Loading...
HomeMy WebLinkAbout2023-127 PO 20240091- RH2 Control Systems NW _ V Purchase Order Fri CITY R F E VMS6 ._ ' Fiscal Year 2024 Page: 1 of 1 B City of Ashland Q - LATTN:Accounts Payable20 E. Main Purchase Ashland, OR 97520 Order# 0240.091 T Phone: 541/552-2010 • 0 Email: payable@ashland.or.us V RH2,CONTROL SYSTEMS NW H C/O Public Works Department E 22722 29TH DRIVE SE l 51 Winburn Way N STE 210 p Ashland, OR 97520 - 0 BOTHELL,WA 98021 • Phone: 541/488-5347 R Email: AP@RH2.COM T Fax: 541/488-6006 i 6141•mbe aLF7 � 19"�i$ E 1 tS� C i �; 4 i,, T ------- mi,- -- Scott Fleury D Df 6r@II-= �r=A r tea eatiOmui .Ian 08/21/2023 • 4978 FOB ASHLAND OR/NET30 City Accounts Payable-WOW olohy) _ tt SCADA Services W P 1 On-call SCADA Integrator services to support the Water 1.0 $20,000.00 $20,000.00 Treatment Plant • Personal Services Agreement(Less than $35,000.00) •. Completion date:. 06/30/2024 ' Project Account: * «** *********GL SUMMARY*************** • • 081900-604100 $20,000.00 ' • • • • • • • � e • By: Date: 0 i:7/17 £ .7. -„ Authorized Signat e .20 000.00 • FORM #3 CITY OF A request for a Purchase .i,r d $�e , q / ASHLAND REQUISITION � Date of request: 08108/2023 Vendor Name Northwest Control Systems LLC DBA RH2 Control Systems NW Address,City,State,Zip 22722 29th Drive SE Bothell,WA 98021 Contact Name Eric Summers Telephone Number 425-951-5338 Email address esummersta�.rh2.com SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ 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 0 Request for Proposal (Copies on file) Cooperative Procurement Less than$5,000 0 State of Oregon Date approved by Council: ❑ Direct Award Contract# _(Attach copy of council communication) 1=1VerbalMritten quote(s)or proposal(s) 1=1State of Washington Intermediate Procurement 0 Sole Source Contract# GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) 0 Other government agency contract $5,000 to$100,000 0 Written quote or proposal attached Agency 0 (3)Written quotes and solicitation attached 1=1Form#4, Personal Services$5K to$75K Contract# PERSONAL SERVICES 0 Special Procurement Intergovernmental Agreement $5,000 to$75,000 0 Form#9,Request for Approval ❑ Agency. ■ Less than$35,000,bydirect appointmentDate original contract approved by Council: ❑ pp 0 Written quote or proposal attached Date 111 (3)Written proposals/written solicitation Date approved by Council: (Date) 0 Form#4, Personal Services$5K to$75K Valid until: _ _ (Date) —(Attach copy of council communication) Description of SERVICES Total Cost , r` ;:$'20';00,0:0:0'..:',-.4j - On-call SCADA Integrator services to support the water treatment division : Item # Quantity Unit Description of MATERIALS Unit Price Total Cost .TOTAL COST 1 ❑■ Per attached quote/proposal $: Project Number Account Number 0 8 1 9 0 0.6 0 4 1 0 0 $_,_ 2 0,0 0 0 0 0 a_s3 j `' IL. i, '°; Project Number - _ _ Account Number • $_,_ _ _,_ _ _•- - Project Number _ _ _ Account Number - $_,- - -,_ _ _•_ _ *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: , IT Director Date Support-Yes/No By signing this requisition form,II certify ythat the City's public contracting requirements have been satisfied. Employee:\IG 7 iO.€#/ rhaA - amiecoDepartment Hea -i qu. to. areaterthan$5,000) Department Manager/Supervisor: City Administrator: 'qua o or greater than$25,000) , Funds appropriated for current fiscal year: YE / NO t Deputy Finance Director-(Eq to greater than$5,000) Date Comments: Form#3-Requisition PERSONAL SERVICES AGREEMENT (LESS THAN $35,000.00) CONSULTANT: Control Systems NW,LLC CITY OF -ASH LAND CONSULTANT'S CONTACT: Eric Summers 20 East Main Street ADDRESS: 22722 29th Drive SE, Suite 210 Ashland,Oregon 97520 Bothell,WA 98021 Telephone: 541/488-5587 Fax: 541/488-6006 TELEPHONE: 425.951.5338 EMAIL: esummers@rh2.com This Personal Services Agreement(hereinafter"Agreement")is entered into by and between the City of Ashland, an Oregon municipal corporation(hereinafter"City")and Control Systems NW,LLC,a foreign limited liability company ("hereinafter"Consultant"),for on call SCADA services. NOW THEREFORE, in 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 sooner terminated 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 06/30/2024. 2. Scope of Work: Consultant will provide on call SCADA services for the Water Treatment division which is attached hereto as"Exhibit A"and incorporated herein by this reference. Consultant's services are collectively referred to herein as the"Work." 3. Supporting Documents/Conflicting Provisions: This Agreement and any exhibits or other supporting documents shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the exhibits or supporting documents. 4. All Costs Borne By Consultant: Consultant shall,at its own risk end expense,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. 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. Page 1 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND CSNW. 6. Compensation: City shall pay Provider for its Work at the hourly rates as set forth in Exhibit"B"(CSNW 2023 SCHEDULE OF RATES AND CHARGES, which is attached hereto and incorporated herein by this reference,as full compensation for Provider's performance of all Work under this Agreement. In no event shall Consultant's total of all compensation and reimbursement under this Agreement exceed the sum of$20,000(twenty 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 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 Work product or 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 hereby assigned to the City.All reuse not occurring as part of this work shall be without liability to the Consultant. 8. Statutory Requirements: The following 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, and agents harmless from any and all losses,claims,actions, costs, expenses,judgments,subrogations, 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 to the extent arising out of the negligent 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,claims,subrogations, actions, costs,judgments, or other damages,caused solely by the 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 30 days' prior written notice delivered by certified mail or in person. 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 be 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; ii. 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 Page 2 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND CSNW. 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(15) 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 each and 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 services 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. e. Obligation/Liability of Parties. Termination or modification of this Agreement pursuant to subsections a, b,or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However,upon receiving a notice of termination(regardless whether such notice is given pursuant to Subsection a,b, c, or d of this section, Consultant shall immediately cease all activities under this Agreement,unless expressly directed otherwise by City in the notice of termination.Further,upon termination, Consultant shall deliver to City all Agreement documents,information, works-in-progress and other property that are or would be deliverables had the Agreement been completed. City shall pay Consultant for Work performed prior to the termination date if such Work was performed in accordance with this Agreement. 12. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City for any purpose. Consultant shall have the complete responsibility for the performance of this Agreement. Consultant shall provide workers'compensation coverage as required in ORS Chapter 656 for all persons employed to perform Work pursuant to this Agreement. Consultant is a subject employer that will comply with ORS 656.017. 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. Consultant shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them,and the approval by City of any assignment or subcontract of the Work shall not create any contractual relation between the assignee or subcontractor and City. • 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 regular basis of the type identified in its obligations under the Agreement; or attempts to assign rights in, or delegate duties under,this Agreement. 15. Insurance. Consultant shall, at its own expense,maintain the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017,which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. Professional Liability insurance with a combined single limit,or the equivalent, of not less than$2,000,000 (two million dollars)per claim. This is to cover any damages caused by error, omission or negligent acts related to the professional services to be provided under this Agreement. "Tail"coverage will be required at the completion of the Work under this Agreement for the remaining Term,for not less than twenty-four(24) Page 3 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND CSNW. months following completion of all Work,provided that the continuous"claims made" coverage has a retroactive date on or before the Effective Date of this Agreement. c. 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,Death, and Property Damage. d. Automobile Liability insurance with a combined single limit,or the equivalent,of not less than$1,000,000 (one million dollars)for each accident for Bodily Injury and Property Damage,including coverage for owned, hired or non-owned vehicles, as applicable. 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 30 days' prior written notice from the Consultant or its insurer(s)to the City. f. Additional Insured/dertificates 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 prior to commencing the Work under this Agreement. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested,complete copies of insurance policies;trust agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions,and/or self-insurance. 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: 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 (iii) Any rules,regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. Page 4 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND CSNW. 18. Governing Law; Jurisdiction; Venue: This Agreement shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action,suit or proceeding(collectively, "the claim") between the City and the Consultant that arises from or relates to this Agreement shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however,the claim must be brought in a federal forum,then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Consultant, by its signature hereon of its authorized representative, hereby consents to the in personam jurisdiction of said courts. 19. THIS AGREEMENT AND THE ATTACHED EXHIBITS CONSTITUTE THE ENTIRE UNDERSTANDING AND AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT,MODIFICATION OR CHANGE OF TERMS OF THIS AGREEMENT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER,CONSENT,MODIFICATION OR CHANGE,IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS,AGREEMENTS,OR REPRESENTATIONS, 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. 20. Amendments. This Agreement may be amended only by written instrument executed by both parties with the same formalities as this Agreement. 21. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this Agreement within the City's fiscal year budget. Consultant understands and agrees that City's payment of amounts under this Agreement attributable to Work performed after the last day of the current fiscal year is contingent on City appropriations,or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion,to continue to make payments under this Agreement. In the event City has insufficient appropriations,limitations or other expenditure authority, City may terminate this Agreement without penalty or liability to City, effective upon the delivery of written notice to Consultant,with no further liability to Consultant. Page 5 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND CSNW. 22. Certification. Consultant shall sign the certification attached hereto as"Exhibit C"and incorporated herein by this reference. CITY OF ASHLAND: CONTROL SYSTEMS NW LLC (CONSULTANT): By: By: Signature Se+eCrtfft52y Richard L.Ballard Printed Name Printed Name 13,14..23 Director Date Title 8/16/2023 Date Purchase Order No. /( q( (W-9 is to be submitted with this signed Agreement)_ Page 6 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND CSNW. EXHIBIT A City of Ashland Personal Services Scope of Work On-Call Instrumentation and Control System Integrator Services August 2023 In accordance with the terms and conditions of the General Services Agreement, Control Systems NW, LLC(CSNW)will provide Supervisory Control and Data Acquisition(SCADA)maintenance services for the City of Ashland's water treatment system. CSNW will furnish labor, materials, and software support on an on-call basis, as needed, or under authorized work orders. Services that may be performed as an element of this General Services Agreement may include but are not limited to the following. • Administer project records and coordinate with the CSNW project team. • Provide emergency support services on an "as requested" basis for the duration of the contract. • Provide services upon request for the installation, modification, and maintenance of the control system equipment. • Provide coordination, programming, configuration,testing, startup, and training services. CSNW will rely upon the accuracy and completeness of information, data, and materials generated or produced by the City of Ashland or others in relation to this Scope of Work. 1 8/14/2023 12:04:21 PM\\corp.rh2.com\dfs\ControlSystemsNW\Operations\Data\COA\COAWF\C23OXXX.00\00 Contract\PSA_SOW WF Instrumentation and Control Sys Integrator.docx Exhibit A CSNW 2023 SCHEDULE OF RATES AND CHARGES RATE LIST RATE UNIT Professional I $162 $/hr Professional II $176 $/hr Professional III $198 $/hr Professional IV $216 $/hr Professional V $229 $/hr Professional VI $247 $/hr Professional VII $263 $/hr _Professional VIII $275 $/hr Professional IX $275 $/hr Technician I $124 $/hr Technician II $137 $/hr Technician III $154 $/hr Technician IV $169 $/hr Technician V $183 $/hr Technician VI $201 $/hr Technician VII $218 $/hr Technician VIII $228 $/hr Control Specialist I $162 $/hr Control Specialist II $176 $/hr Control Specialist III $198 $/hr Control Specialist IV $216 $/hr Control Specialist V $229 $/hr Control Specialist VI $247 $/hr Control Specialist VII $263 $/hr Control Specialist VIII $275 $/hr Control Specialist IX $275 $/hr Control Technician I $124 $/hr Control Technician II $137 $/hr Control Technician III $157 $/hr Control Technician IV $169 $/hr Control Technician V $183 $/hr Control Technician VI $201 $/hr Control Technician VII $218 $/hr Control Technician VIII $228 $/hr Administrative I $83 $/hr Administrative II $97 $/hr Administrative III $114 $/hr Administrative IV $137 $/hr Administrative V $160 $/hr CAD/GIS System $27.50 $/hr CAD Plots-Half Size $2.50 price per plot CAD Plots-Full Size $10.00 price per plot CAD Plots-Large $25.00 price per plot Copies(bw)8.5"X 11" $0.09 price per copy Copies(bw)8.5"X 14" $0.14 price per copy Copies(bw)11"X 17" $0.20 price per copy Copies(color)8.5"X 11" $0.90 price per copy Copies(color)8.5"X 14" $1.20 price per copy Copies(color)11"X 17" $2.00 price per copy Technology Charge 2.50% %of Direct Labor price per mile Mileage $0.6550 (or Current IRS Rate) Subconsultants 15% Cost+ Outside Services at cost Rates listed are adjusted annually. FXHTRTT R CITY OF ASHLAND, OREGON City of Ashland LIVING ALL employers described IJVAG E below must comply with City of Ashland laws regulating payment of a living wage. $18.12 per hour, effective June 30,.2023.: • The Living Wage;isLadjusted annually every June 30,by the Consumer Price Index. Employees must be paid a portion of business of their of health care, retirement, living wage: employer, if the employer has 401K and IRS eligible ten or more employees,and cafeteria plans (including has received financial childcare)benefits to the For all hours worked under a assistance for the project or amount of wages received by business from the City of the employee. service contract between their Ashland in excess of employer and the City of $25,335.05. > Note: For temporary and Ashland if the contract part-time employees,the exceeds$25,335.05 or more. > If their employer is the City of Living Wage does not apply For all hours worked in a Ashland, including the Parks to the first 1040 hours worked and Recreation Department. in any calendar year. For month if the employee spends more details, please see 50%or more of the > In calculating the living wage, Ashland Municipal Code employee's time in that month employers may add the value Section 3.12.020. working on a project or For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,20 East Main Street,Ashland, OR 97520, or visit the City's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND EXHIBIT C 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 it is no longer subject to backup withholding. Consultant further represents and warrants to City that: (a)it has the power and authority to enter into 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 local 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 Oregon 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. RLB (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. RLQ (2)Commercial advertising or business cards or a trade association membership are purchased for the business. RLB (3)Telephone listing is used for the business separate from the personal residence listing. RLB (4)Labor or services are performed only pursuant to written contracts. RLB (5)Labor or services are performed for two or more different persons within a period of one year. (6)Consultant assumes financial responsibility for defective workmanship 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. 8/16/2023 Consultant Date A` ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 06/30/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(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 Jona Bolin NAME: Sammamish Insurance,Inc. PHOA/C,NE No,Eat): (425)898-8780 FAX No): (425)836-2865 704 228th Ave NE,PMB 373 E-MAIL JonaBolin@msn.com ADDRESS: • INSURER(S)AFFORDING COVERAGE NAIC# Sammamish WA 98074INSURERA: Ohio Security Insurance Company 24082 INSURED INSURER B: The Ohio Casualty Insurance Company 24074 Control Systems NW LLCINSURER C: Continental Casualty Company 20443 DBA: RH2 Control Systems NW INSURER D: 22722 29th Dr SE Ste 210 INSURER E: Bothell WA 98021 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2363004090 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD MID POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 1,000,000 DAMAGE CLAIMS-MADE n OCCUR PREM SESTORENTED (Ea occurrence) $ 1,000,000 MED ERCP(Any one person) $ 15,000 A Y BKS59861156 07/10/2023 07/10/2024PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY X PRO- 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: Stop Gap-WA $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y BAS59861156 07/10/2023 07/10/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X AUHIRED TOSONLY X AUTOSONNON-OWNELD PROPERTY DAMAGE (Per accident) $ Y $ X UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ 2,000,000 B EXCESSLIAB CLAIMS-MADE US059861156 07/10/2023 07/10/2024 AGGREGATE $ 2,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITYY/N STATUTE ER , A ANY PROPRIETOR/PARTNER/EXECUTIVE N/A XWS59861156 07/10/2023 07/10/2024 E.L.EACH ACCIDENT $ 1000,000 OFFICER/MEMBER EXCLUDED? - (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT__$ Per Claim $2,000,000 Professional Liability C Claims Made MCH591931734 07/12/2023 07/12/2024 Aggregate $2,000,000 Deductible $15,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Ashland,Oregon and its officials officers and employees are named as additional insured automatically where required by contract and coverage is Primary and Non-Contributory per CG8810 as respects General Liability. Project:Water Filtration Instrumentation&Controls Integrator CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ,deG,,, I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD