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HomeMy WebLinkAbout2023-159 PO 20230221- S&S Sheetmetal Inc Purchase Order Mt ,as11 VITY L. Fiscal Year 2023 Page: 1 of: 1 is ra,i Wa i eTtIMi its l - B City of Ashland �---_�_ � � - L ATTN: Accounts Payable -20 E. Main Purchase L Ashland, OR 97520 Order# 20230221 T Phone: 541/552-2010 O Email:,payable@ashland.or.us V H C/O Facilities Maintenance Div E S &S SHEETMETAL, INC 1 90 North Mountain Ave N. 912 ANTELOPE ROAD p Ashland, OR 97520 ` D WHITE CITY, OR 97503 • Phone: 541/488-5358 R T Fax: 541/552-2304 y_.,_y_.,_ . e�L_ tumi- _ F iirne i 3= t.'�.1.aiiy4i ca gi. •te — y a:-- ---'-_- `p--.N.Dr-u =gt`,=-—_— --[rye ,.{a_-�.}- �.•.�_ _ _ _r__ �/ David Arnold �G rcre yr -7 8 W O g®E 6i� —08: -=ni-5 , -13 __ Y 1.. ... _— - --__----. -� - l� _—�a_.j?S2�ldt-`�a�s=� 3�aa��_-_ �-‘2.---.5---_,._,___-_ `�fi��=3�s=�I=�� =_ 01/26/2023 390 _ FOB ASHLAND OR Cit Accounts_Payable _ — --� '7-77--=';::;-_-:-:-.75--7,---±:—.-S: =7:-:-- rtZ __ _ Ogg;+- ff�—_ s. -� .. ..� - ---�� �e�������'y� �... �-��,�iia�,7c-74 OM 1�����=j',���1sl�v�E��,"2:1"T:4-it!v. ® _u_}+S HVAC Services Police Dept , 1 HVAC Refrigerant Services at Police Department 1.0 - $1,785.00 $1,785.00 Service Quote 235368-2 . Goods and Services Agreement($35,000 or Less) Completion date: 06/30/2023 Project Account: *************** GL SUMMARY*************** 088400-602400 $1,785.00 i By: I t4 ILIA Date: v 0 / ' ' —_ _ Au w•ri !I: `rgnature - _ -. • . i , AFORM#3 7_ o. 0. , 7--7---? SHLAND c I.T YOa IF- A request for a Ourrha$0 Oriel- f , ( . . . . . REQUISITION . Datedtmer$t .. .;..09/2c123 . . ...._, „_.... . Reire0.daiefot:clegyeW: . . - . . - .. . . ... - Vendor Oalpd. .6&§,Shietenetal..:Inc Address,City,Stato,Zip, 912 Aiiteltipe Rand White City OR,97503 Contact Naitie,A..Telephone Number "-'-'. ; , ! ' " :`' --.' ' -'- ''' ''.'. ' .-,-• ,c . -.., , - -'• --• ,.— • Chrishe.-Scitatar.cl-ultilese Fez a rOse udsheek ng.com•-•541,21 0-2946.• Email address . . . . , . _ SOURCING METHOD. TreiteinPlfroin Competitive Biddinq' — 0 Invitation to Bid . .0 Emergency _ 0 Reason for exemption: DateeppreiredpypOto; 0 Form 13 Wntton findings Anc.I.Aiithbrizatibri CI.AMC:2.50 . . '•(Attatheopyiitieuecil communication) p_Artititieetiiiit6er*osaileile"Ched 0 Written quotdar'ProPasal attached , •(If coanoil approval rdiuired,altadi oo • .6(CC' [El Small Procurement 1J Request for Proposal Cooperative Procurement Not exceeding KOH Date approved by Council 01 'State Of Oregon ' El area Award (AtlachtapIrOf council communication) . Contract ft El Vorballkitien quote(s)or 0cpceg$) 0-liecipait fdi OtialifiCaliOns(Piddi6Wotki) El :Statddf Washington Dale approved by Council - . deritraOf#'• .. , _ tAllaah.O_Oy.i3f coO011 oonrunlballen). _ _0 .dhertimiermrtent agency contract intermediate PrOcureinent . 0 Soie`Sontie. , Agency GOODS'&SERVICES - EC.,-"Akiltabldfortn(g-6 100) [Cuiltiktii' 9 ieaterthan MOW and less than 51 00000 0 Written quote or proposal attached• :intergovernmental Agreement LI (3)Written bids aqd solleilatrodettatiled 1:1 Farm#4,Personal servidi$5X to$7.51( Agency PERSONAL SERVICES Data aliprOvad by Council i - . El Annual cost to City does nol 6464:$25;0R Greater thari55:000 and less than$75 000 .Valid.until: (Date) Agreement tiprOdd by LO§al*nd apPIOvddi§lOned.by Cl-Less than$35000,by'dirod appointment III .Special Procurement . - . •City-AcimIniktalof:Atle 26070(4) D 41/Alba pippeSals.ksolicitaliee attached 0 Form P9 Request for ApOevel 0'Annual cost tu'Oiye*eed p50p0 coo* D Form r*Persona!Services .5Kilci.$`75K El Miter!quote or' proposal attached . . aPProiial required"(Attach copy Of council cOrrinithicalfon). paid approved by Council . . Valid Until: ' •piatel- _ . Description_Of'SERVICES, . .Total Gest. . . ...... , . .. _ , ... , .. .. HVAC refrigerant services at Police Department Vtgfq41.,01 . . Ittor-#. .0iantity. ,Orilt .DOSCriPtiottAif'MATERIALS unit peco. Tiii al Cost,, 1 - ,$o••, $0-00 . . . • • • l'O.: $iti-ot) - . $6.00 . . t 11adheci quotefProposal TOTAL COST ......,.