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HomeMy WebLinkAbout2023-140 PO 20240136- Bugs Northwest • Purchase Order pr4 Far CITY CORO Fiscal Year 2024 Page: 1 of: 1. 1g M 21 �anOS [ NTA"= B City of Ashland _ _—.+ �__ I ATM: Accounts Payable20 E. Main Purchase L Ashland, OR 97520. 1 Order# 20240136 T Phone: 541/552-2010 O Email: payable@ashland.or.us V H C/O Facilities Maintenance Div E BUGS NORTHWEST l 90 North Mountain Ave N 2027 SW G ST p Ashland,'OR 97520 . O GRANTS PASS, OR 97526 . 'Phone: 541/488-5358 • R T Fax: 541/552-2304 _��na_a�Ph�►e=�l_u�__n-fir�`=` x�,�i��-6e[���[�tf�i �_i�s, _- _.� ��, - ��tu �� ��.� �;_�_ --_ - s_ David Arnold mutifigtftwria PA: a b [I[Ba8 fl i [!I z` _ � 'JQ 09/22/2023 1287 FOB ASHLAND OR/NET30 City Accounts Payable - ert- dPrl On-call Pest Control 1 On-call Pest Control 1.0 $5,000.00 $5,000.00 Goods and Services Agreement($35,000 or Less) Completion date: 06/30/2024 S Project Account: *************** GL SUMMARY*************** 088400-602400 5 $5,000.00 • J • • r ` • ' i By: ` Date: A thorized Signature 5 000.00 FORM #3 CITY OF / ASHLAND A request for a Purchase Orderl CO REQUISITION I S I T I O N (71 % Date of request: 9/8/2023 Q pq _ Required date for delivery: • Vendor Name Bugs Northwest Address,City,State,Zip 2027 SW G Street, Grants.Pass, OR 97526 Contact Name&Telephone Number 541-472-5003, bugsnw.com.Jamie Heap Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Invitation to Bid 0 Emergency O Reason for exemption: Date approved by Council: 0 Form#13,Written findings and Authorization O AMC 2.50 _(Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached (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# ❑ Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington Date approved by Council: Contract# (Attach copy of council communication) 0 Other government agency contract Intermediate Procurement 0 Sole Source Agency GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 ❑ Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids and 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 and less 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) ❑ (3)Written proposals&solicitation attached 0 Form#9,Request for Approval 0 Annual cost to City exceeds$25,000,Council O Form#4,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: Valid until: (Date) iefesirref SERVICES Total Cost Pest Control FY24 as needed $5',000:00' ,. Item # Quantity Unit Description of MATERIALS Unit Price Total Cost 0 Per attached quotelproposal , TOTAL.COST Project Number: -_ _ _ Account Number: 088400-602400 $5,000x00 *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,t certify that the City's public contracting requirements have been satisfied. Employee: Department Head: i0 1.20.13 qual too i reater than$5,000) Department Manager/Supervisor: City Manager: (Greater th $35,001) Funds appropriated for current fiscal yea / NO i 1/ Finance Director-(Equal to djjjter than$5,000) gat 1 Comments: Form#3-Requisition GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Bugs Northwest CITY OF PROVIDER'S ASHLAND CONTACT: Jamie Heap 20 East Main Street Ashland,Oregon 97520 ADDRESS: 2027 SW G Street Telephone: 541/488-5587 Grants Pass, OR 97526 Fax: 541/488-6006 PHONE: 541-472-5003 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland,an Oregon municipal corporation(hereinafter"City")and Bugs Northwest,(a domestic/foreign business corporation) ("hereinafter"Provider"), for wildlife management. 1. PROVIDER'S OBLIGATIONS 1.1 Provide wildlife management services for FY24 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder, a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 6: Goods and Services Agreement between the City of Ashland and Bugs Northwest • 1.3 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $25,335.05 or more, Provider is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage,as defined in that chapter, to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Provider is also required to post the notice attached hereto as "Exhibit A"predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them,and the approval by the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective 6/1/2022 as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$5,000 (this is maximum, not to exceed amount of ENTIRE Agreement) without express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any 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. Page 2 of 6: Goods and Services Agreement between the City of Ashland and Bugs Northwest 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. 