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HomeMy WebLinkAbout2021-082 PO 20220062- Crete Co. LLC RECORDERFrACITY Purchase Order ,aa Fiscal Year 2022 Page: 1 of: 1 B City of Ashland I I ATTN:Accounts PayableL 20 E. Main Purchase L Ashland, OR 97520 Order# 20220062 T Phone: 541/552-2010 O Email: payable@ashland.or.us • V H C/O Public Works Department E CRETE CO. LLC I 51 Winburn Way N PO BOX 160 p Ashland, OR 97520 O EAGLE POINT, OR 97524 Phone: 541/488-5347 • R T Fax: 541/488-6006 -__71:1._N1-.Q L1=MI 316E a= 1=73V,I=7 _-__ Scott Fleury 07/27/2021 4419 FOB ASHLAND,OR/NET30 City Accounts Pa able Harrison St Improvements • 1 40'x5'x4" Broom finish sidewalk 6"thick @ approach 1.0 $2,000.00 $2,000.00 Project Account: 2 40' Curb and gutter with 12'/16' approach / 1.0 $1,800.00 $1,800.00 Goods and Services Agreement(Less than $25,000) Completion date: 06/310/2022 Project Account: *************** GL SUMMARY*************** 081200-602400 $3,800.00 • 4L4Date: 07/29/2021 _ Authorized Signature $3,800.00 ' OFO,RM #3 CITY OF A tef.gUf;4I'm a ktrt:;4)tt" o .V.e 10,A a o 1S1-1 LAND REQUISITION Date of request: 07/14/2021 Required date for delivery: 08/31/2021 Vendor Name Crete Co,LLC Address,City,State,Zip PO BOX 160,Eagle Point,OR,97524 Contact Name&Telephone Number Justin Puls,541-621-8332 Email address creteco18@oullook.com _ SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Invitation to Bid ❑ 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 ❑ Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: 0 State of Oregon IN Direct Award _(Attach copy of council communication) Contract# ❑ VerbaiMlritten bid(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&solicitation attached ❑ 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 0 Form#9,Request for Approval 0 Annual cost to City exceeds$25,000,Council 0 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 Install 40'x5'x4"broom finish sidewalk 6"thick @ approach and Install 40'of curb&gutter with 12716'approach for the Harrison Street Alley Improvements $ •3800,o0 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost 40'x5'x4"broom finish sidewalk 6"thick @ approach 2,000.00 40'of curb&gutter with 12/16'approach ' 1,800.00 ❑ Per attached quotelproposal TOTAL`COST' Project Number • Account Number 0 0 1 2 0 0.6 0 2 4 0 0 3 $00 0, Account Number - Account Number - 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. iT Director in collaboration with department to approve all hardware and software purchases: iT Director Date Support-Yes/No By signing this requisi'n rm,I certify that the.'i.,-:� holing requirements have been satisfied. Employee: / Department Head: 1 )x'112021 alto r greatef than'3 _ 5,000) Department Manager/Supervisor: City M a' �� (Equal to or€r Tet�2 Funds appropriated for current fiscal year: YES/;e 1 F : I -dor-(Equal to or greater than$5,000) Date Comments: Form 113-Requisition I GOODS AND SERVICES AGREEMENT (LESS THAN $25,000) PROVIDER: Crete CO. LLC CITY OF PROVIDER'S CONTACT: Justin Puls ASHLAND 20 East Main Street ADDRESS: PO Box 160 Ashland,Oregon 97520 Eagle Point, OR 97524 Telephone: 541/488-5587 PHONE: 541-621-8332 Fax: 541/488-6006 This Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Crete Co. LLC, (a domestic limited liability company) ("hereinafter"Provider"), for Replacement of ADA ramp and sidewalk at Ashland Municipal Airport. 1. PROVIDER'S OBLIGATIONS 1.1 Provide Replacement of ADA ramp and sidewalk at Ashland Municipal Airport as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS,and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority 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 • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 6: Agreement between the City of Ashland and Crete Co.LLC 1.3 Provider shall,at its own expense,maintain Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 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. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of$3,800.00 as provided herein as full compensation for the Work as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$3,800.00 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. 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. Page 2 of 6: Agreement between the City of Ashland and Crete Co.LLC 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. 4. SUPPORTING DOCUMENTS 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 City's written Invitation To Bid dated 03/05/2020. • The Provider's complete written Bid form dated 03/30/2020. Page 3 of 6: Agreement between the City of Ashland and Crete Co.LLC 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including,but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due, Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the.City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30,2022, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may,upon not less than thirty (30) days' prior written notice, terminate'this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement,with cause, by not less than fourteen(14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE _ Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: City of Ashland—Public Works Department Attn: Chance Metcalf 20 E.Main Street Ashland, Oregon 97520 Phone: (541)488-5587 With a copy to: City of Ashland—Legal Department 20 E.Main Street - Ashland, OR 97520 Phone: (541)488-5350 If to Provider: Crete Co.LLC Page 4 of 6: Agreement between the City of Ashland and Crete Co.LLC Attn: Justin Puls PO Box 160 Eagle Point, OR 97524 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. 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. Page 5 of 6: Agreement between the City of Ashland and Crete Co.LLC CITY OF ASHLAND: CRETE CO. LLC (PROVIDER): By: Air1 By: /L3t.LJ 16A - :na .r • Signature 3ettr coo ( i UUac1I-1 • Printed Naene Printed Name ticks bone—RSL__ Title Title "7/ t 17.02 \\9\w2_1 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. �� e 6 2 Page 6 of 6: Agreement between the City of Ashland and Crete Co.LLC ;;--"..-"IgitCSA DATE(MMlDD/YYY1� A ''7?Q CERTIFICATE OF LIABILITY INSURANCE 7/14/2021 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(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 CONTACT NAME: BLALOCK INSURANCE PHONE FAX (A/C.No.Ext); (A/C,No): ' 531 NE E STREET,STE E E-MAIL ADDRESS: GRANTS PASS,OR 97526 INSURER(S)AFFORDING COVERAGE NAIC# (541)476-2246 INSURER A: Contractors Bonding and Insurance Company 37206 INSURED • INSURER B CRETE CO LLC INSURER C: PO BOX 160 INSURER D: EAGLE POINT,OR 97524 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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 P LTR TYPE OF INSURANCE �p WBD POLICY NUMBER (MMIDDY/YYYY) (MMDEFF D!YFY/Y) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR D11 PE5010TED 6/20/2021 6/20/2022 PREMISES EaMAMAGE TO ADE X OCCUR $ 300,000 MED EXP(Any one person) $ 5,000 Y PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N PERH STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A • (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ E yes,describe under 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) Products and completed operations coverage is included according to the terms of the policy and subject to applicable policy exclusions. PRODUCTS AND COMPLETED OPERATIONS COVERAGE IS INCLUDED ACCORDING TO THE TERMS OF THE POLICY AND SUBJECT TO APPLICABLE POLICY CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PUBLIC WORKS DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 EAST MAIN STREET ASHLAND,OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL.LIABILITY COVERAGE PART A. Section II — Who Is An Insured is reports, surveys, field orders, amended to include as an additional in- change orders or drawings and sured any person or organization for specifications; or whom you are performing operations when you and such person or organiza- b. Supervisory, inspection, archi- tion have agreed in a written contract or tectural or engineering activities. agreement that such person or organi- 2. "Bodily injury" or "property damage" zation is to be added as an additional occurring after: insured on your policy. Such person or a. All work, including materials, organization is an additional insured on- ly with respect to "bodily injury or"prop- parts or equipment furnished in connection with such workon erty damage" caused by your negli- the project (other than serve ice, gence in