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HomeMy WebLinkAbout2025-011 PO 20250311 and AGRMT - Grayback Forestry 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 E GRAYBACK FORESTRY INC N PO BOX 838 D MERLIN, OR 97532 O Email: GREG@GRAYBACKFORESTRY.COM R 541) 476-0033 03/04/2025 989 03/04/2025 Fuels Reduction Services - NTE $25k 1 Fuel Reduction Services. Project Account: E-000572-999 Purchase Order Fiscal Year 2025 Page: 1 of: 1 �� WR � IF I �� FN(11111 Purchase Order # 20250311 S C/O Oak Knoll Maint Shop H 3070 Hwy 66 P Ashland, OR 97520 Email: jason.minica@ashland.or.us T Phone: 541 /488-5340 O Fax: 541 /488-5314 20250446 FOB ASHLAND OR/NET30 I Parks Department *************** GL SUMMARY *************** 128626 - 604106 $25,000.00 1.0 1 EACH 1 $25,000.001 $25,000.00 By: Date: Authorized Signature $25,000.00 Goods L, �.l and • City Information Contractor Information City of Ashland Firm Name: Grayback Forestry Attn: Jason Minica Contact: Wayde Morrison Address: 1150 Ort Lane 20 E. Main St. Ashland, Oregon 97520 Merlin, OR 97532 Phone: (202) 552-2078 Phone: (541) 476-0033 Email: jason.min ica@ashland. or. US Email: wayde@graybackforestry.com Contract Summary Procurement Method: Small Procurement Completion Date: 06/30/2026 Contract Amount: $ 25,000.00 Twenty -five -thousand -dollars. Description of Services: Fuels Reduction Services - NTE $25k Supporting Documents: 2025 - 2026 Rx Fire Modules and Pricing Dated: 02/08/2025 Dated: 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 GB ] herein signify acknowledgment and agreement to this provision, if applicable, or if not sign "N/A". 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 Grayback Forestry 1. Term and Termination 1.1. 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 the Completion Date indicated in the Contract Summary on page one of this Agreement unless sooner terminated as provided in Subsection 1.2. 1.1. Time is of the essence. Time is of the essence for Contractor's performance of each and every obligation and duty under this Agreement. City, by written notice to Contractor of default or breach, may at any time terminate the whole or any part of this Agreement if Contractor fails to provide the Work called for by this Agreement within the time specified herein or within any extension thereof. 1.2. Termination 1.2.1. The City and Contractor may terminate this Agreement by mutual agreement at any time. 1.2.2. 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. 1.2.3. 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. 2. Compensation 2.1. City shall pay Contractor the sum listed as the "Contract Amount" in the Contract Summary on page one of this Agreement as provided herein as full compensation for the Work as specified in the supporting documents. 2.2. In no event shall Contractor's total of all compensation and reimbursement under this Agreement exceed the "Contract Amount" listed in the Contract Summary without express, written approval from the appropriate Department Head or City Manager. Contractor acknowledges that any work delivered, or expenses incurred without authorization as provided herein is done at Contractor's own risk and as a volunteer without expectation of compensation or reimbursement. 3. Contractor's Obligations 3.1. Performance. Provide the goods or services as set forth in the Supporting Documents attached hereto and, by this reference, incorporated herein. 3.2. Nondiscrimination. Contractor 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 Contractor. Contractor agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Contractor 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 Page 2 of 8: Goods and Services Agreement between the City of Ashland and Grayback Forestry 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 $26,429.65 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 Grayback Forestry 5.2. Commercial Automobile Liability -- with a combined single limit, or the equivalent of not less than $2,000,000 (two million dollars) for each accident for Bodily Injury and Property Damage, including coverage for owned, hired and non -owned vehicles. 5.3. Additional forms: (See Attached) 5.4. Worker's Compensation. Contractor 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. As evidence of the insurance required by this Agreement, the Contractor shall furnish an acceptable insurance certificate prior to commencing any Work with limits not less than $500,000. 