HomeMy WebLinkAbout2022-108 PO 20230193- S&S Sheetmetal Inc PrAll C QITYRECofijL Purchase Order graftgraftflFiscal Year 2023 Page: 1 of: 1 -a Mg"; ( 1�PtNRC B City of Ashland SViitezt. y�i H[e tIE I ATTN: Accounts PayableL 20 E. Main Purchase L Ashland, OR 97520 Order# 20230193 T Phone: 541/552-2010 O Email: payable@ashland.or.us ✓ H C/O Facilities Maintenance Div E S &S SHEETMETAL, INC I 90 North Mountain Ave N 912 ANTELOPE ROAD p Ashland, OR 97520 WHITE CITY, OR 97503 Phone: 541/488-5358 R I Fax: 541/552-2304 _ _ $[�sDavid • e�?PIIldatitci �1d3a �� d+ 9 oma. 5 -- �Arnold 12/13/2022 390 FOB ASHLAND OR City Accounts Payable _ HVAC Services Police Dept 1 HVAC Service Call'at Ashland Police Department 1.0 $2,450.00 $2,450.00 Service Quote#235368 Goods and Services Agreement($35,000 or Less) ' Completion date: 06/30/2023 Project Account: 0 ***************GL SUMMARY*************** 088400-602400 $2,450.00 I irt By: , � Date: ✓ /-2/-t Authoriz-d 7•"a7 re6 — '2450.00 , . i i FORM #3 CITY OF , 62D l 7-d t P 6 Y-9 ASHLAND requost fora 1::3tiJrcili1:ie Omer REQUISITION Date of request: 11/29/2022 Required date for delivery: Vendor Name S&S Sheetmetal,Inc. Address,City,State,Zip 912 Antelope Road,White City,OR 97503 . Contact Name&Telephone Number Christie Salazar christie.salazarCa.sandsheating.com 541-210-2946 ' Email address SOURCING METHOD O Exempt from Competitive Bidding 0 Invitation to Bld ❑ Emergency ❑ Reason for exemption: Dale approved by Council: 0 Form#13,Written findings and Authorization ❑ AMC 2,50 (Attach copy of council communication) ❑ Written quote or proposal attached • O 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: ❑ State of Oregon ® Direct Award (Attach copy of council communication) Contract# ❑ Verbal/Written quote(s)or proposal(s) ❑ Request for Qualifications(Public Works) ❑ Slate 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 0 Applicable Form(#5,6,7 or 8) Contract# • Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids and solicitation attached ❑ Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: El 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) O (3)Written proposals&solicitation attached ❑ Form#9,Request for Approval ❑ 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 isAgggMaigina HVAC services at Ashland Police Department '..$2;45.9.'00.' <°^)< > Item# Quantity Unit Description of MATERIALS Unit Price Total Cost 1 $0 $0.00 $0 $0.00 $0 $0.00 o Per attached quote/proposali: ::TOTAL.ZOSTft Project Number: -_ _ Account Number: 088400-602400 '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 appy 111hardware and software purchases; / IT Director Date Support-Yes/No By signing this requiplo omt,i certify that the City's bIlc co t&ting requirements have been satisfied. Employee: 21 / 4I_. > Department Hea . %Z.•t .tozZ (equal t or greater than$5,000) Department ManageriSupervisor: City Man er: � (Greater than$35 000) Funds appropriated for current fiscal year: 1168'/ NO 1 // Z Z Fina ce Director(Equal to or greater than$5,000) Date' Comments: Form#3-Requisition GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: S&S Sheetmetal,Inc. CITY OF PROVIDER'S ASH LAN D CONTACT: Christie Salazar • •• 20 East Main Street Ashland,Oregon 97520 ADDRESS: 912 Antelope Road Telephone: 541/488-5587 White City,OR 97503 Fax: 541/488-6006 PHONE: 541-210-2946 • This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of • Ashland, an Oregon municipal corporation (hereinafter "City") and S&S Sheetmetal, Inc., (a domestic/foreign • business corporation)("hereinafter"Provider"),for HVAC services. 1. PROVIDER'S OBLIGATIONS • 1.1 Provide HVAC services for Police Department 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 Worlc 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 • 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 S&S Sheetmetal,Inc. 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 11/14/2022 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$2,450 (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 S&S Sheetmetal,Cnc. • 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave, and retirement. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations,and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this • Agreement. •• 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. • 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State.of Oregon for Jackson County unless exclusive jurisdiction is in federal court, • in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue, and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred, as appropriate, so as to effectuate this choice of venue. 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees,contractors,or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God,strikes,lockouts,accidents,or other events beyond the control of the other or the other's officers,employees or agents. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the Goods.Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects,fraud, and warranties. 