HomeMy WebLinkAbout2023-155 PO 20230222- Advanced Automatic Doors, LLC r
Purchase Order
CITYWet
EC
/MI Fiscal Year 2023 Page: 1 of: 1
B City of Ashland = 6 "t g��` ' lTr=r��ar � �t
_ _ _-
ATTN: Accounts Payable Purchase —�
L 20 E. Main 20230222
Ashland, OR 97520 Order#
T Phone: 541/552-2010
O Email: payable@ashland.or.us
E ADVANCED AUTOMATIC DOORS, LLC H C/O Facilities Maintenance Div,
NN 1750 DELTA WATERS RD l 90 North Mountain Ave
D STE 102 PMB371 P Ashland, OR 97520
OR MEDFORD, OR 97504 Phone: 541/488-5358
T Fax: 541/552-2304
` e c__.��"-x v h "fa h
.-:_ -be ��..._....__� V -.:".77Z-Zr''''may 3DinWriress�
David Arnold
ers7er ` °' ae ��� ?ehtifik� te _. _ Cp Vie` t=aatta
01/31/2023 7547 FOB ASHLAND OR/NET30 City Accounts Payable
Automatic Door Services
1 On-Call Automatic Door Service and Repairs' 1.0 $5,000.00 $5,000.00
Goods and Services Agreement($35,000 or Less)
Completion date: 06/30/2023
Project Account:
*************** GL SUMMARY***************
088400-602400 $5,000.00 '
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Authorized Signature Lov• '.5 000.00
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LFRmft3 . 'CITY OF
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A request forQ Ourchase. OITIG' ._ _., 7_ -•-•,2____L- '
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. REQUISITION ..- / "--0 , Dal&of eeque.sl.-• ,. 111-wo23.
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Required date for delivery
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Vendor Name AiiVanced AutOmatk:toms . . . _
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Address,City.i:40i6,-iip 1750 Deita_WAtca .OR 67509 .
Contact Name&Telephone Number -. " • .-1" da - - " - " " • ,
Eniataddiesi• ' ' Andy Cunnititwani,541424-:8188 advaneentoinalicdoors@omaii.6orri
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.SOURCING.METHOD
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El -Brehirit
from Competitive Cinllation to Bid ID Enei0efay --
El Reason for exemption. Dale approved by Council El Enpn#13:WrittOii findings and Atilhori#lich
El AMC. 2'.50' (Attact:COpy.of council coftirlitinication). Q VirrikeilAdOe'Oe proposal attached ' !
El.Written'tcL...roe lir:0'900 altaclied _ - (lfConncil:appAiVal-iiquired,-*106kCcik iii cc):
EL,Small Procurement:: . ID Rennettint:Pronosal •COOpefatitiiiiitictieement
Not exceeding$5,000 Date approved by Council: ; .0'State of
lEil Direct Award . ' (Attacti.Opy of council connunicatinn) . ' Cohlratt#,L
0 Verh4tMiiitim quote(s)or proposal(s) El Request for Qualifications(Public Works) 0 State.6f Washington
.
Date approved by Council: Contract Lit -
- .00 copy ef*kit communic.allg 0 o0*e:g0tite(nnieh'wicii,contract
Intermediate Procurement . .a SiiiiStitirce, .404.
GO 00S.8,SERVICES El -Alipli&able-Fotrh(#5;-6;7603) Contract it • .. ,
Greateitlian$5 000 and less than$100,000 • ID VVritlehqpi0 or proposal attached , Intetoierninentat Agreement
0 (3)ykkilten bids mind iblicItaliati attached r 0 Form#4,Personal Services s. i<to$751( Agency • ,
PERSONAL SERVICES Date approved bibkincil:: . _., _ El Annual cost to City does not exceed$25 GOD
,Greatfit than S5 000 and less $76A00. Valid unlit' •'010' •A01.0.6iiOntiliiiipted by fiootArio OrOciliiotud by
0 tes5#10.$35 000,by direct aOnintnieol . -P 'Siiklal Picibuiitnerit• OitVA:iiniiiijstratori*G2:50.1:404)
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El 0)141jitteIi pt0.4alikOialfaticlitt000,' 0 Forili#9,,Request fi(A0iiro0 , El1:iiiiiiialtosyprq6Deeds•$25,090,p1pneil
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ID :ROA Personal Services.$5Kta$7* D Written quote of.04pSal'ettiatied : approval reqnircd.(Altrich-cuNpf council-comritunibatiOn)
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.Degcripticin'olSERVICES . . . .Tot61 Cost
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Automatic Door service and 100%0
repair for ry23 : i .-, .
