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HomeMy WebLinkAbout2023-095 PO 20240077- Rogue Payroll & Bookkeeping LLC Purchase Order ,al Fiscal Year 2024 Page: 1 of: 1 • 1avlul - B City of Ashland = _ ATTN: Accounts Payable 20 E. Main Purchase 20240077 Ashland, OR 97520 Order.# T Phone: 541/552-2010 . O Email: payable@ashland.or.us ✓ H C/O Finance E ROGUE PAYROLL & BOOKKEEPING LLC • I 20 East Main N 295 E MAIN ST STE 2 p Ashland, OR 97520 ASHLAND, OR 97520 Phone: 541/488-5300 R • T Fax: 541/552-2059 4Ee1.=1- °==7§�a a �=F=e�§I:§ Mariane Berry MDaf T#tBFE —P.=§ealt6 @e�al=l= i 1:1 'Zi-,*a f1€ciao s_t ai3151i1:=1 s1<I'h=c1'-'§ice, Y — 70= IP= [=I§ 08/09/2023 7977 FOB ASHLAND OR/NET30 _ City Accounts Payable =—� r � ��i i' =vi_[a�—l�_�r.�.` Accounting Services • 1 Accounting Services 1.0 $30,000.00 $30,000.00 Interim Senior Accountant Services • Personal Services Agreement(Less than $35,000) . Completion date: October 31, 2023 Project Account: *************** GL SUMMARY*************** . • I 037800-6041 $30,.000.00,, • • r • • • • By Date: -- Authorized Signat $30,000.00 t I vvg -buff'fil 4°C4'113/ciZil---- . • • 6re /FORM #3 • Waif,'I (% 2CITY OF ASHLAND D�A request cnov a Purchase Order , I( REQUISITION Q d Irate of request: . • . Required date for delivery: • Vendor Name RoFP RookkPPping I I c Address,City,State,Zip ,4e,6 ti& 7; h4JaikeL elf, ii Contact Name&Telephone Number Email address Kat Archer,#541.816.8276 • SOURCING METHOD • ❑ Exempt from Competitive Bidding ❑ Emergency . ❑ Reason for exemption: 0 Invitation to Bid 0 Form#13,Written findings and Authorization ❑ AMC 2.50 • Date approved by Council: .❑ Written quote or proposal attached ❑ Written quote or proposal attached _(Attach copy of council communication) _(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 bid(s)or proposal(s) ❑ Request for Qualifications(Public Works) 0 State of Washington . Date approved by Council: Contract.# _(Attach copy of council communication) 0 Other government agency contract • • Intermediate Procurement • 0 Sole Source Agency GOODS&SERVICES • ❑ Applicable Form(#5,6,7.or 8) Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids&solicitation attached 0 Form#4,Personal Services$5K to$75K Agency • • • PERSONAL SERVICES Date approved by Council:_ ❑ Annual cost to City does not exceed$25,000. Greater than$5,000 andless 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) p213)Written proposals&solicitation attached 0 Form#9,Request for Approval. • 0 Annual cost to City exceeds$25,000,Council -orm#4,Petsonal 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 •) • • Item# Quantity Unit Description of MATERIALS -Unit Price Total Cost Atile)rb 45411AnVie . . 10 '190 0a - • • ❑ Per attached quote/proposal TOTAL COST • 037800 604100 0D42° Project Number • _ Account Number - • g 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: i.f • IT Direct r Date Support-Yes/No By signing this requisition form,I certify that the City's public contracting requirements have been satisfied. Employee: Department Head: M s . i :. . i .'qual 4 6 reater t.n$5,000) Department ManagerlSupervisor: City Manager: ed, (Greater than$3 ,000) ' Funds appropriated for current fiscal year: YE NO 7�7 1 7,3 • ` • Finance Director(Equal o or reater than$5,000) Dat Comments: • • Form#3-Requisition r � T . • The following new vendor(s) are now ready for review. W9 is attached and entered into TCM. Ventibr.7• °ogta•x°a' `611`&8 okkeepin0hC Vendor 7978—J&J Tree Service LLC Vendor.7979_milestone landscape group Ilc Vendor 7981 Landmark Ford Inc • Vendor 7982—Rogue Shades Window Tinting Please let me know if you have any questions. Thank You!. Sarah Scott,Accounts Payable • • • • 4. t, City City of Ashland Finance Department 20 E Main St,Ashland,Oregon 97520 (541)552-2410 I TTY 800.735.2900 sarah.scottaashland.or.us ' 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)552-2410.. ' 2 • r • Kariann Olson From: Sarah Scott Sent: Wednesday,August 09,2023 11:19 AM To: Kariann Olson Subject: FW:New Vendor • • • • See new vendors below, ready to go. • • • • From: Bryn Morrison<bryn.morrison@ashland.or.us> . Sent:Wednesday,August 9,2023 6:58 AM To:Jesse Smith<jesse.smith@ashland.or.us> . Cc:Sarah Scott<sarah.scott@ashland.or.us>; Miranda Iwamoto<miranda.iwamoto@ashland.or.us> Subject: Re: New Vendor • Hi, • • These are approved. . Thank you •. ' ' • Bryn Morrison • . Deputy Finance Director • City of Ashland 20 East Main Street,Ashland,OR 97520 541-552-2002 direct/voice,TTY 800-735-2900 541-552-2059 