the performance of your ongo- ing operations performed for that addi- maintenance or repairs) to be tional insured. performed by or on behalf of the additional insured(s) at the loca- A person's or organization's status as tion of the covered operations an additional insured under this en- has been completed;or dorsement ends when your operations b. That portion of"your work"out of for that additional insured are com- pleted. which the injury or damage aris- es has been put to its intended To the extent required under said written use by any person or organiza- contract or agreement, this policy will tion other than another contrac- apply as primary insurance to additional tor or subcontractor engaged in insureds and other insurance which may performing operations for a prin- be available to such additional insureds cipal as a part of the same will be non-contributory.We waive our project. right of recovery against such additional 3. "Bodily injury", "property damage" or insureds. occurring or commencing before B. With respect to the insurance afforded to execution of the written contract or these additional insureds, the following agreement that requires such per- additional exclusions apply: son or organization be added as an This insurance does not apply to: additional insured on your policy. 1. "Bodily injury", "property damage" or C. Definitions arising out of the rendering of, or the "Ongoing operations" means operations failure to render, any professional not included in the "products-completed architectural, engineering or survey- operations hazard." ing services, including but not limited to: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, CBGL 00 71 0512 Includes copyrighted material of Page 1 of 1 Insurance Services Office,Inc.,with its permission. • PROGRESSIVE" • BLALOCK INSURANCE COMM£RC/AL 531 NE E ST SUITE E GRANTS PASS,OR 97526 1-541-476-2246 Policy number: 02122491-1 Underwritten by: ARTISAN AND TRUCKERS CASUALTY CO July 6,2021 Page 1 of 2 • Certificate of Insurance Certificate Holder CRETE CO LLC PO BOX 160 EAGLE POINT,OR 97524 Insured Agent/Surplus Lines Broker CRETE CO LLC BLALOCK INSURANCE PO BOX 160 531 NE E ST SUITE E EAGLE POINT,OR 97524 GRANTS PASS, OR 97526 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change,alter, modify,or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms,exclusions, limitations, endorsements,and conditions of these policies. Policy Effective Date: May 13,2021 Policy Expiration Date: May 13,2022 Insurance coverage(s) Limits BODILY INJURY/PROPERTY DAMAGE $2,000,000 COMBINED SINGLE LIMIT UNINSURED MOTORIST BODILY INJURY $100,000/$300,000 Description of Location/Vehicles/Special Items Scheduled autos only • 2007 CHEVROLET SILVERADO C3500 1GCHK336X7F522754 UNINSURED MOTORIST PROPERTY DAMAGE $20,000 W/$200 DED($300 IF HIT&RUN) PERSONAL INJURY PROTECTION $15,000 COMPREHENSIVE $1,000 DED COLLISION $1,000 DED ROADSIDE ASSISTANCE SELECTED 2007 CHEVROLET SILVERADO K3500 1 GBJK39D77E125410 Stated Amount $15,000 UNINSURED MOTORIST PROPERTY DAMAGE $20,000 W/$200 DED($300 IF HIT&RUN) PERSONAL INJURY PROTECTION $15,000 COMPREHENSIVE $1,000 DED COLLISION $1,000 DED ROADSIDE ASSISTANCE SELECTED Continued Policy number: 02122491-1 Page 2 of 2 Certificate number 18721NET491 Form 5241(10/02) 4iww.saif.com ■ s a I ri Workfe . Li . Oregon. Oregon Workers' Compensation Certificate of Insurance Certificate holder: CITY OF ASHLAND PUBLIC WORKS DEPARTMENT 20 EAST MAIN 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 Crete Co LLC United Insurance Agencies PO Box 160 United Insurance Agencies Eagle Point, Or 97524-0160 541.242.6464 workerscomp@uiaoregon.com Issued 07/13/2021 Limits of liability Policy 879837 Bodily Injury by Accident $500,000 each accident Period 04/01/2021 to 04/01/2022 Bodily Injury by Disease $500,000 each employee Body Injury by Disease $500,000 policy limit Description of operations/locations/special items Important This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the policies above.This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. Authorized representative Chip Terhune President and CEO 400 High Street SE Salem,OR 97312 P:800.285.8525 Policy OLCA CertificateOflnsurance F:503.584.9812