$.. 0:
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. itoti Ile :Quantity Unit Description airIVIATERIALS.:. . .. ,, . . .. -. . . .
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Per attached.c1(1001p70001 -1111tit'ALtiSer:
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Project Number: -- Account.Number 088400402400 . . . . .
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. TigichdIturc must be digrg0 lathe ep).30firiete,aticefint ouretielsp•rtliplinfinotals to*urefetylettest the Settrai extiendiltS-es.-
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IT,Diretehi. ellaboraticelVititti OepariOlefle to tP .' lit all hardware Oid•pgiliereperehdies; .. . ..
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:.-. • .:. .,: •Ir Dire . .'Date' Seppiert-,YesMa' •
By sighing this reg "" itomarige;; that.the CO' 6b/i6 atractirig requirements have satisfied.
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• ...•. Fin. c 0: iriktor,-( 4)0 to or-gare fbr than g0120) Date
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•FOri-O 07.134risitbri
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Kariann Olson
From: Accounts Payable
Sent: Thursday,January 26,2023 5:12 PM
To: Kariann Olson
Subject: RE:W9 Advanced Automatic Doors
Vendor 7547—Advanced Automatic Doors, LLC •
J
The vendor is ready for use!
Heather Rodriguez,Accounts Payable
City of Ashland
Finance Department
20 E Main St,Ashland, Oregon 97520
541-552-2010 I TTY 800.735.2900
Heather.rodriguez@ashland.or.us
Online ashland.or.us;social media (Facebook @CityOfAshlandOregon I Twitter @CityofAshland)
This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records Law for
disclosure and retention. If you have received this message in error, please contact me at 541-552-2010.
Original Message
From: Kariann Olson<kari.olson@ashland.or.us>
Sent:Thursday,January 26,2023 12:16 PM
To:Accounts Payable<payable@ashland.or.us>; Heather Rodriguez<heather.rodriguez@ashland.or.us>
Cc: Kariann Olson<kari.olson@ashland.or.us>
Subject:W9 Advanced Automatic Doors -
Hello Heather,
W9 fora P0.
$
Thank you. :)
Kariann (Kari)Olson, Purchasing Specialist
City of Ashland
Purchasing Office
90 North Mountain Avenue,Ashland, Oregon 97520
541:488.5354 I TTY 800.735.2900
Kari.olson@ashland.or.us
This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records Law for
disclosure and retention. If you have received this message in error, please contact me at 541.488.5354..
•
Original Message
From: noreply@ashland.or.us<noreply@ashland.or.us>
Sent:Thursday,January 26,2023 12:01 PM
To: Kariann Olson<kari.olson@ashland.or.us>
1 •
Subject: Message from "Electric156"
[EXTERNAL SENDER]
This E-mail was sent from "Electric156" (IM C3000).
Scan Date: 01.26.2023 12:00:47 (-0800)
Queries to: noreply@ashland.or.us
(
•
2
GOODS AND SERVICES AGREEMENT ($35,0QO OR LESS)
Advanced Automatic 13ocws
CITY 0 V ASHLAND 'l�OVID R'
CONTACT Andy Cunningham
20[East Main Street
Ashland,Oregon 97520
ADDRESS: 1750 Delta Waters Read,Suite 102 PMB 371 €€
Telephone: 541/4 -5587 fvledford,OR 97504
Fax: 541/488-6006
Pi JO' 1 541-324-8188
This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City nF
Ashland, an Oregon municipal corporation (hereinafter "City") and Advanced Automatic Boors, (a
domas€icff€reign business corporation){°`hereinafter`Provider"),for automatic door service-
1. PROVIDER'S OBLIGATIONS
1.1 Provide automatic door service and repair for FY23 as set forth in the"SUPPOT{TThGt DOCI1 FATS"
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 rio
waiver or extension of such deadline may he authorized except in the same manner as herein provided
for authority to exceed the maximum compensation. The services dcltnc d and described in the
"SIJPPORT'lNG DOC'JMFNTS"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 coinmercial general
liability insurance with a combined single limit, or the equivalen€ of not less than $2,000,100 (two
million dollars)per occurrence for Bodily Injury and Property Damage.
