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HomeMy WebLinkAbout2025-018 AGRMT - AB Yard Maintenance, LLC1.i1 - CITY of City Information City of Ashland Attn: Brian Hendrix 455 Siskiyou Blvd Ashland, Oregon 97520 Goods and services Agreement Contractor Information Firm Name: AB Yard Maintenance, LLC Contact: Abdias Lima Address: 2882 Beebe Rd Central Point, OR Phone: (541) 520-3962 Phone: (541) 973-7369 Email: brian.hendrix@ashlandoregon.gav Email: abdiaS.lima7@gmail.com Contract Summary Procurement Method: Intermediate Completion Date: 05/01/2025 Contract Amount: $ 25,000.00 Twenty-five thousand Description of Services: Wildfire mitigation services for mobile home parks in Ashland Supporting Documents: Informal bid email Dated: 03/24/2025 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 [] 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 AB Yard Maintenance LLC 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 AB Yard Maintenance LLC 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 AB Yard Maintenance LLC 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:D Z5 6. Additional InsuredlCertificates 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 AB Yard Maintenance LLC 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. 62 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 27913.220, 27913.230 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 AB Yard Maintenance LLC 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 AB Yard Maintenance LLC 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- By: 9, x4WJ4 0), Signature Marshall Rasor, Interim Fire Chief Pri ed Name Date Purchase Order No. APPROVED AS TO FORM: City Attorney AB Yard Maintenance LLC (CONTRACTOR): Py:X-1 � Signature !I Printed Name Title zoZ!5 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 AB Yard Maintenance LLC www.saif.com Oregon Workers' Compensation Certificate of Insurance Certificate holder: CITY OF ASHLAND 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 Ab Yard Maintenance, LLC 2882 Beebe Rd Central Point, Or 97502-3494 Producer/contact Listo Tax Solutions Ariel Murray 541.734.9341 ariel@listotax.com Issued 04/03/2025 Limits of liability Policy 100064068 Bodily Injury by Accident $500,000 each accident Period 03/01/2025 to 03/01/2026 Bodily Injury by Disease $500,000 each employee Body Injury by Disease $500,000 policy limit Description of operations/locations/special 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,,- rl-� Chip Terhune President and CEO Policy_OLCA_CertificateOfl nsurance 400 High Street SE Salem, OR 97312 P: 800.285.8525 F:503.584.9812 AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 04I03/2025 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 CONTACT Kimberly Edwards NAME: Ashland Insurance Inc ACNE Ezt: (541) 857-0679 FAC No: (541) 857-9883 801 O'Hare Parkway, Ste 101 E-MAIL kedwards@ashlandinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC p INSURERA: Ohio Security Insurance Co. 24082 Medford OR 97504 INSURED INSURER B : Ab Yard Maintenance, LLC INSURER C 2882 Beebe Rd INSURER D : INSURER E : Central Point OR 97502 INSURERF: COVERAGES CERTIFICATE NUMBER: 24-25 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 ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 1,000,000 $ MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 A Y BLS59027744 09/05/2024 09/05/2025 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 PRO - X POLICY ❑ JEC ❑ LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: AUTOMOBILE LIABILITY COBINED SINGLE LIMIT Ea Maccident $ _ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N $ X UMBRELLA LIAB X1 OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE Y US059027744 04/03/2025 04/03/2026 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) The City of Ashland along with its elected officials, officers and employees are included as Additional Insured for General Liability and Umbrella Liability coverages with written contract. This form is subject to policy terms, conditions and exclusions. 9,rK I IrIUAI C r1ULUCK IiA14I rLLAI IUN 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. 455 Siskiyou Blvd AUTHORIZED REPRESENTATIVE y/ Ashland OR 97520 71"'04� @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD A� D1 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 03/27/2025 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 CONTACT Kimberly Edwards NAME: Ashland Insurance Inc PHONE (541) 857-0679 FAx (541) 857-9883 A/C No Ext : AIC No 801 O'Hare Parkway, Ste 101 E-MAIL kedwards@ashlandinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Ohio Security Insurance Co. 24082 Medford OR 97504 INSURED INSURERS: Ab Yard Maintenance, LLC INSURER C : 2882 Beebe Rd INSURERD: INSURER E : Central Point OR 97502 INSURERF: COVERAGES CERTIFICATE NUMBER: 24-25 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. I �TR TYPE OF INSURANCE AUULIbUtill INSD WVD POLICY NUMBER MM/DDYr1r Y EXP MMIDDY LIMITS X COMMERCIALGENERALLIABILITY EACH OCCURRENCE 5 1,000,000 CLAIMS -MADE FX1 OCCUR PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 15,000 PERSONAL &ADV INJURY $ 1,000,000 A Y BLS59027744 09/05/2024 09/05/2025 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 3,000,000 X POLICY DJECT LOC PRODUCTS -COMPIOPAGG $ 3,000,000 S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S BODILY INJURY (Per person) S ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident S S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAR DED I I RETENTION 5 $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attaohed If more space Is required) Certficate holder is included as Additional Insured for General Liability coverages with written contract. This form is subject to policy terms, conditions and exclusions. :La[4l 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 E. Main St. AUTHORIZED REPRESENTATIVE Ashland OR 97520 01" 4� A lgl . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD JACKSONVILLE INS lNC PO BOX 898 JACKSOWLI-E, OR 97530 Named insured Abdias Lima AB Yard Maintenance 2882 BELBt RD CENTRAL POINT, OR 97502 Commerdial Auto Insurance Coverage Summary This is your Declarations, Page Your coverage has changed ! Ifly PR99RZ AF. Policy number- 99,5523889 Underwritten by: Artisan and Truckers Casualty Co Aprip 4, 2025 Policy Periocl,Apr 2', 2025 - Apr 2, 2026 Page I of 2 progressiveagent.com Online Service Make payinents, check billing activity, print Policy documents, update your policy m (heck the statues of a dahr% 1 -541 -899-7076 JACKSONVILLE INS INC Contact your agent for personalized service. 1-900-444.4487 For (USIOnlei Sen/iQ if yoGagajt is (A na va i ia b ie or to repo it a da i m, Your coverage began the later of April 2, 20,25 at 12:01 a.in, or the effective time shown; on your application, This policy period ends on April 2, 2026 at 12:01 a.m. This coverage SUmmary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for an auto may not be corribined with the limits for the same coverage on anothet auto, unless the policy contract allows the stacking of limits. The policy contract is farm 6912 (02119). The contract is modified by forrm, 2852OR (02/19), 165TOR (02tl 9), Z313 (04/21), 482OR (02/19), 4,881 O,R (02119) and Z228 (01/1 11). The named insured organization type is a sole piroprielorship. Pollicy changes effective April 3, 2025 Changes processed on: . ..... ---- A pril' 11 3, 2 . 02,5 , 4:4 1 8 1 p I rn, ....... r' e' c' T i, ju- m' ... ch a'n'9-e': . . ....... . ......... ...... "I $ L 525.00 ... .. ... Chang g es� ........ .... . .. -"- ......... ... 11 Coven , r , ag , le '' bras , .. b , een ch I an I g I ed - on the po I h I c I y Liability To Others has been changed. Uninsured/Undojinsured Motorist has been changed. The changes shown above will not be effective prior to the tirne the changes were requested, 1101 For"i 6489 OR (04UU(00 nuva Outline of coverage Dre sc,;raw Li abulgty Lo Other's Bodily Irujua°y>araed Property Il�arrrage Liability..... Jnirlsured/Underi�nsured Motorist ., nimuaed Motorist Property Damage .... I See ALuto Coverage Sclaedeale Personal Iraluryr Protection See Auto era Coverage Sched Lille Medical Payments ra ....... y a is Comprehensive See Auto Coverage Schedule Collision See Auto Coverage Schedule Roadside Assistance rr� 2,,09 ..,. 9 II mit .....,combined sin le... 100 fluff combinedsingle limit Limit of liability each accident less deductible t.iiaaait of liability each person less deductible Rejected L bait of lability less deductible, I'll.,. t ina"ut of Lability less deductible See Auto Coverage Schedule Limit of liability less deductible .... Total 12 month policy premium .... . ............ I. A di'as Litres ............................... Auto coverage schedule 1. 2010 TOYOTA TIiN DRA Actual Cash Value (plus' 2,0001.00 Permanently Attached' Equip) V' Zip Code; 97502 RadiLas: 50 miles Personal use: N Body type Pickup (tuck LmbgNy Liability 11311 .miurn W°LAm ufl eD xr,..... WA PD PIP PIP w mi Lrmt Dedur` W ,Umit $,86 2a,0,00 �a9 515 �0�....,..$,0 . (or p Physical Damage Dedurua;Bqe Comp QwY;agt4" ion PIemd7�0Dn De"Vak➢IclMe c dRfa*n Prerl�� iw, Premium $11,000 .�.... 187 ..... 1,060 ..... . ,,yg'8 .... , _ .................. ........... �"^49 Ck h,IiaffiOde Other Coverages Dedimbie Rnaasido Prey„urn Premium um ........ ..., Premium um discount Polify 99552:38�89 Paid In Pull PIP ry,rrmuc��a $9.. Policy number 95523889 Abedias Lima Uexduartrle Frerc urn $1,315 88 ,$200 79 $300 hit & run 99 1187 I 498 38 .... 2,302