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require • Provider to correct them without charge or deliver them at a reduced price;as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this 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 S&S Sheetmetal,Inc. 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 Quote dated November 14,2022. 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 by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: Page 4 of G: Goods and Services Agreement between the City of Ashland and S&S Sheetmetal,Inc. I • • 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)488-5350 • • If to Provider: • S&S Sheetmetal, Inc. Attn: Christie Salazar 541-210-2946 r 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: I 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: • (1) 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 precedingthe Effective Date of this Agreement, has faithfully complied with: (1) 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 S&S Sheetmetal,Inc. • 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: S&S Sheetmetal,Inc. (PROVIDER): y By: `4' e $ Signa�� _}��YY Christie Salazar • 'SeenPrinted Narhe Printed Name Pu�-dC... V� OQk'S ptoiaurs�_ Office Manager Title Title 12. (. 2c zZ_ 11/29/2022 Date Date (W-9,is to be submitted with this signed Agreement) Purchase Order No. Page 6 of 6: Goods and Services Agreement between the City of Ashland and S&S Sheetmetal,Inc. ( oSE Service Quote •• \ [� HEATING & Order#: 235368 Y Y 4 - '::':"`�:-•�- x /��J/`� AIR-GOND Date: 11/14/2022 SHEETMETAL, INC. EST. 1900 Billed To: Project: CITY OF ASHLAND ASHLAND POLICE DEPARTMENT 20 E. MAIN ST. 1155 E. MAIN ST. ASHLAND OR 97520 Our Mission ASHLAND OR 97520 We are committed to raise the bar and make our team the standard others are judged by In commitment of • unsurpassed service,craftsmanship,loyalty,and integrity to our customers and team This quote Is valid until:12114/2022 Payment Terms: Orderf#: Assembly# Part# Description Quantity Price Ext Price Sales Tax First Service Call 1,0000 410.000000 410.00 Nitrogen 1.0000 180.000000 180.00 400002 Service-Labor 16.0000 95.000000 1,520.00 N Misc, Recovery Tanks 1.0000 340,000000 340.00 We are pleased to provide the following quote to remove refrigerant from city mutli unit,repair leaks,then we can decided how much refrigerant needs to be put into system. Unit takes 410a refrigerant and we don't know how much it will take to charge it, QUOTED BY:James Bridgman,Service,Technician ACCEPTED BY: • Notes "In the event customer falls to pay the in invoice amount when due,Interest shall accrue on the Non-Taxable Amount 2,450.00 unpaid balance from the due date of the invoice at the rate of 2%per month(24%per annum). If S&S Sheetmetal,Inc.Is required to seek collection of the amount due by legal process, Taxable Amount 0,00 customer shall be responsible to pay S&S Sheetmetal,Inc.in addition to the Invoice amount, Sales Tax: 0.00 the interest,ail attorney fees and costs Incurred by S&S Sheetmetal,Inc.. - CCB#72049. CA Lic•682160,C43,C20 Quote Total Z450.00 912 Antelope Rd.White City,OR 97503(541)-826-6661 Fax(541-826-6601 www.salf.com i saiF . Oregon Workers' Compensation Certificate of Insurance Certificate holder: CITY OF ASHLAND 90 N.MOUNTAIN AVE ASHLAND,OR 97520 • The policy of insurance listed below has been issued to the insured named below for the policy period indicated.The Insurance afforded by this policy Is subject to all the terms,exclusions and conditions of such policy;this policy is subject to change or cancellation at any time. Insured Producer/contact S&S Sheetmetal Inc Hub International Northwest Lie-Eugene 912 Antelope Rd Mike Godfrey White City,Or 97503-1607 541.650.6772 mike.godfrey@hubinternational.com Issued 09/21/2022 Limits of liability Policy 811929 Bodily Injury by Accident $1,000,000 each accident Period 10/01/2022 to 10/01/2023 Bodily Injury by Disease $1,000,000 each employee Body Injury by Disease $1,000,000 policy limit Description of operations/locations/special Items Job Address: 20 East Main Street,Ashland,OR • Important This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the policies above.This '• certificate does not constitute a contract between the issuing Insurer,authorized representative or producer and the certificate holder. Authorized representative Chip Terhune President and CEO 400 High Street SE Salem,OR 97312 P:800.285.8525 Policy OLC/1 CeriificateOMsurance F:503.584.9812 1 , • • • A OC RC)0 CERTIFICATE OF LIABILITY INSURANCE bATEMMdJD ••• THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS HO 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 HOT 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 poticy(los)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions o!the policy, certain policies may require an endorsement.A statement on this •• certificate does not confer rights to the certificate holder to lieu of such endorsement(s). •• PRODUCER CONTACT • FEDERATED MUTUAL INSURANCE COMPANY PRON CLIENT CONTACT CENTER HOME OFFICE:P.O.BOX 326 PHONE ECIN 888-333.4949 FAX HON 507.446-4664 OWATONNA,MN$5060 ADDRIEESS:CLIENTCONTACTCENTERfv1FEDINS.COM INSURER(S)AFFORDING COVERAGE NAM I! INSURER At FEDERATED RESERVE INSURANCE COMPANY 16024 . INSURED 343-547-6 INSURER B: • S&S SHEETMETAL INC INSURER C: •. 912 ANTELOPE RD INSURER IN WHITE CITY,OR 97503-1607 INSURER Et •• INSURER Ft • COVERAGES CERTIFICATE NUMBER:309 REVISION NUMBER:0 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 AU.THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITSSHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS, . ILpp TR TYPE OF INSURANCE Eh IMMPOLICY NUMBER IDOYXWi IMM(DD EXP LIMITS • X COMMERCIAL GENERALUABIUTY EACII OCCURRENCE $1,000,000 • CLAIMS-MADE �X OCCUR PREM BI E8 tEe eCJWRencol $100,000 MED EXP(Anyone Person) EXCLUDED A - Y N • 9910053 04/24/2022 04/24/2023 PERSONAL aADVminty $1,000,000 _DIN'LAOGREOATE LIMIT APPLIES PER: OENERAL AOOREOATE $2,000,000 X POLICY DR: [II LCD PRODUCTS-COMPJOP A00 $2,000,000 • OTHER; • AUTOMOBILE LIABILITY &O'MBINdEDSSINOLE LIMIT 51,000,000 X ANY AUTO 'BODILWY INJURY(Per person) . A OWNED AUTOS ONLY AUTOSULED N N 9910853 04/24/2022 04/24/2023 BODILY INJURY(Per sccldent — HIRED AUTOS ONLY NAUTTOS ON Y IPeTaeddgegAMAOE X UMBRELLA UAB X OCCUR EACH OCCURRENCE $5,0$5,000,000, A EXCESS LIAR GLAJMS•MADE N N 9910654 04/24/2022 04124/2023 AGGREGATE $5,000,000 • OED I 'RETENTION • WORKERS COMPENSATION PER STATUTE • ER AND EMPLOYERS'LIABILITY • ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICERIMEMBER EXCLUDED? H I A IMandelery In HIM £.L DISEASE•EA EMPLOYEE Not de sales ender E.I.DISEASE•POLICY LIMIT DESCRIPTION OP OPERATIONS Wow DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 151,Add£ons!Remarks Schedule,pm he attached II mere space Is regelred) , THE CERTIFICATE ((OLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS DF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEHENT WITH YOU ENDORSEHENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION •• CITY OF ASHLAND 309 O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C/O FLEET SERVICES/FACILITIES MAINTENANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 N MOUNTAIN AVE ACCORDANCE WITH THE POLICY PROVISIONS. • • ASHLAND,OR 97520.2014 AUTHORIZED REPRESENTATIVE 4 • O 1998-2016 ACORD CORPORATION.Al)rights reserved. • ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD • • I . COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ iT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WiHIEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: � COMMERCIAL GENERAL LIABILITY COVERAGE PART - A. Section II - Who Is An Insured is amended to B, With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract 1. "Bodily or agreement that such person or organization be "property damage" or added as an additional insured on your policy. "personal and advertising injury" arising out Such person or organization is an additional of the rendering of, or the failure to render, insured only with respect to liability for "bodily any professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury"caused, in whole or in part,by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and behalf; specifications; or • in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims additional insured: against any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring, and employment, training or monitoring of others 2. Will not be broader than that which you are by that insured, if the "occurrence" which required by the contract or agreement to caused the "bodily injury" or "property provide for such additional insured. damage", or the offense which caused the A person's or organization's status as an "personal and advertising injury", involved the additional insured under this endorsement ends rendering of or the failure to render any when your operations for that additional insured professional architectural, engineering or are completed. surveying services. • • © Insurance Services Office, Inc., 2018 Page 1 of 2 CG 20 33 12 19 Policy Number: 9910853 Transaction Effective Date:04/24/2022 s � ' 2. "Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring after: additional insureds, the following is added to a. All work, including materials, parts or Section ill -Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. 'Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or 2. Available under the applicable limits of b. That portion of "your work" out of which insurance; the injury or damage arises has been put whichever Is less. to its intended use by any person or organization other than another contractor This endorsement shall not increase the or subcontractor engaged in performing applicable limits of insurance. operations for a principal as a part of the • same project. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9910853 Transaction Effective Date:04/24/2022