HomeMy WebLinkAbout2023-158 PO 20230227- Jahnke Heating & Air J
Purchase Order
pri/4I CO -
ratFiscal Year 2023 Page: 1 of: 1
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B City of Ashlandv,i , nt
I ATTN: Accounts Payable20 E. n Purchase,
L
Ashland,(OR 97520 Order# 20230227
T Phone: 541/552-2010
O Email: payable@ashland.or.us
V
H CIO Facilities Maintenance Div
E JAHNKE HEATING &AIR I 90 North Mountain Ave
N PO BOX 660 p Ashland, OR 97520
TALENT, OR 97540 Phone: 541/488-5358
R •
oT Fax: 541/552-2304
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Dj?a{—_v7_id Arnold
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02/03/2023
273 FOB_ASHLAND OR City Accounts Payable
Compressor Replacement
1 Compressor Replacement 1.0 $2,200.00 $2,200.00
Goods and Services Agreement($35,000 or less)
Completion date: June 30, 2023
Project Account:
***************GL SUMMARY***************
088400-602400 • $2,200.00
•
By: • Date:
Authoriz ignature =:_ 077 "` $2,200.00
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FORM 0 " .
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A request for aPlachaso'Order 7 ASHLAND'
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-t) te iiftellilest,
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Required 4tp•fOr4011vpry::
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=.yend00010 jatink6!steatitic,'And-AitiConditicihiriij,Ina' .
400-94;04,',§t4e.;Zip, 112 South Pacific Hihw-iy TuiLOR_97540
Ciii)tad:Natne,a Telephone Number Maureen Hunt i541475tS5 -
Enia(1,0d000.:
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SOURCING.METHOD' . . . .
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CI:Exempt from Contpatithre Bidding; ' D=Invitation to BItt ' 'ID -Epprgcncy:
1:1 13.44on'fri.r*thnotion:- Date approved hitc0eCii-: . -0 P_Arrri#1 ,:Atittaff tihdittOaed../41firi4lOn . .
El AMC 2'.50. , IAttach 00,0f.p6,00ii.Oriiiiiqiiic.iii0). :0 WiltiO04'Ati#00.6iteclia
El Writtki cjitata Or nrondsal attadhatf: Lit°guild'apricOiral ractuiredi atticti a*of CC)
El..Small Piectirethent, CI'Request for ProtiOsal '.01:41.9.,1:40,006tOiment•( .... .
Not exceeding"$50.00 Date approved byDaiirkiti '0 'Statetit;,,Oregon
f Direct Award . .. . ' (Attach COO of CoOcil.patinaordcappa), Contract#: . .
D.IreibiNikiiien quoteK or proposal(s) ,0 Request for Works) 0 State of Washington
Ditid.anOrdy,edi*COnntjt - -'' - - p6htraci:4::-. '
. (Attach eiihi.oftiitinC0 communication) ;1=1 OthOiTiotiraintilaiit agency c'erdracj
•Int6nnedrate Procurement 0 Sole Source- Agency -:- • '
GOODS&sgRvioq 0. A•tifrli!iiilF.iiirtilifk6;:i oity ,Otintoitt:it
Greater thin15,000 and less thaii$100,000 CI•Writteh.qiic16*0050al attached IntetnoVaniinefital'Asgebinent
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0:(3)Written bids and solicitation attached fl Form#4;.-pericirialS0*.s:OKto'.V5K 'fi.'IgElg_
PERSONALSERVIOES ' ' ' ' ' DateappiOilottbiCeinnoit D;AryatatcrAt to City'ftoes:not exceed$25,1]O()
Griateirthan 15,000 and less thailtJ5,000Valk:11mill: - - - (Date), ' • AgiOnient approved by and appOicidlOgnect by
o .Lissipan.P5,P1 by direct appointment 0---,:Sijettal Procurement • ,qgy-Adinintilaa*Ato 250,076(4)
O (3)lifrittoifOiConOnls'.090itatiOn'adeCtiqd.. 12'Faiya 49:;•.Rot14i for Approval kifti010t*PitYr04c.:eads125,009,OtititiCII
U Form#4,Personal Services $75K 0'Written eitiolobtlii*ebrotta*ed• .001pVal.i04000:.(4itach00.of co0Oil ii;)inniunicatiOn),
Dile apnicivadhy.:.Ociundl: . . .