5.4.1. Workers' Compensation Exemption: If applicable, Contractor affirms and certifies that it is exempt from providing Workers' Compensation per ORS 656.027. Exemption criteria: Contractor initials if exempt: Date: 6. Additional Insured/Certificates of Insurance. The Contractor shall name the City of Ashland, Oregon, along with its elected officials, officers, and employees, as Additional Insureds on all insurance policies (excluding Professional Liability and Workers' Compensation) necessary for this Agreement. This inclusion applies solely to the services provided by the Contractor under this Agreement. The Contractor's insurance must be primary and non-contributory. Before commencing work, the Contractor must provide acceptable insurance certificates as proof of the required coverage. These certificates must specify all parties included as additional Insureds, treating each named and additional named insured as if they were covered under separate policies, without increasing policy limits. Insuring companies or entities must be accepted by the City. Upon request, the Contractor must provide complete copies of insurance policies and trust agreements to the City. Additionally, the Contractor must provide an endorsement naming the City, its officers, employees, and agents as additional insureds by the Effective Date of this Agreement, accompanied by approved certificate(s) of insurance. 7. Indemnity. Contractor 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 Contractor or its officers, employees, contractors, or agents under this Agreement. 8. Notice Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the addresses set forth above with a copy to: City of Ashland — Legal Department 20 E. Main Street Ashland, Oregon 97520 Phone: (541) 488-5350 Page 4 of 8: Goods and Services Agreement between the City of Ashland and Grayback Forestry 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 279B.220, 279B.230 and 279B.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 Grayback Forestry 7.5. Force Majeure. 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. 7.6. Deliveries F.O.B destination. Contractor shall pay all transportation and handling charges for the Goods. Contractor is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Contractor remains liable for latent defects, fraud, and warranties. 7.7. Goods Rejection. The City may reject non -conforming Goods and require Contractor to correct them without charge or deliver them at a reduced price, as negotiated. If Contractor does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 7.8. Goods Warranty Representation. Contractor represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with Supporting Documents and be free from defects in labor, material and manufacture. Contractor shall transfer all warranties to the City. 7.9. 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. 7.10. Jurisdiction. 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. 7.11. Severance. 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 Contractor and the City set forth in this Agreement. 8. Merger. This agreement and the attached exhibits constitute the entire understanding and agreement between the parties. No waiver, consent, modification or change of terms of this agreement 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 agreement. Contractor, by signature of its authorized representative, hereby acknowledges that he/she has read this agreement, understands it, and agrees to be bound by its terms and conditions. Page 6 of 8: Goods and Services Agreement between the City of Ashland and Grayback Forestry 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. CITY OF ASHLAND: &ck ffoy[r 04 By: G2achyHo,(Feb 25, 20251.2:34 PS F) Signature Rocky Houston, Director Printed Name 02/25/2025 Date Purchase Order No. APPROVED AS TO FORM: City Attorney Grayback Forestry (CONTRACTOR): GregB U ce I ( Digitally signed by Greg Bucell i�i Date: 2025.02.25 11:10:25 By: `�-08,00, Signature Greg Bucell Printed Name Business Manager Title 02/25/2025 Date (W-9 is to be submitted with this signed Agreement) Page 7 of 8: Goods and Services Agreement between the City of Ashland and Grayback Forestry City of Ashland LIVING s described ... 1.....U6 t:a.. per hour, effective June 30, 2024. The Living Wage is adjusted annually every W June 30 by the Consumer Price Index. ➢ For all hours worked under a service contract between their employer and the City of Ashland if the contract exceeds $26,429.65 or more. ➢ For all hours worked in a month, if the employee spends 50% or more of the employee's time in that month working on a project or 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 $26,429.65; ➢ If their employer is the City of Ashland, including the Parks and Recreation Department. ➢ In calculating the living wage, employers may add the value of health care, retirement, 401 K, and IRS eligible cafeteria plans (including 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 City's website at www.ashlan.or.us. Notice to Employers: This notice must be posted in areas where it can be seen by all employees. 