1.2.1 "l he 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
iability-
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
• Providershall 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.
piipx I c11-6: Goucts and Services Agn meEnt between the City of Ashiland and Advanced A E16E-natio Doors
1.3 Provider shall,at its own expense, maintain Wnrker's`Coinpensation Insurance in compliance with ORS •
656.017, which requires subject employers to provide worker. compensation coverage for all of its
subject workers.
IA 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, int ntal 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, miles 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 Linder ORS 200.055, in awarding subcontracts as required by ORS 2.7'9A,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 clthe Civil Rights Act of 1964 and other federal nondiscrimination laws.
1.6 Living Wage Requirements; If the amount of this Agreement is $22,310,461 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 Wolk under this Agreement mid to any Subcontractor who
perforins 50% or more of[he 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 assignrncnt 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 1/4/2023 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 Agreetncnt) 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 of icial 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 L ROVTSIi.)NS . •
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 cif6; Goods and Services Agreement between en the Cily t f Aslikeid aid Advaiic4d Attiolit#uic Doors
3.2 Provider is an independent contractor and not an employe()or agent of the City Ibr any impose,
3.3 Provider is not entitled to,and expressly waives all elaims to City benefits such as health and disability
insurance, paid leave,and retirement.
3.4 This Agreement embodies the lull and complete understanding of the parties respecting the subject
matter hereof. It supersedes afl 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.
16 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement;
ORS 279B 220,27913.230 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 Jaekson County unless exclusive jurisdiction is in federal court,
in which case exclusive venue shall he 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 oft iCers,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 limrid by a court of competent jurisdiction to he unenforceable,
such provision shall not ailed 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 1)eliveries will be P.0.13 destination.Provider shall pay all transportation and handling charges for the •
Goods.Provider is responsible and liable for loss or dianiaige until final inspection and acceptance of the
floods by the City. Provider remains liable for latent defects,fraud, and warranties.
3.12 'rile 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 iii 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 comitply, with SUPPORTING DOCUMENTS and be free from .
defects in labor,material and manufacture. Provider shall transfer all warranties to the City.
Pni.Le 3 lir& Gods and Services Agreement iletween the City of Ashland and Advanced Automatic I)ooi's
4. SUPPORTING DOCUMENTS
4.1 'Ilse following doeuinen.s are, by this reference, expressly incorporated in this Agreement, and arc
collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:"
w The Provider's complete written Rate Sheet dated.2023.
4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to he 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 con flicting provisions in any of
the SUPPORTINU I)OCtlivIENTS. In the event of conflict between provisions of two of the
SUPPORTING DOCUMENTS,the several supporting d€3cunients shall be given prccedcitee in the order
listed in Article 4.1.
5. REM EDI I+.:
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:
i 'Termination of th is 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 far damages, specific perlbrmance, or declaratory or
injunctive relief;
5.1.4 These remedies are cumulative to the extent the i-cincdics are not inconsistent,and City may pursue
any remedy or remedies singly,coilectively,Successively or in any eider whiiEmit;ver.
5.2 In no event shall City be liable to Provider lbr any expenses related to tcrmnination of this Agreement or
for anticipated profits. Il'previous amounts paid to Provider exceed the amount due,Provider shall pay
immediately any excess to City upon written demand provided.
6. 'll.'li;RM AND TERMINATION
6.1 Term
This Agreement shall be effective from the date of execution tan behalf clf the City as sot forth below
(the "Effective Bate"), amid shall continue in full force and effect Until June 30, 2023, unless sooner
terminated as provided in Subsection 6.2.
6.2 Termination
( 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 etjuity.
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 sot forth below:
If to the City: •
Pagc 4 of G: Ckxds and Services Agreement bciwcen ttiu City of Ashland and Advanced Automatic 1 moo's
City of Ashland—Facilities Maintenance Department •
Attn: David Arnold
20 H, ivlain Street
Ashland,Oregon 97520
Phone: (541)552-2292
With a copy to:
City of Ashland—Legal Department
20 R Main Street
Ashland,OR 97520
Phone:(541)488-5350
IfProvider:
Advanced Automatic Doors •
Attn: Andy Cunningham
541-324-8188
8, WAIVER OF f1REACII
One or more waivers or failures to object by either party to the other's breach of any provision,term,condition,
or covenant contained in this Agreement shall not be construed as at waiver of any subsequent breach,whether
or not of the same nature.
9. PROVIDER'S COMPLIANCE WITH TAX LAWS
9,] 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:
(1) All tax laws of the State of Oregon, including but not limited to ORS :m5,620 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 ORIS 305.620 and ORS
chapters 316, 317.,and 3I8;
(Ii) Any tax provisions imposed by a political St3bdivision ofthe 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 tltie 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 ofthis 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 01'62 Goads and Scrvitcs A.grceEncnt between the City of Ashland and Advanced Automatic Doors
•
IN WITNESS WHEREOF the parties have caused this Agreement to he signed in their respective names
by their duly authorized representatives as of lhu dates set forth below.
CITY OF ASHLAND: Advanced Automatic Door(PROVIIW12):
By: .......... ..........-- By: s'
attire Signaiui c
Scoff' Andrew Cunningham
Printed Na e Printed Na1ne
400e:ulL k)a tuts ..._.OICE P��.... Owner
Title • Title
01P1 1 1/2023
Date I)ate
•
(W-9 is to he submitted with this signed Agreement)
Purchase Order No.
Page 6 o(6: Goods and Services Agreement between the City of Astat nd grad Advanced Atafontatic Dorars
_ ___
. ••
•
err
Automatic Doors
• 541-324-Erma
fRDVIRNcEDRUTOMf TI DOOfE.NE 1"
2023 Rate Schedule
Mailing/shipping address:
1750 Delta Waters Rd.
STE 102 PM B 371
Medford OR 97504
Phone:541-314-8188
Labor Rate:$70.00 per hour. •
Emergency labor rate;S 105.00 per hour
Travel rate:$70,00 per hour,one way.Travel time will be grouped with other lobs if.possible.
Emergency travel rate:$105.00 per hour,from leaving shop to return to shop.
•
CERTIFICATION OF EXEMPTION FROM
WORKS tS' COMPENSATION INSURANCE REQUIREMENTS
COEtractur is exempt from the requirement to tibtoin workers compensation insurance under ORS
Chapter 656 for the following reason. Contractor is to initial the appropriate box as follows:
SOiJ' PROPRIETOR
(initials) • Contmetor is a sole proprietor,and
• Contractor has no employees,and
• Contractor will not hire employees or sliheonti'c'1Ctors to perform this contract.
CORPORATION- FOR PROFIT
(initials) • Contractor's business is incorporated;and
• MI.employees of the corporation are officers an[l directors and have a si]bsta31tia[ownership interest*in the
corporation,and
• All work will be peribrmu3 by the officers and dircelors;Contractor will not hire other employees or stlbConlraodors
to perform this contract,
CORPORATION-NONPROFIT .
(Frtitials) • Contractor's busiaeSS is ineorporated as a ao]lprufit corporation,and
■ Contractor has no employes;all work is perfbrnted by volunteers,sad
• contractor will not hire employees or subco11tractors to perfornt[his contract.
PARTNERSHIP
als) • Contractor is a partnership,and
• Contractor has no employees,and
• Ail work will he performed by the partners,Contractor vtli UM hire employees or subcontractors to perform this
contract,and
• Contractor is not engaged in work performed in direct connection with the construction,alteration,repair,
in]proveitlentt,ipoving or demolition of an iitlproveilteilt to real properly or appurtenances thereto.*
AMC LIM/T ED LIABILITY COMPANY
(initials) = GuntraCloris a l_Etll4C_liability Company,and
• Contractor has no employees,and
• All work will be performed by the ileenlbcrs;Contractor wilt not hire employees or subcontractors to perform tills
contract,and
• If Contractor has more than one member,Contractor is not engaged in work performed is&hrcei coE]nccti(n with the
construction,alteratkill,repair,improvement,moving or demo]iticnt of an improvement to real property or
appurtenances thereto.*T
l/ t. 4r 01/12/2023
i naturesffAlidtarizedSi her
(Signature ,� } (F}lite}
Andrew Cunningham
(Signer's Title
*NOTE: Under CMR413(•50-U50 a shareholder has a"substantial ownership°`interest if ttle shareholder owlts 10%o€-the
corporation,or if less than 80%is owned,the shareholder has ownership that is as least equal lu or greater than the average
percentage of ownership of all shareholders,
tindercertaincirottltla[ances partnerships and limited liability companies can claim an exempfkin even when perform 111P
construction work. The imgiiircn]ents for this exemption are complicated. Consult with City Attorney's Office before att.exeutpLien
request is accepted from a contractor who will pei{br f censtruCtion tVork,
HI SCOX Hiscox Insurance Company Inc.
Policy Number: P100.770.347.4
Named Insured: Advanced Automatic Doors LLC •
Endorsement Number_ 6
Endorsornont Effective: 12104/2022
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - AUTOMATIC STATUS
This endorsement modifies insurance provided under the fottowinct:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section It—Who Is An insured is amended
to include as an additional insured any per-
son{s} or organization(s) for whom you are
performing operations or leasing a premises
when you and such person(s) or organiza-
tion(s)have agreed in writing in a contract or
agreement that such person(s) or organiza-
tion(s) be added as an additional insured on
your policy. Such person or organization is
an additional insured only with respect to lia-
bility for"bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf:
t In the performance or your ongoing tipOra-
tions;or
2. in connection with your premises owned by or
rented to you.
A person's or organization's status as an addi-
tional insured under this endorsement ends
when your operations or lease agreement for
that additional insured are completed.
•
CGI-E5421 CW€02/14) Includes copyrighted material of Insurance Services Office,Inc.,with its Page I of I
permission,
•
4,ACG7RCERTIFICATE OF LIABILITY INSURANCE pAm omprrrYYE
.
oir1T12o2s
37'11$CERTIFICATE IS ISSUN3 AS A MAT-FR Or 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 TI-fE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT_ If the*RAH-oat*holder is an ADDITIONAL INSURED,the policy(ies)must he endorsed. if SUBROGATION IS WAIVED,subject to .
the Perms and conditions of the policy,certain policies may require 211 ontiorsonienL. A stalemeni vn this 4:ertlfie ite{toes not confer rights to the
certificate balder in Ilea,of GLICIt c3MEOrsoment(4
PRODUCER CONTACs John Marshall
NAME:
Valley InsumnCO PI{ONF -- ' I FAX
tli°1.1 Exi: (F41}74'1-'1533 1 L? L_.-_....-•--
SpringfieId,{7R 97477 hAD}3PO FIrA 194 E $1. : YaIlcylnSl7yt3hoo-colrt
Florio:(591)744-1513 Fax:( )— - ••- INSURER(SJ AFFORDLHG COUENAE.E I NAIL h
INSURER A: HiSCUXif3TISE
INSURED
INSURER a-
Advanced Ai gamalic Dame tLt:
INSURER C
Andrew Cunningham()BA rNsuREJiO-
1754 Della Waters Rd Ste 102PIAB 371
INSURER F;
Medford OR 4775414-
.. - ....... ........ INSURE:ii:
COVERAGES CERTIFICATE N1JMSEfi: REVISION HUMS ER:
TtII S IS TO CERTIFY THAT•TJIF:POLICIES{f1•INSURfoiCE Li:37m rnr-Low HAVF 1II FN IOSUI:1 1{) I Ht 1NSUID:4.1 NAMED nnovF roR THE POLI{:Y Rl':RJCJr)
INUlCArEU. ND!WI II-H 1ANOINO ANY HEDUIREMENI, It=tt i CAH CONDIrtON 01-ANT CON IHACT OR OTHER DOCUMENI'WI IH HEsPECF TO WHICH'4HIS i
CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIEED HEREIN IS SUBJECT TO ALL THE TERMS,
I°XC1 USIO 4iS AND CONDITIONS 01::mai P 1.I{:FE:R_L MITTS SI lOWN MAY HAVE!1{:F:N REDUCED 7iY :;
PAID C AI?MI .
IIiA S ITYPE OF INSURANCE. AUOLI r n POLICY ,'ae ICY EXP •
_TR3 , .�.,......_..,...., ,_ ,y . FOLICYNUMrdER ILIiv vl r.s.tmo7nron� IBM'S
A X COMMERCIAL SENEAALLIABSLETY A 4345795 1210412022 12104/2023:EACHOCGURRCNCC a 1,Q0D,O00
1[:I f.It3S•RSAUSITfl[J(:t;sJlt I ]Y.trum,sr c•D 501 1:0 100,000
rrtrr-1 tE•S+Ela ;ti;'IusxL—s
r-EDEXP(ii w arra weer xif a 5,{10 •
0
---...---•---- I • F£k�CT1ALBhtYJ1NJIJRY g 4,000.000
GENS ADORF.G4TF.C.UfIT AEC'IES PEN fiFNFRAI A{:;iRF[iATF 5 2,000,4700
X ruLlty PR0' A, �,000,OQ4
JCC: I I LOt PRODUCTS COMPIDP a
UIH6 :
_...,...,A,.... ..-. . ,.,.,.,..,.,...,,,..,,,,...........1...,.........._.. [:1,1d[liNr1J SNGLC L1h11 •5
AUTDMOBIe.F.[iABIL[TY I - -- ,
Sig arx;Nan:}
ANYAIND eaoiLl'NARY 'ea:1116U!1) a
ALL UMW 0 SCIcL•U[1L�u aK)UJLY INJURY 4r'ccaaotical) S
AUTOS ___,AUTOS
Uf1N•[JV.Wf-i] PJ1 f EReY r7A1.IUi-.
I!REDAUTOS, AU:OD Ms:m�yAr'1l1 5
3 1 I S
i r ? f L
I UMBRELLA L1,1113I OCCU;i +„ - TAM]OCCURRENCE s ,��
I EXCESS LIAO CI Aih!*.-'-PM F AtC H[-iiAlf: --I.-$---------
} ... --- - STATUTE o
i nFn I I NEWNrIDNS S
WORKERS emelt IiN 'LLADI SN NJ A E.L.fACH A(':f:f{1FNT Intl-.._..._...._......--____----.---.--
AND EMPLi}Y1:7CS'1L401UTY Y r N I �1
ANY PHI]PHILI Owl-WaI ML'R.iXLCIJ I.1VL ! S
U:I•IECR,1OldfCREXCLUDED? ; I
(Marrdnbary Its flBJ EL DISEASE-EA EMPLOYEES
N res.JIF oAR rirvl,:r -----
I7R[•.RIP1KIN DI:OPEI:ih, FUNS below «M EJ. i1ISFAEP-POI ICY TCIr $ _-
s
•
DESCRIPTION OF OPERATtQNSJE.00ATIONS tYE_HICLES 4ACORO le.AdJlllorarllnnarKc Sclicvlula,may ba atlaceraad Il mare 3pecu la cr,toIredl
City of Ashland is named as an additional insured '
c
CERTIFICATE HOLDER CANCELLATION
City of Ashland SI tDULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i
9D 14 Mountain Ave THE EXPiRgatUN DATE THEREOF, NOTICE WILL BE DELIVERED IN
AShland Ofi 97520 ACCORDANCE WITH THE POLICY PROVISIONS.
AUT}iDR1ZED R£PREBFNTATNE
Valley Insurance Associates Inc
Q1988-2014 ACORD CORPORATION. Ail rights reserved.
ACORD 25(2014$01) The ACORI3 name and logo are registered,marks of ACORD
StateIjr�ii
Slats ratite Mututt llulornoblie lhstirathce CaIMpany
O 2358 E160:31-1-0 Wit. VOL
lloommpton it.517022358 DECTARATtONS PA.GJ
PAQ0.i OF 2
NAMED INURED
ATE tri-n.+4.1 l: A POLICY f4uMRER S82 1064-A47-57B
wen the POLICY PEHiOD JUN 0S 2022 to JAN 172022
0UMNIkHEAM, MORIN 6 SAMAi1WA 12:01 A.tv1.Siarsdard'tame
"- 5527 S SHASTA AVE
EAGLE POIlil OR 97524-0514 STATE FARM PAYMENT PLAN NUM8;=F# -'
11 ar3B1 Et41b
AGENT
HORY WOW IN3URANOi_AGENCY INC
2419 AERO WAY STE 101
MEDFORD,OR 97.504-9789 . .
PHONE:( 41)772-1404
DO NOT PAY PREMIUMS SHOWN ON THIS PAISE.
IF AM AMOUNT 1S DUE,THEN A SEPARATE STATEMENT 1y ENCLOSED.
YOUR GAR
,a,vu.-r.. �'.'.vrn'^-u.ra.n.'..>: �7r�•� ,f..+o...++>,-..wr�:.,_,c.- ..��..«- -w,--^',tea ,,
a i -'•, �-Vr^' n',
2015 FURL 't HANS 150 VAN 1 FTNC-1 C:417FKA53304 I00F3011600
:rk.
A Coverage
..,,,,,..,.�M. . „ .. ...?1: ,: ry:.'Inl ,.r-
Each P0r50n Eae41 Aacidant
art, .-. �;.,..:
:..,.. ..._._. "il 1,1:x- ._ : rT... ...... ._... ... .. ,.i.�•w' v::�ti'�.., +-vaw.:e �anc.>'.w.r.+3. _._
r/a.'r°�,�r;`�'^ ,�•:.'ji i�:jl r�rw �w- .. !.�Q;M"::i.,<«.a,....>.« _.. .. ,.,... �:.....a..,e .. ���:z�C
Properly Damage Limit - -
$100..000
,z. }�„fta. �•I:�:.�y;..�-.�.,.w.�..-�.,.-�:rn:�=�s..�w'.e.-.-.. :a..,,;,yi,"..,..;..:... y�''�'�"'�y".X��:
..(See Policy Schedule 4or Limits.).
