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2023-189 PO 20240165- Knife River Materials
fir , ic� Purchase Order , Aail Fiscal Year 2024 Page: 1 of: 1 • • It !;eLigi iy =si1-4a 1 .a�_ i P"-- :22•N LM Fl 7eI6gioiLA --_ N -- B City of Ashland _I WNItLF_—_ _ I ATTN:Accounts Payable L 20 E. Main Purchase L Ashland, OR 97520 Order# 20240165 T Phone: 541/552-2010 . O Email: payable@ashland.or.us • V "' H CIO Water Division E . KNIFE RIVER MATERIALS 1 90 North Mountaiin Ave N PO BOX 1145 p Ashland, OR 97520 . , O . MEDFORD, OR 97501 Phone: 541/488-5353 • R T Fax: 541/552-2329 —i=,E0g-a 1 g=i€®c=I- `_yi=IiI to412*.o0 f1-1 m.gliiiIl-I E3=i= i ] 1_— --= _- i_Tl:,_=42j:12=1_=Isi-?c— .---- —__ (541) 779-6304 Steve Walker(Water)Jason Robustelli Wastewater) =Batm1Ater$!M—teritirr�il e—m- _ = _=7_.§i2=Ia= —�Ma~)(_i=1=LT: 131= 7_e i2_oi _ -- 6I=>1=1 =1e'.a�'1 1 10/17/2023 774 FOB ASHLAND OR/NET30 . Cit Accounts Payable ani =a1 r iTI '-3I•.— — - =- __ _ ,INI IN'E-- EMTM m't, M eelil-'_ Asphalt Patching 1 Asphalt Patching 1.0 $2.00 $2.00 (Quotes for asphalt patching jobs anticipated to exceed$2,500) • Contract for Asphalt Patching Services . Completion date: June 30, 2028 Special Procurement _ • ' • Approved bythe City Council May 16, 2023 Valid until: June 30, 2028 • • S •. Project Account: • . Project Account: *************** GLSUMMARY*************** 081800-602400 $1.00 I I 086000-602400 $1.00 • / • • . -- �/1, if By: ' ►� r Date: � "'N ` Authorized Signature _±S _ 1 $2.00 • FORM #3 CITY OF �.�� $_ ASHLAND e'(' ;S'�, To a 't.tr( ?S,Orae REQUISITION Date of request: 10/17/2023 Required date for delivery: Vendor Name KNIFE RIVER • Address,City,State,Zip Contact Name&Telephone Number 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: ❑ State of Oregon ❑ Direct Award _(Attach copy of council communication) Contract# ❑ Verbal/Written bid(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 ❑ 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&solicitation attached 0 Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: 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 O Less than$35,000,by direct appointment t❑ Special Procurement City Administrator.AMC 2.50.070(4) 0 (3)Written proposals&solicitation attached El Form#9,Request for Approval 0 Annual cost to City exceeds$25,000,Council O Form#4,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) • Date approved by Council: 05/16/2023 Valid until:06/30/2028 (Date) Description of SERVICES • ASPHALT PATCHING(Quotes will be requested for jobs anticipated to exceed$2,500) TOTAL COST $ 2.00 • Item# Quantity Unit • Description of MATERIALS Unit Price Total Cost ❑ Per attached quote/proposal TOTAL COST Project Number Account Number 0 8 1 8 0 0. 6 0 2 4 o a , Account Number Account Number 0 8 6 0 0 0. 6 0 2 4 0 0 *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 all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisitio• orm,t ceerit i y *. the City's public contracting requirements have been satisfied. �� /�~�9 Department Head: �- I . I 23 Employee: f�'!i i e'er' q.... o or greater an$5,000) Departmeuj onager/Supervisor: ��/� _ / i Manager: (Greater than$3 000) Funds appropriated for current fiscal year. NO 3pni titv5. Fhance I ector-(Equ• o or* -ater than$5,000) Dat Comments: • • Form#3-Requisition - • • vas Council Business Meeting • • May 16,2023 r" ftetl Special Procurement- Asphalt Patching • kgr '�•y' xj , kY Michael Morrison Operations Deputy Director uttja i 7y ' michael.morrison(a ashland.or.us 541-552-2325 • letatT p '`. Requested by Council ❑• Update❑ Request for Approval ❑x Presentation ❑ SUMMARY • Approval is being requested for a Class-Special Procurement. • This Class-Special Procurement (sourcing method) will allow the use of an alternative solicitation • process to procure asphalt patching services. City departments have to make repairs to power lines,storm drains and water lines,etc.which requires the removal of minimal areas of asphalt to expose the areas in need of repairs and/or utility installations.Written price quotes (price/square foot) for jobs up to$2,500.00 will be obtained every 60 to 90 days for asphalt patching services' Departments will be required to obtain at least three.(3) written quotes for each individual asphalt patching job anticipated to exceed $2,500.00. Currently,there are two (2) asphalt paving contractors willing to do the small jobs and one (1) contractor that only wants to bid on asphalt patching jobs that exceed $2,500.00.Contracts and insurance certificates will be kept on file for each of the asphalt patching contractors for the term of the Class Special Procurement. • • • POLICIES,PLANS&GOALS SUPPORTED ' BACKGROUND AND ADDITIONAL INFORMATION A Special Procurement (sourcing method) is used for the purpose of seeking an exemption from the competitive bid process,custom designing a contracting approach,or the direct selection or award of a publiccontract or for a series of contracts.The attached Form#9 Special Procurement Request for Approval (written findings) is attached for your review and consideration. The Class-Special Procurement previously approved by Council on June 7,2016,is due to expire on June 30,2023. • . - • - FISCAL IMPACTS • • Departments budget for repairs such as asphalt patching, each fiscal year. . • DISCUSSION QUESTIONS - • • SUGGESTED NEXT STEPS . Staff recommends the Class-Special Procurement be approved for the reasons provided in the attached written findings. • Pagel of 2 , • r rMeeting Council Business • • REFERENCES&ATTACHMENTS 1. Form #9 Special Procurement Request for Approval (Written Findings) • • • • • • • • • • • • • • • • • • Page 2of2 1 rime fic#.• 5,;ilduz • CITY OF FORM #9 ASHLAND • - :;1PEC n L PROCURES EN - 1 EQ P STO Kai AP OVAL • To: City Council,Local Contract Review Board From: Mike Morrison, Operations Deputy Director - Date: May 16,2023 • Subject: • REQUEST FOR APPROVAL OF A SPECIAL PROCUREMENT - In accordance with ORS279B.085,this request for approval of a Special Procurement is being presented to the City Council for approval. This written requestfor approval describes the proposed.contracting procedure and the goods or services or the class of goods or services to be acquired through the special procurement and the circumstances that justify the use of a special procurement under the standards set forth ORS 279B.085(4). • 1. Requesting Department Name: Water,Wastewater,and Electric • 2. Department Contact Name: Steve Walker(Water),Jason Robustelli(Wastewater),Rick Barton(Electric) 3. Type of Request: X Class Special Procurement Contract-specific Special Procurement • 4. Time Period Requested: From July 1,2023 to: June 30,2028 • • 5. Total Estimated Cost: 6. Short title of the Procurement: Asphalt Patching Services Supplies and/or Services or class of Supplies.and/or Services to be acquired: City departments have to make required and necessary repairs to power lines, storm drains and water lines, etc.which requires the removal of asphalt to expose the areas in need of repairs and/or utility installations. An asphalt paving contractor will then be hired to provide the material and labor to patch .(replace)the asphalt as needed. Most of the asphalt paving jobs are relatively small asphalt patching jobs that range in cost from$450.00 to$2,500.00. 7:Background and Proposed Contracting Procedure: Provide a description of what has been done, in the past and the proposed procedure.The Agency may,but is not required to,also include the following types of documents:Notice/Advertising, Solicitation(s),Bid/Proposal Forms(s), Contract Foim(s), and any other documents or forms to be used in the proposed contracting procedure. Attach additional sheets as needed. Background: . The Class Special Procurement previously approved by Council on June 7,2016, • is due to expire on June 30,2023. Form#9-Special Procurement—Request for Approval,Page 1 of 3,5/1/2023 0 • Proposed-procedure: Written price quotes (price/square foot) for jobs up to $2,500.00 will be obtained every 60 to 90 days for asphalt patching services. Departments will be required to obtain at least three(3)written quotes for each individual asphalt patching job anticipated to exceed$2,500.00. Currently, there are two (2) asphalt paving contractors willing to do the small jobs and one (1) contractor that only wants to bid on asphalt patching jobs that exceed $2,500.00. Contracts and insurance certificates will be kept on file for each of the asphalt patching contractors for the term of the Class-Special Procurement. • 8. Justification for use of Special Procurement: Describe the circumstances that justify the use of a Special Procurement. Attach relevant documentation. . This Class Special Procurement(sourcing method)will allow the use of an alternative solicitation process to procure asphalt patching services. This process will simplify the solicitation and contracting process for the departments by eliminating the need for each department to request quotes, process a contract and obtain insurance certificates for each of the small asphalt paving jobs. The proposed solicitation process will continue to be an open and competitive process and contracts and insurance certificates will be maintained for each of the asphalt patching contractors. 9. Findings to Satisfy the Required Standards: This proposed special procurement: X (a)will be unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts because: The proposed solicitation process is open and competitive and will remain open and competitive.. (Please provide specific information that demonstrates how the proposed Special Procurement meets this requirement.); and X (b)(i)will result in substantial cost savings to the contracting agency or to the public because: Eliminating a duplication of efforts by the departments in regard to satisfying the public contracting requirements will result in cost savings•for each city department that has a need for asphalt patching services. • (Please provide the total estimate cost savings to be gained and the rationale for determining the cost savings);or • X (b)(ii)will otherwise substantially promote the public interest in a manner that could not practicably be realized by complying with the requirements of ORS 279B.055,279B.060,279B.065, or 279B.070, or any rules,adopted thereunder because: The proposed solicitation process will remain open and competitive,result in cost savings by eliminating a duplication of efforts by departments and satisfy the City's public contracting requirements. (Please provide specific information that demonstrates how the proposed Special Procurement meets this requirement.) • • Form#9-Special Procurement—Request for Approval,Page 2 of 3,5/1/2023 • Public Notice: Pursuant to ORS 279B.085(5)and OAR 137-047-0285(2),,a Contracting Agency shall give public notice of the Contract Review Authority's approval of a Special Procurement in•the same manner as a public notice of competitive sealed Bids under ORS 279B.055(4) and OAR 137-047-0300. The public notice shall describe the Goods or Services or class of Goods or Services to be acquired through the Special Procurement and shall give such public notice of the approval of a Special Procurement at least seven(7)Days before Award of.the Contract. • • After the Special Procurement has been approved by the City council,the following public notice will be posted on the City's website to allow for the seven(7) day protest period. Date Public Notice first appeared on www.ashland.or.us-[fapproved, May 17, 2023] PUBLIC NOTICE Approval of a Special Procurement First date of publication: [if approved, May 17, 2023] . A request for approval of a Special.Procurement was presented to and approved by the City Council,acting as the Local Contract Review Board, on.[fapproved May 16, 2023] This Class Special Procurement(sourcing method)will allow the use of an alternative solicitation process to procure asphalt patching services. Written price quotes (price/square foot)for jobs up to $2,50Q.00 will be obtained every 60 to 90 days for • asphalt patching services. Departments will be required to obtain at least three(3)written quotes for each asphalt patching jobs anticipated to exceed$2,500.00. This process will simplify the solicitation and contracting process for the departments by eliminating the need for each department to request quotes,process a contract and obtain insurance . • certificates for each of the small asphalt paving jobs. The proposed solicitation process will continue to be an open and competitive process and contracts and insurance certificates will be maintained for each of the asphalt patching contractors. It has been determined based on written findings that the Special Procurement will be unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts, and result in substantial cost savings or • . substantially promote the public interest in a manner that could not be realized by • complying with the requirements that are applicable in ORS 279B.055,279B.060, 279B.065,or 279B.070. • An affected person may protest the request for approval of a Special Procurement in accordance with ORS 279B.400 and OAR 137-047-0300. A written protest shall be delivered to the following address: City of Ashland,Kariann Olson,Purchasing • Representative,90 N.Mountain Avenue,Ashland, OR 97520. The seven(7)protest period will expire at 5:00pm on[ifpublished May 17, 2023, will expire May 24, 2023] This public notice is being published on the City's Internet World Wide Web site at least seven days prior to the award of a public contract resulting from this request for approval of a Special Procurement. . • Form#9-Special Procurement—Request for Approval,Page 3 of 3,5/1/2023 . . • , • . . , . . . • • • . . . . • . • . - . . - - . 1 . . . . . . • . . . . . . . . • • ' . - . _ Posting Number: PUBLIC NOTICE ASPHALT PATCHING 1 - ( • • . • Project Name: SPECIAL PROCURMIENTASPHALT PATCHING • . _ . . • • Release Date: 5/17/2023 . . - . .•• .-, • • . . - ' . Due Date:. 5/24/2023 • • . . . Due Time: 50000 PM - ' • . . . . • Status: None - • . • ' • , Description: PUBLIC NOTICE - . . . . Approval of a Special Procurement • - - . . . . • . . . . . • First date of publication: May 17,2)23-, • ' . - . • ' . . . . . . - . • A request for approval of a Special Procurement was presented to and approved by the City Council,acting as the Local Contract Review Board, on'Nay 16,2023. • . . . • • . . - . • - , . This Class Special Procurement(sourcing method)will allow the use of an alternative solicitation process to procure asphalt patching • • services_ Written price quotes(price/square foot)for jobs up to$2,500_00-will be obtained every 60-to 90 days for asphalt patching services. Departments will be required to obtain at least three(3)written quotes for each asphalt patching jobs anticipated to exceed.$2.500.00.This • . process will simplify the solicitation and contracting process for the departments by etillTifInting.the need for each department to request qtrotes, , . . _ proce.ss a contract and obtain insurance certificates for each ofthe small asphalt paving jobs.Currently,there are two(2)local contractors that . . • • continue to want to bid on asphalt patching jobs less than$2500 and one(1)contractor that has requested to bid.on jobs that exceed S2,500_The • . proposed solicitation process will continue to be an open and competitive process and contracts and insurance certificates will be maintained for „ . . • each oldie.asphalt patching contractors. . • . . ' . . It has been determined based on written findings that the Special Procurement null be unlikely to encourage favoritism in the awarding of public . . contracts or to substantially diminish competition for public contracts,and result in substantial cost savings or substantially promote the public • • . . interestin a manner that could not be realized by complying with the requirements that are applicable in ORS 27913.055,279B..060;27933_065, • • or 279B.070. . . . .. . .- - • • . . . . An affected pe.rsonmay protest the request for approval of a Special Procurement in accordance uith ORS 279B.400 and OAR 137-047-0300. • . - A-written protest shall be delivered to the.following address:City ofAshland;Kari Olson,Purchasing Representative,90I&Mountain Avenue, Ashland,OR 97520. The seven(7)protest period will expire at 5:00pm on May 24,2023. - . . - • This public notice is being published on the City's Internet World Wide Web site at least seven days prior to the award of a public contract resulting from this request for approval of a Special Procurement. • . • • . . . Request Bid Packet and/or Plan Holder List and Other Information . • . . . . . . . . . . . . . • . . . . _ • - . . . _. . . . . • • . • . . . . • •. . . . ' 1 L Contract for Asphalt Patching.Services CITY OF CONTRACTOR: Knife River Materials AS H LAN D CONTACT: Erica Corliss, Contract Manager 20 East Main Street • Ashland, Oregon 97520 ADDRESS: PO Box 1145, Medford, OR 97501 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-779-6304 DATE AGREEMENT PREPARED:August 31,2023 EMAIL: Erica.Corliss@kniferiver.com • BEGINNING DATE: September 1, 2023 COMPLETION DATE: June 30, 2028 COMPENSATION: Written bids (price/square foot) for asphalt patching jobs up to $2,500.00 will be obtained every 60-90 days for asphalt patching services. Departments will be required to obtain at least three (3) written bids for each individual asphalt patching job anticipated to exceed $2,500.00. GOODS AND SERVICES TO BE PROVIDED: ASPHALT PATCHING SERVICES ADDITIONAL TERMS:. Special Procurement(Sourcing Method/Alternative contracting process) approved by . the City Council on May 16, 2023, for a term beginning July 1, 2023.and ending June 30, 2028. NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: ' 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. • 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel • assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. . 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the • contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. 5. Ownership of Documents: All docdmehts prepared by Contractor pursuant to this contract shall be the property of City, 6. Statutory Requirements: ORS 279B.220, 2798.225, 2793.230, 2793.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $25,335.05 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor' who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless , from any and all losses,claims, actions, costs, expenses,judgments, subrogations, 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 contract by Contractor(including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, orother damages, directly, solely, and,proximately causedby the negligence of City. 9. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. • b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. c. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City,under any of the following conditions: 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; Contract for Asphalt Patching Services, Page 1 of 5 • • • 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 contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. . If any license or certificate required by law or regulation to be held by Contractor to provide the • services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Contractor may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach'has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require;then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Contractor's performance of each and every obligation and duty under - this contract. City by written notice to Contractor of default or breach, may at any time terminate the whole or any part of this contract if Contractor fails to provide services called for by this contract within the time specified herein or in 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 contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section,Contractor.shall immediately cease all activities under • this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, • Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to the termination date.if such work was performed in accordance with the Contract. 10. Independent Contractor Status:. Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 11. Non-discrimination Certification:The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any. requirement of ORS 279A.110 or the administrative rules implementing the Statute. 12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 13. Assignment and Subcontracts: Contractor shall not assign this contract 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. Contractor 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 City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor.and City. 14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 1 Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of any covenant,warranty, certification, or obligation,it owes under the Contract; if it loses its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor has qualified as a QRF for this 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 Contract; or attempts to assign rights in, • or delegate duties under, the Contract. 16. Insurance. Contractor shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017;which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. General Liability insurance with a combined single limit, or theequivalent, of not less than$2,000,000 or for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the • indemnity provided,under this contract. c. • Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s)without 30 days'written notice from the Contractor or its insurer(s) to • the City. • • Contract for Asphalt Patching Services, Page 2 of 5 e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its , elected officials, officers and employees as Additional'Insureds on any insurance policies required herein, _ excluding Workers' Compensation, but only with respect to Contractor's services to be provided under this . Contract.As evidence of the insurance coverages required by this Contract, the Contractorshall furnish acceptable insurance certificates prior to commencing work.under this contract.The contractor's insurance is . primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance.policies, trust agreements, etc, shall be provided to the City. The Contractor shall be financially responsible for all pertinent • deductibles, self-insured retentions and/or self-insurance. . 17. Governing Law; Jurisdiction;Venue: This contract shall be.governed and construed in accordance with the laws • of the State of Oregonfwithout resort to any jurisdiction's conflict of laws, rules or doctrines. .Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to this contract shall be brought and conductedsolelyand exclusively within • • the Circuit Court of Jackson County for the State of Oregon. If;however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the . •• District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts: In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from-any claim or from the jurisdiction. 18. THIS CONTRACT AND•ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL• • BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL.BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. • CONTRACTOR, BY•SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT , • HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. . 19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery ofpritten notice to Contractor,with no further . liability to Contractor. 20.•Prior Approval Required Provision.Approval by the City of Ashland Council or the Public Contracting Officer is, • required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by , reference. . Knife River Material : City of Ashland: ' By Joe SOa1 OS Date:202310.1 3 3:21:48by Joe ares ' , -67.00. • Signature By / i • Joe Soares • Print Name • • it/*)'� General Manager 9 • Date • Title ' • r.. lied.D AS TO FORM • . Tli end ity "ttom®y . . • • Dat ®� 2 . • Contract for Asphalt Patching Services, Page 3 of 5 • EXHIBIT A . CERTIFICATIONS/REPRESENTATIONS: Contractor, 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) Contractor is not subject tobackup 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. Contractor further represents and • warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed.in . accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it a corporation authorized to act on behalf of the entity designated above and authorized to do business.in Oregon or is an independent Contractor as defined in the contract'documents, and has checked four or more of the following criteria: . V (1) I carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. V (2) Commercial advertising or business cards or a trade association membership are purchased for the business. V (3) Telephone listing is used for the business separate from the personal residence listing.' V/ (4) Labor or services are performed only pursuant to written contracts. V (5) Labor or services are performed for two or more different persons within a period of one year. _ 0 ' V (6) I assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission • insurance or liability insurance relating to the labor or servicesto be provided. • Digitally Joe Soares Date:2023.10.1aby Joe res 3 13:22:47 07100' Contractor ' (Date) • • • J • Contract for Asphalt Patching Services, Page 4 of 5 • , • CITY OF ASHLAND , OREGON EXHIBIT B • 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. • $18.12 per hour effective June 30, 2023 (Increases annuallyJune 30 bythe • Val Consumer every Consumer Price Index) • • • • Employees must be paid a portion of business of their 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 assistance for the project or the employee, > For all hours worked under a business from the City of. service contract between their Ashland in excess of •D Note: "Employee"does not employer and the City of $25,355.05. include temporary or part-time Ashland if the contract employees hired for less than exceeds$25,335.05 or more, > If their employer is the City of 1040 hours in any twelve- Ashland including the Parks month period. For more ➢ •For all hours worked in a and Recreation Department. details on applicability of this month if the employee spends policy, please see Ashland 50%or more of the ➢ In calculating the living wage, Municipal Code Section .employee's time in that month employers may add the value 3.12.020. working on a project or ofhealth 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. Notice to Employers: This notice must be posted predominantly in areas where it can. be seen by all employees. • CITY OF • ' • ASH LAN * Contract for Asphalt Patching Services, Page 5 of 5 Aco • CERTIFICATE OF LIABILITY INSURANCE D;T,sMM(OD�) 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). PRODUCERNAMEACT Marsh I U.S.Operations MARSH USA LLC PHONE 333 South 7th Street,Suite 1400 (A/C.No.Ext): 866-966-4664 I FAX No): 212-948-5382 Minneapolis,MN 55402-2400 E-MAILS: Minneapolis.CertRequest@marsh.com ADDRE • INSURER(S)AFFORDING COVERAGE NAIC# CN103060364-LTMM-GAWX-23-24 INSURER A:Liberty Mutual Fire Ins Co 23035 INSURED • INSURER B:Berkshire Hathaway Specialty Insurance 22276 LTM,Incorporated • . dba Knife River Materials INSURER C: • • PO Box 1145 • • Medford,'OR 97501. • INSURER D: • . INSURER E: . • INSURER F: • _ • COVERAGES CERTIFICATE NUMBER: CHI-010466916-01 • • 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• LTYPE OF INSURANCE • ANSA WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDDlYYYY) (MMIDD/YYYY) • A X COMMERCIAL GENERAL LIABILITY TB2641445115023 06/01/2023 06/01/2024 EACH OCCURRENCE $ '1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ca occurrence) $ 1,000,000 MED EXP(Any one person) $ ' 10,000 ' PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X jE LOC PRODUCTS-COMP/OP AG'G $ 2,000,000 • OTHER: $ A AUTOMOBILE LIABILITY AS26.41446115033 • 06/01/2023 06/01/2024 CMaBcIcdEDINGLELIMIT 5,000,000E $ X ANY AUTO BODILY INJURY(Per person) $ • OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED • PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY • (Per accident) , $ . B UMBRELLA LIAB X OCCUR 47XSF32875101 06/01/2023 06/01/2024 EACHbCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000;000 DED RETENTION$ • - $ A WORKERS COMPENSATION WA264D446115013(AOS) 06/01/2023 06/01/2024 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER A Y!N . WC264144611506306/01/2023 06/01/2024 1,000,000 OFFCER/MEMBEREXCLUDED?ECUTIVE N N/A - (MN) E.L.EACH ACCIDENT $ (Mandatory in NH) • E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 'A General Liab.Excess Buffer TL2641446115043 06/01/2023 06/01/2024 Each Occ/Pers.&Adv.Injury • 4,000,000 GL Agg•I Prod.-Comp OpsAgg 4,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) . • Re:Asphalt Patching Services,KRM Project#:various until 6/30/2028. . • The City of Ashland and its elected officials,officers,and employees while acting within the scope of their duties as such Is/are included as additional insured under.general liability where required by written ' contract and does not include professional liability coverage. Blanket Additional Insured for Automobile Liability is included where required by written contract.Auto Liability:Primary and Non-contributory applies. to the insured's owned autos where required by written contract. Primary and Non-Contributory applies for General Liability where required by written contract. CERTIFICATE HOLDER CANCELLATION City of Ashland • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520 . ACCORDANCE WITH THE POLICY PROVISIONS.' • AUTHORIZED REPRESENTATIVE of Marsh USA LLC 1 ©1988-2016 ACORD CORPORATION. All rights reserved. AOORD 25(2016/03) The ACORD name and logo are registered marks of ACORD• • • • • AGENCY CUSTOMER ID: CN103060364 LOC#: Minneapolis A`R D® • ADDITIONAL REMARKS.SCHEDULE Page 2 of 2 AGENCY NAMED INSURED . • MARSH USA LLC LTM,Incorporated • dba Knife River Materials • POLICY NUMBER • PO Box 1145 Medford,OR 97501 • CARRIER NAIC CODE EFFECTIVE DATE:• ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, • FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance • Excess liability applies to general liability,products and completed operations,automobile liability,and employers liability. Excess Uability is follow form of primary subject to policy terms,conditions and exclusions. • • • • • • • • • • • • • • • • • • • • • • • ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. 'The ACORD name and logo are registered marks of ACORD • • • POLICY NUMBER:AS2-641-446115-033 COMMERCIAL AUTO CA 20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY: • • DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifiesinsurance provided under the following: • • AUTO DEALERS COVERAGE FORM BUSINESS AUTO.COVERAGE FORM MOTOR CARRIER COVERAGE FORM • • With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. • This endorsement identifies person(s)or organization(s)who are"insureds"for Covered Autos Liability Coverage 'under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. • • SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization where the named insured has agreed by • written contract to include such person or organization as a ' designated insured. • • • • Information required to complete this Schedule, if not shown above,will be shown in the Declarations. • Each person ororganization shown in the Schedule is an"insured"for Covered Autos Liability Coverage,but only to the extent that person dr organization qualifies. as an"insured"under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2.of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. • • CA 20 48 1013 • © Insurance Services Office, Inc., 2011 Page 1 of 1 • • Policy Number:AS2-641-446115-033 Issued By: Liberty Mutual Fire•Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • • NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement-modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART • .- MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART • TRUCKERS COVERAGE PART • EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART "COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART • . PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Other'Person(s)! _ Email Address or mailing Number Organization(s):" address: Days Notice: Per schedule of certificate holders Per schedule of certificate holder 90 on file with the company on file with the company A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, .before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification.of a pending cancellation of coverage is intended as a courtesy,only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 05 11 ©2011, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. • • • • • Policy Number:AS2-641-446115-033 _ Issued by: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED.-NONCONTRIBUTING . This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM ' GARAGE COVERAGE FORM . MOTOR CARRIERS COVERAGE FORM TRUCKERS COVERAGE.FORM Withrespect to coverageprovided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. • . This endorsement identifies person(s) or organization(s) who .are "insureds" under the Who Is An Insured Provision of.the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s)or Organizations(s): . . Any person or organization for which the. Named Insured has agreed by written • contract executed prior to loss to furnish this endorsement. c • Regarding Designated Contractor Project: Each person or organization shown in the Schedule of this endorsement is an "insured"for Liability Coverage, but • only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained In Section II of the Coverage Form. • The following is added to the Other Insurance Condition: ' If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contribution from such insurance. • • • • • • • AC 8423 08 11 ©2010, Liberty Mutual Group of Companies. All rights•reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission; ' r • POLICY NUMBER:TB2-641-446115-023 COMMERCIAL GENERAL LIABILITY CG 20 1012 19 THIS ENDORSEMENT CHANGES THE,POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR • CONTRACTORS SCHEDULED PERSON OR • • ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART . • • A. Section II — Who Is An Insured is amended to . '1. All work, including materials, parts or include as an additional insured the person(s)•or equipment furnished in connection with such organization(s) shown in the Schedule, but only with / work, on the project (other than service, respect to liability for "bodily injury", "property . maintenance or repairs) to be performedby or damage" or "personal and advertising injury" on behalf of the additional •insured(s) at the caused, in whole or in part, by: location of the covered operations has been 1. Your acts or omissions; or completed; or • 2. The acts or omissions of those acting on your 2. That portion of "your work" out of which the behalf; injury or damage arises has been put to its in the performance of your. ongoing operations for intended use.by any person or organization the additional insured(s). at the location(s) other than another contractor or, subcontractor designated above. engaged in performing operations for a principal as a part of the same project. However: C. With respect to the insurance afforded to these 1. The insurance afforded to such additional additional .insureds, the following 'is. added to insured only applies to the extent permitted by . Section III-Limits Of Insurance: law;and If coverage provided to the additional insured is 2. If coverage provided to the additional insured is required by a contract or agreement, the most we required by a. contract or agreement, .the. ,. • will pay on behalf of the additional insured is the insurance afforded to such additionalinsured will amount of'insurance: not be broader than that which you are required 1. Required by the contract or agreement;or by the contract or agreement to provide for such • additional insured. 2. Available' under the applicable limits of B. With respect to the insurance afforded to these insurance; additional insureds, the following .additional (,' : whichever is less. exclusions apply: This endorsement shall not increase the This insurance does not apply to "bodily injury"'or ' applicable limits of insurance. "property damage"occurring after: Schedule . . Name Of Additional Insured Person(s) Location(s)Of Covered Operations Or Organization(s): Any person or organization for whom you have agreed All locations as required by a written contract or . in a writtencontract or agreement, prior to an agreement entered into prior to an "occurrence"or "occurrence"or offense,that such person or . offense. organization be added as an additional insured to your . policy. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. • CG 20 10 12 19 ©Insurance Services Office, Inc.,2018 Page 1 of 1 , • POLICY NUMBER:TB2-641-446115-023 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART • PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these. include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury' . or If coverage provided to the additional insured is „property damage" caused,. in whole or in part, by required by a contract or agreement, the most we your work at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the"products-completed operations hazard". 1. Required by the contract or agreement; or However: • 2. Available under the applicable limits• of 1. The insurance afforded to such ,additional insurance; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the applicable 2. If coverage provided to the additional insured is limits of insurance. required by a contract or agreement, the insurance afforded to such additional ,insured will not be broader than that which you are required by the contract or agreement to • provide for such additional insured. Schedule Name Of Additional Insured Person(s) - . Or Organization(s): Location And Description Of Completed Operations • Any person or organization for whom you have agreed All locations as required by a written contract or in a written contract or`agreement, prior to an agreement entered into prior to an "occurrence"or • "occurrence" or offense,that such person or offense. organization be added as an additional insured to your policy. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. • • • • CG 20 37 12 19 ©Insurance Services Office, Inc.,2018 Page 1 of 1 • • Policy Number.TB2-641-446115-023 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • NOTICE OF CANCELLATION TO THIRD PARTIES • This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART . • • MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART • . TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART • COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY - UMBRELLA COVERAGE FORM • • A If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule of this endorsement We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. • • B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. • All other terms and conditions of this policy remain unchanged. • • Schedule • Name of Other Person(s) / Email Address or mailing address: Number Days Notice: Organization(s): • • "Per Schedule On File With The Company" "Per Schedule On File With The Company" 90 • • • • LIM 99 010511 ©2011, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. • Policy No.TB2-641-446115-023 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - • OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: . COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART • The following is addedto the Other Insurance (2)You have agreed in writing in a contract or Condition and -supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance;and • • • • • . CG 20 01 1219 ©Insurance Services Office, Inc.,2018 Page 1 of 1 • . • • NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below.We will send notice to the email or mailing address listed below at least 10 days,or the number of days listed below, if any, before cancellation becomes effective. In no event does.the notice to the third party exceed the notice to the first named insured. • B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Schedule Name of Other Person(s)! Email Address or mailing address: Number Days Notice: Organization(s): Schedule on file with the Schedule on file with the 90 Company Company • • • • • • • All other terms and conditions of this policy remain unchanged. • • • • Issued by Liberty Mutual Fire Insurance Company 16588 • For attachment to Policy No.WA2-6413-446115-013 Effective Date Premium$ Issued to Knife River Corporation Endorsement No. • • WC 99 20 75 ®2016 Liberty Mutual Insurance Page 1 of 1 Ed.12/01/2016 • . NOTICE OF CANCELLATION TO THIRD PARTIES • A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below.We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage Is.Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. . Schedule Name of Other Person(s)I Email Address or mailing address: Number Days Notice: Organization(s): Schedule on file with the Schedule on file with the 90 Company Company • • • • • All other terms and conditions of this policy remain unchanged. • • Issued by Liberty Mutual Fire insurance Company 16586 For attachment to Policy No.WC2-641-446115-063 Effective Date Premium$ Issued to Knife River Corporation Endorsement No. • WC 99 20 75 ®2016 Liberty Mutual Insurance Page 1 of 1 Ed.12/0112016