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HomeMy WebLinkAbout2022-139 PO 20230170- Interior Office Concepts Inc Purchase Order •CIT RECORDER ,� Fiscal Year 2023 )Page: 1 of: 1 !FA B City of Ashland • - . ATTN: Accounts PayableL 20 E. n Purchase L Ashland, OR97520 Order# 20230170 T Phone: 541/552-2010 4 0 Email: payable@ashland.or.us r V H C/O Facilities Maintenance Div E INTERIOR OFFICE CONCEPTS INC I 90 North Mountain Ave N " PO BOX 1507 p Ashland, OR 97520 O JACKSONVILLE, OR 97530 Phone: 541/488-5358 R T Fax: 541/552-2304 1-Y z. Yad-t1 urtib.v/,r~ri111wWbai (541) 776-4043 David Arnold 4ff _ef.Oreslu t r[do 11/16/2022 803 FOB ASHLAND OR/NET30 City Accounts Payable Furniture & Planning Services 1 Planning, furniture and service for FY 23 1.0 • $3,900.00 $3,000.00 Goods and Services Agreement($35,000 or less) Completion date: June 30, 2023 Project Account: , *************** GL SUMMARY*************** , I 088400-602400 $3,000.00' • • • • • • • I � � sA By: 11 ( Date: —ELT Authorized Signature - .3 000.00 -- V V `FORM #3 CITY OF . v, D A I,� t:��aO4�:for V,:'����'t.,Ctaa�_at�3 I<�.,I' D �� �r ° • 7 �S H LA N D REQUISITION Date of request:- 10/31/2022.:' Required date for delivery: ... . Vendor Name Workspace Address,City,State,Zip 110 E. Main Street,Jacksonville, OR 97530 Contact Name&Telephone Number • Brad Warren 541-227-1609 brad(a).workspaceteam.com Email address • SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Invitation to Bid ❑ Emergency ❑ Reason for exemption: Date approved by Council: ❑ Form#13,Written findings and Authorization ❑ AMC 2:50 (Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached _(If council approval required,attach copy of CC) ® Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: 0 State of Oregon ® Direct Award _(Attach copy of council communication) Contract# • O Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) ❑ State of Washington ' Date approved by Council: Contract# •_(Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement 0 Sole Source Agency • GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# ' Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids and solicitation attached ❑ Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Cquncll: 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 Valid until: (Date) Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment ❑ Special Procurement . City Administrator,AMC 2.50.070(4) 0 (3)Written proposals&solicitation attached ❑ Form#9,Request for Approval ❑ Annual cost to City exceeds$25,000,Council I ❑ Form#4,Personal Services$5K to$75K ❑ Written quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: • Valid until: (Dale) Description of SERVICES Total Cost Planning, ftrniture and service forFY2 3 . :1:& :,Fg:i0MMEME item# Quantity Unit Description of MATERIALS Unit Price Total Cost 1 • $0 $0.00 $0 $0.00 $0 $0.00 •❑ Per attached quote/proposal • " T.OTAL`>COST= ? Nam 0.00'...: ., <; Project Number: Account Number: 088400-602400 _i-:::;:;>;.;;:;;-: *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. • IT Director in collaboration with depart a t to approve all hardware and software purchases: /7"D/rector Date Support-Yes/No By signing this raga 'ale,,I codify t t t City's public contracting requirements have been satisfied. Employee: /!� �/ Department Hea . or It z C (Equ to or grea� Z or than$5,000) Department Manager/Supervisor: City anager: mat Iii (Greater than$35,060) j1/7 year.' Funds appropriated for current fists! / NO A V ma t ice Diff tor-(Equal to or greater than$5,000) Date Comments: • Form#3-Requisition • • GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) • •• • PROVIDER: Workspace CITY OF PROVIDER'S ASH LAND CONTACT:° Brad Warren • 20 East Main Street Ashland,Oregon 97520 ADDRESS: 110 E.Main Street. Telephone: 541/488-5587 Jacksonville, OR 97530 • Fax: 541/488-6006 PHONE: 541-227-1609 •• • • This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the Cityof • Ashland, an Oregon municipal corporation (hereinafter "City") and Workspace, (a domestic/foreign business • corporation)("hereinafter"Provider"), for planning, furniture and service. • 1. PROVIDER'S OBLIGATIONS 1.1 Provide planning, furniture and service for FY23 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and,by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and'that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to•exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS"shall hereinafter be collectively referred to as"Work." • 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder,a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the•equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and • Automobile Liability; 1.2.2 Each policy of such insurance shall be•on an "occurrence" and not a "claims made"form, and • shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been • issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • • Provider shall immediately notify the City of any change in insurance coverage • • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 6: Goods and Services Agreement between the City of Ashland and Workspace • • • 1.3 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, • familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights-and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $22,310.46 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 this Agreement and to any Subcontractor who performs 50%or more of the Work under this Agreement. Provider is also required to post the notice • attached hereto as"Exhibit A"predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them,and the approval . by the City of any assignment or subcontract shall not create any contractual relation between the assignee • or subcontractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective 10/18/2022 as specified in the SUPPORTING DOCUMENTS. • 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$3,000 (this is maximum, not to exceed amount of ENTIRE Agreement) without express, written approval from the City official Whose signature appears below, or such official's successor in office. Provider.expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 3. GENERAL PROVISIONS • 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. Page 2 of 6: Goods and Services Agreement between the City of Ashland and Workspace • 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave,and retirement. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof.•It supersedes all prior agreements, negotiations,and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. • 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. • • 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under ibis Agreement shall be in the .•• . Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue, and expressly consents that, upon motion of the other party, any case may be dismissed or its venue • transferred, as appropriate,so as to effectuate this choice of venue. . 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of • • any nature resulting from, arising-out of, or relating to the activities of Provider or its officers, employees,contractors,or agents under this Agreement. • • 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God,strikes,lockouts,accidents,or other events beyond the control of the other-or the other's officers,employees or agents. • 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable,preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be.F.O.B destination. Provider shall pay all transportation and handling charges for the Goods. Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects,fraud, and warranties. 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72(UCC). 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor,material and manufacture. Provider shall transfer all warranties to the City. Page 3 of 6: Goods and Services Agreement between the City of Ashland and Workspace • • • • 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:" • • O The Provider's complete written Rate Sheet dated October 18, 2022. 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually • complimentary and supplementary wherever possible. In the event of a conflict which cannot be so . resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including, but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1,4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively,successively or in any order whatsoever. 5,2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits, If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION • 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 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, 6.2.2 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 thanfourteen(14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: • • If to the City: • •Page 4 of 6: Goods and Services Agreement between the City of Ashland and Workspace • • 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: Workspace • Attn:Brad Warren • 541-227-1609 • 8. WAIVER OF BREACH • One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant 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 of this Agreement, including any extensions hereof, comply • with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to • Provider;and (iii) Any rules,regulations, charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider, for a period of no fewer than six(6)calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305,620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider;and • (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of . the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the,tax laWs of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement, Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. • Page 5 of 6: Goods and Services Agreement between the City of Ashland and Workspace • IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND:, Workspace(PROVIDER):. By: vB(/ By: Si• •ature Signature Seo- Clair Steffens Printed Naitte Printed Name • COO tcam 1ote�:S rte*c . Title Title itlt12 cm-2- 10/31/22 • ate Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. g ° 7D • • • • • • • • • • • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Workspace . 1 worksD J e. October 18,2022 planning+furniture+service • OMNIA CONTRACT # 2020000622-5 • FEE SCHEDULE Rate Per Hour o Design $85 o Basic/ Non-Union Installation- Regular Business Hours $90 o Basic/ Non-Union Installation- After Hours $3.35 o Standard/ Non-Union Project Management $90 o Standard/ Non-Union Asset Management $90 o Union Installation- Regular Business Hours $150 o Union Installation- After Hours $225 o Union Project Management $150 o Union Asset Management $150 o Cost Per Truck $45 . i office 541.776.4043 service@workspaceteam.com 110 E Main St fax 541.776.4043 workspaceteam.com Jacksonville,OR 97530 • ® DATE(MM/DDNYYY) A�'ORU 4...---- CERTIFICATE OF LIABILITY INSURANCE 10/27/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES , BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. • If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT • Hart Insurance Agency - Medford PHONE Misty 0 Whorley FAX ' PO Box 1240 IANC.No.Ext): (541) 779-4232 INC.Nal: ADDRESS: mWhorley0hartirieurance.COm Grants Pass OB 97526• INSURER(S)AFFORDING COVERAGE NAILS • INSURER A:SAIF Corporation 36196 INSURED (541) 776-4043 INSURER B:Travelers. Casualty Insurance Com 19046 Interior Office Concepts Inc • INSURER c;Travelers Property Casualty Comp 25674 •• PO Box 1507 • INSURER D: • Jacksonville OR 97530 • INSURER E: 1 INSURER P: COVERAGES CERTIFICATE NUMBER:cert ID 23639 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD • INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP . LTR TYPE OF INSURANCE INS WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS•MADE [X I OCCUR Y 68000485785 D9/05/2022 09/05/2023 pREMISESERENTED rnce) $ 300,000 MED EXP(Any one person) _ $ 500 • PERSONAL&ADV INJURY S 2,000,000 GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 • X POLICY n PRO-JECT I I 1 LOC PRODUCTS-COMP/OP AGG $ 4,000,00 0 OTHER: $ AUT°MOBILELIABILITY COMBINED SINGLE LIMIT $ . (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ ATOS ONLY ATOS AUTOSHIRED NON-OWNED ONLY AUTOS ONLY (Per acc accident) $ • $ C UMBRELLALIAB X OCCUR COP3R437036 09/05/2022 09/05/2023 EACH OCCURRENCE S 1,000,000 X EXCESSLIAB CLAIMS-MADE AGGREGATE 5 1,000,000 BED X RETENTIONS 5,000 S A WORKERSNDEMEMPLOYERTIONS' 879175 03/01/2022 03/01/2023 X PER ERH AND EMPLOYERS'LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE Y!N E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED7 Y N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 . It yes,descdbeunder 1,000,000 DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ $• $ • DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) With respect to the City of Ashland, Oregon its officers, agents and employees - policy includes automatic additional insured where required by written oontract per attached CGD105 04/94. 111 CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE• THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN • ACCORDANCE WITH THE POLICY PROVISIONS. .' City of Ashland 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 D. �- 1 , ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD . Page 1 of 1 AC R® DATE(MM!DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. • IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTANAME:CT Misty A Morley Hart Insurance Agency - Medford PHONE FAX PO Box 1240 (ANC,No,Ext): (541) 779-4232 IANC,No): . E-MAIL' Grants Pass OR 97528 ADDRESS: mwhorleyDhartinsuranoe.corn INSURER(S)AFFORDING COVERAGE NAIL N INSURER A:Acuity A Mutual Insurance Co 14184 INSURED • (541) 776-4043 INSURERS: Interior Office Concepts Inc INSURER C: PO Box 1507 INSURERD: Jacksonville OR 97530 • INSURER E: • INSURER F: COVERAGES • CERTIFICATE NUMBER:Cert ID 23641 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED..NOTIMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPEOFINSURANCE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMJDDNYYY) (MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCED $ I CLAIMS-MADE OCCUR PREMISES l a occurrence) PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AOG $ OTHER: $ AUTOMOBILEUABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ee accident) A X ANY AUTO X ZK8319 09/05/2022 09/05/2023 BODILY INJURY(Per person)• $ OWNED r— SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY — AUTOS ONLY (Perautdent) •• $ A UMBRELLALIAB X OCCUR. ZK8319 09/05/202209/05/2023 EACH OCCURRENCE $ 1,000,000 X EXCESS UAB CLAIMS-MADE • AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION j PERTUTE 0TH • AND EMPLOYERS'LIABILITY Y!N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) G,L DISEASE-GA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L-DISEASE-POLICY LIMIT $ $ S DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may bo attached Ir more space Is required) With respect to the City of Ashland, Oregon its officers, agents and employees - policy includes automatic additional insured where required by written contract per attached CA7214 10/98 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. • 20 Mast Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 D. ©1988-2015 ACORQ CORPORATION. All rights reserved. • ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1 . • • COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT,CAREFULLY. BLANKET ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE•PART PROVISIONS: 1. WHO IS AN INSURED (SECTION I1) is amended in a written contract for this insurance to to include as an insured any person or organiza apply on a primary or contributory basis. • • tion (called hereafter "additional insured") whom 3. This insurance'does not apply: you have agreed in a written contract, executed prior to loss, to name as additional insured, but a. on any basis to any person or organization only with respect to liability arising out of "your for whom you have purchased an Owners work" or your ongoing operations for that addi- and Contractors Protective policy. tional insured performed by you or for you. b. to "bodily injury," "property damage," "per- 2. With respect to the insurance afforded to Addi- sonal injury," or "advertising injury" arising tional Insureds the following conditions apply: out of the rendering of or the failure to render any professional services by or for you, in- a. Limits of. insurance — The following limits of eluding: liability apply: 1. The preparing, approving or failing to 1. The limits which you agreed to provide; prepare or approve maps, drawings, or opinions, reports, surveys, change or- 2. The limits shown on the declarations, ders, designs or specifications; and whichever is less. 2. Supervisory, inspection or engineering b. This insurance is excess over any valid and services. collectible insurance unless you have agreed • • . i ,CG D1 05 04 94 . ' Copyright, The Travelers indemnity Company, 1994. Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. i • • ADDITIONAL INSURED-AUTOMATIC STATUS WHEN REQUIRED IN CA-7214(10-98) WRITTEN AGREEMENT WITH YOU -PRIMARY This endorsement modifies insurance provided under out of operations performed for the additional insured the following: by you, BUSINESS AUTO COVERAGE FORM 2. The coverage provided by this endorsement will GARAGE COVERAGE FORM. be primary and noncontributory with respect to any MOTOR CARRIER COVERAGE FORM other coverage available to the additional Insured. 1. Who Is an Insured under Section II - Liability 3. The Limits of Insurance applicable to the Coverage is amended to include any person or additional insured are those specified in the written organization with whom you have agreed in writing in con-tract or agreement or in the Declarations for this a contract or agreement that such person or Coverage Form, whichever is less. These Limits of organization be added as an additional insured on Insurance are inclusive and not in addition to the your policy. Such persons or organizations are addi- Limits of insurance shown in the Declarations. tional insureds only with respect to liability arising • • • • • • • • • • • • • • CA-7214(10.98) Includes copyrighted material of insurance Services Office,Inc.,with Its permission. Page 1 of 1