Valid until: . ri-LAIDj_ ,
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Description Of-SERVICES Total Cost _. .
Compressor Replacement 14;200100:
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Etenn.•#. Quantity Witt ,Diterlitiori-:atMATERIALS 'Unit Pride: Total Cost
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.1 . 40., $0.00
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:$00
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O Per wiood-ciiMelpi.90$#1 r .. COST • '
. . .. . • ,44{1,030'.! .
' Project Number- - - - - -- - - -- - Account_ _ NUMbet:088400,602400
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'Expendilure must be cliakie0 to The account hitrrbOrIfOtiiq fir0060-4.-i*Mtelykpli:Of fh,C actual expenditures
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IT Director in.pollabniation OtikOppitliient Co rove aft hardware and soft - •
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IrDitOrk'- .'Date 'Siopa.ft--Yes/No
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By egning This racji4ig, ' 0,',Iditify that the City' public conyading..04010th,0 40.13*pfiifidO,. .
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Empl9yox -:.tiepariinent Hen,______-• ,iit_-101-41 -lii Z.I. 20 2, .
'oat to be 'reater than$50001
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bepartnteniklanagerIgitpenAson, .':ditiltianager: . • •
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Funds.apptapriated fot•curi.ent fiscal year YES I NO ,- _ • , - -• - . . • .•• •
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' • •' 'ri.n.04cgOk0cfnr,P401.1.141 iie:gre100130$5,00).: Data • • " •
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GOODS AND SERVICES AGREEMENT($35,000 OR LESS)
•
PROVIDER:. Jahnke Heating and Air Conditioning,Inc.
CITY .Q F PROVIDER'S
AS H LAN D CONTACT: Maureen Hunt
20 east Main Street
Ashland,Oregon 97520 ADDRESS: 112 South Pacific Highway
Telephone: 54I/488-5587 Talent,OR 97540
Fax 541/48a-6006 •
PHONE: 541-275-0656
This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of
Ashland, an Oregon municipal corporation (hereinafter"City") and Jahnke Healing and Air Conditioning,Inc.,
(a dornestieffareign business corporation)("hereinafter"Provider"),for HVAC services.
1. PROVIDER'S OBLIGATIONS
1.1 Provide compressor replacement 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 hi 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 telae 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 aeoceurrence"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;
a 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
• De evidenced by a certificate or certificates of such insurance approved by the City.
rage i a6: Goods and Services Agreement between the City of Ashland and Jahnke Heating and Air Conditioning.lnc.
13 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.I l0.
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 $22,310.45 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 anycontractual relation between the assignee
or subcontractor and the City.
2. CLT YtS OBLIGATIONS
2.1 City shall pay Provider the hourly rates effective 1/25/2023 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$2,200 (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 awn 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 freeto procure similar types of goods and services from other providers in its sole
discretion,
Page 2 ofb: Goods and SW/tees Agreement between the City of Ashland and Jahnke Heating and Ah Conditioning,Inc.
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 he 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 shalt 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 P.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 then, 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 end manufacture.Provider shall transfer all warranties to the City.
Page 3 of 6: Goods and Services Agreement between Thr;City cf Ashland and Jalankce Heating and Air Conditioning,Inc.
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:"
a The Provider's complete written Estimate dated January 25,2023,
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 A.I.
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 arc 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 "Emotive Date"), and shall continue in full force and effect until June 30, 2023, 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.
6.22 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.
1. NOTICE
Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in
writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or
by mailing using registered or certified United States mail, return receipt requested,postage prepaid, to the
address set forth below:
If to the City;
Paye 4 nf6: Goods and Services Agreement between the City of Ashland and Jahnke beating and Air Conditioning,be.
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:
Jahnke Heating and Air Conditioning,Inc.
Attn:Maureen Hunt
541-275-0656
S. WAIVER OF BREACH
One or more waivers or failures to object by either party to the other's breach a fany provision,term,condition,
or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether
or not of the same nature.
9. PROVIDER'S COMPLIANCE WITH TAX LAWS
9.1 Provider represents and warrants to the City that;
9.1.1 Provider shall,throughout the term ot:this Agreement, including any extensions hereof,comply
with:
(i) All tax laws of the State of Oregon, including but not limited to ORS 305.6201 and ORS
chapters 316,317,and 3.18;
(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
A eernent, 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;
(11) 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.
Pep 5 of 6: Goads and Services Agreement between the City of Ashland and J ahralce Heating and Air Conditionings int.
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 furl!'below.
CITY OF ASHLAND: Jahnke Heating and Air Coudltloning,Inc. (PROVIDER):
#
l` taw tare Signature
sc err trt..i t r\+—
Printed Name Printed Name
W .br S Ott - ,' . ... M a2noL.. V
Title Title
2.1.20 ....... . .
Date Date
(W-9 is to be submitted with this signed Agreement)
purchase Order No.
Page.6 of G: [bods and Services Agreement between the City or Ashland and Jahnke heating and Air Conditioning,Inc,
Jahnke Heating&.Air Inc Estimate 44582129
P 0 Box 660, Job 44582628
HEATING 6' Taient,OR 97540 Estimate Date 1%25/2423
AIR CONDITIONING Inc. 541-535-4470541-779.8496 Customer PO
Billing Address Joh Address
CI1YOF ASHLAND CITY OF ASHLAND
90 North Mountain Avenue . 9g North Mountain Avenue
Ashland,OR 97520 USA Ashland,OR 97520 USA
Estimate Details
Compressor replacement:Recover refrigerant,Replace compressor with.customer owned compressor and recharge system to factory
specs.Includes new filter drier,torch materials,and R410A refrigerant.
Task fl Description Quantity Your Price Your Total
T610042 Campressor'Change out 1Ph Up to 5 Ton 2.00 $2,200.00 $2,200.00
Labor and materials to replace compressor-:Includes torch materials,recovery,
evacuation,liquid line filter drier,and refrigerant
NOTE!Does not include compressor(will ha suppiied bycustomer}'
Potential Savings $330.05
Sub=Total .$2,200.00
Tax $$0.00
Total 52,200.00
We appreciate your business!Thank you for choosiniJahnko Heating,&Air!
I,the undersigned,am owner/authorized representative of:the premises atwhlch the work described is to he done..I hereby authorize you to`
perform said work and to use such labor and materials as"you deem advisable.I agreethat the price given below is a complete price:for ail work
stated,with no breakdown of material and labor to be provided.I agree to pay reasonable attorney's fees and court costs in,the event of legal
action.I have read and agree to all the termsset forth,and have received a copy of the contract and Notice to Owner(xxxxxx).I hereby
authorize you to proceed with describedwork at a contract price of$2,200.00.which will be DUE UPON COMPLETION,unless a Purchasing
Agreement has been approved,in which the terms of the PurchasingAgreement will apply.
1 912213
41:3945
June 03,2022
JAHNKE HEATING&AIR CONDITION
757;4TH ST
)A+HITE CITY, OR 97503-6648
Re: Barrett Business Services, Inc_t"BBSI")
Letter of Self-Insurance for Workers'Compensation Coverage
As the named addressee of this Letter,your company's required workers'compensation coverage is provided
through BBSI's state approved Self-insured Workers' Compensation Plan by way of your co-employment
contract with BBSI. Additional information is as follows;
•
State: Oregon Workers'Composat n UiY ts_ Emr lover Liability Limits: i.
Sell insurance Certification ; 1468 Statutory $5,000,000.00 Each Accident.
$5,000,000.00 Disease Coverage Limit by Cl,ent
i - $5,000,000.00 Disease;Each Employee
Other Comments(place an"X"if applicable):
X Planed"Letter Holder": City of Ashland 90 North Mountain Avenue Ashland, OR 97520
X :Other: Effective 51112020 through 4/3012023. Sulo;ect to 30 days notice of cancellation.
Additionally.I3BSl's self-insured program is Further supported by an excess workers'oompensation insurance policy with
ACE American Insurance Co.. Copy of certificate is available upon request.
