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HomeMy WebLinkAbout2023-054 PO 20230348- Rogue Valley Drywall LLC Purchase Order j FrCRECORD r� E Fiscal Year 2023 Page: 1 of: 1 B City of Ashland 1 adi4a T'Olt;- ¢- EO = LATTN: Accounts Payable Purchase L Ashland, OR 97520 Order# 20230348 T Phone: 541/552-2010 ' 0 Email: payable@ashland.or.us . V H C/O Facilities Maintenance Div r ROGUE VALLEY DRYWALL LLC I 90 North Mountain Ave N '334 TAN OAK DR p Ashland, OR 97520 - D MEDFORD, OR 97504 Phone: 541/488-5358 • R O Fax: 541/552-2304 V_ia ne-Nu-€fit ti luTteVs si 2;4 : r`i KE!T,_iii=ran __ - p,_y.��/��j� • David Arnold tBrit—mli7.Qr 'i ,3 s 6-=_ - .0 � Vii_ - @7'ss - 4 — _ — s 06/27/2023 _ 7812 FOB ASHLAND OR/NET30 City Accounts Payable'14 re i z =— a2111 r : = W-4 's ' x1t MIMI 2, ' gr=r51 6 Hrieri Drywall UB Office 1 Drywall Services (UB Office/The Grove) 1.0 $5,000.00 $5,000.00 Estimate: $3,000.00 Not to exceed$5,000.00 Goods and Services Agreement($35,000,or less) - Completion date: 06/30/2023 Project Account: . • ***************GL SUMMARY*************** I 088400-602400 $5,000.00 I' • -e7"'•;7-:",7-:"-----;---7:17.117::=2 ' �2 yam By: =43t*___ 1 i Date: I-V Aut orize• Signatur=11 _ '.5 000.00 frA ' Purchase Order Fat Fiscal Year 2023 Page: 1 of: 1 B City of Ashland - r i`i3k.®E�.a e — EN I ATTN: Accounts PayableL = 1 L 20 E. Main Ashland, OR 97520 Order# 2023/0348 T Phone: 541/552-2010 _ - 0 Email: •. _- - • .nd.or.us / sem- , L� _�—.,, C/O Facilities Maintenance Div HEAT-IMAYTANES /�� 10 North Mountain Ave p 334 TAN OAKD Lam' - ' r� - Ashland, OR 97520 • MEDFO_RD OR'97504 Phone: 541/488-5358 " _ �' Fax: 541/552-2304 r o-Mbli3 u► e=- era ilailliMb I s tion l_T_ - ==== 1 t ".�v t t_' _._. — — , � David Arnold -_ [of -QrderaniaTeifital,.g = -- ratiffe a 6_a ; _ �� At10I -�: 06/27/2023_ 7812 FOB ASHLAND OR/NET30 Ci Accounts Payable =fis # ---- @e rii t r . T-- , -- _ Vii*,,[ I 1VA t alai Drywall UB Office 1 Drywall Services (UB Office/The Grove) 1.0 $5,000.00 $5,000.00 Estimate: $3,000.00 Not to exceed $5,000.00 Goods and Services Agreement($35,000 or less) Completion date: 06/30/2023 , I Project Account: ***************GL SUMMARY'*************** 088400-602400 $5,000.00 I I 1 • . sem= By4`` l,1 AJl,. Date:_ a �� — ut orized Sign-tu4/14,es, 5 000.00 " FORM #3d. CITY OF A request fora Purchase Order ASHLAND REQUISITIONDate of request: . 0 ,-9 0 '146 Required date for delivery: Vendor Name Rogue Valley nrywa►► Address,City,State,Zip 334 Tan Oak.-Medford,OR 97504 Contact Name&Telephone mber Heath Maytanes (541)531-6085 roguevalleydrywall@gmail.com Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding . ❑ Emergency ❑ Reason for exemption:_ 0 Invitation to Bid (Copies on file) 0 Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: 0 Written quote or proposal attached ❑ Written quote or proposal attached ' ® Small Procurement Cooperative Procurement Less than$5,000 0 Request for Proposal (Copies on file) ❑ State of Oregon . ® Direct Award Date approved by Council: Contract# ❑ Verbal/Written quote(s)or proposal(s) 0 State of Washington Intermediate Procurement 0 Sole Source Contract# GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) 0 Other government agency contract $5,000 to$100,000 0 Written quote or proposal attached Agency ❑ (3)Written quotes attached -0 Special Procurement Contract# PERSONAL SERVICES 0 Form#9,Request for ApprovalIntergovernmental Agreement $5,000 to$75,000 0 Written quote or proposal attached 0 Agency ❑ Less than$35,000,by direct appointment Date approved by Council: Date original contract approved by Council: ❑ (3)Written proposals attached Valid until: (Date) , (Date) Description of SERVICES ' Tot ost N•6' 'd .. '_ ,01_- _,e---'6- ,a-6 • Drywall Services as needed ` $,`5;000:00 =—�. Item# Quantity Unit Description of MATERIALS • • Unit Price Total Cost 1 • Sheetrock/mud/tape/texture as heeded $5,000.00 • • • TOTAL.