fax 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)552-2002 From:Jesse Smith<jesse.smith@ashland.or.us> S Sent:Wednesday,August 9, 2023 6:55:18 AM To: Bryn Morrison<brvn.morrison@ashland.or.us> . Cc:Sarah Scott<sarah.scott@ashland.or.us>; Miranda Iwamoto<miranda.iwamoto@ashland.or.us> . Subject: FW: New Vendor All look good,your goat your convenience Bryn. . Thank you, S • S • From:Sarah Scott<sarah.scott@ashland.or.us> Sent:Tuesday,August 08,2023 3:05 PM . To:Jesse Smith<iesse.smith@ashland.or.us>; Miranda Iwamoto<miranda.iwamoto@ashland.or.us> . Subject: New Vendor 1 7 � • • • • CITY OF • • FORM #4 ASHLAND DETERMINATIONS TO PROCURE • 'PERSONAL SERVICES • $5,000 to $75,000 • To: Sabrina Cotta Deputy City Manager,for Joseph L.Lessard,City Manager , From: Mariane Beny,Finance Director • Date: July 7,2023 • • Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES • In accordance with AMC 2.50.120(A), for personal services contracts greater than $5,000, but less than $75,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City'does not have the personnel or resources to perform the • services required under the proposed contract. r1 Background - The Finance Department hasa time-sensitive need for a Senior Accountant due to the loss of Cindy Hanks, Accounting and Audit Manager.Given that it is year-end and the beginning of Audit season,that the recruiting effort . will take some time,and that the Accounting Department is already short staffed by two positions,it would be prudent to ensure that our Accounting operations continue without risk to the department's internal controls and financial responsibilities city-wide by temporarily filling a crucial position for year-end,audit and payroll'processing. ' Rogue Bookkeeping provides accounting and financial clerical assistance for interim needs such as this.Finance requires an interim Senior Accountant to assist in reconciliation of asset accounts,assisting in the creation of financial • reports,audit schedules and other financial statements,provide back-up and review bi-monthly payroll,and perform other duties as assigned. It is anticipated that Finance will hire a full-time,permanent Senior Accountant within the next 2-3 months.Therefore, . the estimated cost for temporary placement until then is approximately,and shall not exceed,$30,000. • Pursuant to AMC 2.50.120(A),has a reasonable inquiry been conducted as to the availability of City personnel to perform the services,.and that the Citydoes not have the personnel and resources • to perform the services required under the proposed contract? • • As described above,the Finance Department is already short-staffed.The position needed requires specific education, experience and skills in the field of Accounting.PerAMC 2.50.120(C),3 informal solicitations were sent out to • determine availability,qualificationsand cost.Rogue Bookkeeping and their proposed candidate meets our criteria. • . Requested.by: Mariane Berty 97- Date: July 7,2023 par ment.Head (J • I . Approved by: Date: 7/7/2023 City Manager Comments: • Form#4-Department Head Determinations to Procure Personal Services,Page 1 of 1,7/7/2023 • • ' i . • PERSONAL SERVICES AGREEMENT (LESS THAN $35,000) . , CONSULTANT: Rogue Payroll& • • 'Bookkeeping LLC. CITY OF • AS H LAN D CONTACT:.Kat Archer 20 East Main Street • • • Ashland,Oregon 97520 • ADDRESS: 295 E.Main 2,Ashland 97520 • . . Telephone: 541/488-5300 . . • . Fax: 541/488-5311 TELEPHONE: 541.601.0738 • H EMAIL: kat@roguebookkeeping.com • This Personal Services Agreement (hereinafter "Agreement") is entered,into by and between the City of Ashland, an Oregon municipal corporation(hereinafter "City") and Rogue Payroll &Bookkeeping LLC, (a domestic/foreign business corporation) ("hereinafter"Consultant"),.for accounting services. • • NOW THEREFORE, hi consideration of the mutual covenants contained herein,the City and Consultant hereby agree as follows: • . . , 1. Effective Date and Duration: This Agreement shall become-effective on the date of execution on behalf of the City, as set forth below(the"Effective Date"), and unless soonerterminated as . specifically provided herein,shall terminate upon the City's•affirmative acceptance of Consultant's Work as complete and Consultant's acceptance of the'City's final payment therefore,but not later • than October 31,2023. . 2. • Scope of Work: Consultant will provide Accounting Services as described accordingly:Perforin accounting duties in conformance with Generally Accepted Accounting Principles (GAAP); • Reconciliation of general ledger accounts,particularly bank accounts;Prepare financial schedules • relating to the Audit; Review and provide,support for the bi-monthly payroll and also assist in the preparation of payroll filings; Support Accounting Supervisor and Budget/Audit Lead with various senior accounting.duties; Other projects as necessary to support the overall needs of the City's. • Finance Department. Consultant's.services are collectively referred to herein as the"Work." • • 3. Supporting Documents/Exhibits; Conflicting Provisions: This Agreement and any exhibits or • other supporting documents shall be construed to be mutually complementary and supplementary: wherever possible. In the event of a conflict which cannot be so resolved,the provision's of this Agreement itself shall control over any conflicting provisions in any of the exhibits or supporting •, • • documents. • . • • 4. All Costs Borne by Consultant: Consultant shall, at its.own risk,perform the Work described above and,unless otherwise specified in this Agreement, furnish all labor, equipment, and • materials required for the-proper performance of such Work. 1 • 1 • • 5. Qualified Work: Consultant has represented, and by entering into this Agreement now represents, that all personnel assigned to the Work to be performed under this Agreement are fully • qualified to perform the service to which they will be assigned in a skilled and worker-like manner . and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. • • 6. Compensation: City shall pay Consultant the sum of$70/hour (seventy dollars per hour).as • full compensation for Consultant's services under this Agreement.' In no event shall Consultant's. total of all compensation and reimbursement under this Agreement exceed the sum of$30,000 . . (thirty thousand dollars) without the express, written approval from the City official whose signature appears below,or such official's successor in office. Payments shall be made within thirty (30)days of the date of receipt by the City of Consultant's invoice. Should this Agreement be terminated prior to completion of all Work,payments will be made for any phase of the Work • completed and accepted as of the date of termination. • 7. Ownership of Work/Documents: All Worlc,work product, or other documents produced in furtherance of this Agreement belong to the City, and any copyright,patent, trademark proprietary • or any other protected intellectual property right shall vest in and is herebyassigned to the City.. 8. 'Statutory Requirements:.The follotibing laws of the State of-Oregon are hereby incorporated by . reference into this Agreement: ORS 279B.220, 279B.230 and 279B.235. • 9.. Living Wage Requirements: If the amount of this Agreement is$25,335.05 or more, Consultant • • 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. Consultant is also required to post the notice attached hereto as "Exhibit B"predominantly in areas where it will be • seen by all employees. • 10. Indemnification: Consultant hereby agrees to defend, indemnify, save, and hold City, its officers, employees, arid agents harmless from any and all losses, claims, actions, costs, expenses, • • judgments, or other damages resulting.from injury to any person (including injury resulting in • death),or damage(including'loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this Agreement by Consultant(including but not limited.to, • Consultant's employees, agents,and others designated by Consultant to perform Work or services • attendant to this Agreement). However, Consultant shall not be held responsible for any losses, • expenses,actions,costs, or other damages, caused solely by the gross negligence of City. 11. Termination: • • a. Mutual Consent. This Agreement may be terminated at any time by the mutual consent of both parties. b. City's Convenience. This Agreement may be terminated by City at any time upon not less than thirty (30)days' prior written notice delivered by certified mail or in person. 7 • • c. For Cause. City may terminate or modify this Agreement, in whole or in part, effective • upon delivery of written notice to Consultant, or at such later.date as may established by City under any of the following conditions: i. If City funding from federal,state,county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; . • If federal or state regulations or guidelines are modified, changed,or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this Agreement or are no longer eligible for the funding proposed for payments authorized by this Agreement; or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this Agreement is for any reason denied,revoked; suspended,or not renewed. • . . . • • d. For Default or Breach. • i. Either City or Consultant may terminate this Agreement.in the event of a breach of the , • Agreement by the other. Prior to such termination the party seeking termination shall • • give to the other party written notice of the breach and its intent to terminate. If the party committing the breach has not'entirely cured the breach within fifteen(3 5)days • of the date of the notice, or within such other period as the party giving the notice may authorize in writing,then the Agreement may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of eachand every obligation and • duty under this-Agreement. City, by written notice to Consultant of default or breach, may at any time terminate the whole or any part of this Agreement if Consultant fails •• to provide the Work called for by this Agreement within the time specified herein or within any extension thereof. . • • iii. The rights and remedies of City provided in this subsection(d) are not exclusive and are in addition to any other rights and remedies provided by law or under this • Agreement. ' • 12. ' Independent Contractor Status: Consultant is an independent contractor and not an employee of the City for any purpose. S • • . . 13. Assignment: Consultant shall not assign this Agreement or subcontract any portion of the Work without the written consent of City. Any attempted assignment or subcontract without written • consent of City shall be void. • • • • 14. Default. The Consultant shall be in default of this Agreement if Consultant: commits any material breach or default of any covenant,warranty,certification, or obligation under the Agreement; institutes an action.for relief in bankruptcy or has instituted against it an action for insolvency;makes a general assignment for the benefit of creditors; or ceases doing business on a • • • 3- . a . r " i • • • l • • • • • • regular basis of the type identified in its obligations under the Agreement; or attempts to assign rights in,or delegate duties under,this Agreerirerit. 15. Insurance. Consultant shall, at its own expense,maintain the following insurance: a. Workers' Compensation. Consultant shall obtain and maintain Workers' Compensation • insurance in compliance with ORS 656.017,which requires subject employers to provide • Oregon Workers' Compensation coverage for its subject workers,unless such employers are exempt under ORS 656.126. If exempt under ORS 656.126, Consultant shall certify such • exemption to the.City. • b. Professional Liability insurance with a combined single limit, or the equivalent, of not less • than$2,000,000 (two million dollars)per occurrence. This is to cover any damages caused by error,omission or negligent acts related to the Work to be provided under this Agreement. c. General Liability insurance with a combined single limit, or the equivalent,of not less than. . $2,000,000 (two million dollars)pei occurrence for Bodily Injury,Death, and Property . Damage. Kat Archer.Auto Liability N/A.My office is within walking distance.Will not be driving. • d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than ..! .e! • e. Notice of cancellation or change. There shall be no cancellation,material change,reduction of limits or intent not to renew the insurance coverage(s).without thirty(30) days' prior written notice from the.Consultant or its insurer(s)to the City. • f. Additional Insured/Certificates of Insurance. Consultant shall name the City of Ashland, Oregon,and its elected officials, officers and employees as Additional Insureds on any insurance policies,excluding Professional Liability and Workers' Compensation,required herein, but only with . • • respect to Consultant's services to be provided under this Agreement.The consultant's insurance is primary and non-contributory.As evidence of the insurance coverages required by this Agreement,the Consultant shall furnish acceptable.insurance certificates and endorsements prior to commencing the Work under this Agreement. • 16. Nondiscrimination: Consultant 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 any Work under this Agreement when employed by Consultant. Consultant • agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation . statutes,'rules and regulations. Further, Consultant 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. 17. Consultant's Compliance With Tax Laws: 17.1 Consultant represents and warrants to the City that: • • • • •• 1 • ' E 17.1.1 Consultant 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 Consultant; and • (iii) Any rules,regulations,charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 17.1.2 Consultant,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 Consultant;and f (iii) Any rules,regulations,charter provisions; or ordinances that implement or enforce any of the foregoing tax laws or provisions. • 18. Governing Law; Jurisdiction: This Agreement shall be'governed and construed in accordance •:with 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. • 19. 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, by mailing using registered or certified United States mail,return• receipt requested,postae prepaid, orby-electronically confirmed at theaddress or facsimile number set forth below: If to the City: r Finance Department • Attn:Mariane Berry ' S Address:20 East Main Street ' Ashland, Oregon,97520 • ! Telephone: 541-488,5300 • S • S With a copy to: • City of Ashland-Legal Department S 20 East Main Street • Ashland, Oregon 97520 • •• Telephone: 541-48&-5350 •• • • • • If to Consultant: Rogue Payroll&Bookkeeping LLC • 295 E. Main Suite 2 Ashland, Oregon 97520 • Tel#541.601.0738,Email kat@roguebooklceeping.com 20. Amendments. This Agreement may be amended only by written instrument executed by both parties with the same formalities as this Agreement. 21. THIS AGREEMENT AND THE ATTACHED EXHIBITS CONSTITUTE THE ENTIRE UNDERSTANDING BETWEEN THE PARTIES. THERE ARE NO DERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS,EITHER ORAL OR WRITTEN,NOT SPECIFIED HEREIN REGARDING THIS AGREEMENT. CONSULTANT,BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE,HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS AGREEMENT,UNDERSTANDS IT,AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. • 22. Certification. Consultant shall execute the certification attached hereto as"Exhibit C"and incorporated herein by this reference. • 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 ASH AND:. ROGUE PAYROLL&BOOKKEEPING: By: �/ By: / li�ioiuily 4 • • Signature Signature VI WA' COO — Katherine (Kat)Archer Printed �Namey � Printed Name T6ptkiv) Ci4j lY1Jt V . . Memberitle Title 7/2 J To.2: 07/19/2023 JJJ Date Date • • • Purchase Order No. (W-9 is to be submitted with this signed Agreement) , • . EXHIBIT.B ' CITY OF ASHLAND, OREGON • • . City of Ashland - . . • • LIVING . • • . ALL employers described • WAGE • . • below must comply with City • . of Ashland laws regulating ' . • payment of a tiving wage. • - •. .. $18.12 per hour,effective June 30,2023. • M The Living Wage is adjusted annually every • June 30 by the Consumer.Price Index, . • Employees must be paid a portion of.the basuiee�el aihealthcare,retirement • their empleyer,rfthe 491i,K,and IRS elit le living wage: employer hasten ormare safdaiaplans(including enIdayees,arod has:erased - • &Howe)e)hu e%t®tile. • ; Far all hems aetker9urelera hrtanciall assistance dna the ertplepee's amountdumps. • • . swine=tract betiveen their • ptci •mr fnasiness bnm l e • employer and the City of -Cityof A i1and r ' Nate: Foetemporary and • Ashland aftheca ract $25,33505; • pad-tine griees,the, tLivingoi'erageduesnotapply . . • emeed's95,333.115lar more. r It:heiremployer is tie Cltyd . to the first idl`JD" hours waked Faraillanerrsv�xark irua A`h d,rficlurfingtheParks in any calendar year. For • month,if the employee and Reoeatiom Departrn t , mere details,pitease see . . 'spends 59' ar mare et the Arland t!atluni�Lypai Gads. - • e layeels time in that meati Im calsufating the frsir 'aege. SeetiaID 312.92@. . v�errl;angaraapresectae emblem maayaddthevalue For additional information • • Call the Ashland City Manager's office at 541-488-6002 or write to tie City Manager, . City&tail,20 East Main Street,Ashland,OR 97520,or visit the City's mbsite at www.ashland.or us. , • Notice to Employers: This notice must be posted in areas where it an be seed by all employees.. • • CITY OF • • • • ASHLAND • • • EXHIBIT e. • CERTIFICATIONS/REPRESENTATIONS: Consultant, by and through its authorized representative, • under penalty of perjury, certifies that(a)the number shown on the attached W-9 form is its correct • taxpayer ID (or is waiting for the number to be issued to it and (b) Consultant is not subject to backup withholding because: (i) it is exempt from backup withholding,or(ii) it has not been notified by the Internal Revenue Service(IRS)that it is subject to backup withholding as a result of a failure to report all interest or dividends, or(iii)the IRS has notified it that itis no longer subject to backup withholding. • Consultant further represents and warrants to City that: (a) it has the power and authority to enter into this Agreement and perform the Work, (b)the Agreement,when executed and delivered, shall be a valid and binding obligation of Consultant enforceable in accordance with its terms, (c)the work under the Agreement shall be performed in accordance with the highest professional standards, and(d) Consultant is qualified,professionally competent, and duly licensed(if applicable).to perform the Work. Consultant - also certifies under penalty of perjury that its business is not in violation of any,Or•egon tax laws, it is an • independent contractor as defined in the Agreement,.it is authorized to do business in the State of Oregon, . and Consultant has checked four or more of the following criteria that apply.to its business. • • V (1) Consultant carries out the work or services at a location separate from a private residence or is in a specific portion of a private residence,set aside as the location of the business. V (2) Commercial advertising or business cards or a trade association membership are purchased / for the business. . • V (3)Telephone listing is used for thebusiness separate from the personal residence listing. (4)Labor or services are performed only pursuant to written contracts. V (5) Labor or services are performed for two.or more different persons within a period of one year. . V (6) Consultant assumes financial responsibility for defective workinanship.or for service not • provided as evidenced by the ownership of performance bonds, warranties, errors and. omission (professional liability) insurance Or liability insurance relating to the Work or services to be provided. • • • • Consultant's signature . • • 07/19/2023 Date S • • • DATE(MM/DD/YYYY) A• CCPRE, • CERTIFICATE OF LIABILITY INSURANCE 7/25r2023 • 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 NAME: . CONTACT Sheryl Wats • Protectors Insurance,LLC • • PHONE 541-842-2968 aC,No):541-772 1906 • P.O.Box 4669 (Arc.No.Exti: E-MAIL Medford OR 97504 • ADDRESS: sherylwnD,protectorsjns.Com • , -1 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Ohio Security Insurance' • 24082 ROGUE88 INSURED • INSURER B:Philadelphia Insurance Comp. ' Rogue Payroll&Bookkeeping LLCwsuRER c:SAIF Corporation 36196.• `•' • Katat Archer . 295 E Main St STE 2 . INSURER D: Ashland OR 97520 INSURER e: • INSURER F: ' COVERAGES • CERTIFICATE NUMBER:866938599 - 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 .r 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. IL R ADDL BR POLICY EFF POLICY EXP LIMITS ;` . TYPE OF INSURANCE INso SUVD WPOLICY NUMBER (MMIDDrYYYY) {MM(DD/YYYYi A X COMMERCIAL GENERAL LIABILITY Y Y BZ559958577 6/15/2023 6/15/2024 EACH OCCURRENCE $2,000,000 • DAMAGE TO RENTED 000,000 CLAIMS-MADE OCCUR • PREMISES(Ea occurrence) S 4, MED EXP(Any one person) $15,000 . •PERSONAL&ADV INJURY . $1,000,000 ' GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 X POLICY JE PROCT I I LOC - PRODUCTS-COMP/OP AGG .$ OTHER: COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea'accident) • ANY AUTO BODILY INJU8Y(Per parson) $ , • ' OWNED SCHEDULED - BODILY INJURY(Per accident) $ ' AUTOS ONLY . AUTOS PROPERTY DAMAGE $ ' HIRED NON-OWNED - :• (per accldenti AUTOS ONLY _ AUTOS ONLY • $ -UMBRELLA LIAB • OCCUR• EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED • RETENTIONS C WORKERS COMPENSATION 890321 2/1/2023 . 2/1/2024 X STATUTE ETH AND EMPLOYERS'LIABILITY I Y I N ANYPROpRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $500;000 OFFICER/MEMBEREXCLUDEDT N/A (Mandatory In NH) ' DESCRIPTION OF OPERATIONS below ' E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $500,000 'B Professional Liability PHSD1793924 6/15/2023 6/15/2024 Occurence 2,000,000 Aggregate • 2,000,000 DESCRIPTIO1!OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) ' 07/18/23 Professional Liability Increased to$2,000,000 with retro date 07/18/23 for $1,000,000 limit The City of Ashland,Oregon,its officers,agents and employees as Additidnal Insured For General Liability per attached form BP045. General Liability Waiver of Subrogation oer attached from BP0497. General Liability Primary Non Contributory per attached form BP1488.General Liability 30 Day Notice of cancellation per attached form BP0497. Professional Liability 30 day notice pre attached PI-CANXAICH-02 05-11. Workers Comp Notice of Cancellation per attached. •. CERTIFICATE HOLDER CANCELLATION • 'SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE • • • THE EXPIRATION DATE THEREOF, NOTICE, WILL BE DELIVERED IN ' ACCORDANCE WITH THE POLICY PROVISIONS. City Of Ashland, Oregon • . 