For additional information,please contact your local BBSI office at: MEDFORD
(541)772-6469
2045 Cardinal Way Suite 100
Very truly yours, Medford, OR 97504
Gary Kramer
President and Chief Executive Officer doc:..t}sr-a
, A CERTIFICATE OF LIABILITY INSURANCE Essuzra
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOTRAATICH ONLY AND CONFERS No RICEHTs UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OA NEGATIVELY AMEi1D,EXTEND OR ALTER THE GOVERA{EE AH OROED f!Y THE POLICIES PELOW,THIS
CERTIFICATE OF FNSLJRAHCC DOES NOT CONsTETUTE A CONTRAcT s3!TWEEtT THE ISsUrNG INSURER S), AtillioR1ZEt3 PEPAESENTATIVE OR
PRODUCER,AND THE CERfIFICATE NO&.DE3J_
IMPORTANT: IL the cerliNc$le 11oldee Is OH ADDIIIONAL INSURED,the vol[c3n4cs)Enlssl have.ADDITIONAL 1fFSIRIEO provIalens or ire rndvr cd,R
SUBROGAT{ON IS WAIVED,sulked to the toms-and c5Rdl1Eatls or th5 paJl'y1, wan palltles may regains et endaosetnEl1t A 31a1MatriE en slels
r 1-le... .Itnrs not buffer rt r•ft to Nle califrcele holder to IY,0 al slid,ends=• -
PRODUCER CONTACT
FEDERATED MUTUAL 3NSELRANCE COMPANY
NAEAA, Cl WW1 CY7NTA.C.,'T,OE-I Ml..IC,•„,,,,,,,-,-
HEM€OFFLCL.P.O.430X 320 m IED.Kith:886,33.7,4CE O 11A14,•itai:94741E.4554
AWATONNJk,?Sy SSC)9D6,ullut.5.,S :cSr?IITACT[ NTER&dFEID S 1•01
lN!URERLSIA$04kDING SGFEHAISE HASON
ILiooICRF.R AI FF,E}F,RATF.I7 MUTUAL lNSURANCF CQh£PAl'CY 13935
INSURED 368.839.9`EURERB_
JAHNKE HEATFNG&AIR CONDITJO1 I NG INC mann ---- —
cr
PO PDX baa —_............ . •" •
TALENT,OR 37540,0E60 ENSURER Dc -
LHEURER E:
IHSMRER F! —_
COVERAGES OERTIFECIA1E HUMBER:98 DEVI6Ic0 NUMBER:1 •
THIS IR TO CERTIFY TNAE TIE£PoL90 E OF INSURANCE LISTED EELCW HAVE BEEN ISSUED TO THE ENSURED HAMED ABOVE FOR THE FOUCT PERCOP 1
t1iDlrfTao. HOFWITHSTANDING ANY RECILIEREMEIM. TERM OR ECNEIE TCIEY OF ART CONTRACT OR OTHER OOCUJ!ERT YrITH KICPEE:T TO WHICH THIS
CFRTEF0E ATF.MAY INE I55LJ@D OR MAY PERTAIN,TI-1 INStfRANCE AFFCR DFD RY THE PEJI.1 EIE.R JIFSCRIAFOJ NARAEN IS SUBJECT TO Al C THF TFEI.OI.FACT IIRSI]NR
AND r]7HOkTIONS OF 6L)tl POLICIES.LIMITS SHOWN MAY LEAVE FIFER REDIIO.EO BY PAID CLAIMS.
ALSO $r9Pl SUSRJ POLICY EH POLICY ESP
TTI[ TYPE OFIHSI RAHPE fia.'g POLICY NUMBER rtJ,417DAYYYt1 ' i1{igare 1 •„�-, Duan .__ ,..•
v
X 40MMr tAI.CENERALI3AIRHTY EACHOCCURAEN2L $1,000,000
"" ___#BWMS Mr1mE D CiCCJ1R CANT LO[TB RENE° S1000.10PREMISES Ea nromrenct
MED ZIP.{Any Ana Plraaa-0 EXCLUDED
A - -- ; Y t# 9d69aaLI 61f08121t22 041DEJ2D23 PERSONAL RADV11E EIRP $1,000,000
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IEACAIPTEON OF OPERATCNE J LADATIDNS r VEHICLES 1ACCRD 141,Ad9ENNl Remarks BdKAYE,RKTha at tthet El ANG miters.ktiarri.4
SEE ATTACHED PAGE
r]ERTr43CATF HOMER CANCELLATION
3ES-838.4 SS 1 '
OW OF ASHLAND SHORED AMY OF THE ADOVE DE:&GRIPED POLICIES HE CANCELLED UEEORE
2U E MAIN ST .THE EBPIRATEO?4 DATE THEREOF, NOTICE WILL EIE DELIVERED IN
ASHLAND.OR 8752E14514 'ACCORDANCE WITH THE POLICY PROVISIONS,
JU)TNaRIEFB AEPJIlS[ILTgYES,x
0 l6EE 2n15 ACU110 CORPORATIOEL At rigs is navel—vett
AGORD SE{20181L1:Ii DM ADORE}name a1H!1Dgu aria registered marks of MORD
ADENcY CUSTOMER Ib; 3664,30.0
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ACCJrRJC
ADDITIONAL REMARKS SCHEDULE Pepe 1 of 1
Fe3ERC4 MUM°INV dxfu
FEDERATED MUTUAL INSURANCE COMPANY JAM NKEHEATIN3 8AIR CONDITIONING INC
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POLICY YUt,56ER PO BOX SED
SEE CERTIFICATE If 95.1 TALENT,oR 9753D t saO
CPRNIEFI NM:CUt7
SEE CERTIFICATE f€95,E -c'isGE'DAM:........... ... ...........'.....................................................
-SEE CERTIFICATE 851
ADDITIONAL REMARKS
THIS ADDITIONAL REAMHKs FORM is A SCHEDULE TO A4O10 FORM,
FORM NOMSER: FORM TITLE; C :T • •2 • , ;: •t
ADITSAHAL INSURED ALSO INCLUDES THE CITY OF ASRLAPEk. OREGON, /Ts OFFICERG. mons AND EIPLDYEED
THE CERTIFICATE HDLDER Is AN AIID2IXDHAL. INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL MIRED - I NERC,
LESSEM UR CONTRACTORS • AUTOMATIC STATUS WHEN REWIRED IN LDdJSTRUCTIUN AGREEMENT UM YOU EN[IORSEHI:N1' FOR
CEt£RAL LIABILITY,
ITHE CERTIFICATE HOLDER Is Mf AUJXTXUHAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ':
ENDORSEMENT FOR BUSINESS AUTO LIABILITY.
INSURANCE PROVIDED HY THE BENERAL LIABILITY COVERAGE IS PRIMARY AND NONCDITfRIBUTORY OVER DIRER INSURANCE.
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ACCORD 141 WOWO1l o R POR CORPORATION.AD rIghls reserved.
Tho ADORD Ilona ad WO MO I'eglriarcd marks or ACM
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ iT CAREFULLY.
ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
With respect to coverage provided by this emforsernent, the provisions of iho Coverage Form apply unless
modified by the endorserrrent,
A. WHD IS AN INSURED for"bodily injury"and "property damage" liability is amended to include:
Any person or organization other than a joint venture, for which you have agreed by written contract to •
procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered
"auto"with your permission. However,this additional insurance does not apply to:
(1) The owner or anyone else: from whom you hire or borrow a covered "auto". This exception does
not apply if the covered "auto" is a "trailer"connected to a covered"auto"you own.
12) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her
household.
(a) Someone using a covered 'auto" while he or she is working in a business of selling, servicing,
repairing, parking or storing "autos"unless that business is yours.
(4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a
limited liability company), or a lessee or borrower or any of their "employees", while moving
property to or from a covered 'auto".
(5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a
covered "auto"owned by him or her or a member of his or her household.
B. The coverage extended to any additional insured by this endorsement is Eimitod to, and subject to all terms,
conditions, and exclusions of the Coverage Part to which this endorsement is attached. ••
In addition, coverage shalt not exceed the terms and conditions that are required by the terms of the written
agreement to add any insured, or to procure insurance.
C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the
agreement between the parties,or the limits provided by this policy.
D. Additional exclusions. The insurance afforded to any person or organization as an insured under this
endorsement does not apply:
1. To"loss"which occurs prior to the date of your contract with such person or organization:
2. To "toss" arising out of the sole negligence of any person or organization that would not be an insured
except for this endorsement.
3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the
leased or rented "auto"or the policy period ends, whichever occurs first.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
CA-F-927(03-03) Policy Number: 90h36f 8 Transaction Effective Date:44/O8f2g22
COMMERCIAL GENERAL LIABILITY
CG20011219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The folrowing is added to the Other Insurance (2) You have agroed in writino in a contract
Condition and supersedes any provision to the or agroemUE at that this insurance would be
contrary; primary and would not seek contribution
Primary And Noncontributory Insurance from any other insurance available to the
This insurance is primary to and will not seek additional insured.
contribution from any other insurance available to
an additional insured under your policy provided
that;
(1) The additional insured is a Named Insured
under such other insurance;and.
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@ insurance Services Office, Inc,, 2018 Page 1 of 1
0G 20 01 12 10 Policy Number:9089008 Transaction Effective Date:{34/08!2022
COMMERCIAL GENERAL LIABILITY
CG 20 33 121
THIS ENDORSEMENT CHANCES THE POLICY. PLEASE READ IT.CAREFULLY.
ADDITIONAL INSURED - OWNERS LESSEES OR
CONTRACTORS AUTOMATIC STATUS WHEN
REQUIRED IN A WRITTEN CONSTRUCTION
AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMiVMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured any person or additional insureds, he following additional
organization for whore you are performing exclusions apply:
operations when you and such person or This insurance does not apply to:
organization have agreed in writing in a contract 1. 'Bodily "
or agreement that such person or organization beY in fur Y "profrarty damaged or
added as an additional insured on your policy. "personal and advertising injury" arising out
Such person or organization is an additional
the rendering of, or the failure to render,
insured only with respect to liability for "bodily any professional architectural, engineering or
injury". "property damages or "personal and surveying services,including;
advertising infury"caused,in whole or in part, by: a. The preparing. approving, or failing to
1. Your acts or omissions•sir prepare or approve,maps,shop drawings,
' opinions, reports, surveys, field orders,
2. The ads or omissions of those acting on your change orders or drawings and.
behalf; specifications;or •
in the performance of your ongoing operations for b. Supervisory, inspection, architectural or
the additional insured. engineering activities,
However, the insurance _ afforded to such This exclusion applies even if the claims
additional insured_ against any insured allege negligence or other
1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring,
and employment, training or monitoring of others
2. Will not be broader than that which you are by that insured, if the "occurrence" which
required by the contract or agreement to. caused the "bodily injury" or "property
provide for such additional insured. damage", or the offense which caused the
A person's or organization's status as an "pe.rsernal and advertising injury", involved the
additional insured under this endorsement ends rendering of or the failure to render any
when your operations for that additional tns€ers.d professional architectural, engineering Bering nr.
are completed.
Insurance
services.
Insurance Services Office, Inc.. 2018 Page 1 of 2
CG 20 33 12 19 Policy Number:0060008 Transaction Effective Date:UFO/2422
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2. "Bodily injury' or "property damage" C, With respect to the insurance afforded to these
occurring after; additional insureds, the following is added to
a. All work, including materials, parts or Section III -Limits Of insurance:
equipment. furnished in connection wills The most we will pay on behalf of the additional
such work, on the project (other than insured is Eho amount of insurance:
service, maintenance or repairs) to be 1. Required by the oontract or agroefnen€ you
performed by or on behalf of the additional have entered into with the additional insured;
insured(s) at the location of the covered car
operations has been completed;or 2. Available under the applicable limits of
b. Thai portion of "your work" out of which insurance;
the injury or damage arises has been put
to its intended use by any person or whichever is less,
organization other than another contractor This endorsement shall not increase the
or subcontractor engaged in performing applicable limits of insurance,
operations for a principal as a part of khe •
same project.
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Page 2 of 2 O insurance Services Office, Inc„ 2018
CG 20 33 12 19 Policy Number:9089608 Transaction Effective Date:0410812022