•T;.:•tir............. :.; ........ ..Iw::ra::an:�.+z.:.;r.:::,w. w:..::�:H:..=•y't'sy'';�r""'"- - r,.- ,,- .. _.
��_�."r?r>�'R<�t,:.ticsw{i0 R. s�� �5'`u;,�:�,,...,. ,,...w.,,,..,.,w::-;a''w�..�,.-,,,,.,,.,..,.,,..,..r.,;,..:..:•,.,::;�;n-• +�" -•
Collision Coverage-$1i0tl Deductihlenv n M. 741 35
�3,�..n--�.:..ao-�•.,. n�.:�� �5�1 �-�7]61'.R-�1SIa�"•"�+�'tib{��t�"'r'i�'..�:5�5.','��"enc"�'_•'•err._a..;c`,S,'�..'':?�Y.•..,":Jw�:<��,..*.n',,,,'�"..�„-,
Car Rental and Travel l:xpersaes Dover/19e $8.89
�.... ,:�ti^^w a""'" . •1- .,. -^s • .:.aaaa�: ..
m�nx-xE�xr—xw«aw-x�;;���e: :. .. c"c•��.�:r� .�� ":�'r..±ga-��e�,:�x�w�_>:�•:.c_.•. �. .-. - �,.••�r::.ti.:.
Each L71 , Each I,nss _
..... Tsq.. .�.v •
... :Y r. ..`,»va :���Q'�'-�a�.a"{�'r^_��„ ti"^•t%s�-��%.�i._..'_
=:a,�`^�_��•rr..rir:rw,:::,.�" ..nm....
iia Ur irasuied Motor Vehicle Cover $40.37
'� •It� f�-�I;ilk"""` srxr:aacu�r�_>�4ceM�-.s (r.°�'�'•�,'..,�,_�L4•"•_"°"" ... _ ._
ars.^:::,e'„�-^.rc;•c:s-�.acs.,:.-•:;:, _.. . .
Bad)Person, F.aoh Accident
•iC.IYT'A'X �7_ •,l.Y/�[1.�:. , N57 KTr` �"i.AyT_„'•'.�'wW �. Y.ti a`w`r'Lync"�'�'�iti.'�r_.n�"..r' v::,�e�:�e ..,,�>\5n iW�w`.•,✓,w”u'v,,.n..,•inrv,
.:. ••• mvwrnvwx
Property 13,arna.a Limit
•,'.'•',:�. ,;.. ,,...w�",:...�::•:Y� •1 , x+.-yt«w.�!-....-:....+..•..t;_..:'. >...=.'^.'.�"o:'^.-�'.'^�!+!.Y" A'a'xr~rgV,�'•.wev£,
$20A04
i..x.. >FII`:A!f.SJ oece,.=er:
CONTINUED
U11B$IO QB See Heverae;.fide
n2l iw,6�tixr
xxh�u tai.m.w�y
This policy Is issued by State Farm Mutual Automobile Insurance Company.
MUTUAL CONDITIONS
1. Membership.While this policy is in force,the first Insured shown on the Declarations Page Is
• entitled to vote at all meetings of members and to receive dividends the Board of Directors in
its discretion may declare in accordance with reasonable classifications and groupings of
policyholders established#4y such Board,
2. No Contingent Liability.This policy Is tion-assessable.
• 2. Annual Meeting.The annual meeting of the members of the company shall be held at its
home office at Bloomington.Illinois,on the second Monday of June at the hour of 10:00 A.M.,
unless the Board al Directors shall Disci to change the lima and place of such meeting, in
which case, but not otherwise, due notice shall be mailed each member at the address
disclosed in this policy at least 10 days prior thereto.
In Witness Whereof, the State Farm Mutual Automobile insurance Company has oaused this
policy b be signed by Its President and Secretary at BfoomIngton,Illinois.
,,,,wllilawdL
Smrnrnry Presideid
•
•
Bic
•
Sfa#e aYrrr Stale Farah Mutual Automob kr ltlsurane°Company p Y 1051-1-0 MUTL VOL
= PO flax 2:358
l3lonrnNvgtoli IL 04702-2358 DEME Al A I IONS RAGE
PAGE 2OF2
NAMED INSURED :17-2154-1 a A POLICY NLUM1 H 332 10[14-A17-3'N
z POLICY PERIOD JUN aka 2022 to JAN 17 2023
X2237 SHASTA AVETime
5SHA , r1.11310:14 s SAh1AH3'EiA 12;01 A. Slandardme
S
L't;GLF. POINT ak 97524-3514
SI MEI-Al-3M PAYMSNf PLANNUMSL-H
113999841;
•
.�1 c'' -: y;,' :k • 4•044.':�
,. ck�.M'tu+ «.a:..�i.:i,.:....,.:r,::.,�.row:n...�i.:.�::...�.,•.m.,�....:w>..s.r.>v..:uo✓c.E.�.iwrr.?:.�:vxr:�c:•.w;��«l:�s*v� n5� `wi,.ti5�
Replaced policy number 3821064-3.7A.
Your total renewal premium for JUL 17 2022 to JAN 17 2023 is$273,45-
'The total prrttnlurm itslsld above reflects a recentctisnge to your potter and/beg month renewal premium,
Refer to the Drive Safe&save(Tim Insert for information about an important program for which you may be eligible.
Nate 1-'arm works herd to offer you the peel combination Of price,8e: los,and protection, The amount you pay for automobile
. insurance Is determined by Many factors such as the coverages you have,where you live,the kind of oar you drive,how your
cars used,who drives the car,and infermatiott fromconsumer reports.
Your premium was determined by the int:natation on driers,driving maords,and other information you provided,as well
as consumer report information,including:Number of consumer initiated inquiries in the last 12 months with 30-day.
exceptions;Number of Cns:antor Initiated Credit Cartl Inquiries cndlor Percent of Accouthe Percent of Accounts with a
Balance.
Consumer report reference number:221372011 12286
Credit information was obtained on; ANDREW CUNNINGHAM
Please refer to the enofoset ins,cri for addslional information.
Notice of insuranoe information collection practices-persona!,family,or household Insurance transactions:
We often collect personal information from persona other than the individual or individuals listed on the paficy,
Such personal information may,in Certain circumstances,be disclosed to third parties without your authorization.
If you would like additional.information concerning the collection and disclosure of personal in,otmation-cn<F your right
Se S89 and COr:eIt any personal information in your tiles•it will be furnished upon request.
.caic:x�uwrs. r
Rai—A IN "..._ .:tiro c a�,c S�� k' 3 •7 :�7,! 1.'.SF WE -FE:17. it r i-4 5417-
YOUR POLICY CONSISTS OF THIS DECLARATIONS PAGE THE POLICY BOOKLET -
FIRMTH 9A837Y 8 AND
ANYNT ENQORRENEWAL OT NOTICE. APPLY, If.JCLUOIN2 THOSE ISSUED TO YOU
CREDITOR- SELCu COMIMUNITY CREDIT UNION INSURANCE VERIFICATION, Pd HOX
924509, FORT WORTH TX 76124-4509.
612801 AMENDATORY EN7ORSEMENT-
69370,2 AMENDATORY ENDORSEMENT.
ORIGINAL COST OF CUSTOMIZATION NONE OR UP TO $1000.
Agent: RORY WOLD INSURANCE AGENCY IMO
Telephone:(541p73-1404
01184103085 Prepared JUL Cu7 2022 2134-AEE
X438542 01 a61 tr1 ib11 Io1Ya5ra)
0.70: (1:1.0Y1rd)
Y ,
This policy is issued by Stale Farm Mutual Automobile Insurance Company_
MUTUAL CONDITIONS
I. Membership.While this policy Is in tome,the first insured shown on The Declarations Page is
entitled to vote at all meetings of members and to receive dividends the Board of Directors in
Its discretion may declare in accordance with reasonable classifications and groupings or
policyholders established by such Board,
2. No Contingent Liability.This policy is non•assessable.
3. Annual Meeting.The annual meeting of the members od the company shall be held at its
home office al Bloomington,Illinois,on the second Monday of June at the hour of 10:00 A.M..
unless the Board oI Directors shall elect to change the time and place of such meeting, In
which case, but slot otherwise, due notice shall be mailed each member at the address
disclosed In this policy at least 14 days prior thereto.
In Witness Whereof, the State Farm Mutual Automobile Insurance Company has caused this
policy to be signed by its President and Secretary at Bloomington,illino's_
Bitualary Pi 6ek'ent
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ti[a