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue, and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred, as appropriate, so as to effectuate this choice of venue. 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees, contractors, or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God, strikes, lockouts, accidents, or other events beyond the control of the other or the other's officers, employees or agents. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the Goods.Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects, fraud, and warranties. 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor, material and manufacture. Provider shall transfer all warranties to the City. Page 3 of 6: Goods and Services Agreement between the City of Ashland and Bugs Northwest 4. SUPPORTING DOCUMENTS 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" • The Provider's complete written Rate Sheet dated June 1, 2022. 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including,but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2024, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30) days' prior written notice, terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement, with cause, by not less than fourteen (14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: Page 4 of 6: Goods and Services Agreement between the City of Ashland and Bugs Northwest If to the City: City of Ashland—Facilities Maintenance Department Attn: David Arnold 20 E. Main Street Ashland, Oregon 97520 Phone: (541) 552-2292 With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541)488-5350 If to Provider: Bugs Northwest Attn: Jamie Heap 2027 SW G Street Grants Pass, OR 97526 541-472-5003 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant containedin this Agreement shall not be construed as a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider, for a period of no fewer than six (6) calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. Page 5 of 6: Goods and Services Agreement between the City of Ashland and Bugs Northwest 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: Bugs Northwest (PROVIDER): By: By: Signature Signature Printed Name Printed Name Title Title Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Bugs Northwest 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: Bugs NorthwesL(FRO : By: By: / ;ft-- Signature ftSi nature Stoll" `"- J Printed Name UPrinted Name p tr .notio.5 Ot cr .1/fired TitleTitle et- 20. 23 eq— 7-7 d z3 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. 0 7=116I� l� • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Bugs Northwest • AR® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) osro7/2023 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 pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). — CONTACT Chris Grider PRODUCER NAME: Siskiyou Insurance Marketplace.Inc. • rat o.Ext,: (541)479-6672 FAX No): (541)474-6632 704 Sw 4th Street ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Grants Pass OR 97526 INSURER :SAIF INSURED INSURER 8: Green Line Corporation INSURER C: DBA;Bu INSURER D: 5 W G Street INSURER E: Grants Pass OR 97526 INSURER F: . . COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP UNITS LTR TYPE OF INSURANCE IN•D I POLICY NUMBER JMM!DD/YYYYI JMMIDDIYYIIL COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ O CLAIMS-MADE OCCUR DAMAGE PREMISES(Fa occurrence) $ MED EXP(Any one person) $ . — PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY n jE& n LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY (Ea aE Een SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-O MVED PROPERTY DAMAGE $ AUTOS ONLY _- AUTOS ONLY (Per accident) $ UMBRELLA LIAR I OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY STATUTE ER A OFFICERR/MMEMBERREXCCLUDED? c�� Y❑ NIA N 747737 04/01/2023 04/01/2024 E.LFACHACCIDENT $ 500,000 (Mandatory lnNH) EL DISEASE-EA EMPLOYEE$ 500.000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEFECLES(ACORD 101,Additional Remarks Schedule,may ha attached If more space lx required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7HE EXPIRATION DATE 'THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND ACCORDANCE WITH 7HE POLICY PROVISIONS. 20 E.MAIN ST. AUTHORIZED�Ap REPRESENTATIVE - I Ashland OR 97520 Fax: Email: 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (INCLUDING COMPLETED OPERATIONS) AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The insurance provided by this endorsement shall not serve to increase our limits of insurance as described in SECTION III-LIMITS OF INSURANCE. A. SECTION II—WHO IS AN INSURED is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for: 1. "Bodily injury","property damage"or"personal and advertising injury"caused,in whole or in part,by: a. Your acts or omissions;or b. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for that additional insured;and 2. "bodily injury", "property damage" included in the "products-completed operations hazard" with respect to "your work" performed for that additional insured. B. Only with respect to the insurance afforded to any additional insureds by this endorsement, paragraph 4. Other Insurance, subparagraph a.Primary Insurance of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to read as follows: This insurance shall be considered primary if any other valid and collectible insurance is available to any person or organization included as an additional insured under this endorsement and such other insurance shall be excess of and will not contribute to the insurance afforded by this endorsement C. Only with respect to the insurance afforded to any additional insureds by this endorsement, paragraph 8.Transfer Of Rights of Recovery Against Others To Us, of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: We will waive any right of recovery we may have against any person or organization added as an additional insured under the terms of this endorsement against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for "bodily injury" or"property damage" arising out of your ongoing operations or"your work" included within the products completed operations hazard done under a contract or agreement with that person or organization." ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. SGL 0070 00050 12 22 Page 1 of 1 ,4 R e CERTIFICATE OF LIABILITY INSURANCE 9f7/ 3D"""") 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 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 LIPCA Inc. CONTACT LIPCA, Inc. PO Box 80663 PHONEFAX Baton Rouge,LA 70898 (NC.L.Ess); (225)927-3283 WC,No):(225)927-3295 ADDRESS: info@Iipca.COm INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A: Accelerant Specialty Insurance Company 16890 INSURED Green Line Corporation INSURER B: Bugs Northwest INSURER C: 2027SWGSt Grants Pass,OR 97526 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 67337 REVISION NUMBER: 20230910 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. . IFF POUCY EXP LTRR TYPE OF INSURANCE OS LR SUERyPOLICY NUMBER ./M POLICY DE/YYYYUMMIDDIYYYYL, UNITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE I O REN fbD 100,000 ii COMMERCIAL GENERAL LIABILITY I/ ✓ LIP00070PK000273-00 9/10/2023 9/10/2024 PREMISES(Ea occurrence) $ _ CLAIMS-MADE n OCCUR MED EXP(Any one person) $ 5,000 A V Deductible 1,000 PERSONAL 8,ADV INJURY $ 2,000,000 4' "Pollution Liability included at policy limits GENERAL AGGREGATE $ 4,000,000 GEN-'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG_ S 4,000,000 VIPOLICY n JPG7 n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE UMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ — ALL OWNED —SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) S UMBRELLA UAB _ OCCUR EACH OCCURRENCE _ $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY YIN PER STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 1 1 N!A EL EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under • DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Pest and Wildlife Services City of Ashland is included as an additional insured including waiver of subrogation on a primary&non-contributory basis with respect general liability per endorsements S GL 0070 00008 12 22..&S GL 0070 00050 12 22.when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Ashland 20 E.Main St SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ashland,OR 97520 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ACORD 25(2014/01) ©1988-2014ORD C RPOR ON.All rights reserved. The ACORD name and logo are registered marks of ACORD • CC/DEBBRA DERENSKI Pi70LI9E11/UE` ' 205 NW E ST COMMERCIAL GRANTS PASS,OR 97526 Named insured Policy number: 952679404 Underwritten by: Artisan and Truckers Casualty Co DAVID A MAYS • Auout 10,2023 BUGS NORTHWEST Policy Period:Sep 29,2023-Sep 29,2024 2027 SW G ST Page 1 of 3 GRANTS PASS,OR 97526 agent.progressive.com Online Service Make payments,check billing activity,print policy documents,update your policy or • check the status of a claim. Commercial Auto 1-541-479-0362 Insurance Coverage Summary CC/Contact youurragenntfNSKI or personalized service. This is your Renewal 1.800-444-4487 For customer service if your agent is Declarations Page unavailable or to report a claim. This Renewal Declarations Page is effective only if the minimum amount due to renew your policy s received or postmarked by September 29,2023. Your coverage begins on September 29,2023 at 12:01 an. This policy expires on September 29,2024 at 12:01 a.m. Your insurance policy and any policy endorsements contain a full explanation of your coverage.The policy limits shown for an auto may not be combined witi-the limits for the same coverage on another auto,unless the policy contract allows the stacking of limits. The policy contract is form 6912(02/19).The contract is modified by forms 28520R(02/19),16520F(02/19),5701 (02/19),48520R (02/19),488108(02/1S)and Z228(01111 . The named insured organization type is a soie.proprietorship. • Outline of coverage Description Limits Deductible Premium Liability To Others $3,558 Bodily Injury Liability $250,000 each person/$500,000 each accider Property Damage Liab:lity $100,000 each accident Uninsured/Underinsured Motorist $250,000 each person/$500,000 each accident 425 Uninsured Motorist Property Damage $200 193 See Auto Coverage Schedule Limit of liability each accident less deducible $300 hit&run Persona!Injury Protection 249 See Auto Coverage Schedule Limit of liability each person less deductible Medical Payments Rejected Comprehensive 549 See Auto Coverage Schedule Limit of liability less deductible Collision 1,199 See Auto Coverage Schedule Limit of liability less deductible Total 12 month policy premium $6,173 Rated drivers 1. DAVID A MAYS .... ...... 2. RICKY D DOWNES 3. ELIAH DINURLORANGER ConttnN Form 6480 OP(04.201 Policy number: 952679404• DAVID A MAYS r Page 2 of 3 Auto coverage schedule 1. 2010 FORD RANGER Stated Amount:* $8,300(including PermanentiyAttached Equip) ViN: 1FTKR1AD4APA35512 Garaging Zip Code:97526 Radius: 100 miles Personal use:N Body type:Pickup Truck Liability UMMIM UM PD UM PD PI? PIP PIP Liability Premium Premi,:m Limit Premium Limit Deductibie Premium Premium 3590 $81 520,000 535 $15,000 $0 $44 camp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total • Premium 5100 $81 $500 $158 $1,089 • 2. 2009 FORD RANGER Stated Amount:* $8,300(including Permanently Attached Equip) VIN:1FTYR10D39PA51076 Garaging Zip Code:97526 Radius: 100 miles Personal use:N Body type:Pickup Track • Liability UMNIM UM PD UM PD PIP PIP PIP Liability Premium Premium Limit Premium Limit Deductible Premium _ Premium $690 $81 $20,000 $35 $15,000 $0 $41 comp Comp collision collision Physical Damage Deducible Premium Deducible Premium Auto Total Premium 5100 $79 $500 $152 $1,078 3. 2009 FORD RANGER Stated Amount:* $8,300(including Permanently Attached Equip) molimmila VIN:1FTYR10D99PA54631 Garaging Zip Code:97526 Radius: 100 miles Personal use:N Body type:Pickup Track n liability UMIIJIM UM PD UM PD PiP PIP PIP Liability Premium Premium Unlit Premium Uma Deductible Premium o - v = Premium $690 $81 $20,000 $35 $15,000 $0 $410 o - 1 . Camp Comp Collision Collision o Physical Damage Deducible Premium Deducible Premium Auto Total - _ Premium $100 $79 $500 $152 $1,078 0 4. 2009 FORD F150 Stated Amount:"$10,800(including Permanently Attached Equip) o MINNOW VIN:1FTPF14889KB71843 Garaging Zip Code:97526 Radius: 100 miles o YC Personal use:N Body type:Pickup Truck o lability UMJIJIM UM PD UM PD PIP PIP PIP ¢ C Liability Premium Premium Uma Premium Lima Deductible Premium — Premium 3534 $81 $20,000 $41 $15,000 $0 $41 Comp camp Collision Collision Physical Damage Deductible Premium Deducible Premium Auto Total Premium $100 $109 $500 $198 $1,104 5. 2018 NISSAN NV Actual Cash Value(plus$2,000.00 Permanently Attached Equip) VIN:SBZAFOAAOJN850919 Garaging Zip Code:97525 Radius:200 miles Personal use:Y Body type:Cargo Van Liability UMNIM UM PD UM PD PIP PIP ?IP Liability Premium Premium Limit Premium Limit Deducible Premium Premium $854 $101 $20,000 $47 $15,000 SO $82 Como Comp Collision Collision Physical Damage Deducible Premium Deducible Premium Auto Total Premium $500 $201 $500 $539 $1,824 El continued Form 5489 OP(04.20) • POLICY NUMBER: LIP00070PK000273-00 COMMERCIAL GENERAL LIABILITY SGL 0070 00008 12 22 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: COMMERCIAL GENERAL LIABILITY COVERAGE PART • SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s)Of Covered Operations City of Ashland 20 E. Main St Ashland,OR 97520 All Locations Per Written Contract Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s). shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed;or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. S GL 0070 00008 12 22 ©Insurance Services Office, Inc.,2012 Page 1 of 2