2025 - 2026 City of Ashland Parks and Recreation Rx Fire Modules and Pricing Subunit Level Complexity Description Slashing Al Level I Unit density is estimated to average less than 60 percent cover to be cut A2 Level 11 Unit density is estimated to average greater than 60 percent cover to be cut Lop and Scatter B1 Level I Amount of slash to be lopped and scattered averages less than 20 tons per acre Pruning C1 Level I Less than 100 TPA C2 Level 11 Greater than 100 TPA Density Management Resource - Conifer Stands D1 Level I The percent cover of material to be cut is less than 60 percent D2 Level 11 The percent cover of material to be cut is greater than 60 percent Density Management Resource - Woodland / Shrub E1 Level I The percent cover of material to be cut is less than 60 percent E2 Level 11 The percent cover of material to be cut is greater than 60 percent Hand Pile and Cover F1 Level I An average of fewer than 20 piles per acre F2 Level 11 An average of 21 to 40 piles per acre F3 Level III An average of 41 to 60 piles per acre F4 Level IV An average of 61 to 80 piles per acre F5 Level V An average of 81 to 100 piles per acre F6 Level VI An average of 101 to 120 piles per acre F7 Level VI I An average of 121 to 140 piles per acre F8 Level VI II An average of 141 or greater piles per acre Fireline Construction Maintenance G1 Level I Hand fireline renovation, where firelines have previously been constructed G2 Level 11 When new hand firelines are constructed on unit boundaries or through continuous downed slash Fuels Pullback 11 Level I Fuels pullback on less than 20 trees or snags per acre 12 Level 11 Fuels pullback on greater than 21 trees or snags per acre Prescribed Burn and Mop -Up: Hand Pile Burn M1 Level I Low An average of fewer than 20 piles per acre. M2 Level 11 Low An average of 21 to 40 piles per acre. M3 Level III Low An average of 41 to 60 piles per acre. M4 Level IV Low An average of 61 to 80 piles per acre. M5 Level V Low An average of 81 to 100 piles per acre. M6 Level VI Low An average of 101 to 120 piles per acre. M7 Level VI I Low An average of 121 to 140 piles per acre. M8 Level VI II Low An average of 141 and greater piles per acre. Prescribed Fire Modules N1 All Levels Two Person Crew Module N2 All Levels Engine Module Type VI, Two -Person Crew N3 All Levels Five Person Crew Module N4 All Levels Engine Module Type VI, with Operator and Crew Member N5 All Levels Engine Module Type VI, with Operator and Crew Member +five -person crew N6 All Levels Engine Module Type VI, with Operator and Crew Member + two -person crew with water delivery system Prescribed Fire Modules N7 All Levels Engine Module Type VI, with Operator and Crew Member + five -person crew with water delivery system 2025 2026 *2027 $441.19 $485.31 $619.41 $681.35 $123.38 $135.72 $267.95 $294.75 $398.82 $438.70 $528.43 $581.27 $734.07 $807.48 $727.90 $800.69 $995.79 $1,095.37 $454.90 $500.39 $619.41 $681.35 $883.63 $971.99 $1,120.42 $1,232.47 $1,343.51 $1,477.86 $1,738.59 $1,912.45 $2,111.23 $2,322.36 $3,732.67 $4,105.94 $0.70 $0.77 $1.22 $1.34 $61.07 $67.18 $122.14 $134.35 $135.30 $148.83 $183.63 $201.99 $241.63 $265.79 $318.95 $350.84 $386.60 $425.26 $483.25 $531.58 $579.90 $637.89 $676.55 $744.21 $1,334.45 $1,467.89 $1,798.54 $1,978.40 $2,844.06 $3,128.46 $3,180.29 $3,498.32 $4,560.28 $5,016.31 $4,010.39 $4,411.43 $5,793.19 $6,372.51 2025 - 2026 City of Ashland Parks and Recreation Rx Fire Modules and Pricing Subunit Level Complexity Description 2025 2026 *2027 N8 All Levels Water Delivery System witth one Operator and Transportation $1,490.32 $1,639.35 N9 All Levels Tactical Water Tender Module with one Operator $1,974.43 $2,171.87 N10 All Levels Snag Felling Module, two -person team (paid hourly) $197.45 $217.19 N11 All Levels 5-Person Chainsaw Crew, five -person crew with chainsaws $3,584.84 $3,943.33 N12 All Levels Chipper-15" Capacity with operator (paid hourly) $206.64 $227.31 N13 All Levels Firing or Holding Boss $977.21 $1,074.93 N14 All Levels FMC Track Machine (Softtrack) with one operator $2,679.42 $2,947.37 N15 All Levels UTV Polaris 6x6 Engine (pump and 100 gallon capcity) with one operator $1,650.00 $1,815.00 N16 All Levels Burn Plan Preparation $1,650.00 $1,815.00 N17 All Levels Full Service Burning <10 acres $2,750.00 $3,025.00 N18 All Levels Full Service Burning >10 acres but <20 acres $2,200.00 $2,420.00 N19 All Levels Full Service Burning >20 acresbut <40 acres $1,650.00 $1,815.00 N20 All Levels Full Service>40 $1,100.00 $1,210.00 N21 All Levels Skid Steer w/300 gal. $2,200.00 $2,420.00 * - Pricing for year 2027 will be based on current years pricing and negotiated up to a maximum of 10 % increase e d u (11. D HIP 111110 A Final Audit Report Created: 2025-02-25 By: Brandon Terry (brandon.terry@ashland.or.us) Status: Signed Transaction ID: CBJCHBCAABAA-4xOXtWF67ggiuEDlp4WfBXR9ABOFjXX 2025-02-25 "Goods and Services Agreement - Fuels Reduction Services" Hi story Document created by Brandon Terry (brandon.terry@ash land. or. us) 2025-02-25 - 7:23:53 PM GMT !. Document emailed to Rocky Houston (rocky. housto n @ash land. or. us) for signature 2025-02-25 - 7:23:59 PM GMT Email viewed by Rocky Houston (rocky. houston @ash land. or. us) 2025-02-25 - 8:33:52 PM GMT ,00, Document e-signed by Rocky Houston (rocky.houston@ashIand. or. us) Signature Date: 2025-02-25 - 8:34:34 PM GMT - Time Source: server Agreement completed. 2025-02-25 - 8:34:34 PM GMT 0� Adobe Acrobat Sign ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/10/2025 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 Protectors Insurance, LLC P.O. Box 4669 OR 97501 CONTACT NAME: Kendall Pori PHONE FAX A/C No Ext : 541-842-2963 A/C, No): 541-772-1906 E-MMedford ADDRESS: kendallp@protectorsins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Cincinnati Specialty Ins Co 13037 INSURED GRAYFOR-01 Grayback Forestry Inc PO Box 838 INSURERB: Arch Insurance Co INsuRERc: Landmark American Insurance Co INSURERD: Merlin OR 97532-0838 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1750103120 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Loggers BFPD Y Y CSU0238415 9/1/2024 9/1/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY � ECT1:1 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 LBFPD $ 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY MWPK09386200 9/1/2024 9/1/2025 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ C UMBRELLALIAB EXCESS LAB X OCCUR CLAIMS -MADE LHA602387 9/1/2024 9/1/2025 EACH OCCURRENCE $2,000,000 X AGGREGATE $ 2,000,000 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland Parks & Recreation 20 E. Main Street AurrloRlz ESENTATIVE = OR 97520 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Form w=9 (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. Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. Give form to the requester. Do not send to the IRS. 1 Name of entity/individual. 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.) Grayback Forestry, Inc. 2 Business name/disregarded entity name, if different from above. 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check 4 Exemptions codes apply only to monly one of the following seven boxes. certain entities, not individuals; o- c ❑ Individual/sole proprietor ❑ C corporation ❑✓ S corporation ❑ Partnership ❑ Trust/estate see instructions on page 3): 0 ❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) . . . . Exempt payee code (if any) = Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax yclassification 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 G❑ Other (see instructions) code (if any) a o 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification, (Applies to accounts maintained y and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check ❑ outside the United States. �? this box if you have any foreign partners, owners, or beneficiaries. See instructions . . . . . . . . 5 Address (number, street, and apt. or suite no.). See instructions. Requester's name and address (optional) cn PO Box 838 6 City, state, and ZIP code Merlin, OR 97535 7 List account number(s) here (optional) er Identification Number I i u Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other _ _ M entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or TIN, later. Employer identification number Note: If the account is in more than one name, see the instructions for line 1. See also What Name and ❑❑� _ ��--� Number To Give the Requester for guidelines on whose number to enter. 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, cancel t, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and divide ou esquire o si_ the c rtification, but you must provide your correct TIN. See the instructions for Part 11, later. Sign Signature of Date 24 to l Here U.S. person General Instructions 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 www.lrs.gov1FormW9. What's New Line 3a has been modified to clarify 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 Form 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. 10231X Form W-9 (Rev. 3-2024)