(COS T Ill Per attached quotelproposal l 5,00,0:00 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 approve all hardware and software purchases: • IT Director Date Support-Yes/No • By signing this re uisition form,I certiat th City's p blic contracting requirements have been satisfied. Employee Signature: � Department Head Signature: d(>• Cc't3.2c1:'3 �� to;-M1-7717.n$5,000) Additional signatures(if applicable): r Funds appropriated for current fiscal year: / NO 1 h v, _ . (� , _-� • Finance'Director-(Equal t.- greater than'$5,00 , �� Comments: 4 . • • Form#3•-Requisition v , i , Kariann Olson ) Y ' • l From: Heather Rodriguez r , Sent ` Tuesday,June.27,2023 8:56 AM C To: Kariann Olson Cc: Cathy Crocker ;' Subject: FW:W9 Rogue Valley Drywall Attachments: W9 Rogue Valley Drywall.pdf Vendor 7812—Rogue Valley Drywall LLC is ready for use. Heather Rodriguez,Accounts Payable City of Ashland ( • Finance Department , 20 E Main St,Ashland, Oregon 97520 . , (541)552-2010 I TTY 800.735.2900 ' _ ' . Heather.Rodriguez@ashland.or.us - i Online ashland.or.us; social media (Facebook @CityOfAshlandOregon I Twitter @CityofAshland) . This email transmission is official business of the City of Ashland,and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this.message in error, please contact me at(541)552-2010.. Original Message, , From:Kariann Olson<kari.olson@ashland.or.us> ' Sent: Monday,June 26, 2023 9:44 AM . To: Heather Rodriguez<heather.rodriguez@ashland.or.us> i . Cc: Kariann Olson<kari.olson@ashland.or.us> J Subject:W9 Rogue Valley Drywall ,f Hello Heather, , , Happy Monday , I think you got this W9 before, but not absolutely sure. Dave Arnold hos an invoice to pay. Thank you. .' , i , . Kariann (Kari) Olson, Purchasing Specialist , . City of Ashland • j Purchasing Office 90 North Mountain Avenue,Ashland,Oregon 97520 ; . 541.488.5354 I TTY 800.735.2900 i . Kari.olson@ashland.or.us l , This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error, please contact me at 541.488.5354.. Original Message _ . From: noreply@ashland.or.us<noreply@ashland.or.us> i Sent: Monday,June 26,2023 9:57 AM l 1 I. To: Kariann Olson<kari.olson@ashland.or.us> Subject: Message from "Electric156" [EXTERNAL SENDER] This E-mail was sent from "Electric156" (IM C3000). Scan Date: 06.26.2023 09:57:04(-0700) Queries to: noreply@ashland.or.us •y .r • • J i r 2 • GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Rogue Valley Drywall CITY OF PROVIDER'S AS H LAN D CONTACT: Heath Maytanes 20 East Main Street Ashland,Oregon 97520 ADDRESS: 334 Tan Oak Telephone: 541/488-5587 Medford, OR 97504 Fax: 541/488-6006 PHONE: 541-531-6085 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between.the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Rogue Valley Drywall, (a domestic/foreign business corporation) ("hereinafter"Provider"), for drywall services. , 1. PROVIDER'S OBLIGATIONS • 1.1 Provide drywall services for FY23 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and,by this reference,incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no 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 additionalnamed 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 Rogue Valley Drywall 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 tocomply 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 5/15/23 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$5,000 (this is maximum, not to exceed amount of ENTIRE Agreement) without express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Workdelivered 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 Rogue Valley Drywall • 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.220,279)3.230 and 279)3.235. 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 Rogue Valley Drywall 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:" e The Provider's complete written Rate Sheet dated 5/15/2023. 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 6: Goods and Services Agreement between the City of Ashland and Rogue Valley Drywall 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 Depar l.nient 20 E. Main Street Ashland, OR 97520 Phone:(541)488-5350 If to Provider: Rogue Valley Drywall Attn:Heath Maytanes 541-531-6085. 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 Rogue Valley Drywall 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: Rogue Valley D ; all(PROVIDER): By: t By: ///(iiU(// ake � `'�' e Sign tore aorr diemsM J0(.fs Printed Pri ted Q�� L L.-152r"\ IQ12rc-111__ Title • ,.Title •2023 /51 00-o Date Date • (W-9 is to be submitted with this signed Agreement) / e 9 4 Purchase Order No. • • • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Rogue Valley Drywall 6/12/23,8:33 AM Estimate EST7742 RogueValleyDrywall ESTIMATE EST7742 Heath Maytanes ` ,LA • 334 Tan Oak 97504 DATE 5415316085 • 05/15/2023 N eII Gi®I rucllai Bandit Gnrtecdd Onldaetlrl roguevalleydrywall@gmail.com TOTAL USD $3,000.00 TO City of Ashland David Arnold D 5419510292 david.arnold@ashland.or.us DESCRIPTION RATE QTY AMOUNT Sheetrock/mud/tape/texture/primer at The Grove $3,000.00 1 $3,000.00 Install date set for May 25th • TOTAL USD $3,000.00 • • • • • • httnc•//ann-invnirasimnle-cnm/v/hONd1 WIUTE 1/1 - ,�--, ROGUVAL-39 HBAYSINGER ACORLY ( DATE MM/DDNYYY) 1/4...:-..----- • CERTIFICATE OF LIABILITY INSURANCE MMID23 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 • mem.Sani•Pariani• • • Medford Office PayneWest Insurance,a Marsh McLennan Agency LLC Company (A/CNNo,Ext):.(541)282-1413 FAX No): 38 North Central Ave. E-MAIL ss:spariani@paynewest.com Medford,OR 97501 INSURER(S)AFFORDING COVERAGE NAIC# ,- K='" INSURER A:Main Street America Protection Ins Co 13026 `ritiir:}k : k.0 .. INSURER B:SAIF Corporation 36196 INSURED F< a,, m Rogue Valley Diybi all LLC i INSURER C: 334 Tan Oak= ''� aiq ��3¢1 `Sc'; INSURER 0 Medforda�Ol '87504 k y } 2i INSURER E: . f O r,.; AMP- INSURER F: COVERAGES rY . CEi2TiFICATE. ' U _. MBER: REVISION NUMBER: THIS IS TO CERTIFY THAT`THE POLJC' $,p�' NSURANCE;LI,STED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY )=C;191REMENT„,I (V'i' )t CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MIRY PE,RfiAIN, THE INStIRAI,C)^.AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S(YGH POLICIES.LIMI7,S„SHOWN.J, AY HAVE BEEN REDUCED,BY PAID CLAIMS. INSRKi,ADDL SUER ` 'A'3' POLICY EFF POLICY EXP LTR TYPE OF INSURANCE = INSD WV?, POLICY NXINIBER IMM/ O/MY) IMMIDDIYMI LIMITS A COMMERCIAL GENERAL LIABILITY , EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR ktall4 MPJ580 :: ;; 12/15/2022 12/15/2023 DAMAGE TO RENTED :< 4 PREMISES IEa occurence) $ E+ a s,ei t MED EXP(Any one person) $ 10,000 • _ , rv.S -o 5 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIty)lT 1PPLES{ €R I ....M10' `= GENERAL AGGREGATE $ 2,000,000 POLICY 41-4:-6,-'1I LOQ r:ik- 9f .t PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: `ask ti` P44a )F $ AUTOMOBILE LjA�E)LITY %Th_ if,,,R �ll 3 3 (4,Alipi'et; Ea acccidentD)SINGLE LIMIT $ ANYAUTO' 4. ` ' BODILYINJURY(Perperson) $ • OWNED a SCHEDULED •,, AUTOS ONL .,,� — AUTOS r rWO”' BODILY INJURY(Per accident) $ F.°" S ('<I '''''''''4",,i!, N e PROPERTY pAMAGE AUTOS ONLY gv 11„AT II ' r PROP RTY 1) $ £. S. A UMBRELLA LIAB OCCO(1 T' k`,,i1_ ,ft;V., 3 eE�ACF OCCURRENCE $ 1,000,000 CUJ5RR05F 5,13/1b 3 12/15/2023`.AGGhL,OATE S EXCESS LIAR CLAItj j NADE Y AS:!--;0',,P DED X RETENTIONS 10,0Q0 tts 4 t ' �� �', zt Aggregattiz $ 1,000,000 B WORKERS COMPENSATION e ' 4 t� ._ 3 PER k T OTH- AND EMPLOYERS'LIABILITY a t' + SSi • STATUTE' ER ANY PROPRIETOR/PARTNER/EXECUTIVE '1/N s.. '', .-'�'I00055l�7 AR `+t zit 3/15/2023? i 5/2024 L`EACHACCIDEN' $ 1,000,000 OFFICER/MEMBEREXCLUDED? N$/A .:- r 1,000,000 (Mandatory n NH) -.4k4-,,,,,W.,,, i e 1 0 V , E L.'D)SEASE-EA EM( YEE $ If yes,describe under _;''� a•F:,Sq ''kt 1. 1,000,000 DESCRIPTION OF OPERATIONS below ..:, �..: E.L.DISEASE .POLICY LIMIT 5s . ,els six.a }ten•t• :m..,n :< ter:,... DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101;Additional Remarks Schedule;lZr�ay be t aohad It ore space is required) s • • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Public Works 90 North Mountain Ave Ashland,OR 97520 AUTHORIZED REPRESENTATIVE . ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • rs ,-----'''' ROGUVAL-39 HBAYSINGER ,4,coRtflp CERTIFICATE OF LIABILITY INSURANCE DATD"'"Y) ���� 6//13/213/2023 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 Sam Pariani NAME: Medford Office • PHONE PayneWest Insurance,a Marsh McLennan Agency LLC Company (A/C,No,Ext):(541)282-1413 (NC,No): 38 North Central Ave. . ADDRESS :spariani©paynewest.com Medford,OR 97501 INSURER(S)AFFORDING COVERAGE NAIC# � INSURER A:Main Street America Protection Ins Co 13026 INSUREDa ''7 + INSURER B:SAIF Corporation 36196 Rogue Valle Drywall LLC(, INSURER C: 334 Tan Oaks ;('" INSURER D: Medford,'O 7504 ."-. , `' :" , �x a INSURER E: ' ,,,.w. ''' � . ,�e cw.`° INSURER F: COVERAGES *OP CERTIFICA'T.EINUMBER: REVISION NUMBER: THIS IS TO.CERTIFY THAT 'HE POLICIES,OF,I,NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN, EQU� EMENT, Tf3M sO,R„CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY pER AIN, THr 41NSURA,NC AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCII,POLICIES.LIMITSrsHOWN'MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE wow NSD$� Pouf NUMBER POLICY EFF I IMOLICY EXP M DD/YYYY1 LIMITS A COMMERCIAL GENERAL LIABILITY ) �' 'W ' EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR x to MPJ58O5F rr 12/15/2022 12/15/2023 pRESES IEa occuErrence) $ "r' 9,01 c MED EXP(Any one person) $ 10,000 ”r rFli.fi PERSONAL&ADV INJURY 1,000,000 x "�s1 � {. - 2,000,000 GEN'L AGGREGATE LIryJI�PPLIE$ E R �l 4 GENERAL AGGREGATE POLICY��� L C ,iki� . PRODUCTS-COMP/OPAGG $ 2,000,000,r OTHER: rs S f e x 4, `#- 4 $ ,, I '5 _.wa' COMBINED SINGLE LIMIT AUTOMOBILE L'IAQ(CJTY L �r �a (Ea accident) $ t0 t ' i BODILY (Per person) $ ANY AUTOI, Eu "via { OWNED AUTOS ONL i t SCHEDULED „,,_,.:4q,,:":. ,:..,.,xre r `' L. s UTAS , Ff �r BODILY INJURY(Per accident) $ p� , „F DAMAGE AUTOS ONLY .f'OS ONLY r , 'F1�1 • a '. (Perr accident) $ "� n �. xf Y FCf�x x. 'a'F ��.'RL d�4'e,4f $ • A UMBRELLA LIAB OCCUR � n a t EA H CURRENCE $ 1'000,000 EXCESS LIAB CLAI_M�S!MADE CUJ5505F 5/13/2023 12/15/20 �` r r „z ,� a rAGGREDATE J • t DED X RETENTION$ 1 000 ;� � X. Aggregq, .' $ 1,000,000 B WORKERS COMPENSATION ffi " a a .'-.”` ''',0,,,.4,14.PER " '0TH- AND EMPLOYERS'LIABILITY ,/'(r .-7:::"A:.,- '" ,$ . STATUTE ER YINit"6 „100055'51 1BAR ' '� a 3/15/2023 512024 ,E: 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVEXCLUDEr,�,izf-. ✓�x ,,-' ". ¢,, mila ACH ACCIDE g� $ OFFICER/MEMBER EXCLUDED? N l I1 r s` (Mandatory In NH) ro x '. E L DISEASE-.VIMF i3OY E $ 1,000,000 If yes,describe under .'2Jior) ,�' a DESCRIPTION OF OPERATIONS below # WA ySm.,,,, .)t1. u4." 1, E L DISEASE.POLICY LIMITS,$ / 1,000,UUU DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedul� ,e a� ,,,,„ p-,� ` y�e&ached 1�-ore space Is required) _ City of Ashland Public Works is additional insured per attached form BP0451 >_i ,� � r 1, • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI of Ashland • THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. Public Works 90 North Mountain Ave Ashland,OR 97520 AUTHORIZED REPRESENTATIVE • ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD . , • . • . . . ., , . BUSINESSOWNERS BP 04 51 01 06 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH ADDITIONAL INSURED . . . REQUIREMENT IN CONSTRUCTION CONTRACT This endorseme t ,'''o slfies insurance provided under the following: 4:0: ..,,,4 BUSINESSo NERS,c4VERAGE FORM i,- -v ,.,...4 4 L.•,, V'2,- The followi g is add . tcliiwo.Irappil:ia. Who Is An A person's or organization's status as an Insured in.Sectiiiffit-Liaby,; ilitt4;40" insured under this endorsement ends when Nov , '' . 3. Any person(s) or#44ifzifibn(s).,forkhom you your operations for that insured are completed 4 &qt. is ., 1. are performing opft 1 , also w,—ad tional ., or the contractors agreement is terminated. insured, if you, lor such. 4rsoilAR or organization(s) have agiteprAritin*ip. a 9I -ILr,. contract or agreement that such son s) or organization(s) be included as arilpIdditionaji:i. 1, insured on your policy:iSuch„ 1?... on(s) -oik':?.;, organization(s) is an additit04141,cired,oft0641 / with respect to liability for "bodily ,.fiii40, '', "prpOSAY..fifan10,6V or"personal and a. ,419Sing fer inj6rief'Caused;164,hole or in part, by::°7-,' , • ..1.14:;;:,” 4°, '' } ' ( a. Your acts or.p, Issions; or .1,1, '-‘,„•%:,4,1-4,,•,..,.4„,,,,, iv,--.A.,,,,w., ,,,,,, b. he acts or omissions of those acting pW ,,,,,*a4if l,;,. .,,,, your behalf; ,iie , i-i&-. <:',-;itk, -11.P. -4/ 11.:"L•f',"•", in the !,:.: iriandOPTIVOTiepObbing operations for the additional ii ured. 4 tW1.144\ , . ,k-4 *•••.;4°.e , ;• ” . f4.4.,• prer.,,,- ".1.... F',1;°;.!°1 4,.,••;;V:4?- /.4k4.. i§!•,.W. „Om...AA.- •-•:„ 4:o.. • 44,„ ••••'40''' .,-.. ,,,(erP41 „,-. -5,44 le 1...,:e,,, -'4"(.4idh4O'' ...,:-":„ ..•6 A:'A:4 •'"Ait: , ''' ,.'0'..;: IV ... 04.e0";:. '.*"..•2•;, .0..:$14„ ,A, .0,A•Ni: ..a..&t, 0 e,,,„•,, ,,64A11,, • me.64 ,44,...,.• F4 4;64' 44 C'''t4A 4' ,.:1,4Vk 41'1,10 ••,*4 .:,-,„-- NC,;4:Pi --et*: Ale:;;.'51.1;,.''''''' ' •,4,04.4,4..9,r4 eiROP.:••h'' ''''''r":.410°' , .!yt..- BP 04 51 01 06 © ISO Properties, Inc., 2004. Page 1 of 1 13 INSURED COPY