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HomeMy WebLinkAbout2025-010 PO 20250319 and AGRMT - S & S Sheetmetal, IncB City of Ashland L ATTN: Accounts Payable L 20 E. Main Ashland, OR 97520 T Phone:541/552-2010 O Email: payable -_ashland.or.us V E S & S SHEETMETAL, INC N 912 ANTELOPE ROAD D WHITE CITY, OR 97503 O R 20250437 Purchase Order C/O Public Works - Operations H 90 North Mountain Ave. P Ashland, OR 97520 Email: cathy.crocker@ashland.or.us T Phone: 541 /488-5353 O Fax: 541 /552-2329 03/05/2025 1 390 1 1 FOB ASHLAND OR HVAC Service at Wast Water Facilities Lab 1 HVAC Services: Replace (2) Heat Pump split systems Project Account: Project Account: *************** GL SUMMARY *************** 086100 - 602400 088400 - 602220 $31,536.40 $13,515.60 Public Works Department 1.0 1 EACH 1 $45,052.001 $45,052.00 By: Date: Authorized Signature $45 052.00 "CITY OF ASHLAND Goods and Services Agreement City Information Contractor Information City of Ashland Firm Name: S & S Heating & AC Attn: Cathy Crocker Contact: Mike Shipley 90 N. Mountain Address: 912 Antelope Rd Ashland, Oregon 97520 Medford, OR 97503 Phone: (541) 552-2359 Phone: (541) 826-6661 Email: cathy.crocker@ashland.or. Email: mike.ship,ley@sandsheating.com Contract Summary Procurement Method: Intermediate Completion Date: 06/30/2025 Contract Amount: $45,052.00 Description of Services: HVAC Services at Waste Water Facilities Lab Supporting Documents: Project Bid Dated,: 07/29/2024 Agreement Dated: 02/14/2025 Dated: Dated: This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and the Contractor listed under Contractor Information above, (hereinafter "Contractor"), for the services listed under Description of Services and the Supporting Documents as noted in the Contract Summary above. 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 the Supporting Documents, the Supporting Documents shall be given precedence in the order listed above. The Contractor's initials [ MS herein signify acknowledgment and agreement to this provision, if applicable, or if not sign "N/K. The goods and services defined and described in the Supporting Documents shall hereinafter be collectively referred to as "Work." Page 1 of 8: Goods and Services Agreement between the City of Ashland and S & S Heating & Air -fond (VVM business enterprise certified under ORS 200,055, in awarding subcontracts as required by ORS 279A.110. 3.3. Subcontractor Notification. In all solicitations either by competitive bidding or negotiation made by Contractor 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 Contractors of the Contractor's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 3.4. Living Wage Requirements. If the amount of this Agreement 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 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. Contractor is also required to post the notice attached hereto as "Exhibit A" predominantly in areas where it will be seen by all employees. 4. Contractor's Compliance with Tax Laws 4.1. Contractor represents and warrants to the City that: 4.1.1. Contractor shall, throughout the term of this Agreement, including any extensions hereof, comply with: • All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; • Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Contractor; and • Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 4.1.2. Contractor further certifies that contractor is not in violation of any Oregon tax laws referenced in ORS 305.380(4). 4.2. Tax Compliance Breach. Contractor's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Contractor'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. 5. Insurance. Contractor 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 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall include: 5.1. Commercial general liability -- with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars) per occurrence and $3,000,000 (three million dollars) in the aggregate for Bodily Injury and Property Damage. Page 3 of 8: Goods and Services Agreement between the City of Ashland and S & S Heating & Air -fond (WW) 6. Remedies 6.1. In the event Contractor 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: 6.1.1. Termination of this Agreement. 6.1.2. Withholding all monies due for the Work that Contractor has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively. 6.1.3. Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief. 6.1.4. 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. 6.2. 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 under the Agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Agreement; or, without written authorization by the City, attempts to assign rights in, or delegate duties under, this Agreement. 6.3. Liability Limitation. In no event shall City be liable to Contractor for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Contractor exceed the amount due, Contractor shall pay immediately any excess to City upon written demand provided. 7. General Provisions 7.1. Non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Contractor and is free to procure similar types of goods and services from other Contractors in its sole discretion. 7.2. Independent Contractor Status. Contractor is an independent contractor and not an employee or agent of the City for any purpose. 7.3. Statutory Requirements. The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 2796.220, 27913.230 and 27913.235 7.4. Assignment. Contractor 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. 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 the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. Page 5 of 8: Goods and Services Agreement between the City of Ashland and S & S Heating & Air -fond (VWV) WITNESS WHEREOF, the parties have executed this Agreement in their respective names by their duly authorized representatives as of the dates indicated below, This Agreement may be executed in two counterparts, each of which shall be deemed an original, with equal force and effect as if executed in a single document. By: Al .......... ----) Signature R0b6A-++Ibr4#@r- sr'c Printed Name Date Purchase Order No. APPROVED AS TO FORM: City Attorney S & S Heating & Air -Coed (WVV) (CONTRACTOR): By: Signature Mike Shipley Printed Name President Title 02/14/2025 Date (W-9 is to be submitted with this signed Agreement) Page 7 of 7: Goods, and Services Agreement between the City of Ashland and S & S Heating & Air -fond (WW) Wednesday, August 07, 2024, J III I13roposal Purge 1 1) Joihnson ))) Controls Johnson Controls, Inc. 588 Parsons Drive; Suite B Medford, OR 97501 Tel. (541) 857-5112 Fax (541) 245-3475 Remove and Replace (2) Air Cooled Spit Heat Pump Svstems Furnish and install the following. o (1) York Indoor Horizontal Split HP Fan Coil and (1) Air Cooled Condenser • 7.5 Ton • One circuit • 200 VAC, 60 Hz, 3 phase • Across the line start • EMS temperature reset • Suction and discharge kits • ETL Listed • TXVs • Start Up • Freight o (1) York Indoor Horizontal Split HP Fan Coil and (1) Air Cooled Condenser • 10 Ton • One circuit • 200 VAC, 60 Hz, 3 phase • Across the line start • EMS temperature reset • Suction and discharge kits • ETL Listed • TXVs • Start Up • Freight • Remove existing louvers and replace after project completion • Decommission and remove indoor and outdoor units • Install new indoor units utilizing existing economizer sections • New copper refrigerant piping between indoor and outdoor units • Miscellaneous ductwork modifications • Disconnect and reconnect electrical service • New JCI DDC Controls System • refrigerant • Crane • Permit • Twelve Month Warranty Wednesday, august 07, 2024 JCIII IIF)irgposa� Page 2 Proposal Clarifications • Provide (1) year warranty on all material and workmanship from date of completion of the above referenced project. • Project assumes regular working hours. • Johnson Controls shall submit engineering drawings in MS Visio format. • Johnson Controls will offer standard software and hardware. Exclusions: The following items are not included in the listed prices: • Roofing modifications • Structural modifications for the roof mounted condensing units • All Asbestos abatement. • Any painting or patching. • Providing or installing Access doors in ceilings, walls or ducts. • Start-up labor or warranty service work on the mechanical equipment or those controls, which are furnished as part of the unit. • Providing or installing of any fire life safety systems, including smoke detectors. • Providing or installing of VFDs, motor starters or disconnects. • Wiring for fire alarm shutdown of HVAC equipment. PRICE SUMMARY Your Net Installed Budget Price .........................$ 260,000.00 (Price is good until 9-28-2024) TERMS • All equipment is FOB Factory, Freight allowed. • Contract Terms & Conditions per this proposal. • Payment Terms subject to credit approval. • Taxes, Fees, Permits are NOT included. • Warranty is from day of startup or 18 months. • This pricing is valid for sixty days from the date of this proposal. '...................Submitted ......By: Erin McBride erin.valle o.mcbride ci.com Off. 541-857-5112 Cell 916-903-3450 This proposal is hereby accepted and JCI is authorized to proceed with the work; subject to credit approval by JCI Milwaukee WI Erin V. McBride / Johnson Control Inc (JCI Purchaser / Company Name (print) Proposal Offered By / JCI Signature - Purchaser Date Signature 08-07-2024 Date JCI CONTROLS TERMS AND CONDITIONS By accepting this proposal, Purchaser agrees to be bound by the following terms and conditions: SCOPE OF WORK. This proposal is based upon the use of straight time labor only. Plastering, patching and painting are excluded. "in -line" duct and piping devices, including, but not limited to, valves, dampers, humidifiers, wells, taps, flow meters, orifices. etc., if required hereunder to be furnished by Johnson, shall be distributed and installed by others under Johnson's supervision but at no additional cost to Johnson. Purchaser agrees to provide Johnson with required field utilities (electricity, toilets, drinking water, project hoist, elevator service, etc.) without charge. Johnson agrees to keep the job site clean of debris arising out of its own operations. Purchaser shall not back charge Johnson for any costs or expenses without Johnson's written consent. Unless specifically noted in the statement of the scope of work or services undertaken by JCI under this agreement, JCI's obligations under this agreement expressly exclude any work or service of any nature associated or connected with the identification. abatement, clean up, control, removal, or disposal of environment Hazards or dangerous substances, to include but not be limited to asbestos or PCBs, discovered in or on the premises. Any language or provision of the agreement elsewhere contained which may authorize or empower the Purchaser to change, modify, or alter the scope of work or services to be performed by JCI shall not operate to compel JCI to perform any work relating to Hazards without JCI's express written consent. INVOICING & PAYMENTS. Johnson may invoice Purchaser monthly for all materials delivered to the job site or to an off -site storage facility and for all work performed on -site and off -site. Waivers of lien will be furnished upon request, as the work progresses, to the extent payments are received. If Johnson's invoice is not paid within 30 days of its issuance, it is delinquent. MATERIALS. If the materials or equipment included in this proposal become temporarily or permanently unavailable for reasons beyond the control and without the fault of Johnson, then in the case of such temporary unavailability, the time for performance of the work shall be extended to the extent thereof, and in the case of permanent unavailability, Johnson shall (a) be excused from furnishing said materials or equipment, and (b) be reimbursed for the difference between the cost of the materials or equipment permanently unavailable and the cost of a reasonably available substitute therefor. WARRANTY. Johnson warrants that the equipment manufactured by it shall be free from defects in material and workmanship arising from normal usage for a period of one (1) year from delivery of said equipment, or if installed by Johnson. for a period of one (1 ) year from installation. Johnson warrants that for equipment furnished and or installed but not manufactured by Johnson, Johnson will extend the same warranty terms and conditions which Johnson receives from the manufacturer of said equipment, For equipment installed by Johnson, if Purchaser provides written notice to Johnson of any such defect within thirty (30) days after the appearance or discovery of such defect, Johnson shall, at its option, repair or replace the defective equipment. For equipment not installed by Johnson, if Purchaser returns the defective equipment to Johnson within thirty (30) days after appearance or discovery of such defect, Johnson shall, at its option. repair or replace the defective equipment and return said equipment to Purchaser. All transportation charges incurred in connection with the warranty for equipment not installed by Johnson shall be borne by Purchaser. These warranties do not extend to any equipment which has been repaired by others, abused, altered or misused, or which has not been properly and reasonably maintained. THESE WARRANTIES ARE IN LIEU OF ALL OTHER WARRANTIES. EXPRESS OR IMPLIED. INCLUDING, BUT NOT LIMITED TO, THOSE OF MERCHANTABILITY AND FITNESS FOR A SPECIFIC PURPOSE. LIABILITY. Johnson shall not be liable for any special, indirect or consequential damages arising in any manner from the equipment or material furnished or the work performed pursuant to this agreement. TAXES. The price of this proposal does not include duties, sales. use, excise, or other similar taxes, unless required by federal, state or local law. Purchaser shall pay. in addition to the stated price, all taxes not legally required to be paid by Johnson or, alternatively, shall provide Johnson with acceptable tax exemption certificates. Johnson shall provide Purchaser with any tax payment certificate upon request and after completion and acceptance of the work. DELAYS. Johnson shall not be liable for any delay in the performance of the work resulting from or attributed to acts or circumstances beyond Johnson s control, including. but not limited to, acts of God, fire, riots, labor disputes, conditions of the premises, acts or omissions of the Purchaser, Owner. or other Contractors or delays caused by suppliers or subcontractors of Johnson, etc. COMPLIANCE WITH LAWS. Johnson shall comply with all applicable federal, state and local laws and regulations and shall obtain all temporary licenses and permits required for the prosecution of the work. Licenses and permits of a permanent nature shall be procured and paid for by the Purchaser. DISPUTES. All disputes involving more than $15,000 shall be resolved by arbitration in accordance with the rules of the American Arbitration Association. The prevailing party shall recover all legal costs and attorney's fees incurred as a result. Nothing here shall limit any rights under construction lien laws. INSURANCE. Insurance coverage in excess of Johnson's standard limits will be furnished when requested and required. No credit will be given or premium paid by Johnson for insurance afforded by others. INDEMNITY. The Parties hereto agree to indemnify each other from any and all liabilities, claims, expenses, losses or damages, including attorneys fees, which may arise in connection with the execution of the work herein specified and which are caused, in whole or in part by the negligent act or omission of the Indemnifying Party. OCCUPATIONAL SAFETY AND HEALTH. The Parties hereto agree to notify each other immediately upon becoming aware of an inspection under, or any alleged violation of, the Occupational Safety and Health Act relating in any way to the project or project site. ENTIRE AGREEMENT. This proposal, upon acceptance. shall constitute the entire agreement between the parties and supersedes any prior representations or understandings. CHANGES. No change or modification of any of the terms and conditions stated herein shall be binding upon Johnson unless accepted by Johnson in writing. PROJECT ESTIMATE S&S � iI �11 II�t_m�'AIR C'ON'Lt SI-IEETMETAL,, IN+C. DATE: 07/29/2024 QUOTE ID: 336 CONTACT: Dave Arnold CUSTOMER: CITY OF ASHLAND Ph:(541) 951-0292 STREET: 20 E. MAIN ST. david.arnold@ashland.or.us CITY: ASHLAND, OR 97520 DATE SUBMITTED: 07/29/2024 PREPARED BY: Duer, Art DESCRIPTION: CITY OF ASH. - WASTE WATER FACILTY LAB CHANGE OUT SCOPE OF WORK: We are pleased to provide the following quote to you: REPLACE 2 HEAT PUMP SPLIT SYSTEMS: INCLUDING OUTDOOR HEAT PUMP UNITS AND INDOOR FANCOILS W/ AUX HEATING. TO INCLUDE, DUCT ADAPTERS, REFRIGERANT PIPING, DRAIN CONNECTIONS, PERMITS AND COMCHECK. MISC. PARTS AND MATERIALS TO COMPLETE INSTALLATION. REMOVAL AND DISPOSAL OF EQUIPMENT AND REFRIGERANT. ELECTRICAL TO BE COMPLETED BY OTHERS. INCLUDES MANUFACTURER PROVIDED WARRANTY AND 1 YEAR CRAFTSMANSHIP WARRANTY. NOTE: WE WILL REQUIRE ACCESS TO THE PARK BEHIND THE BUILDING FOR OUR REACH LIFT. DEPENDING ON CONDITION OF THE GROUND, DAMAGE MAY RESULT TO THE GRASS AND PATH, ANY REPAIRS OR PREVENTIVE MEASURES BY OTHERS. EXTERIOR LOUVERS TO ACCESS FANCOIL UNITS TO BE REMOVED AND RE -INSTALLED BY OTHERS. SCHEDULING: ALL WORK TO BE DONE DURING REGULAR BUSINESS HOURS MONDAY - FRIDAY 7:30 AM - 4:00 PM NOTE: 9 WEEK LEAD TIME ON EQUIPMENT. ITEM _._--------- . _..... QUANTITY UNIT PRICE TOTAL CARRIER 10 TON HEAT PUMP, FANCOIL AND 35KW HEAT STRIP. 1 $21,223.00 $21,223.00 CARRIER 7.5 TON HEAT PUMP, FANCOIL AND 25KW HEAT STRIP. ,..._.__---------------- _---------- .________.__ _.._..___..._,__......._M...M._..___.___.._._. 1 $17,829.00 $17,829.00 ___. __.___ ...... _�_....___w.___..___._._. LABOR 1 $4,400.00 $4,400.00 MISC. MATERIAL AND PERMITS/COMCHECK__.__.._.__.m...._.,,�,,...._w_..._....w__.__w�.w....._____.._..._...w....__._.__....__..._ _ _ ........... 1 $1,200.00 __._ . ..,.__.....___ $1,200.00 _.. REACH LIFT DROP/PICKUP RENTAL_..w._._._____..._._._.._....w.__..M__...._.._._.._____.__.__....____.__.._.._____ ____..�____._..M. w.__ _.._._...__._ __w._________ ....___� _..._....wwww_._____.__ 1 $400.00 $400.00 Tota 1 ___..w._,�._.___..._..ww.. $45,052.00 6 (�jg�e1 SIGNATURE PRINT NAME DATE 1 '`�"' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/1312025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY OFFICE: P.O. BOX 328 PHONE FME (AIC, No, Ext): 888-333-4949 INC,A/No): 507-446-4664 OWATONNA, MN 55060 ADDRESS: CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC # INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED INSURER B: S & S SHEETMETAL INC 912 ANTELOPE RD INSURER C: INSURER D: WHITE CITY, OR 97503-1607 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 245 REVISION NUMBER: 0 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 LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DDIYVYV POLICY EXP MMIDD/YYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N 9910853 04/24/2025 04/24/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) EXCLUDED PERSONAL& ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY ❑JPECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS & COMPIOP ACC $2,000,000 AOWNED AUTOMOBILE LIABILITY JANYAUTC AUTOS ONLY ASUTOSULED HIRED AUTOS ONLY NON -OWNED AUTOS ONLY Y N 9910853 04/24/2025 04/24/2026 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per Person) BODILY INJURY (Per Accident) PROPERTY DAMAGE (Per Accident) A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N 9910854 04/24/2025 04/24/2026 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/ EXECUTIVE OF EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE 77THER E.L EACH ACCIDENT E.L DISEASE EA EMPLOYEE E.L DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION 20 E MAIN ST ASHLAND. OR 97520-1814 245 0 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t Vim'"RL I C/ ; 6 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY S & S SHEETMETAL INC 912 ANTELOPE RD WHITE CITY, OR 97503-1607 POLICY NUMBER SEE CERTIFICATE # 245.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 245.O SEE CERTIFICATE # 245.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE ADDITIONAL INSURED ALSO INCLUDES: THE CITY OF ASHLAND, OREGON, ITS OFFICERS, AGENTS AND EMPLOYEES ARE SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 '`�"' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/1312025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY OFFICE: P.O. BOX 328 PHONE FME (AIC, No, Ext): 888-333-4949 INC,A/No): 507-446-4664 OWATONNA, MN 55060 ADDRESS: CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC # INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED INSURER B: S & S SHEETMETAL INC 912 ANTELOPE RD INSURER C: INSURER D: WHITE CITY, OR 97503-1607 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 245 REVISION NUMBER: 0 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 LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DDIYVYV POLICY EXP MMIDD/YYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N 9910853 04/24/2025 04/24/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) EXCLUDED PERSONAL& ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY ❑JPECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS & COMPIOP ACC $2,000,000 AOWNED AUTOMOBILE LIABILITY JANYAUTC AUTOS ONLY ASUTOSULED HIRED AUTOS ONLY NON -OWNED AUTOS ONLY Y N 9910853 04/24/2025 04/24/2026 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per Person) BODILY INJURY (Per Accident) PROPERTY DAMAGE (Per Accident) A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N 9910854 04/24/2025 04/24/2026 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/ EXECUTIVE OF EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE 77THER E.L EACH ACCIDENT E.L DISEASE EA EMPLOYEE E.L DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION 20 E MAIN ST ASHLAND. OR 97520-1814 245 0 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t Vim'"RL I C/ ; 6 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY S & S SHEETMETAL INC 912 ANTELOPE RD WHITE CITY, OR 97503-1607 POLICY NUMBER SEE CERTIFICATE # 245.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 245.O SEE CERTIFICATE # 245.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE ADDITIONAL INSURED ALSO INCLUDES: THE CITY OF ASHLAND, OREGON, ITS OFFICERS, AGENTS AND EMPLOYEES ARE SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD