00 $147.20 Sub-Total $147.20 $0.00 $147.20 • Invoice Sub-Total $5,621.13 Sales Tax Total Due USD $5,621.13 Direct Billing Inquiries: (866)635-1302 Terms:Unless otherwise agreed in the contract between Johnson Controls and Customer,payment shall be.due full upon receipt,and interest shall be due at a rate of 1.5%per month(18%annually)on Invoices not timely paid along with any other recoverable costs of collection. Disposable,Environmental&Usage(DEU)fee listed on this invoice may include charges for one or more of the following miscellaneous:Electrical, pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal. A lump sum charge was applied rather than •itemizing usage. We hereby certify that these goods are produced in compliance with all applicable requirements of sections 6,7 and 12 of the Fair Labor Standards Act of 1938,as amended,and of regulations and orders of the Administrator of the Wage and Hour Division issued under section 14 thereof. Please reference the invoice number and amount with all payments. Remit to only the address below. Payment Terms: NET 30 Remit Payment To: Direct Billing Inquiries JOHNSON CONTROLS To Service Department: (866)635-1302 PO BOX 730068 . DALLAS,TX,75373-0068 To Remit Via Credit Card: • • To Remit Via ACH Wire Transfers: Call the phone number listed above. JP Morgan Chase INVOICE#: 1-119703163685 One Chase Manhattan Plaza New York,NY 10005 Credit to:Johnson Controls Inc. ABA#071-000013 Depositor Acct#55-14347 AMOUNT DUE: USD $5,62113 Type of Account:Checking CORP-BBC-OTC-BTS-SSNA-Remittance@jci.com Page2of2 A ® DATE(MMIDD/YYYY) , CERTIFICATE OF LIABILITY INSURANCE 08/27/2021 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Chad Mannella NAME: Marsh USA Inc. 540 West Madison Street PHONE. .Ext): (866)966-4664 FAX No): Suite 1200 E-MAIL JCI.certre uest marsh.com Chicago,IL 60661 ADDRESS: JCI.c,ertrequest@marsh.com Attn:JCLCertrequest@marsh.com INSURER(S)AFFORDING COVERAGE NAIC# CN101230596-5-21-22' INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B: Johnson Controls US Holdings,LLC Johnson Controls,Inc. INSURER C: Tyco International Holding Sari. INSURER D: SimplexGrinnell LP(see attached Acord 101) 5757 North Green Bay Avenue INSURER E: Milwaukee,WI 53209 INSURER F: COVERAGES CERTIFICATE NUMBER: CHI-009794565-03 REVISION NUMBER: 3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRY EXP LTTYPE OF INSURANCE ANBD SUBRwPOLICY NUMBER (MMIDO//YYYYY) (MM/DD//YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X MWZY313947-21 10/01/2021 10/01/2022 EACH OCCURRENCE $ 5,000,000 DAMAGE TO RENED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 5,000,000 X Contractual Liability MED EXP(Any one person) $ . 50,000 •X XCU Included _PERSONAL&ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 20,000,000 X POLICY .JECT LOC PRODUCTS-COMP/OP AGG $ INC IN GEN AGG OTHER: $ A AUTOMOBILE LIABILITY • X MWTB 313946-21(Excludes New Hamp) 10/01/2021 10/01/2022 COMBaccidINEent)D SINGLE LIMIT $ 2,500,000 (Ea A X ANY AUTO MWTB 313949-21(Primary NH$250k) 10/01/2021 10/01/2022 BODILY INJURY(Per person) $ A OWNED SCHEDULED • MWZX 313950(Excess NH$2.25mm) 10/01/2021 10/01/2022 BODILY INJURY(Per accident) $ I AUTOS ONLY _AUTOS HIRED NON-OWNED Excess NH Auto is Follow Form PROPERTY DAMAGE $ AUTOS ONLY _AUTOS ONLY (Per accident) • to Primary NH Auto $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB ~CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION MWC 313943-21(AOS-see page 2) 10/01/2021 10/01/2022 X SEA UTE ETH A AND EMPLOYERS'LIABILITY Y/N MWXS 313944-21(OH&WA) 10101/2021 10/01/2022 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ /M OFFICEREMBEREXCLUDED7 N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ . DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Ashland is included as additional insured per the attached.See attached Acord 101 for additional information including Additional Insured,Primary/Noncontributory,Waiver of Subrogation and Notice of Cancellation provisions. If an'X'is indicated in either the'ADDL INSD'or'SUBR WVD'boxes above,the indicated provision applies,BUT ONLY to the extent required by written contract and only as outlined in this Certificate of Insurance. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN Ashland,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Wea,Z.24 ?2.S lac. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: CN101230596 _ • LOC#: Milwaukee A ® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Johnson Controls US Holdings,LLC Johnson Controls,Inc. POLICY NUMBER Tyco International Holding S.a.r.i. • SimplexGrinnell LP(see attached Acord 101) 5757 North Green Bay Avenue CARRIER NAIC CODE Milwaukee,WI 53209 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance WORKERS COMPENSATION: Workers Compensation"AOS"Policy Includes coverage for employees from the follovdng States WHILE WORKING IN ANY STATE:AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,IA,10,IL,IN,KS,KY,LA, • MA,MD,ME,MI,MN,MO,MS,MT,NC,NE,NH,NJ,NM,NV,NY,OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WI,&WV. PRIMARY COVERAGE: The General Liability and Automobile Liability policies are primary and not excess of or contributing with other insurance or self-Insurance,where required by written lease or written contract For General Uability, this applies to both ongoing and completed operations. WAIVER OF SUBROGATION: The General Uability,Automobile Uability,Workers'Compensation and Employers Uability policies Include a Waiver of Subrogation In favor of the certholder and any other person or organization,BUT ONLY to the extent required by written contract. ADDITIONAL INSURED-AUTOMOBILE LIABILITY: The Automobile Uability policy,if required by written contract,Includes coverage for Additional Insureds as required by such written contract. ADDITIONAL INSURED-GENERAL UABILITY: For General Liability,if required by written contract,the following are included as additional Insureds,as required pursuant to a written contract with a named Insured,per attached Policy Endorsements A2 and A2A:THE CERTIFICATE HOLDER LISTED ON THIS CERTIFICATE OF LIABILITY INSURANCE,AND EACH OTHER PERSON OR ORGANIZATION REQUIRED TO BE INCLUDED AS AN ADDITIONAL INSURED PURSUANT TO A WRITTEN CONTRACT WITH THE NAMED INSURED. ONGOING OPERATIONS AND COMPLETED OPERATIONS INSURANCE The General Liability Insurance Includes Insurance for ongoing operations and completed operations. LIMIT OF LIABILITY: The Uability Limit that applies is the amount indicated on the face of this Certificate of Liability Insurance,or the minimum Liability limit that Is required by the written contract,whichever Is less. If there in no contract then the Uability Limit is limited to$1,000,000, NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS: Should any of the above described policies be cancelled,other than for non-payment,before the expiration date thereof,30 days advice of cancellation will be delivered to certificate holders in accordance with the policy endorsements. NAMED INSURED: • Air Distribution Technologies IP,LLC;Air System Components,Inc.;ArkLaTek Mechanical Services;Carter Brothers,LLC;GEM Access Systems,Inc.;Central CPVC Corporation;Central Sprinkler LLC; Chemguard,Inc.;Connect 24 Wireless Communications Inc.;Digital Security Controls,Inc.;Eastern Sheet Metal,Inc.;Elpas,Inc.;Exacq Technologies,Inc.;FBN Transportation,Inc.;Federal Energy Infrastructure Solutions,LLC;Grinnell Fire Protection Solutions LLC;Grinnell LLC;Haz-Tank Fabricators,Inc.;IMECO LLC;Integrated Systems and Power,Inc.;Johnson Controls(Suisse)SA;Johnson Controls ' Air Conditioning and Refrigeration,Inc.;Johnson Controls Building Automation Systems,LLC;Johnson Controls Digital Solutions LLC;Johnson Controls Engineering,LLC;Johnson Controls Federal Systems, Inc.;Johnson Controls Fre Protection LP;Johnson Controls Foundation,Inc.;Johnson Controls Government Systems,LLC;Johnson Controls,Inc.;Johnson Controls Navy Systems,LLC;Johnson Controls PI Project Site Operations LLC;Johnson Controls Security Solutions LLC;Johnson Controls-Hitachi Air Conditioning North America LLC;Johnson Controls US Holdings,LLC;Koch Filter Corporation;Master Protection LP dba FlreMaster,Qolsys,Inc.;Retail Expert,Inc.;Richmond Alarm Company LLC;Ruskin Company;Ruskin Rooftop Systems,Inc.;Ruskin Service Company;Senelco Iberia,Inc.;Sensormatic Asia/Pacific,Inc.;Sensormatic Electronics(Puerto Rico)LLC;Sensormatic Electronics,LLC;ShopperTrak International Investment LLC;ShopperTrak RCT Corporation;Shurjolnt America,Inc.;Silent-Aire USA Inc.;SimplexGrinnell LP;Tyco Fire&Security LLC;Tyco Fire Products LP;Tyco Integrated Security LLC;Tyco International Holding S.a.r.I.;Tyco International Management Company,LLC;Visonlc Inc.;WillFire HC,LLC;York International(SA),Inc.;York International Corporation - • ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IL 10 (12106) OLD REPUBLIC INSURANCE COMPANY ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION -ENDORSEMENT A2 Named Insured Endorsement Number Johnson Controls US Holdings LLC Policy Prefix Policy Number Policy Period Effective Date of Endorsement MWZY31394721 10/01/21 - 10/01122 10/01/21 Issued By THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured PersonsOr Organization(s): If required by contract,the person or organization listed on the certificate of Insurance as addtilonal insured,and each other person or organization required to be included as an'additional insured pursuant to a contract with a named Insured. Location(s)Of Covered Operations: As required by contract. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II-Who Is An Insured Is amended to include as an additional Insured the person(s)or organizations) shown In the Schedule, but only with respect to liability for°bodily injury", "property damage" or"personal and advertising Injury"caused solely by: 1. Your acts or omissions;or 2. The acts or omissions of those acting on your behalf; in the performance,ofyour ongoing operations for:the additional.lneured(s),at.the,location(s)designated above. B. With respect.to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to"bodily injury"or"property damage"occurring after; 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed;or 2. That portion of"your work'out of which the Injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project GL 289 001 1012 MWZY 31394721 Johnson Controls US Holdings LLC 10/01/21-10/01/22 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS-COMPLETED OPERATIONS-ENDORSEMENT AM Named Insured Endorsement Number Johnson Controls US Holdings LLC Policy Prefix Policy Number Policy Period Effective Date of Endorsement M WZY 313947 21 10/01/21 - 10/01/22 10/01/21 Issued By THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): If required by contract,the person or organization listed on the certificate of Insurance as additional Insured,and each other person or organization required to be Included as an additional insured pursuant to a contract with a named Insured. Location And Description Of Completed Operations: As required by contract. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organizations) shown In the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused solely by"your work" at the location designated and described In the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". • GL 289 0021012 MWZY 31394721 Johnson Controls US Holdings LLC 10/01/21-10101122