20 E Mian St - AUTHORIZED REPRESENTATIVE . Ashland _ * /j • i � titr �_!U�1�. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BUSINESSOWNERS • BP 04 50 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • ADDITIONAL INSURED .- OWNERS, LESSEES OR CONTRACTORS - SCHEDULED' PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) • City of Ashland Oregon and its elected officials, • officers and employees a • Location(s) Of Covered Operations 295 E MAIN ST STE 2, ASHLAND, OR, 97520 Locations per contract. Ashland OR 97520 • Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II -Liability is amended as follows: B. With respect to the insurance afforded to A. The following is added to Paragraph C.Who these additional insureds, the following addi- Is An Insured: tional exclusions apply: • 3. Any person(s) or organization(s) shown This insurance does not apply to "bodily in- in the Schedule is also an additional in- jury" or "property damage" occurring after: sured, but only with respect to liability for 1. 'All work, including . materials, parts or "bodily injury", "property damage" or . . equipment furnished in connection with "personal and advertising •injury" such work, on the project (other than ser- • caused, in whole or in part, by: vice, maintenance or repairs) to be per- a. Your acts or omissions; or formed by or on behalf of the additional • b. The acts or omissions of those acting insured(s) at the location of the covered • operations has been completed; or on your behalf; in the performance of your ongoing oper- 2 That portion of "your work" out of which ations for the additional insured(s) at the the injury or damage arises has been put location(s) .designated above. to its intended use by any person or or- ganization other than another contractor However: or subcontractor engaged in performing a. The insurance afforded to such addi- operations for a principal as a part of the tional insured only applies to the ex- same project. tent permitted by law; and b. Ifcoverage provided to the addition- al insured is required by a contract or agreement, the insurance afforded to such additional • insured will not be . broader than that which •you are re- • quired by the contract or agreement • . to provide for such additional in- sured. BP 04 50 07 13 © Insurance Services Office, Inc., 2012 • Page 1 of 2 • • C. With respect to the insurance afforded to 2. Available under the applicable Limits Of • these additional • insureds, the following is Insurance shown in the Declarations; added to Paragraph A. Liability And Medical whichever is less. Expenses Limits Of Insurance: This endorsement shall not increase the ap- If coverage provided•to the, additional insured g p plicable Limits Of Insurance shown in the is required by a contract or agreement, the Declarations. ' most we will pay on behalf of the additional • insured is the amount of insurance: • ' i 1. Required by the contract or agreement;• (( or I • • • • • • • • • • • BP 04 50 07 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 • . POLICY NUMBER: BUSINESSOWNERS BP04970106 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • • WAIVER OF TRANSFER OF RIGHTS OF RECOVERY • • AGAINST OTHERS TO US. ' This endorsement modifies insurance provided under the_following: • BUSINESSOWNERS COVERAGE FORM SCHEDULE* Name Of Person Or Organization: . . . ' City of Ashland Oregon and its elected officials, officers and employees , 20 E Main St Ashland OR 97502 • • Paragraph K. Transfer Of. Rights Of Recovery Against Others To Us in Section III - Common Policy Conditions is amended by the addition of the following: • We waive any right of recovery we may have • against the person. or organization shown in the • Schedule above because of payments we make' •for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization . and included in ' i• the "products-completed operations hazard". 0 This waiver applies only to the person or organi- • • zation shown in the Schedule above. • ' • • *Information required to complete this Schedule, if not shown..above, will be shown in the Declarations. • • BP 04 97 01 06 • •. ©ISO Properties, Inc., 2004 Page 1 of 1 I , BUSINESSOWNERS BP 89 45 04 18 • • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • AMENDMENT OF CANCELLATION PROVISIONS ' This endorsement modifies:insurance provided under the following: - BUSINESSOWNERS COVERAGE FORM SCHEDULE . • C , 1. Name: . City of Ashland Oregon 2. Mailing Address. or Email Address: 20 E Main St. Ashland OR 97502 • n 3. Number of Days Advance Notice: 30 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. . The following' is-added to Section:III -Common Policy Conditions: • A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or • organization shown in the Schedule above. In no event will the notice to the person 'or organization • - scheduled above exceed the notice to the first named insured. " . B. Our obligation to sendnotice to the person or organization listed in the Schedule above will terminate at the earlier of the current 'policy. period expiration or when'you no longer have a legal or. contractual • • . obligation to such person or organization to maintain insurance coverage under a policy• which requires. • that such person or organization be notified in the event of cancellation. . • • ' . • © 2018 Liberty Mutual Insurance BP 89 45 04 18 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 1 . V, •• . . I - . 1 • • • • • BUSINESSOWNERS • BP 14 88 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY -- • OTHER INSURANCE CONDITION • This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM- . • • The following is added to Paragraph H. Other 2. You have agreed in writing in a contract or • Insurance of Section III — Common Policy agreement that this insurance would be Conditions and supersedes any provision to the • primary and would not seek contribution from contrary: any other insurance available to the additional Primary And Noncontributory Insurance insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional ihsured under your policy provided that:• 1. The additional insured is a Named Insured under such other insurance;and • • • • • • • • • • • • • • • • • • •\ • BP 14 88 07 13 ©Insurance Services Office, Inc.,2012 Page 1 of 1 PI-CANXAICH-002(05/11) • • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTICE TO SCHEDULED.ADDITIONAL INSURED OR CERTIFICATE HOLDER This endorsement modifies insurance provided under the following: • • COMMERCIAL GENERAL LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART COMMERCIAL CRIME COVERAGE PART , • COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART • • . SCHEDULE OF ADDITIONAL INSUREDS OR CERTIFICATE HOLDERS - Al or CH Additional Insured or Certificate Holder - Address CH City of Ashland. 20 E Main St, Ashland OR 97520 • • . • • r . The following is added to A.CANCELLATION of the Common Policy Conditions of the above applicable coverage part:, • . A. In•the event we cancel the policy in accordance with the policy's terms and conditions;we will •endeavor to mail written notice of cancellation to Additional Insureds or Certificate Holders, • shown in the above SCHEDULE within the time frame listed below. However,failure to mail • ' • such notice shall impose no obligation of any kind upon us, our agents or representatives. 1. 30 . days before the effective date of cancellation if we cancel for any reason other than for I�I •non-payment of premium. • • • As respects Additional Insureds,the above cancellation provision applies only when the • Additional Insured shown in the above SCHEDULE is added to the policy by a separate . • • ' additional insured endorsement as the CANCELLATION'NOTICE TO ADDITIONAL INSURED. • OR CERTIFICATE HOLDER does not provide additional insured coverage. , • • . • • • • • Page 1 of 1 . - . _ 'i • www.salf.com saifr: Oregon Workers' Compensation - Certificate of Insurance • Certificate holder: • CITY OF ASHLAND,OREGON 20EMAIN ST . 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 • Rogue Payroll&Bookkeeping LLC Protectors Insurance LLC 295 E Main St Ste 2 Karol.Igou Ashland,Or 97520-1848 541.773.5358 info@protectorsins.com Issued 07/24/2023 Limits of liability Policy 890321 Bodily.Injury by Accident $500,000 each accident Period 02/01/2023 to 02/01/2024 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. CANCELLATION: ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW.SAIF WILL ENDEAVOR TO PROVIDE • WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE. Authorized representative . /t— e • Chip Terhune President and CEO • • 400 High Street SE • • • ' • Salem,OR 97312 P:800.285.8525 Poucy_oLCa ceruucateoflnsurance • F:503.584.9812