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HomeMy WebLinkAbout2024-015 PO 20240058 - Greenway Spray LLCFORM #3 REQUISITION Vendor Name Address, City, State, Zip Contact Name & Telephone Number E •I dd CITY OF ASHLAND Date of request: 03/05/2024 Required date for delivery: 03105/2024 Greenway Spray LLC 3165 Old Stage Rd, Central Point, Or 97502 Greg Stewart (541) 622-9949 mat a ress greg@greenwayspray.com 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) ❑ 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 # 0 Verbal/Written bid(s) or proposal(s) ❑ Request for Qualifications (Public Works) ❑ State of Washington Date approved by Council: Contract # Attach copy of council communication ❑ Other government agency contract Agency Intermediate Procurement ❑ Sole Source GOODS & SERVICES ❑ Applicable Form (#5, 6, 7 or 8) Contract # Greater than $5,000 and less than $100,000 ❑ Written quote or proposal attached ❑ Form #4, Personal Services $5K to $75K Date approved by Council: Intergovernmental Agreement Agency ❑ Annual cost to City does not exceed $25,000. ❑ (3) Written bids & solicitation attached PERSONAL SERVICES 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 City Administrator. AMC 2.50.070(4) ❑ Special Procurement ❑ (3) Written proposals & solicitation attached ❑ Form 49, 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 Routine Herbicide Treatment on the Ashland Municipal Airport TOTAL COST $ 4,950.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost ❑■ Per attached quote/proposal Project Number _ _ _ _ _ _ . _ _ _ Account Number o a 5 7 o o . e o 2 3 5 3 TOTAL COST $ 4,950.00 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 all hardware and software purchases: IT Director Date Support -Yes/ No By signing this requisition form, I certify that the C ty's public contracting requirements have been satisfied. Employee: (�/� ��2� Department Hea �• Z E Ito o greater than $5,000) Department Manager/Supervisor: City Manager: ` (Greater than $35,000) Funds appropriated for current fiscal year: YES / NO Finance Director- (Equal to orgreater than $5,000) Date Comments: Form #3 - Requisition GOODS AND SERVICES AGREEMENT (LESS THAN $35,000) PROVIDER: Greenway Spray LLC CITY OF PROVIDER'S CONTACT: Greg Stewart -ASH LAN D 20 East Main Street ADDRESS: 3155 Old Stage Rd, Central Point, Or 97502 Ashland, Oregon 97520 Telephone: 541/488-5587 PHONE: 541-622-9949 Fax: 541/488-6006 EMAIL: greg@greenwayspray.com This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Greenway Spray LLC, (a domestic business corporation) ("hereinafter "Provider"), for routine herbicide treatment at the Ashland Municipal Airport. 1. PROVIDER'S OBLIGATIONS 1.1 Routine herbicide treatment at the Ashland Municipal Airport as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder, a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars) per occurrence for Bodily injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and • Automobile Liability; and • Workers' Compensation. 1.2.2 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each, provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage Pege 1 of 5: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC I ' ' • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. 1.3 Provider shall, at its own expense, maintain Worker's Compensation Insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise, minority -owned business, woman -owned business, a business that a service -disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.I 10. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $25,335.05 or more, Provider is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in that chapter, to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Provider is also required to post the notice attached hereto as "Exhibit A" predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of $4,950.00 (four thousand nine -hundred fifty dollars) as provided herein as full compensation for the Work as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of $4,950.00 (four thousand nine -hundred fifty dollars) without express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 'Page 2 of 5: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance, paid leave, and retirement. 3.4 This Agreement embodies the Rill and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements, negotiations, and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 27913.220, 279B.230 and 279B.235. 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue, and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred, as appropriate, so as to effectuate this choice of venue. 3.8 Provider shall defend, save, hold harmless and indemnify the City and its officers, employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees, contractors, or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God, strikes, lockouts, accidents, or other events beyond the control of the other or the other's officers, employees or agents. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the Goods. Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects, fraud, and warranties. 3.12 The City may inspect and test the Goods. The City may reject non -conforming Goods and require Provider to correct them without charge or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Page 3 of 5: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 3.13 Provider represents and warrants that the Goods are new, current, and frilly warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor, material and manufacture. Provider shall transfer all warranties to the City. 4. SUPPORTING DOCUMENTS 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" • The Provider's complete written estimate dated February 27, 2024. 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved, the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS, the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including, but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent, and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due, Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2024, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30) days' prior written notice, terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement, with cause, by not less than fourteen (14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Page 4 of.5: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: City of Ashland — Public Works Department Attn: Chance Metcalf 20 E. Main Street Ashland, Oregon 97520 Phone: (541) 488-5587 With a copy to: City of Ashland — Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541) 488-5350 If to Provider: Greenway Spray LLC Attn: Greg Stewart 3155 Old Stage Rd Central Point, Or 97502 Phone: (541) 622-9949 8. -WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision, term, condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach, whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider, for a period of no fewer than six (6) calendar years preceding the Effective Date of this Agreement, has faithfiilly complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) . Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. Page 5 of 5: Goods and Services Agreement between the City of Ashland and Greenway Spray LLC 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of (lie State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement, at law, or in equity. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND: Printed Nam •12 0 ro-M7ZARTA11111111111 s.7.z-j Date Purchase Order No. GREENWAY SPRAY LLC (PROVIDER): By: Signature Printed Name Title 3� 7- -,7-q Date is to be submitted with this signed Agreement) Page 6 of 5: Goods and Services Agreement between the City of Ashland and Green%vay Spray LLC EXHIBIT A City of Ashland LIVING i For all hours worked under a service contract between their employer and the City of Ashland 9the contract exceeds $25,335.05 or more. • For all hours worked in a month, if the employee spends 50% or more of the employees time in that month working on a project or WAGE per hour, effective June 30, 2023. The Living Wage is adjusted annually every June 30 by the Consumer Price Index. portion of the business of their employer, if the employer has ten or more employees, and has received financial assistance for the project or business from the City of Ashland over $25,335.05; If their employer is the City of Ashland, including the Parks and Recreation Department In calculating the living wage, employers may addthevalue of health care, retirement, 401K, and IRS eligible cafeteria plans (includng childcare) benefits to the employee's amount of wages. Note: For temporary and part-time employees, the Living Wage does not apply to the first 1040 hours worked in any calendar year. For more details, please see Ashland Municipal Code Section 3.12.020. Call the Ashland City Manager's office at 541-488-6002 or write to the City Manager, City Hall, 20 East Main Street, Ashland, OR 97520, or visit the CWs website at www.ashland.orms. Notice to Employers: This notice must be posted in areas where it can be seen by all employees. CITY 0p ASHLAND Page 7 of 5: Goods and Services Agreement behveen the City of Ashland and Greenway Spray LLC February 27, 2024 City of Ashland Public Works / Engineering 51 Winburn Way Ashland, OR 97520 Attention: Chance Metcalf Project Manager Chance, Thank you for the opportunity to discuss the work you are interested in having performed at Ashland Airport. The scope of work is focused on the elimination of weed growth that is causing a deterioration of the asphalt and is an obstruction to the lighting and reflectors along the taxiway and runway. Below is a breakdown of the scope of work we discussed and how we plan on targeting each of these areas. The following areas will be sprayed with a GPS guided and calibrated spray boom: - Where visible cracks in the asphalt are closer than 8' apart. - Unpaved areas between the hanger doors. - The outdoor airplane parking area that adjoins the South taxiway. The areas below would be spot sprayed using a calibrated handgun: - 15' around drains that lead directly to streams. - Underneath all parked aircraft. - Where the large fuel tanks are located. - Signs and lights inside the 12' swale border. - The areas at the back of the two East airplane hangars, where the space is too narrow for equipment. - Asphalt griding piles and along the highway ROW both sides of main entrance. Below are the products that we have chosen to use and why we think they would best suit your needs: - Alligare Glyphosate 5.4 is a glyphosate product that is labeled for aquatic sites and airports. Greenway Spray LLC will be using this product for all post emergent herbicide applications. Glyphosate is a safe contact herbicide that only affects vegetation it is sprayed on. It doesn't contain a surfactant making it a safer product where drainage is a concern. - Some of the weeds we will be targeting are star thistle, black mustard, tar weed and henbit. The pre - emergent application we recommend for the airport vegetative swale border is combination of Flumiozazin and Esplanade. This chemistry is desirable because It binds with the soil and has a limited ability to move off site. It also will target many of the weed seeds that you currently have in the existing seed bed impeding seed germination this coming season. - The pre -emergent we recommend for the cracks in the blacktop will be Flumiozazin. We use the same active ingredient in vineyard rows for weed suppression at the base of the grape vines. It has characteristics that allow it to bind with clay, so movement is very limited. - For safety, Greenway Spray LLC will use the best surfactant package on the market. We would use Crosshair by Wilbur -Ellis for our drift control. The Rogue Valley has seen many cases of off target applications and we won't be one of them. For our spreader/sticker we would use Rainier EA labeled for airports and aquatic sites. In advance of starting the work, we will be posting the areas to be sprayed 48 hours prior to any pesticide application at the interior airport entrances. This is to notify the public of the work that will be taking place. We will also coordinate with your office as to the date, time, and the method of application. It will be necessary to time this application before the rainy season ends. To activate the pre -emergent, we will need to receive at least .5" of rain. We recommend this application takes place no later than the end of March. The application timing will be based on the weather forecast. With favorable weather we don't see this project taking more than 5 hours to complete. Our schedule is booked tight this spring. Upon approval, and a written notice to proceed, we will coordinate with your office to get the herbicide application done within five weeks. Greenway Spray is committed to the safe application of herbicides with the least amount of environmental impact. We do this by using products that will best control the target according to their site. We are licensed through the`Oregon Department of Agriculture, bonded, and insured. Herbicides will not be sprayed on ground that has standing water. Reasonable buffers will be in place for all areas with water including streams, springs, irrigation runoff and riparian areas. Native plants and trees will NOT be sprayed, only the areas previously approved by you. Greenway Spray is a safety -first company. We supply our team with up-to-date training in safe pesticide handling and application. I have an extensive background in herbicide selection and application and will be on this project throughout. We appreciate your interest in Greenway Spray and look forward to doing business with the City of Ashland. If you have any questions or concerns regarding the attached estimate, please feel free to contact me directly. Sincerely, Greg Stew rt, Owner Greenway Spray LLC AG-L1015139CPA AG-L1030214CPO (541) 622-9949 --. Greenway Spray LLC 00000 3155 Old Stage Road Central Point, OR 97502 Name / Address City of Ashland Public Norks/Engincering 51 Winburn Way Ashland. OR 97520 Estimate Date Estimate # 2/27/2024 192 Project Description Qty Rate Total Custom spray 18 acres of weeds al the Ashland Airport "ith pre and 18 275.00 4.950.00 post emergent herbicide. Areas include: All taxiway asphall cracks and edges slopping .where it narrows to the North. Unpaved areas between the hanger doors. 6" - 12" swath that follows the vegetative swale on the and runway shoulders. Signs. lights and reflectors will be treated individually 2' in all directions with a rectangular spray pattern. Asphalt piles and ROW :dons Dead Indian Memorial Road South entrance. 'thank you I'or your business. Total$4.950.00 A�oRo® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM,Dp1YYY5� 02/27/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING iNSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must 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 NAME: Brian SeagOe Rothert Insurance HONK Ext 541-476-3311 AIC. No : 541-476-5626 ADDR15ss: bdan tcis com @ 9P• c/o Towne Centre Insurance Service, LLC INSURERS AFFORDING COVERAGE NAIC # 315 SE 7th Street INSURERA: Scottsdale Insurance Company 41297 Grants Pass OR 97626 INSURED INSURER B INSURER C : Greenway Spray LLC INSURERD: 3155 Old S(age Rd INSURER E : INSURERF: Central Point OR 97502 COVFRAGFS RFRTIFICATF MIIMRFR• [?FVICInAI MIIMRFR- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR TYPEOFINSURANCE AUULbUBN INSD WVD POLICY NUMBER pOLICYEFF MM/DD I POLICYEXP MWDD LIMITS A >( COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F)d OCCUR Y CPS7935197 02/15/2024 02/15/2025 EACH OCCURRENCE $ 1,000,000 DAMAGE TOR T D P EMISES Ea occurrence)$ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL& ADV INJURY $ 1,000.000 GEN'LAGGREGATE LIMIT APPLIES PER: X FI POLICY ❑ JEC LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HiREDAUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT Ea acddentl $ BODILY INJURY (Per person) S BODILY INJURY (Per acckfent) S PROPERTY DAMAGE (Per aoddent) $ S A UMBRELLALIAB EXCESS LIAB x OCCUR CLAIMS -MADE CXS4018196 02/15/2024 02/15/2025 EACH OCCURRENCE $ 2,000,000 X AGGREGATE $ 2,000,000 OED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYCERIMEMBER/PARTNER/EXECUTIVE OFFICERlA(EMBER EXCLUDED? (Mandatory In NH) I! yes, describe under DESCRIPTION OF OPERATIONS below NIA PER OTH- S ATU E R E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) See Additional Remarks Schedule Acord 101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main ST AUTHORIZED REPRESENTATIVE Ashland OR 97520 'W Aa ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ACORO® AGENCY Rothert Insurance POLICY NUMBER CARRIER SEE CERTIFICATE AGENCY CUSTOMER ID: 1644693 LOC #: ADDITIONAL REMARKS SCHEDULE NAMEDINSURED Greenway Spray LLC 3155 Old Stage Rd NAIL CODE Central Point, OR, 97502 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE THIS IS EVIDENCE OF INSURANCE PROCURED AND DEVELOPED UNDER THE OREGON SURPLUS LINE LAWS. IT IS NOT COVERED BY THE PROVISIONS OF ORS 734.610 OR 734.710 RELATING TO THE OREGON INSURANCE GUARANTY ASSOCIATION. IF THE INSURER ISSUING THIS INSURANCE BECOMES INSOLVENT, THE OREGON INSURANCE GUARANTY ASSOCIATION HAS NO OBLIGATION TO PAY CLAIMS UNDER THIS EVIDENCE OF INSURANCE. Pest Control w/ crop spraying Certificate holder Is added as an additional Insured per form CG2033 ACORD 101 000R1011 Page 2 of 2 2008 ACORD CORPORATION. All rights reserved. ' The ACORD name and logo are registered marks of ACORD FoForm�VQ (Rev. March 2024) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Go to www.irs.gov/FormW9 for instructions and the latest information. uerore you begin. For guidance related to the purpose of Form W-9. see Purpose of Fnrm hAtnw Give form to the requester. Do not send to the IRS. 1 Name of enlitylndividual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded entity's name on line 2.) Greenway Spray l.t_C 2 Business name/disregarded entity name, it different Iron above. M rn 3a Check the appropriate box for federal tax classification of the ernlily/incirv'idual whose name is entered on line 1. Check 4 Exemptions (codes appy only to a only one of the following seven boxes. certain entities, not indlv(duals; e Individual/sole proprietor ❑ C corporation ❑ S corporation ❑Partnership ❑ Trust/estate see instructions on page 3): 0 y 0 ❑✓ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) g Exempt payee code (if any) T ° Note; Check the "LLC" box above and. In the entry space, enter the appropriate code (C, S, or P) for the lax o classification of the LLC, unless It is a disregarded entity. A disregarded entity should Instead check the appropriate Exemption from Foreign Account Tax o box for the tax classification of its owner. Compliance Act (FATCA) reporting N = � ❑Other (see Instructions) code (If any) u 4 3b If on line 3a you checked "Partnership" or-Trusl/estate.- or checked "LLC" and entered "I" as its lax classification, v and you are providing this form to a partnership, trust, or estate in which you have an ownership Interest, check (Applies to accounts maintained this box if you have any foreign partners. owners. or beneficiaries. See inStYLIC ns . . . , _ . ❑ outside the United States.) aw 5 Address (number, street, and apt, or suite no.). See instructions. Requester's name and address (optionaQ 3155 Old Stage Road 6 City, state, and ZIP code Central Point, OR 97502 7 Usl account number(s) here (optionaQ Identification NUMDer ( I Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social security number J backup withholding. sole .For individuals, this is generally your e instructions security number (SSN). However, for a — M — resident alien, sole proprietor, or disregarded amity, see the instructions for Part I, later. For other entitles, it Is your employer identification number (EIN). if you do not have a number, see How to get a or TIN, later. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2.1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S, person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting Is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than Interest and dividends,,you are not required to sign the certification, but you must provide your correct TIN, See the Instructions for Part II, later, Sign signature of /�1� /!Yt Here U.S. person .ztifi' �/1/ Date General instructi Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to wmvJrs.gov/FormW9. What's New Una 3a has been modified to clarity how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the "LLC" box and enter its appropriate tax classification, New line 3b has been added to this form. A flow -through entity is required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow -through entity in which It has an ownership interest. This change is intended to provide a flow -through entity with Information regarding the status of its Indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements, For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065). Purpose of Forth An Individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat. No. 10231 X Form W-9 (Rev, 3-2024) �way.saiLcom Oregon Workers' Compensation Certificate of Insurance Certificate holder: CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND, OR 97520 saifOyegon. Work. Life, The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by this policy is subject to all the terms, exclusions and conditions of such policy; this policy Is subject to change or cancellation at any time. Insured Producer/contact Greenway Spray LLC SAIF Corporation 3155 Old Stage Rd SAIF Corporation Central Point, Or 97502-1478 Issued 02/27/2024 Limits of liability Policy 857891 Bodily Injury by Accident $1,000,000 each accident Period 02/01/2024 to 02101/2025 Bodily Injury by Disease $1,000,000 each employee Body injury by Disease $1,000,000 policy limit Description of operations/locatlonslspeclat Items Important This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. This certificate does not constitute a contract between the Issuing insurer, authorized representative or producer and the certificate holder. Authorized representative &t"L 7 Chip Terhune President and CEO Potky_OLCA_C a diric a l e OI M s ura rKe 400 High Street SE Salem, OR 97312 P: 800.285.8525 F: 503.584.9812