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HomeMy WebLinkAbout2022-161 PO 20220348- Polaris Land Surveying LLC Purchase Order /Ma + - gEC•RDER Fiscal Year 2022 Page: 1 of: 1 B City of Ashland Jzls�jL� ; 1ss� tEl�b �lu� -- I ATTN: Accounts Payable -y�—T----_—_— �—;- � 20 E. Main Purchase 2.02203.48 Ashland, OR 97520 Order# T Phone: 541/552-2010 • O Email: payable@ashland.or.us S C/O Parks Department E POLARIS LAND SURVEYING LLC H Admin Office N PO BOX 459 340 South Pioneer D P Ashland, OR 97520 O ASHLAND, OR 97520 T Phone: 541/488-5340 R p Fax: 541/488-5314 Le LaJ�a:LaJ'H Nl9mu i — °e.15 a 6'.s=6. 7101- �e':cSs�gji_791I_J �ea411 e- 1I e i _� a L=7-1 L : —_ ___ 541 482-5009_ __ Michael Black aaJ@st=7� Is a ]W,1Z-51131@;901 1� -jpJ_c.41--Fi€�E _ 'i 05/24/2022 604 FOB ASHLAND OR . Ci Accounts Pa able 1-. L 1 _; �a �., ase `� Topographical Survey_. , ._=- _ _ —. 1 Topographical Survey for 2228 East Main Street 1.0 $6,400.00 $6,400.00 Personal Services Agreement(less than $35,000) Completion date: July 31,.2022 Project Account:. E-000745-999 *************** GL SUMMARY*************** 123000-704200 $6,400.00 . I I I • By: Date: Authorized ignatur'es,e _T- - r=— $6 400.00 �� FORM #3 CITY OF e ., .0 , y ASHLAND ,, , i(k1: 1 ,„ =: il ' -i0. . . " 1, //�` REQUISITION i• � r frequest: 05/05/2022 Required date for delivery: Vendor Name Polaris Land Surveying,LLC . • • Address,City,State,Zip PO Box 459 Ashland OR 97520 • Contact Name&Telephone Number • Shaun Kampmann' Email address shawn@polarissurvey.com, SOURCING METHOD .j ❑ Exempt from Competitive Bidding El 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) ❑ 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: El State of Oregon • 0 Direct Award _(Attach copy of council communication) Contract# ' ❑ VerbalMlritten bid(s)or proposal(s) El Request for Qualifications(Public Works) ❑ State of Washington Date approved by Council: - Contract It _(Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement- ❑ Sole Source Agency GOODS&SERVICES 0 Applicable'Form(#5,6,7 or 8) Contract# ' Greater than$5,000 and less than$100,000 ❑ Written quote or proposal attached Intergovernmental Agreement (3)Written bids&solicitation attached ❑ Form#4,Personal Services$5K to$75K , Agency • PERSONAL SERVICES Date approved by Council: ❑ Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 ,. Valid until: (Date) Agreement approved by Legal and approved/signed by © Less than$35,000,by direct appointment 0 Special Procurement . City Administrator.AMC 2.50.070(4) • ❑ (3)Written proposals&solicitation attached ❑ Form#9,Request for Approval ❑ Annual cost to City exceeds$25,000,Council ❑ 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:_ _ ___• (Date) _ Description of SERVICES Topographical Survey for 2228 East Main TOTAL COST $ 6,400.00 _ , ' , Item# Quantity Unit • Description of MATERIALS Unit Price Total Cost • EI Per attached quotelproposal • •'TOTAL'cosT • Project Number u o o 7 4 5. o 0 0 •Account Number 1 2 3 0 0 0.7 0 4.L o 0 64.00. Account Number Account Number - *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director In collaboration with department to approve alt,hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,I certify that the City's public contracting requirements have been satisfied. -� -- Employee: /Q�/�;�-1 Department Head: • • (Equal to or greater than$5,000) Department Manager/Supervisor: City Manager: . • (Greater than$35,000) Funds appropriated for current.fitcal year: YES/NO 'V �.