___....,.,_.... ..,, . . , .. , . .. . . , ,,. .. .. . Project Number:_ _ _ ._ _ _ _ _ AtCOU tit Nuinber:'0138400-602400: . -'• , . . pdriipo.Tr/4 bp 04%0 0104 qpprppi6p ace ml nwnbers fort flhqnggs fcaOtirefejy.r.001te a0141 Ojondittge.14 IT Director in•collaboration with department to:app ' i hardwate atirlsoitware purchases:. . .. . .1-I-airador *Date 'Sap:port'-Yes 1 Na Hy Aping this re4fits"dh flian,1 t 04 thaFilio'City's..(.101 gort trictin4 P.Ojiiktiriphr;hkC06-e iatiOad. EmPloyee:. -'.------t.' , - ' - _____z --, -Department Heat .(' • Meal to-01 g eater thang,000.) • . . Department 11.011060110.00Seri r • City Manager . . (0testerthe05,0119 . •- .. . , ,-... . Funds appropriated for current fiscal year tS/NO , • . . . . . ... ' 'Finance DfrectorqEquAticr or greaser than#5,000) - Date • • . .Comments: . . . .• • . .. . . . . . .. . . ... .. . . .. •• . . Foinr#311equgon . • GOODS AND SERVICES ICES AGREEMEN R ($35,000 OR LESS) PROVIDER: S&S She etrnetal,Inc. CITY OF PR()VIIAR°S -ASHLAND CONTACT: Christie Salazar 20 East Main Street Ashland,Oregon 97520 ADDRESS: 912 Antelope l{oad Telephone: 5411488-5587 White City, OR 97503 Fax: S41/488-6006 PI l ON 1::: 541-210-2946 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, ari Oregon municipal corporation (hereinafter "City") and S&S Sllcelrnelal, Inc., (a domestic/foreign business corporation)("hereinafter{`Provider"), lbr HVAC services. I, 'PROVIDER'S OlcL,IGA7'1ONS 1.1 Provide refrigerant for Police Department 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 $2,000,0013 (two million dollars)per occurrence for Bodily TnjUry 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 1.iabihty. i.2.2 P.ach policy of such insurance shall be cni an "occurrence"and not a"claims made"form,and slaa€I: • 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. Pogo. 1,01'6; Goods and Seivic s Agrecmantbcixvccn tiro City of Ashland and S&S Shcciraufel,Inc. 13 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance with OKS 656,017, which requires subject employers [0 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 statics, 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 20(}.1055, 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 wider 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 V2,310.46 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.Lhis 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. 13 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 subcoaitractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective 1118/2023 as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Providers total of all compensation and reimbursement under this Agreement exceed the sum of$1785.00(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 oilier% 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 iii writing. Provider further acknowledges that any Work delivered or expenses ineu31•ed without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 3, (ENI+RM.. PROVISIONS 3.I 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 7 or&, Gods and Services Agreement between the City ufAsh€and and S&S Stieetmetal,Enc, 3.2 Provider is an independent contractor and not an einployee 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,€ The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B220,27913.230 and 27913.235. 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 he 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 patty, 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 ira performance caused by acts of Clod,strikes; lockouts,accidents,or other events beyond the control ofthe other or the other's officer's,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, hut such unenforceable provision shall he 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. 3.1 1 Deliveries will be F.0.3 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 delicts, fraud,and warranties. 3.12 The City may inspect and test the Goiods. The City may reject nim-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(t.:CC). 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMEN.PS and be free from defects in labor, material and manufacture. Provider shall transfer all warranties to the City'. Page 3 S+N; (kinds and Services Agreement between the-City of Ashland aid S&S Sfieetinetal,1�ie. 4. SUPPORTING DOCUMENTS 4,1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively refbrrcd to in this Agreement as the "SUPPORTING DOCUMENTS:" • The Provider's complete written Quote dated January 1$,2023. • 4.2 This Agreement and the SE.11'PORTINCG DOCUMENTS shall be construed to be mutually compliineiitary 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 ST1PPOT(TING DOCUMENTS;the several supporting documents shall he given precedence in the order listed in Article 4.1. S. REMEDIES 5.1 Tn 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 inearlSESiknIt,and City may pursue any remedy or remedies singly,collectively,successively or in any order whatsoever. 5.2 Tn no event shall City be liable to Provider for any expenses related to termination a 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 5.1 l'emi 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, 2023, unless sooner terminated as provided in Subsection 6.2. 6.2 '1'ermination 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 he given sander 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 TJnited States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: Puge 4 o(ii: Goods and Scrvic:esAgreemtienit between the City of Ashland and S&S S1iadroctn1,Inc, City of Ashland Facicities Maintenance Department Attic D av id Arnold 20 F:. Main Street Ashland, Oregon 97520 Phone: (541) 552-2292 With a copy tat City of Ashland—l;,egal Department 20 E. Main Street Ashland,OR 97520 Phone: (541)0$8-5350 Ii'to Provider: S&S Sheetmetal, Inc. Attn: Christie Salazar 541-210-2946 • S. 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 contained in this Agreement shall not he construed as a waives'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 Agee meat, inc lucl€ng any extensions hereof, Comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 acid 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,of ordinances that iinplenwnt or en three any of the foregoing tax laws or provisions. 9.1.2 Provider, for a period Ulna fewer than six(6)calendar•years preceding the El hetive Date of this • Agreement, has faithfully complied with: (1) All lax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317,and 338; (ii) Any tax previsions 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 breath 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. i'gc 5 of6; Goods and Services Agreement belly=the City of Ashland and S&S Sheetrncta€,Tnc. • IN WITNESS WHEREOF the pasties have caused this Agreement to be signed in their respective names by their duly authorized representatives ats oi'the dues set forth below. CITY OF ASHLAND: S&S Slicctmctal,Inc. (PROVIDER): By: �� By: C614;7&4 i Signal. Christie Salazar etT'�c.AW e Printed Narnk Printed Name Pol,ant�s-�, DIR..eer-t— Office tvl anger 1'itf� Title ,t. Zti 2n 2'3 January 19, 2023 Date - Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. 7—, e . Pilar 6 iii 6: Goods and Services Agreement between the City of Ashland and Si S Sheettnrta],Inc. • Q��y 1St •Ji f-re Quote A `r� s & s HAI INi& Order#: 235368-2 x AIR-COW) Date: 01!'18/2023 SHEBT ETAI1INC. §4 '47 1 a Billed To: Project: CITY OF ASHLAND ASHLAND POLICE DEPARTMENT 20 E.MAIN ST- 1155 E.MAIN ST. ASHLAND OR 975201 ASHLAND OR 97520 Our Mission We are committed to rase the hsr and make our team the stsndo rd others are judged by in commitment of urisurpessed service,craftsmanship,loyalty,and integrity to our customers and toarn This quote rs valid until:01118/2023 Payment Terms: Order#!: Assembly# Part# Description Quantity Price Ext Price Sales Tax 410a Refrigerant 25.0000 60.000000 1,500.00 400002 Service-Labor 3.0000 95.000000 285.00 Ed We are pleased to provide the following quote to add another 25Ibs of 410a refrigerant to city mutli forAshland Police Oeparfineni and tighten what leeks we cera see at BC oaratcaller. NOTE: 1. Does not mean we are repairing all leaks,to do that system would be down for 2.3 days.Nitrogen and all gas would need to he pulled. 2.We have already put in(2)rugs of refrigerant.Found unit holds 251bs no 3Olbs-Will have credit on Quote 235358 QUOTED BY:James Bridgman,Service Manager ACCEPTED BY: • • Notes • "Irl lira evont customer fails to pay the in invoice amount when dGe,interest shall accrue an the Non-Taxable Amount: 1,785.00 ' impala he/anco from the due data of lite Invoice at the rate of 2%per month{24%per annum). if S&S Sbeeirrsatal,inn.is relquirert to fiaak collection of the amount due by legal process, Taxable Amount: {},Q{} customer shall he responsible to pay S&S Shastmetal,inc_in addition to the invoice amount, Sales Tax; 0.00 ?he interest,all atlorrrey fees and casts incurred ty S&S Sheelrnetal,Inc.. • CCB#72049.CA Lic.682150,C43,C20 Quote Total 1,785.0I) 912 Antelope Rd,White City,OR 975113(541)-826-6661 Fax(541-526-6601 wmhsuif.uoin sailyr, Oregon. Oregon Workers' Compensation Certificate of Insurance Genii!sate holder: CITY OF ASHLAND 99 N.MOUNTAIN AVE ASHLAND,OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated_The insurance afforded by this policy is subject to all the terms,exclusions and conditions of such policy;this policy is subject to change or cancellation at any time. insured Producerlcoritact . S&S Siseetotetel rite Hub international Northwest LIc-Eugene 912 Antelope Rd !'dike Codffsey White City,Or 97503-1607 511.650.6772 mike,godlrey r©hubinternational,cottl issued 0912112072 Limits of liability Policy 811929 Bodily Injury by Accident $1,000,000 each accident Period 10/0112022 to 10101/2023 Bodily Injury by Disease $1,Q[]0,000 nacrt employee Body Injury by Disease $1,000,000 policy limit Descriptionof operation sllocatianstspoci iI items Job Address: 20 east Maio Street,Ashland,OR Important This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate does not amend,extend or after the coverage afforded by the policies above_This certificate does not oonstitute a contract between the issuing insurer,authorized representative or producer and the certificate holder. Authorized representative C.F4L- Chip Terhune President and GEO • f RR lig t 5treo15s- Salem,03 V7312 Pr 8CO_285.B:i 2:i Prziry_acn ElliatkalysuiteiW F 583.504.4812 ACIaRirlit CERTIFICATE OF LIABILITY INSURANCE am= T1116 cERTIFicaTE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO 11101ITS UPON THE CERTIFICATE HOMER. TMIS CERTIFtCIITE DOES NOT AFFIRMATIVELY OR NEOATIVELY AMEND.EXTEND OR ALTER THE COVERADE AFFORDED DY THE POLICIES BELOW.TRIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ESSUINO INSURERCS}, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTEfICATE HOLDER- IMPORTANT: II the eeEttt1cate harder Is an ADDITIONAL INSURED,the polEsy Iles}muse lava ADDITIONAL INSURED Previsions Or be En/In/sad, If SUf17CGATION hS WAIVED,sublaet to tlho{am t grief eaaulficc el the;witty.eertetn policies mew require an Indara0T11E111.A statement ea IVIS cartll[eete doe&not carder ri.hds..Ilin,Endincate nonter In Hsu of such endorsornenUs}_. - PRODUCER .... CONTACT _ Is . • FLOE .kTED MUTUAL INSURANCE COMPANY s �` `T HOME OFFICE P.O,PDX 5 ma-Ro..i sur,$$B_ IAS4:!-_ FAX 3 c No:5ra--446.45G4 cINA7CII#NA,4Al4 35480 EnnuRtes:CUENTCONTACTCEtIiT,EMIEWIN$.COM ...............:..............1RaDRENISL AFFORDING COVERAGE If AIC 9 ENSURER AI FEDERATED RESERVE INSURANCE ChMPA1IY 16424 INSURED ;1Qg..,54y_ INSURE&Al S 13 S SI-ME-METAL INC INSURER az 912 ANTELOPE REI WHITE CITY,OR 915113.1607 INSURER O.! _ lNsekltu re crosER LLE& CERTLFICATE NUMBER;309 REVISION NUMBE+E 0 TINS. LS TO CERTIF7 THAT THE PQUCIE8 QF N1semaNrrE LIE TEO'BELOW HAVE BEEN ISSUE!)TO 711E NIBUREC NAMED A9OVE Fat THs POLICY PE1ttO6 1NC[CATED HOTYItTHSTNIDINO ANY RE lJlltEAlENT. TERM OR 0O61DI1IC24 Of ANY 4K1191TACT OR CTTRER DgaIMEEIT M TH RESPECT YtT MICR THIS C!TLTIFICATE RUIN EEl'IAe11En(IA oarraRTAIN,IRE INetIFIANcE AFFORDED BY THE POLICIES DESCRIBED NNFPFIN as SLIRJF.CT'RIALL THE YERLAS,EXCLtP51ON6 AND CON6ITIOHS OF gum!mimes.IEUITE SHOWN MAY HAVE SEEN REDUCED DY PAID CLANS. ILL R nil OFLIS1IRANCE SYHR rollcr1IUAtp&e POt1DY EFF POLH:Y EILP Elkira I INFR W'lI] ......... [MMID0AY1^fYt uFlnDDnwq COMMERCIALCEHERA7LLMIARY EACH i'ttA/MS.EIME IOLA L FACHO7CURaENCE _.... $1.S100,00:19M TmEU [ QRn.wEOL $itlD 1LEED EXP IA13act ADAson1 EXCLUDED A Y N I. 9910653 C402412022 : 042a .KEZONALarAPYIIM It II1MOOD -GI L AG elms ATE VENT APPLIES PER: l°ENEMA00E1E0MR $2prp,005 9FOLICY ❑hies U LOC inonlrcts-DOM mfg.AOL .S2,�,�. OMER: AUTOMOBILE LIA81L1TY COMBINED DIME LIMIT $1.000.000 •.L£LEcddrBO X PalY MAO — E •imbrue INd1 LY W11610A OYnOE IFNaUTeXtY ..WHECNI{0 _.............. . .._NFi'C3 N N %HELM : tl nairein 04/2-012029 MEMINIDAu YINTel&AS NOIRIESIED .— .... HIRED AUCTAN �AUttp.s ONLY PROPERTY DAMAGE . AVM 24.ArRMA A UMBRELLA LIAa X•OCCUR EACH OCCURRENCE I $5 p4n A EXCESS LIAR ;Ei Lai. ADE N N SSIDOM 114t20I2 2 0,144)2013 AccgEcxrC $S4000,001 DEO I ;RETENTION • • PlORHENai 0MPEIEaATEOHrrITr LR AND EMPLOYIIaa'PARI ISY YI N NW PAOPMET6RIPABTRERISXEOtmYE OFFICERIIA.EURER EXCLUDED? I..__ hEAA ManrIatatyIn MO 1 E.L=EASE IEreA CeERlMan er DESCRIPTION 9FDPERAT19Na bAWw • i I 4EtcocirIION oPaPaNArlEIAI LOCATIONS t MIMES 1ACORD IPLMAIAw1B'Butts Or1E,s.,F,LT Aru.S.a.lae,.thlte A epUlE l THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDTT!DRs or THE A]DITIDNAL 1#sUREb - MINERS, LESSEES OR CONTRACTORS - AUTOHATIC STATUS SHEN 11111U/RED IN CONSTRUCTION AEREEEHENT WITH YOU ENDORSEMENT FOR Vr4.3IFRAL LIABILITY. CERTAROATE HOLDER - CANcELIATt-ON S71Y OF ASHLAND 342-547-6 3U9 0 SHOULD AtIY OP THE fH1DVF DESCRIBED POLICIES BE CANCELLED BEFORE .. CIO FLEET SERVICE91FAcrL1TIL•s MAENTENANCE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELEVER[•O IN 90 N MOUNTAIN AUX AOOORDANGE Whit THE POLICY PROVISIONf Am-IL/0o,OR 2152D-2014 ._ AVOICRIZEO REPREEEITME c ) $a 19916-2015 MORD CORPORATION.Alt rights rescrvcsL AOORD 25(40IO10.3) The AOOAD nano and few ate rep[tlered Watts Of ACORD COMMERCIAL GENERAL LIABILITY CO 20 33 12 19 THIS ENDORSEMENT CHANGES 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: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section ll - Who is An Insured is amended to S. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, The fallowing additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organlea1ion have agreed in writing in a contract t "Bodily injury", "property damage' or or agreement that such person or organisation be "personal and advertising injury" arising out added as an additional insured can your policy_ of the rendering of, Or the failure to render, Such person or organization is an additional sured only with respect to liability for "bodily caw professional architectural, engineering or injury", "property darrrcye" or "persona} andsurveying services, including: advertising injury"caused, in whole or in part, by; a. The preparing, approving, or failing to 1. Your:ids or ornissions;or prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, 2. The acts 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 ernployfnent, training or monitoring of others 2. Will not he broader than that which you are by that insured, ii the "occurrence" which required by the contract or agreement to caused the "bodily injury" or "property provide for such additional insured. darniage", or the offense which caused the A persos3's or organization's status as an 'personal 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 insured professional architectural, engineering or :ire completed. surveying services. 0 Insurance Services Office, Inc.,2016 Page 1 oft CO 20 32 12 19 Policy Number: 9910553 Transaction Effective late:04124(2022 z 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 with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1, Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations hes been completed;or 2, Available under the applicable limits of b. That 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 ether 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 the same project. Page 2 of 2 d Insurance Services Office,Inc,, 2018 CO 20 33 1219 Policy Number:9510&5a Transaction Effective Dale_04/24f2022