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HomeMy WebLinkAbout2019-288 PO 20200147 Rogue Valley Backflow Services LLC • • Purchase Order Fiscal Year 2020 Page: 1 of: 1 ci-yo it 1 D eC� tl gip"' j Yr013aI - 1 � L I-'[ B City of Ashland I ATTN: Accounts Payable20 E. Main Purchase L Ashland, OR 97520 Order# 20200147 T Phone: 541/552-2010 r 0 Email: payable@ashland.or.us I . V H C/O Facilities Maintenance Div E ROGUE VALLEY BACKFLOW SERVICES LLC l 90 North Mountain Ave N 717 W 1ST ST p Ashland, OR 97520 O PHOENIX, OR 97535 Phone: 541/4$8-5358 R TO Fax: 541/552-2304 . '=_l€[s[a d4,1.1,1=F'oilh,,.1 1 1 1 1_0- 5 ig 1 ! e t ' , is I a"4 David Arnold 09/09/2019 1770 FOB ASHLAND OR Cit Accounts Payable - - --__ e�T:'�� 9�.j+.�- _ = �- --'.z.:_ 1 ' Backflow Services 1 Backflow Services 1 , $4,000.0000 $4,000.00 Goods &Services Agreement Completion date: 0/30/2020 Project Account: ***************GL SUMMARY*************** i 082400-602400 $4,000.00 • • • F- -- = By: C ' t,.44 Date: Cf, f t 4 l t F 3 Authorized Signature ca _ 4 000.00 FORM #3 % - CITY OF , - : ASHLAND A request for :41 P:1 7'ch. =v e Order ` � REQUISITION ' " ilZeofrequest: , 9/5/2019 u Required date for delivery: Vendor Name Roque Valley Backflow Service Address,City,State,Zip 717 West 1st Street,Phoenix,OR 97535 ' Contact Name&Telephone Number Erin Akers 541-482-9464 Email address SOURCING METHOD ❑ Exempt from Competitive Bidding • 0 Emergency O Reason for exemption: 0 Invitation to Bid 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 (Attach copy of council communication) ' _(If council approval required,attach copy of CC) ® Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council:_ 0 State of Oregon ® Direct Award _(Attach copy of council communication) Contract# O Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) ❑ 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 0 Ap3licable Form(#5,6,7 or 8) • Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement O (3)Written quotes and solicitation attached D Form#4,Personal Services>$5K&<$75K Agency PERSONAL SERVICES 0 Special Procurement 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 0 Form#9,Request for Approval Agreement approved by Legal and,,approvedlsigned by ❑ -Direct appointment not to exceed$35,000 0 Written quote or proposal attached • City Administrator.AMC 2.50.070(4)' ❑ (3)Written proposals/written solicitation Date approved by Council: 0 Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services>$5K&<$75K Valid until: • (Date) approval required.(Attach copy of council communication) Description of_SERVICES Total Cost _ Backflow services for FY20 $4,000;00:,' Item# Quantity Unit Description of MATERIALS Unit Price Total Cost 1 O Per attached quotelproposal TOTAL COST:q:: $ Project Number _ ( _ Account Number 082400-602400 } w d ` *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 a proW all hardware and software purchases: ' IT Director Date Support-Yes/No By signing this re tion-form;I-c ify that the City' publie'contracting requirements have been satisfied. Employee: Department Head: 4 16-70ov!y' (Equal to or greater than$5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than$25,000) Funds appropriated for current fiscal year: YES / NO Deputy Finance Director-(Equal to or greater than$5,000) Date Comments: , Form#3-Reauisition j L 4 GOODS &SERVICES AGREEMENT PROVIDER: Rogue Valley Backflow Service CITY Ck F • PROVIDER'S Erin Akers A H LAN D CONTACT: 20 East Main Street Ashland,Oregon 97520 ADDRESS: 717 West 1St Street Telephone: 541/488-5587 Phoenix, OR 97535 Fax: 541/488-6006 PHONE: 541-482-9464 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 Backflow Service, a domestic business corporation("hereinafter"Provider"),for backflow service. 1. PROVIDER'S OBLIGATIONS 1.1 Provide backflow service for FY20-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 goods and 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 5: Agreement between the City of Ashland and Rogue Valley Backflow Service A . 1.3 All subject employers working under this Agreement are either employers that will comply with ORS 656.017 or employers that are exempt under ORS 656.126. 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. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of$4,000 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$4,000 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. 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. Page 2 of 5: Agreement between the City of Ashland and Rogue Valley Backflow Service 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 effectuatethis 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. 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 Provider's complete written Rate Sheet dated April 19, 2019 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, 2020, unless sooner terminated as provided in Subsection 6.2. • Page 3 of 5: Agreement between the City of Ashland and Rogue Valley Backflow Service 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—Facilities Maintenance Department Attn: David Arnold 90 North Mountain Avenue Ashland, Oregon 97520 Phone: (541) 552-2292 With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 • Phone: (541)488-5350 If to Provider: Rogue Valley Backflow Services Attn: Erin Akers 717 West 1st Street Phoenix, OR 97535 541-482-9464 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any prevision,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 bya 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. Page 4 of 5: Agreement between the City of Ashland and Rogue Valley Backflow Service' 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. CITY OF ASHLAND: Rogue Valley Backflow Service (PROVIDER): By: By: ���, Signature Signature /194144- G /9 CA6-& Printed Name Printed Name - PA/ 41.11 01/31(\-e91/0 Title Titl 6 Se,.zig '7 / t ‘31 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. e) l�7 Page 5 of 5: Agreement between the City of Ashland and Rogue Valley Backflow Service ® DATE(MM/DD/YYYY) A`o D CERTIFICATE OF LIABILITY INSURANCE 09/04/2019 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 Teri Triem Focus1 Insurance Group,Inc PHONE FAX 720 E Jackson St (A/C.No.ExtI: 541-772-3120 (A/c,No):541-772-7900 Medford,OR 97504 E-MAIL teri@focus1ins.com License#: NPN: 16192192&CA INSURER(S)AFFORDINGCOVERAGE NAIC# 1 INSURER A: Attune Insurance INSURED •ROGUE VALLEY BACKFLOW SERVICE LLC INSURER B: Ohio Security Insurance Company 24082 DBA ROGUE VALLEY BACKFLOW SERVICE. INSURER C: 717 W 1st St INSURER D: Phoenix, OR 97535 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-378263 REVISION NUMBER: 7 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 TYPE OF INSURANCE IANSD DDL SWVD POLICY NUMBER (UBR MMIDD/EFF (MM/DD Y) LIMITS A X COMMERCIAL GENERAL LIABILITY Y BTIS00001HIBP-24091-0108/28/2019 08/28/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE OCLAIMS-MADE X OCCUR PREM SES(Ea occuE ence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: • GENERAL AGGREGATE $ 2,000,000 �( POLICY JET LOC _PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ • B AUTOMOBILE LIABILITY BAS58217718 12/14/2018 12/14/2019 (FaaBudeDSINGLELIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED _ BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS HIRED NON-OWNED PROP PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION EH AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) V EL DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is also Additional Insured per Form SM04040118 • CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN The City of Ashland, Oregon ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main St ASHLAND, OR 97520 AUTHO IZED REPRESENTATIVE J (TTI) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks ofACORD Printed by TT1 on September 04,2019 at 12:41 PM • BUSINESSOWNERS SM 04 04 01 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM .The provisions of the Businessowners Coverage Form apply except as otherwise provided in this endorsement. All numbers and letters used to designate paragraphs in this endorsement are specific to this endorsement only. The following is a summary of increased limits of insurance and additional coverage provided by this endorsement. For complete details on specific coverage, refer to the appropriate provisions in this endorsement. Unless'otherwise noted, if similar coverage is provided in this endorsement and is also provided in another coverage form or coverage endorsement attached to this policy, the coverage provided by this endorsement will apply first. Similar coverage provided elsewhere in the policy will apply after the limit in this endorsement has/ been exhausted. Unless otherwise stated in this Endorsement, the Coverage provided in this Endorsement is subject to the Deductible shown in the Businessowners Coverage Form Declarations, or$500, whichever is less. However, if Flood, Earthquake, Earthquake Sprinkler Leakage, Windstorm or Hail, Hurricane and/or Difference in Conditions Coverage is provided, the deductible shown in the specific coverage declarations applies. The titles and descriptions in the Coverage Schedule below are intended solely for ease of reference and do not in any way limit, expand or otherwise affect the provisions of this endorsement. BUSINESSOWNERS SCHEDULE OF COVERAGE CHANGES COVERAGE LIMIT OF INSURANCE PAGE Building Glass Included in Building Limit. Coverage, page 4 Property Limitations- Furs,fur garments and garments trimmed in fur Coverage, page 4 Theft -$5,000. Jewelry,watches,jewels,pearls, precious and semi-precious stones,gold,silver,bullion- $5,000. Patterns, dies,molds and forms-$10,000 Fire Department Service Up to$25,000 unless a higher limit is shown in Coverage, page 4 Charge the Declarations. Civil Authority: Actual loss of Business Income due to civil Coverage, page 4 Business Income action that prevents access to business area for six consecutive weeks;or when the coverage ends. Coverage begins 48 hours after the time of the first action. Necessary Extra ' - Coverage for necessary extra expense begins Expense immediately after the time of the first action that prohibits access and ends six consecutive weeks after the date of that action;or when coverage for Business Income ends. - SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc.All Rights Reserved. May not be copied without permission. • COVERAGE LIMIT OF INSURANCE PAGE Money Orders and $10,000 Coverage,page 4 "Counterfeit Money" Forgery Or Alteration $10,000, unless a higher Limit Of Insurance is Coverage,page 4 shown in the Declarations. Business Income From $10,000 Coverage, page 4 Dependent Properties • Fire Extinguisher $25,000 Coverage, page 4 Systems Recharge Expense Electronic Data $25,000 Aggregate per Policy Year unless higher Coverage,page 5 Limit of Insurance is shown in the Declarations. Fire/Theft Reward Lesser of$10,000;or the dollar amount of the Coverage, page 5 covered fire or theft loss. (This coverage is not applicable in New York) Water Back-up and $15,000 on an aggregate annual limit basis, Coverage,page 5 - Sump Overflow regardless of the number of locations or losses. Fine Arts Coverage $10,000 for any one loss at each described Coverage,page 5 premises. Newly Acquired Or Buildings:$300,000 at each building; Coverage,page 6 Constructed Property Building Personal Property:$250,000 at each building. • Personal Property Off- $15,000 Coverage, page 6 Premises Outdoor Property $10,000 unless a higher limit for Outdoor Coverage,page 6 Property is shown in the-Declarations,but not more than$2,500 for any one tree,shrub or plant. Personal Effects $10,000 at each Described Premises. Coverage,page 6 Valuable Papers and $25,000 in any one occurrence at the described_ Coverage,page 6 Records premises,unless a higher Limit Of Insurance is shown in the Declarations. $5,000 for a loss not at the described premises. Accounts Receivable $25,000 in any one occurrence at the described Coverage,page 6 premises,unless a higher Limit Of Insurance is shown in the Declarations. $5,000 for a loss not at the described premises. Appurtenant Structures $50,000 for loss or damage in any one . Coverage,page 6 occurrence for any combination of loss or damage to Building and Business Personal Property. r Outdoor Signs $25,000 in any one occurrence unless a higher Coverage,page 6 and 7 Limit of Insurance for Outdoor Signs is shown in the Declarations. SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc.All • Rights Reserved. May not be copied without permission. COVERAGE - LIMIT OF INSURANCE PAGE Money and Securities $10,000 Inside"the Premises for"money"and Coverage, Page 7 "securities";$10,000 Outside the Premises for "money"and"securities"while anywhere else. Employee Dishonesty $10,000 unless a higher-Limit of Insurance is Coverage,page 7 shown in the Declarations. Property Definition- Paragraph a.(1)(a)is replaced as follows: (a)48 Coverage, page 7 "Period of restoration" hours after the time of direct physical loss or damage for Business Income Coverage; Section II-1. Business $1,000 for the cost of bail bonds required , Coverage, page 7 Liability-f. Coverage because of accidents or traffic law violations;the Extension cost of appeal bonds or bonds to release Supplementary attachments, but only within limits of insurance; Payments reasonable expenses incurred to assist in the investigation of the claim, including loss of earnings up to$500 per day for time away from work. Contractual Liability for Deletes the contractual liability exclusion for Exclusion revision, page 7 Personal Injury personal injury coverage. Broad Form Additional Automatically includes Additional Insureds when Coverage, page 8 and 9 Insured required by contract. Waiver Of Transfer Of Waives right of recovery we may have against Coverage, page 9 Rights Against Us entity because of payments made if there is a contract,executed prior to the loss requiring such waiver. • SECTION II-EXCLUSIONS Asbestos - "Bodily injury',"property damage"or"personal Exclusion language,page 7 and 8 and advertising injury"arising out of exposure or threat of exposure to asbestos in any form. Nuclear Hazard Nuclear reaction or radiation or radioactive Exclusion language, page 8 contamination however caused. Fungi or Bacteria "Bodily injury", "property damage"or"personal Exclusion language,page 8 and advertising injury"from any actual, alleged or threatened contact,of any kind with"fungi"or bacteria within a building or structure including its contents,regardless of any other cause,event, material or product contributed concurrently... . • SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 3 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc. All Rights Reserved. May not be copied without permission. • I. SECTION I—PROPERTY is amended as follows: A. Building Glass Coverage The following Building Glass Coverage is added to Section A. Coverage, 1. Covered Property: We will pay for direct physical loss of or damage to all glass that is part of a building or structure at the described premises owned by you. The amount we will pay for this additional coverage is included in the applicable Building Limit as set forth in Section C. Limits of Insurance of the policy. This coverage is in addition to Glass Expenses coverage provided under Paragraph n., Additional Coverages. B. Loss or Damage by Theft The following change is made to item c. in Section A.Coverage,4. Limitations For loss or damage by theft, the applicable limits shown below apply, unless a higher Limit of Insurance is shown in the Declarations: (1) $5,000 for furs,fur garments and garments trimmed with fur. (2) $5,000 for jewelry, watches, watch movements, jewels, pearls, precious and semiprecious stones, • bullion, gold, silver, platinum and other precious alloys or metals. (3) $10,000,for patterns, dies, molds and forms. C. Enhancements to Existing Additional Coverages' The following changes are made to Section A. Coverage, 5.Additional Coverages: 1. Fire Department Service Charge Paragraph c. Fire Department Service Charge is amended to provide that we will pay up to a limit of $25,000, and that no deductible applies to this Additional Coverage. • 2. CivirAuthority Paragraph i. Civil Authority is amended to provide that the,beginning and end of such coverage will be: a. Civil Authority Coverage for Business Income will begin 48 hours after the time of the first action of civil authority that prohibits access to the described premises and will apply for a period of six consecutive weeks from the date on which.such coverage began. b. Civil Authority Coverage for Extra Expense will begin immediately after the time of the first action of civil authority that prohibits access to the described premises and will apply for a period of six consecutive weeks from the date on which such coverage began; or when your Civil Authority Coverage for Business Income ends,whichever is later. 3. Money Orders and "Counterfeit Money" Paragraph j. Money Orders and "Counterfeit Money" is amended to provide that the most we will ' pay for any loss under this Additional Coverage is$10,000. 4. Forgery Or Alteration Paragraph k. Forgery Or Alteration, Subparagraph (4) is amended to provide that the most we will pay for any loss, including legal expenses, under this Additional Coverage is$10,000, unless a higher Limit Of Insurance is shown in the Declarations. 5. Business Income From Dependent Properties Paragraph m. Business Income From Dependent Properties, Subparagraph (1) only is amended to provide that the most we will pay under this Additional Coverage is$10,000 unless a higher Limit of Insurance is shown in the Declarations. • 6. Extinguisher Systems Recharge Expense Paragraph o. Fire Extinguisher Systems Recharge Expense is amended to provide that: a. The maximum distance from the described premises within which we will pay for the cost of recharging or replacing, whichever is less, your fire extinguishers and fire extinguishing systems(including hydrostatic testing if needed) if they are discharged is increased to 1,000 feet; and b. The most we will pay under this Additional Coverage is$25,000 in any one occurrence. SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc.All Rights Reserved. May not be copied without permission. 7. Electronic Data Paragraph p. Electronic Data, Subparagraph (3) only is amended to provide that the most we will pay under this Additional Coverage- Electronic Data, for all loss or damage sustained in any one policy year, regardless of the number of occurrences of loss or damage or the number of premises, locations or computer systems involved is $25,000, unless a higher Limit of Insurance is shown in the Declarations. This increased limit remains subject to the requirement that if loss payment on the first occurrence does not exhaust this amount, then the balance is available for subsequent loss or damage sustained in, but not after, that policy year. With respect to an occurrence which begins in one policy year and continues or results in additional loss or damage in a subsequent policy year(s), all loss or damage.is deemed to be sustained in the policy year in which the occurrence began. D. New Additional Coverages: _ The following coverages are added to Section A.Coverage, 5. Additional Coverages 1. Fire/Theft Reward (This coverage is not applicable in New York) . a. We will pay for a reward for information leading to a felony conviction in connection with an occurrence that results in a fire or theft loss covered this policy up to the lesser of$10,000 or the dollar amount of the covered fire or theft loss. b. This limit for this reward applies regardless of the number of persons providing that information. For the purposes of this Additional Coverage, an occurrence means a single act or series of acts caused by one or more persons resulting in a covered fire or theft loss. This reward is not available to any person responsible in any way for the fire or theft loss or to the Named Insured. No deductible applies to this Additional Coverage. 2. Water Back-up and Sump Overflow We will pay for direct physical loss or damage to Covered Property covered under SECTION I- PROPERTY caused by or resulting from:, , a. Water or waterborne material which backs up through or overflows or is otherwise discharged from a sewer or drain; or, b. Water or waterborne material which overflows or is otherwise discharged from a sump, sump pump or related equipment, even if the overflow or discharge results from mechanical breakdown of a sump pump or its related equipment. However, we will not pay the cost of repairing or replacing a sump pump or its related equipment in the event of mechanical breakdown. The most we will pay for the coverage provided under this Additional Coverage is $15,000 on an annual aggregate limit, regardless of-the number of locations or losses. If a Water Back-up and Sump Overflow scheduled endorsement is added to the policy this coverage will not apply. 3. Fine Art Coverage a. We will pay for direct loss or damage to Fine Art whether owned by you or others, and in your care, custody or control. b. Fine Art includes, but is not limited to, antiques, paintings, etchings, drawings, tapestries, sculptures and fragile property such as porcelains, china and marble. c. The most we will pay for loss in any one occurrence under this Additional Coverage is $10,000 at each described premises. Our payment for loss or damage to personal property of others will only be for the account of the owner of the property. The amount payable under this Additional Coverage is additional insurance over the insurance available for Business Personal Property. d. The value of Fine Art will be the least of the following amounts: (1) The actual cash value of that property; (2) The cost of reasonably restoring that property to its condition immediately before the loss; or, (3) The cost of replacing that property with substantially identical property. e. In the event of loss,the value of property will be determined as of the time of loss. SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 5 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc.,All Rights Reserved. May not be copied without permission. t E. 'Enhancements to Existing Coverage Extensions The following changes are made to Section A. Coverage, 6. Coverage Extensions: 1. Newly Acquired Or Constructed Property Paragraph a. Newly Acquired Or Constructed Property, is amended to provide that: a. The most we will pay for loss or damage to Buildings under Subparagraph (1) of this Coverage _ Extension is$300,000 at each building. b. The most we will pay for loss or damage to Business Personal Property under Subparagraph (2) of this Coverage Extension is$250,000 at each building c. The expiration date in Subparagraph(3)(b) is increased from 30 days to 60 days. 2. Personal Property Off-Premises • Paragraph b. Personal Property Off-Premises is amended to provide that the most we will pay for loss or damage under this Coverage Extension is$15,000. • 3. Outdoor Property Paragraph c. Outdoor Property is amended to provide that the most we will pay for loss or damage under this Coverage Extension is $10,000 unless a higher limit for Outdoor Property is shown in the Declarations, but not more than$2,500 for any one tree,shrub or plant. 4. Personal Effects Paragraph d. Personal Effects is amended to provide that the most we will pay for loss or damage under this Coverage Extension is$10,000 at each described premises., 5. Valuable Papers And Records Paragraph e. Valuable Papers and Records, Subparagraph (3) only, is amended_to provide that the most we will pay under this Coverage Extension for loss or damage to"valuable papers and records" in 'any one occurrence at the described premises is $25,000, unless a higher Limit of Insurance for "valuable papers and records" is shown in the Declarations. For "valuable papers and records" not at the described premises,the most we will pay is$5,000. 6. Accounts Receivable Paragraph f. Accounts Receivable, Subparagraph (2) only, is amended to provide that the'most we will pay under this Coverage Extension for loss or damage in any one occurrence at the described premises is $25,000, unless a higher Limit of Insurance for accounts receivable is shown in the Declarations. For accounts receivable not at the described premises,the most we will pay is$5,000. F. Coverage Extension -Appurtenant Structures The following coverage is added to Section A.Coverage,6.Coverage Extensions: Appurtenant Structures (1) When there is a Building Limit of Insurance shown in the Declarations, you may extend the insurance provided by this policy for the described premises to apply to direct physical loss or damage caused by or resulting from a Covered Cause of Loss to Incidental Appurtenant Structures within 1,000 feet of the . described premises. (2) When there is a Business Personal Property Limit of Insurance shown in the Declarations at the described premises, you may extend the insurance provided by this policy to apply to direct physical loss or damage caused by or resulting from a Covered Cause of Loss to Business Personal Property within Incidental Appurtenant Structures within 1,000 feet of the described premises. (3) Incidental Appurtenant Structures include storage buildings, carports, garages and similar structures which have not been specifically described in the Declarations.The most we will pay for loss or damage under this Coverage Extension in any one occurrence for any combination of loss or damage to Building and Business Personal Property is$50,000. G. Limits of Insurance—Outdoor Signs • The following change is made to Section C. Limits of Insurance: Paragraph 2. is amended to provide that the most we will pay for loss or damage to outdoor signs,whether or not the sign is attached to a building, is$25,000 per sign in any one occurrence. SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 6 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc.All Rights Reserved. May not be copied without permission. H. Enhancements To Optional Coverages The following changes are made to Section G. Optional Coverages: 1. Outdoor Signs Paragraph d. of 1. Outdoor Signs is amended to provide that the most we will pay for loss or damage in any,one occurrence is $5,000, unless a higher Limit of Insurance for Outdoor Signs is shown in the Declarations: 2. Money and Securities Paragraph c.(1) and c.(2) of 2. Money and Securities is amended to provide that the most we will pay for loss or damage in any one occurrence is $10,000, unless a higher Limit of Insurance is shown in the Declarations. 3. Employee Dishonesty • Paragraph c. of 3. Employee Dishonesty is amended to provide that most we will pay for loss or damage in any one occurrence is$10,000, unless a higher Limit of Insurance for Employee Dishonesty is shown in the Declarations. • I. Property Definitions Section H. Property Definitions, Subparagraph a.(1)(a) of Definition 9."Period of restoration"is deleted and replaced with by the following: (a) 48 hours after the time of direct physical loss or damage for Business Income.Coverage; or II. SECTION II—LIABILITY is amended as follows: A. The following change is made to A.Coverages: Paragraph (1), sections (b), (c) and (d) of Subparagraph f. Coverage Extension-Supplementary Payments of Paragraph 1. Business Liability, are deleted and replaced by the following: (b) Up to$1,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for"bodily injury"applies.We do not have to furnish these bonds. (c) The cost of appeal bonds or bonds to release attachments, but only for bond amounts within our Limit of Insurance.We do not have to furnish these bonds. (d) All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit", including actual loss of earnings up to $500 per day because of time off from work. B. The following changes are made to-B. Exclusions, Paragraph 1. Applicable To Business Liability Coverage: 1. Contractual•Liability for Personal Injury, Subparagraph (4) of Exclusion p. Personal and Advertising Injury is replaced by the following: (4) Arising out of an offense defined in Subparagraph f. (use of another's advertising idea in your "advertisement") or g. (infringing upon another's copyright, trade dress or slogan in your "advertisement") of Sectioh F. Liability And Medical Expenses Definitions, Definition 14., "Personal and advertising injury", for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. 2. The following exclusions are added: a. Asbestos (1) "Bodily injury", "property damage" or"personal and advertising injury" arising out of any actual or alleged exposure to asbestos or asbestos containing materials, including the mere presence of asbestos in any form. (2) Any damages,judgments, settlements, loss costs or expenses that: (a) May be awarded or incurred by reason of any claim or"suit" alleging actual or threatened injury or damage of any nature or kind to persons or property which would not have occurred in whole or in part.but for the presence of asbestos; • SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 7 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc. All Rights Reserved. May not be copied without permission. E , (b) Arise out of any request, demand, order or statutory or regulatory requirement that any insured or others test for,-monitor, cleanup, remove, encapsulate, contain, treat, detoxify or neutralize or in any way respond to or assess the effects of an asbestos presence; or (c) Arise out of any claim or"suit"for damages because of testing for, monitoring, cleaning up, removing, encapsulating, containing, treating, detoxifying or neutralizing or in any way responding to or assessing the effects of an asbestos presence. b. Nuclear Hazard • Bodily injury", "property damage" or "personal and advertising injury" arising out of any nuclear reaction or radiation or radioactive contamination, however caused. But if nuclear reaction or radiation, or radioactive contamination, results in fire, we will pay for "bodily injury" or "property damage"caused by the fire. c. Fungi or Bacteria (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of the actual, alleged or threatened inhalation of, ingestion of or presence of any-"fungi" or bacteria within a building or structure, including its contents, regardless of whether any other cause, event, material or product contributed concurrently or in any way or sequence to such injury or damage. (2) Any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating or disposing of , or in any way responding to, or assessing the effects of, "fungi" or bacteria, by any insured or by any other person or entity. C. Broad Form Additional Insured The following is added to C.Who Is An Insured: 1. Each of the following is also an insured: Any person or organization with whom you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your policy under SECTION II - LIABILITY'. Such person or organization is an additional insured only with respect to liability for"bodily injury" or"property damage"caused by an "occurrence"first taking place after the effective date of the contract, agreement or permit, and caused in whole or in part, by: a. Your ongoing operations performed for that person or organization, "your product," or premises owned or used by you; however this provision does not include any architects, engineers, or surveyors with respect to any injury or damage arising out of the rendering or failure to render any professional services by or for you, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. - b. Your maintenance, operation or use of equipment, other than aircraft, "auto" or watercraft, rented or leased to you by such person or organization. A person or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such rented leased equipment ends. With respect to the insurance afforded to these additional insureds,this insurance does not apply to any"occurrence"which takes place after the rental agreement or equipment lease expires. c. "Bodily injury" or"property damage" arising out of"your products"which are distributed or sold in the regular course of that person's or organization's business, however the insurance afforded • that person or organization does not apply to: (1) "Bodily injury" or"property damage"for which that person or organization is obligated to pay damages by reason of the assumption of liability in a contract or agreement; however this exclusiondoes not apply to liability for damages that person or organization would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by that person or organization; - SM 04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 8 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc.All Rights Reserved. May not be copied without permission. T (4) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspections, adjustments, tests or servicing as that person or organization has agreed to make or normally undertakes to make in the usual course of . business in connection with the sale of the product; or (6) Products which, after distribution or sale by you, have been labeled or re-labeled or used as a • container, part of ingredient of any other thing or substance by or for that person or organization; however this insurance does not apply to any insured person or_organization, from who you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. the coverage afforded to an additional insured under this Paragraph 3. is subject to the following: a. The Limits of Insurance provided will be the lesser of: _ (1) The Limits of Insurance shown in the Declarations;or (2) The Limits of Insurance you are required to provide under the written contract, written agreement or written permit. b. This coverage will be excess with respect to the person or organization included as an additional insured by its provisions; any other insurance that person or organization has will be primary with respect to this insurance, unless this coverage is required td be primary and not contributory in the written contract, written agreement or written permit. c. This coverage does not apply unless the written contract or written agreement has been executed (executed means signed by the named insured and additional insured) or written permit issued prior to"occurrence"giving rise to the "bodily injury"or"property damage". D. Waiver of Transfer of Rights Against Others To Us The following is added to Paragraph K. Transfer Of Rights Of Recovery Against Others To Us in SECTION III—COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization because of payments we make under SECTION II — LIABILITY for injury or damage arising out of your ongoing operations or "your work" done under a contract with a person or organization and included in the "products- completed operations hazard", provided the contract is effective prior to the `occurrence" giving rise to the injury or damage. All other terms and conditions of the policy remain unchanged. - SM'04 04 01 18 Includes copyrighted material of Insurance Services Office, Inc. Page 9 of 9 with its permission.©2018 Blackboard U.S. Holdings, Inc.All Rights Reserved. May not be copied without permission. Rogue Valley Backflow Service Erin Akers LCB#15844 OHD#5438 717W1st St Phoenix,OR 97535 (541)482-9464 e-mail: backflow(a7_mail.com April 19, 2019 To: City of Ashland To whom it concerns, The charge for a backflow ass.embly test is $25.00 per assembly. As a general rule for our continuing customers, we do not charge a repair labor fee for `typical' repairs when done at the time of testing. The cost of the average repair part is included with the invoice. The most common parts are valued at around $12.00-$50.00. In addition,service calls outside of the testing schedule will be charged at a rate of$40.00 flat or $50.00 per hour when time spent exceeds 1(one) hour. If, in testing and /or repair, the cost exceeds the usual, an authorizing representative of the city is contacted before incurring such expense for approval and direction to proceed. Please feel free to contact me with any questions or if further information is needed. Thanks, Erin Akers, Owner/Operator Rogue Valley Backflow Service Rogue Valley Backflow Service Erin Akers LCB#15844 OHD#5438 717 W 1st St • Phoenix,OR 97535 (541)482-9464 e-mail: backflow@mail.com August 12, 2019 To: City of Ashland To whom it concerns, - Regarding the City of Ashland's Service Agreement General Liability Insurance requirement, I would like to request an exception. As the owner of Rogue Valley Backflow Service, my company currently carries $1,000,000 worth of Liability Insurance while providing backflow tests and repairs. During the process of performing these tests and in some circumstances doing repair work, incidents are extremely rare and-personal injury or property damage is almost unheard of. Please contact me if you have any questions or would like more information. Thank you, Erin Akers, owner/operator Rogue Valley Backflow Service 1 www.saif.com 111 Oregon Workers' Compensation Work. Certificate of Insurance sai Oregon. Certificate holder: CITY OF ASHLAND, CITY SHOPS 90 NORTH-MOUNTAIN AVENUE 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 issubject 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 Valley Backflow Service LLC United Insurance Agencies Rogue Valley Backflow Service United Insurance Agencies 717 W 1st St 54.1.242.6464 workerscomp@uiaoregon.com Phoenix, Or 97535-9787 Issued 08/07/2019 Limits of liability Policy 875425 Bodily Injury by Accident $500,000 each accident Period 09/01/2019 to 09/01/2020 Bodily Injury by Disease $500,000 each employee Body Injury by Disease $500,000 policy limit Description of operations/locations/special items All operations 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 )(2) C40>L-- Kerry Barnett President and CEO • 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.584.9812 ❑„rr,. ni rn rcAifirafaflflncl lranca