��Q�L May 1 f, 2022 Finance Director-(Equal to argreateultarr$5,0QO) Date Colhtlents: . . Form 113-Requisition , • a • • • PERSONAL SERVICES AGREEMENT(LESS THAN$35,000) . CONSULTANT: Polaris Land Surveying,LLC CITY OF s H LAN D. ADDRESS: PO Box 459 20 East Main Street Ashland OR, 97520 Ashland;Oregon 97520 Telephone: 541/488-5340 TELEPHONE: 541-482-5009 Fax: 541/552-5314 • •EMAIL: shawn@polarissurvey.com This Personal Services Agreement(hereinafter"Agreement")is entered into by and between,the City E of Ashland,an Oregon municipal corporation(hereinafter "City")and Polaris Land Surveying,LLC,a domestic business corporation("hereinafter"Consultant"),for a full Property Boundary&Topographic Site Survey of ' the park site located at 2228 East Main Street. I• ' � 1 NOW THEREFORE,.in consideration of the mutual covenants contained herein,the City and Consultant hereby agree as follows: 1. Effective Date and Duration: This Agreement shall become effective on the date of execution on behalf of the City,as set forth below(the"Effective Date"),and unless sooner terminated as specifically provided herein,shall terminate upon the City's affirmative acceptance of Consultant's Work as complete and Consultant's acceptance of the City's final payment therefore,but not later than July 31, 2022. 2. Scope of Work: Consultant will provide a full Property Boundary&Topographic Site Survey of the . . park site located at 2228 East Main Street.as more fully set forth in the Consultant's Proposal dated April 30,2022 which is attached hereto as"Exhibit A"and incorporated herein by this-reference. • Consultant's services are collectively referred to herein as the"Work." 3. Supporting Documents/Exhibits; Conflicting Provisions: This Agreement and any exhibits or other • supporting documents shall be construed to be mutually complementary 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 exhibits or supporting documents. • 4. All Costs Borne by Consultant: Consultant shall,at its own risk,perform the Work described above and,unless otherwise specified in this Agreement,furnish all labor,-equipment,and materials required for the proper performance of such Work. 5. Qualified Work: Consultant has represented,and by entering into this Agreement now represents,that all personnel assigned to the Work to be performed under this Agreement are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be • registered,Iicensed or bonded by the State of Oregon,.are so registered,licensed and bonded. 6. Compensation: City shall pay Consultant the sum of$6,400.00(Sixty Page 1 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND Polaris Land Surveying,LLC. • i f Four Hundred Dollars)as full compensation for Consultant's performance of all Work under this Agreement. In no event shall Consultant's total of all compensation and reimbursement under this Agreement exceed the sum,of$6,400.00(Sixty-Four Hundred Dollars)without the express,written approval from the City official whose signature-appears below,or such official's successor in office. Payments shall be made within thirty(30)days of the date of receipt.by the City of Consultant's invoice. E Should this Agreement be terminated prior to completion of all Work,payments will be made for any phase of the Work completed and accepted as of the date of termination: 7. Ownership of Work/Documents: All Work,work product,or other documents produced in - 1 . furtherance of this Agreement belong to the City,and any copyright,patent,trademark proprietary or 1 • any other protected intellectual property right shall vest in and is hereby assigned to the City. S. Statutory Requirements: The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. y . 9. Living Wage Requirements: If the amount of this Agreement is$22,310.46 or more,Consultant is i 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 I Subcontractor who performs 50%or more of the Work under this Agreement. Consultant is also required to post the notice attached hereto as"Exhibit B"predominantly in areas where it will be seen 1 . by all employees. - 10. Indemnification: Consultant hereby agrees to defend,indemnify,save,and hold City,its officers, ijii f employees,and agents harmless from any and all losses,claims,actions,costs,expenses,judgments, or other damages resulting from injury to any person(including injury resulting in death),or damage (including loss or destruction)to property,of whatsoever nature arising out of or.incident to the performance of this Agreement by Consultant(including but not limited to,Consultant's employees, agents,and others designated by Consultant to perform Work or services attendant to this Agreement). However,Consultant shall not be held responsible for any losses,expenses,actions,costs,or other damages,caused solely by the gross negligence of City. • 11. Termination: a. Mutual Consent. This Agreement may be terminated at any time by the mutualconsent of both parties. • ` b. City's Convenience. This Agreement may be terminated by City at any time upon not less than 11 • thirty(30)days' prior written notice delivered by certified mail orin person. . i c. For Cause. City may terminate or modify this Agreement,in whole or in part,effective upon 1 delivery of written notice to Consultant,or at such later date as may be established by City under •any of the following conditions: i i. If City funding from federal,state,county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; i ii. •If federal or state regulations or guidelines are modified,changed,or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this Agreement or are no longer eligible for the funding proposed for payments authorized by this F Agreement;or i Page 2 of b: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND Polaris Land Surveying,LLC. i 1 iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this Agreement is for any reason denied,revoked, suspended,or not renewed. d: For Default or Breach. • 1. Either City or Consultant may terminate this Agreement in the event of a breach of the Agreement by the other. Prior to such termination the party seeking termination shall give to • the other party written notice of the breach and its intent to terminate, If the party committing the breach has not entirely cured the breach within fifteen(15) days of the date•of the notice,or within such other period as the party giving the notice may authorize in writing, . then the Agreement may be terminated at any time thereafter by a writtennotice of . termination by the party giving notice. • ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this Agreement. City,by written notice to Consultant of default or breach,may at any time terminate the whole or any part of this Agreement if Consultant fails to provide the Work called for by this Agreement within the time specified herein or within any extension thereof. iii. The rights and remedies of City provided in this subsection(d)are not exclusive and are in addition to any other rights and remedies provided by law or under this Agreement. 12. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City for any purpose. 13. Assignment: Consultant shall not assign this Agreement or subcontract any portion of the Work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. 14. Default. The Consultant shall be in default of this Agreement if Consultant: commits any material breach or default of any covenant,warranty,certification,or obligation under the Agreement;institutes • an action for relief in bankruptcy or has instituted against it an action for insolvency;makes a general assignment for the benefit of creditors;or ceases doing business on a regular basis of the type identified in its,obligations under the Agreement;or attempts to assign rights in,or delegate duties under,this Agreement. . 15. Insurance. Consultant shall,at its own expense,maintain the following insurance: a. Workers' Compensation. Consultant shall obtain and maintain Workers'Compensation insurance in compliance with ORS 656.017,which requires subject employers to provide Oregon Workers' Compensation coverage for its subject workers,unless such employers are exempt under ORS • 656.126. If exempt under ORS 656.126,Consultant shall certify such exemption to the City. • b. Professional Liability.insurance with a combined single limit,or the equivalent,of not less than $40041031(two milili' o lay'1 per occurrence. This is;to cover any damages caused by error, omission or negligent acts related to the Work to be provided under this Agreement, c. General Liability insurance with a combined single limit,or the equivalent,of not less than 2 000 00 0 tt�wo miil02 a odar per occurrence for Bodily Injury,Death,and Property Damage. Page 3 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND Polaris Land Surveying,LLC. • ' i • 1 • • ` i d. Automobile Liability insurance with a combined single limit,or the equivalent,of not less than grODOT000I(one million dolla►�a for each accident for Bodily Injury and Property Damage,including coverage for owned,hired or non-owned vehicles,as applicable. e. Notice of cancellation or change. 'There shall be no cancellation,material change,reduction of limits or intent not to renew the insurance coverages)without thirty(30)days' prior written notice from the Consultant or its insurer(s)to the City. • 1. Additional Insured/Certificates of Insurance. Consultant shall name the City of Ashland,Oregon, • and its elected officials,officers and employees as Additional Insureds on any insurance policies, excluding Professional Liability and Workers' Compensation,required herein,but only with ' respect to Consultant's services to be provided under this Agreement.The consultant's insurance is primary and non-contributory.As evidenceof the insurance coverages required by this Agreement, • the Consultant shall furnish acceptable insurance certificates and endorsements prior to commencing the Work under this Agreement.• • 16. Nondiscrimination: Consultant agrees that no person shall,on the'grounds of race,chlor,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 any Work under this Agreement when employed by Consultant. Consultant agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes,rules • and regulations. Further,Congultant 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 • regdired by ORS 279A.110. 17. Consultant's Compliance With Tax Laws: . 17.1 Consultant represents and warrants to the City that: ' ' . • 17.1.1 Consultant 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 Consultant;and (iii).Any rules,regulations,charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. • 17.1.2 Consultant,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 Consultant;and (iii) Any rules,regulations,charter provisions,.or ordinances that implement or enforce any of the foregoing tax laws Or provisions. . 18. Governing Law;Jurisdiction: This Agreement shall be governed and construed in accordance Page 4 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND Polaris Land Surveying,LLC. • ' • • • • with 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. 19. Notice. Whenever notice is required or permitted to be given under this Agreement,such notice shall be given in writing to the other parti•by personal delivery,by sending via a reputable commercial overnight courier,by mailing using registered or certified United States mail,return receipt requested,postage prepaid,or by electronically confirmed at the address or facsimile number set forth below: • If to the City: • Ashland Parks and Recreation Commission • Attn:Contract Administrator. 340 S.Pioneer Street Ashland,Oregon 97520 • With a copy to: ' City of Ashland-Legal Department 20 East Main Street • Ashland,Oregon 97520 • If to Consultant: • - Polaris Land Surveying,LLC POBox 459 Ashland OR,97520 20. Amendments. This Agreement may be amended only by written instrument executed by both parties • • with the same formalities as this Agreement. 21. • THIS AGREEMENT AND THE ATTACHED EXHIBITS CONSTITUTE THE ENTIRE UNDERSTANDING BETWEEN THE PARTIES. THERE ARE NO UNDERSTANDINGS, • AGREEMENTS,OR REPRESENTATIONS,EITHER ORAL OR WRITTEN,NOT SPECIFIED HEREIN REGARDING THIS AGREEMENT. CONSULTANT,BY SIGNATURE OF ITS '• AUTHORIZED REPRESENTATIVE,HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS AGREEMENT,UNDERSTANDS IT,AND AGREES TO BE BOUND BY.ITS TERMS AND CONDITIONS. • 22. Certification. Consultant shall.execute the certification attached hereto as"Exhibit C" and incorporated • herein by this reference. • • 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. , • Page 5 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND Polaris Land Surveying,LLC. . CITY OF ASHLAND: Polaris Land Surveying,LLC.(CONSULTANT): By: By: . 4k/A-.11.----14-141":1 Signature 4+/A-.11. --- Signature ' Signature , /1ifd/14, / r d /46*- Printed Name Printed Name Title Title V Date. Date Purchase Order No. (W-9 is to be submitted with this signed Agreement) • • Page 6 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND Polaris Land Surveying,LLC. • • • • EXHIBIT B CITY OF ASHLAND, OREGON • City. of Ashland • LIVING • ALL employers described - WAG E below must comply with City • of Ashland laws regulating •a ment of a livin• wa•e. I $15.96,per hoar;•effective June 30,2021: . • The•Living Wage is adjusted:annually.every. . June 30 by the Consumer Price:Index. Employees must be paid a portion of business oftheir - 401K and IRS eligible living wage: employer,if the employer has cafeteria plans(including ten or more employees,and childcare)benefits to the has received financial amount of wages received by > For all hours worked under a assistance for the project or the employee. business from the City of service contract between their Ashland in excess of > Note: For temporary and employer and the City of $22,310.46. part-time employees,the Ashland if the contract Living Wage does not apply exceeds$22,310.46 or more, > If their employer is the City of to the first 1040 hours worked • Ashland,including the Parks in any calendar year. For > For all hours worked in a and Recreation Department. . more details,"please see . month if the employee spends Ashland Municipal Code • • 50%or more of the > In calculating the living wage, Section 3.12.020. employee's time in that month employers may add the value working on a project or of health care,retirement,• For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,20 East Main Street,Ashland,OR 97520,or visit the City's website at www.ashland.or.us. INotice to Employers:This notice must be posted predominantly in areas where it can be seen by all employees. • CITY OF ASHLAND • Page 1 of I: EXHIBIT B , • i EXHIBIT C • CERTIFICATIONS/RCPRESENTATIONS: Consultant,by and through its authorized representative,under penalty of perjury,certifies that(a)the number shown on the attached W-9 form is its correct taxpayer ID(or is waiting for the number to be issued to it and(b)Consultant is not subject to backup withholding because: (i)it is exempt from backup withholding,or(ii)it has not been notified by the Internal Revenue Service(IRS)that it is subject to backup withholding as a result of a failure to report all interest or dividends,or(iii)the IRS has notified it that it is no longer subject to backup withholding. Consultant further represents and Warrants to City that: (a)it has the power and authority to enter into this Agreement and perform the Work,(b)the Agreement,when executed and delivered,shall be a valid and binding obligation of Consultant enforceable in accordance with its terms,(c)the work under the Agreement shall be performed in accordance with the highest professional standards,and(d)Consultant is qualified,professionally competent,and duly licensed (if applicable)to perform the Work. Consultant also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, it is an independent contractor as defined in the Agreement,it is authorized to do business in the State of Oregon,and Consultant has checked four or more of the following criteria that apply to its business. • V (1)Consultant carries out the work or services at a location separate from a private ' residence or is in a specific portion of a private residence,set aside as the location of the ss. (2)-Commercibuinesal advertising or business cards or a trade association membership are �. / purchased for the business. 1/ (3)Telephone listing is used for the business separate from the personal residence t listing. (4)Labor or services are performed only pursuant to written contracts. • 1,7 (5)Labor or services are performed for two or more different persons within a period � of one year. / V/ (6)Consultant assumes financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties,errors and omission(professional liability)insurance or liability insurance relating to the Work or services to be provided. • Consultant's signature • kUj r. 14 Date • • • Page 1 of 1: EXHIBIT C • • • • • • AC CERTIFICATE CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY). ' 05/02/2022 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 pollcy(ies)must have ADDITIONAL INSURED provislons'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 Ryan Schorovsky State arm Jon Snowden Insurance Agency,Inc. , inrc°,No.ERR: (541)482-2461 IFN FAx Nol: (541)482-4957 420 Bridge St ADDRESS: ryan.schorovsky.szmr@statefarm.com b ' INSURER(S)AFFORDING COVERAGE NAIC 6 Ashland • OR 97520 INSURER A:Slate Farm Fire and Casualty Company 25143 INSUREDINSURER B: State Farm Mutual Automobile Insurance Company 25178 Polaris Land Surveying,LLC INSURER C: • PO Box 459 - INSURER D: • - INSURER E: Ashland OR 97520INSURERF: . • COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD . INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRR TYPE OF INSURANCE ?NSD WVD • POLICY NUMBER PMIDOYEFF PMJDDIY YYI • LIMITS (MMIDDIYYW) (MMIDD/YYYY) ' X COMMERCIAL GENERAL LIABILITY • EACH OCCURRENCE 5 1,000,000 CLAIMS•MADE X OCCUR , PREM SEGE S EaEou RENTED $ 300.000 _ • MED EXP(Any one parson) 5 5,000 L _ Y 97-CQ-H089-5 05/07/2022 05/07/2023 PERSONAL&ADV INJURY s GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 , 1 POLICY n 28-i Plum LOC PRODUCTS-COMP/OP'AGG $ OTHER S. AUTOMOBILE LIABILITY L23 4521-D30-371 04/30/2022 10/30/2022 lee MBleNdEeeO SINGLE LIMIT $ 1,000,000 ANY AUTOBODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS 090 4953-B09-37F ' 02/09/2022 08/09/2022— • B X Y • BODILY INJURY(Per accident) $ . _ HIRED NON.OWNED. PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY /Per accident) S • i . UMBRELLA LIAB OCCUR EACH OCCURRENCE S ! EXCESS LIAB CLAIMS-MADE / AGGREGATE S DED RETENTION 5 . S • WORKERS COMPENSATION PER UTF ETH S • . AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? El N/A 97-CM-P557-9 05105/2022 05105/2023 (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 500,000' • • • If yes,deecdbe of • DESCRIPTION OF OPERATIONSbelow E.LDISEASE-POLICYLIMIT S 500,000 . • • "DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If mon*pace la required) • Land Surveying . _ On-call services The City of Ashland,its elected officials&employees are Included as additional Insureds. Coverage Is primary and non-contributory. • 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 OREGON AND ITS ELECTED ACCORDANCE WITH THE POLICY PROVISIONS. OFFICIALS,OFFICERS&EMPLOYEES AUTHORIZED REPRESENTATIVE .20'H MAIN ST ���f �' 29Gti2 ASHLAND OR 97520 '" I Ie . ©1988-2015 ACORD CORPORATION. All rights reserved. • ACORD 25(2016/03) The ACORD name and logo are registered marks ofACOI3D . •1001458 132849.14 04-13.2022 . . • , • i A RD® CERTIFICATE OF LIABILITY INSURANCE • DATE(MM/DblYYW) I 08,17/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS i CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED ' REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; If the certificate holder is an ADDITIONAL INSURED,the pollcy(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 • • CONTACT LeZette Brewton NAME: Assurance Risk Managers,Inc. PHONE (303)454-9562 FAX (303)454-9684 (AIC.No,Ext): (A/C,Na): i; r 10851 East Bethany Drive q AILss: iezette,brewton@arm-Lcom I DR Suite 300 • INSURER(S)AFFORDING COVERAGE 11/4/AleN E Aurora CO 80014-2688 INSURER A: Hanover Insurance Company - 22202 INSURED • , INSURER B: • Polaris Land SurVeyIng,LLC. INSURER C: 1 ---1 P O Box 459 INSURER : INSURER E: . • Ashland OR 97520-0016 INSURERP: COVERAGES - CERTIFICATE NUMBER: 21-22 E&O REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD i INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.. ! r ApOLIC EFF POLICY EXP LTR TYPE OF INSURANCE IN5D VE/13 NUMBER , AIM1DDMW) thimmoYYYYt LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CESJCLAIMS-MADE ri OCCUR PREMISES(Ea occurrence) $ • P •� . _ MED EXP(Anyone person) $ [�} — • PERSONAL&ADVINJURY $ GENT-AGGREGATE PER: GENERAL AGGREGATE $ ,13; •POLIGY,n 1.28, n LOC PRODUCTS•COMP/DPA%) S h OTHER: S ' AUTOMOBILE LIABILITY (Ea OBBBIINdEDtSINGLE LIMIT $ ANY AUTO— BODILY INJURY(Per person) S • P OWNED —SCHEDULEDII _AUTOS ONLY AUTOS a001LYINJURY(Perauldenl) S I HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY _ (Perauldent). .• s . • LI . UMBRELLA LIAB OCCUR • EACH OCCURRENCE $ ' li ~ EXCESS UAB CLAIMS-MADE AGGREGATE S • t DED RETENTION 5 S • t. WORKERS COMPENSATION' I PER r • 0TH-t AND EMPLOYERS'LIABILITY YIN STATUTE ER 1 I I ANY PROPRIETOR/PARTNER/EXECUTIVE N!A EL.EACHACCIDENT $ OFFICER/MEMBER EXCLUDED? • (Mandatory In NH) • EL DISEASE-EA EMPLOYEE S , • !ryas,describe under • DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 1 • PROFESSIONAL LIABILITY EACH CLAIM 1,000,000 .1A CLAIMS MADE POLICY LH4 A349055 08 06/28/2021 06/28/2022 aggregate • 2,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it mare space la required) 1 • PSA 025,000 or less) • . • t . . I I •CERTIFICATE HOLDER CANCELLATION • : • - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Ashland Oregon&Its Elected Officials 8,Employees ACCORDANCE WITH THE POLICY PROVISIONS. • 20 E Main St l ' AUTHORIZED REPRESENTATIVE• I Ashland OR 97520 Atitt,t,54 AwAiti.- � i • - ©1988.2015 ACORD CORPORATION. All rights reserved. jr ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD • • li @ ' • • L- A 4 > L ANP SURVEYING , 1- 1,- C •�• Y • • • s i April 30,2022 City of Ashland Parks Dept. • 340 South Pioneer Street • Ashland,Oregon 97520 Attn: Tara Kiewel,Manager Re: Boundary&Topographic Site Survey 2228 East Main Street,Ashland,Oregon Assessor's Map No.39 1E 11 CB,Tax Lot 200 _ Hi Tara, Per your request regarding the proposed East Main Park,the following is a proposal for surveying'services to perform a full Property Boundary&Topographic Site Survey of the park site located at 2228 East Main Street,per the scope of services outlined below: SCOPE OF SERVICES: ♦ Research of deeds,easements,surveys and utilities for the above described property and adjoiners,based on a title report to be furnished by owner. ♦ Field survey to re-establish project survey control network previously utilized by this office in the local area to determine subject property boundaries and easements.Also to survey and map site'topography and street sections. along East Main&Abbott Avenue to include pavement,curbs,sidewalks, fencelines,ditches,buildings,utilities,retaining walls,drainageways,slopes, • grades,signage,trees and other general topographic features. $ Office calculations and analysis of field survey data to determine property boundaries and preparation of the topographic site plan mapping at one foot contour Intervals.Deliverables to Include mapping In electronic AutoCAP.dwg format as well as on printed media to a standard engineering scale. ♦ Prepare and file a Map of Survey with the offiice of the Jackson County • Surveyor to conform with Oregon Revised Statutes(O.R.S.)209.250. • FEES; • • Fees will be paid on an Hourly oasis according to the attached hourly rate schedule enclosed as Exhibit&valid until December 31,2022.The estimated cost to perform the j'• P. 0. Sox 459, Ashland, Oregon 97520 w Phone': (54 i) 452-5009 or Fox: (541) 459.0797 Mobile: (541) 601-3000 it www,polarlosorvey.com 1 • Y Tara Kiewel ' Survey Proposal • Paget • professional surveying services as outlined in the Scope of Services above is as follows: A range between Fifty Eight Hundred and Sixty • Four Hundred Dollars. ($5,800.00-$0,400.00) Polaris Land Surveying LLC will endeavor to keep the actual cost of the work as low as • may be consistent with the purpose of the project and with proper workmanship and materials. All additional work that is outside the scope of services as described shall also be paid for at the hourlyrate schedule enclosed as Exhibit A. Any fees required by. City of Ashland,Jackson County,title companies,or other quasi-governmental agencies • • are not included in the surveying costs outlined above and shall be the responsibility of • the owner. S As compensation for services rendered,an invoice will 128 sent on the first day of each month,or at the conclusion of the project,showing the hours and rates of the various classifications of personnel working on the project. Payment of the Invoice amount must be made within 15 days of the invoice date. Late payments may be subject to a service charge of 1.5%per month of the unpaid balance,at the discretion of Polaris Land • Surveying LLC. This letter is written as a Surveying Proposal and Agreement.An acceptance line is provided for your signature if you wish to engage us to perform the aforementioned services.Please return one signed copy far our files. • In the event suit or action Is instituted to enforce this agreement or any terms hereof, or in the event of an appeal from suit,action or proceeding,the prevailing party shall be entitled to such sums as the court may adjudge reasonable as attorney's fees in such ' E suit,action or appeal. Please don't hesitate to call if you have any questions. F. • Yours truly, Shawn Kampmann Professional Land Surveyor • • S:\surveys11426-221COA Parks-Roc East Main Park Survey proposal.docx AIJTHORIZATlON1 • r "• Approved By Date P. 0. Box 459, Aohland, Oregon 97520 *• Phone: (541) 4132•-5009 Ye Pax: (541) 485-0797 Mobile: (541) 901-3000 a www.polarlaaurvey.eorn • . k • • • • i• A r� LAN ," SURVEYING , LLC_ • • EXHIBIT"A" • POLARIS LAND SURVEYING LLC • • EE SCHEDIJ . (EFFECTIVE JANUARY 1,2022) PRINCIPAL LAND SURVEYOR $140.00 I hour PROFESSIONAL LAND SURVEYOR $120.00/hour . SENIOR SURVEY TECHNICIAN .....$ 90.001 hour . • . SURVEY TECHNICIAN $ 80.00I hour DRAFTING TECHNICIAN $ 80.001 hour 0 SURVEY FIELD CREW(STANDARD) $160.001 hour • SURVEY FIELD CREW(WI GPS) 0 $ 180.00 I hour • DOCUMENT PROCE55ING. $ 60.001 hour • MILEAGE(out of town projects) • $ 0;545/mile OUT-OF-POCKET EXPENSES . ACTUAL COST • • • i '%, P. 0. Sox 459; A6Lland, Oregon 97520 Phone: (541) 482-5009 R Pax: (541) 458-0797 Mobile: (541) 501-3000 n www.polarissarvcy.com • CMP-4684.1 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ.IT CAREFULLY. ADDITIONAL INSURED—OWNERS, LESSEES,OR CONTRACTORS(Scheduled) This endorsement modifies insurance provided_underthe following: • BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number:97-CQ-H089-5 • Named Insured: POLARIS LAND SURVEYING LLC Name And Address Of Additional Insured Person Or Organization: CITY OF ASHLAND OREGON AND ITS ELECTED OFFICIALS,OFFICERS&EMPLOYEES 20 E Main St Ashland OR 97520-1814 • • 1. SECTION II-WHO IS AN INSURED of SECTION II—LIABILITY is amended to include;as an additional insured,any person or organization shown in the Schedule, but only: 1 a. Ongoing Operations With respect to liability for"bodily injury",;"property damage",or"personal and advertising injury"caused by your ongoing operations for that additional insured and only to the extent that such"bodily injury","property damage"or"personal and advertising injury"is caused by your negligence or the negligence of those performing operations\on your behalf;or b. Products-Completed Operations To the extent that the liability for"bodily injury"or"property damage"is caused by"your work"performed for that additional insured and included in the"products-completed operations hazard". . 2.. Any insurance provided to the additional insured shall only apply with respect to a claim made or a"suit"brought for damages for which you are provided coverage. 3. Primary Insurance.The insurance afforded the additional insured shall be primary insurance.Any insurance carried by the additional insured shall be noncontributory with respect to coverage provided by you. All other policy provisions apply. . • CMP-4684.1 1009821 2000 154101 200 05-14-2019 ' ©,Copyright,State Farm Mutual Automobile Insurance Company,2018 Includes copyrighted material of Insurance Services Office,Inc.,with its permission.