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HomeMy WebLinkAbout2024-138 AGRMT - PacWest Machinery I i �G IT YY Goods and Services Agreement L A i City Information Contractor Information City of Ashland Firm Name: PacWest Machinery Attn: Tommy Hoak Contact: Steve Callan 90 N. Mountain Address: 19255 NE Sandy Blvd ! Ashland, Oregon 97520 Portland, OR 97230 Phone: (541) 552-2356 Phone: (503) 799-0436 Email: tommy.hoak@ashland.or.us Email: scallan@pacwestmachinery.com Contract Summary Procurement Method: Small I Completion Date: 06/30/2025 Contract Amount: $ 21,740.00 Description of Services: Paver repair and service Supporting Documents: Estimate Dated, 12/02/2024 W-g Dated: Insurance Dated: Agreement Dated: 12/6/24 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. I 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 Suppo ing Documents. In the event of conflict between provisions of the Supporting Documents, t rting 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/ . The goods and services defined and described in the Supporting Documents shall hereinafter be collectively referred to as "Work." i f Page 1 of S: Goods and Services Agreement between the City of Ashland and PacWest Machinery i I 1. Term and Termination 11. 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 j 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 PacWest Machinery i i I 1 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 60% 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 PacWest Machinery I I 1 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) 6A. Worker's Compensation, Contractor shall, at its own expense, maintain Worker's Compensation Insurance in compliance with ORS 656,017,which requires subject employers i 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 InsurediCertificates of Insurance. The Contractor shall name the City of Ashland, Oregon, along with its elected officials, officers, and employees, as Additional Insureds on all I insurance policies (excluding Professional Liability and Workers' Compensation) necessary for j 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 ail 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) 488-6350 Page 4 of 8: Goods and Services Agreement between the City of Ashland and PacWest Machinery i i 1 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 i 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 I 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, 279P.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 6 of 8: Goods and Services Agreement between the City of Ashland and PacWesl Machinery 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 PacWest Machinery S 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: PacWest Machinery(CONTRACTOR): By: By: _7Wa� Signature gnature Printed Name Printed Name Date Title Az Date Purchase Order No. (W-9 is to be submitted with this signed Agreement) APPROVED AS TO FORM: City Attorney Page 7 of 8: Goods and Services Agreement between the City of Ashland and PacWest Machinery of Anshliand 'LIVING a • ^ Wfi A' E , . per hour, effective June 30, 2024. The Living Wage is adjusted annually every June 30 by the Consumer Price Index. portion of the business of of health care, retirement, their employer, if the 401 K, and IRS eligible ' ' employer has ten or more cafeteria plans(including employees, and has received childcare)benefits to the ➢ For all hours worked under a financial assistance for the employee's amount of wages, project or business from the service contract between their City of Ashland over ➢ Note: For temporary and employer and the City of $26,429,65; part-time employees,the Ashland if the contract ` Living Wage does not apply exceeds$26,429.65 or more, ➢ If their employer is the City of to the first 1040 hours worked ➢ For all hours worked in a Ashland, including the Parks in any calendar year, For and Recreation Department. more details, please see month, if the employee Ashland Municipal Code spends 50%or more of the ➢ In calculating the living wage, Section 3,12,020. employee's time in that month employers may add the value working on a project or Cali 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.ashland,or.us. Notice to Employers: This notice must be posted in areas where it can be seen by all employees. C IT Y OF ASHLAND ika0 DATE R' CERTIFICATE OF LIABILITY INSURANCE 12/0920024 YYYY) 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 NAME: Sentry Customer Service Sentry Insurance PHONE FAX 1800 North Point Drive A/C No Ext: 800-473-6879 A/C No): 800-514-7191 Stevens Point,WI 54481 EMAIL ADDRESS: businessproducts_direct@sentry.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Sentry Select Insurance Company 21180 INSURED INSURER B: PacWest Machinery LLC INSURER C: 8207 S 216th St Kent,WA 98032-1935 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:4121619 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE M OCCUR DAMAREMISGEES TO Ea occ RENTED urrence $500,000 P MED EXP(Any one person) $5,000 A X 2544074006 10/01/2024 10/01/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 X POLICY ❑PRO- POLICY ❑LOG PRODUCTS-COMP/OP AGO $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS 2544074001 10/01/2024 10/01/2025 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY P era ccident X UMBRELLA LAB H OCCUR EACH OCCURRENCE $8,000,000 A X EXCESS LIAB CLAIMS-MADE 2544074008 10/01/2024 10/01/2025 AGGREGATE $24,000,000 DED RETENTION$ PRODUCTS-COMP/OP AGO $24,000,000 WORKERS COMPENSATION I STATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Employee Benefits Occurrence Limit $500,000 Errors&Omissions Annual Aggregate Limit $ 1,000,000 Deductible $ 1,000 A ERRORS&OMISSIONS 2544074005 10/01/2024 10/01/2025 All Other Errors& Occurrence Limit $250,000 Omissions Annual Aggregate Limit $500,000 Deductible 2,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Refer to attached CERTIFICATE HOLDER CANCELLATION City of Ashland,elected officials,officers,and employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 41v ACORD 25(2016/03) Page 1 of 2 ©1988-2015 ACORD CORPORATION.All rights reserved. 2544074 The ACORD name and logo are registered marks of ACORD 12/09/2024 Sentry Select Insurance Company 1 00001 0000000000 24344 0 N 5c780ce5-ee5e-44d7-987a-Oba3251fde19 �..� AGENCY CUSTOMER ID: XXXXXX3567 ACOR�� LOC#: ADDITIONAL REMARKS SCHEDULE Page ? of ? AGENCY NAMED INSURED Marisa Jannaman PacWest Machinery LLC POLICY NUMBER 2544074006 CARRIER NAIC CODE Sentry Select Insurance Company 21180 EFFECTIVE DATE: 10/01/2024 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance General Liability GL Coverage provided is primary and non-contributory per the terms of endorsement CG 20 01. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. 2544074 The ACORD name and logo are registered marks of ACORD 12/09/2024 Sentry Select Insurance Company ika0 DATE R' CERTIFICATE OF LIABILITY INSURANCE 12/0920024 YYYY) 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 NAME: Sentry Customer Service Sentry Insurance PHONE FAX 1800 North Point Drive A/C No Ext: 800-473-6879 A/C No): 800-514-7191 Stevens Point,WI 54481 EMAIL ADDRESS: businessproducts_direct@sentry.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Sentry Select Insurance Company 21180 INSURED INSURER B: PacWest Machinery LLC INSURER C: 8207 S 216th St Kent,WA 98032-1935 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:4121619 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAREMISGEESTO Ea occ RENTED urrence $ P IVIED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑PRO ❑ ECT LOG PRODUCTS-COMP/OP AGO $ J OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION SPER TATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ POLLUTION LIABILITY AGGREGATE LIMIT $ 1,000,000 A X I CLAIMS-MADE OCCUR N/A 2544074007 10/01/2024 10/01/2025 POLLUTION INCIDENT LIMIT $ 1,000,000 CLEANUP COSTS-COVERED $ 100,000 LOCATION LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Ashland,elected officials,officers,and employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 411 / ACORD 25(2016/03) Page 1 of 2 ©1988-2015 ACCORD CORPORATION.All rights reserved. 2544074 The ACORD name and logo are registered marks of ACORD 12/09/2024 Sentry Select Insurance Company 1 00001 0000000000 24344 0 N 03f3e1b9-748b-47d4-a243-35e4fc41a1b9 �..� AGENCY CUSTOMER ID: XXXXXX3567 ACOR�� LOC#: ADDITIONAL REMARKS SCHEDULE Page ? of ? AGENCY NAMED INSURED Marisa Jannaman PacWest Machinery LLC POLICY NUMBER 2544074007 CARRIER NAIC CODE Sentry Select Insurance Company 21180 EFFECTIVE DATE: 10/01/2024 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. 2544074 The ACORD name and logo are registered marks of ACORD 12/09/2024 Sentry Select Insurance Company ika0 DATE R' CERTIFICATE OF LIABILITY INSURANCE 12/0920024 YYYY) 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 NAME: Sentry Customer Service Sentry Insurance PHONE FAX 1800 North Point Drive A/C No Ext: 800-473-6879 A/C No): 800-514-7191 Stevens Point,WI 54481 EMAIL ADDRESS: businessproducts_direct@sentry.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Sentry Select Insurance Company 21180 INSURED INSURER B: PacWest Machinery LLC INSURER C: 8207 S 216th St Kent,WA 98032-1935 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:4121619 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAREMISGEESTO Ea occ RENTED urrence $ P MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑PRO ❑ ECT LOG PRODUCTS-COMP/OP AGO $ J OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION SPER TATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Cyber Liability and Data Breach Response N/A 2544074010 10/01/2024 10/01/2025 Policy Aggregate Limit of Liability $ 100,000 Retention $2,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Ashland,elected officials,officers,and employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 411 / ACORD 25(2016/03) Page 1 of 2 ©1988-2015 ACCORD CORPORATION.All rights reserved. 2544074 The ACORD name and logo are registered marks of ACORD 12/09/2024 Sentry Select Insurance Company 1 00001 0000000000 24344 0 N 21518fed-f8e440a3-ba80-5387fab01824 �..� AGENCY CUSTOMER ID: XXXXXX3567 ACOR�� LOC#: ADDITIONAL REMARKS SCHEDULE Page ? of ? AGENCY NAMED INSURED Marisa Jannaman PacWest Machinery LLC POLICY NUMBER 2544074010 CARRIER NAIC CODE Sentry Select Insurance Company 21180 EFFECTIVE DATE: 10/01/2024 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. 2544074 The ACORD name and logo are registered marks of ACORD 12/09/2024 Sentry Select Insurance Company POLICY NUMBER: 2544074006 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations City of Ashland, elected officials, officers, and 19255 NE Sandy Blvd Portland, OR 97230 employees Description: Paver repair and service Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: respectwith lb°Iity for personal ,and Iladvertising This insurance does not apply to "bodily injury" or "property damage" or property damage occurring after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs)to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or law; and subcontractor engaged in performing 2. If coverage provided to the additional insured operations for a principal as a part of the same is required by a contract or agreement, the project. insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Change effective 12/09/2024 CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Pagel of 2 2544074 12/09/2024 Sentry Select Insurance Company 1 00001 0000000000 24344 0 N ecc3cdc8-e5d5-420b-9628-6f9bc3155f1a C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable limits of insurance. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Change effective 12/09/2024 Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 2544074 12/09/2024 Sentry Select Insurance Company COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2)You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 2544074 08/21/2024 Sentry Select Insurance Company 72c88085-c858-46b8-9d92-b162870dd25c IL 70 58 02 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION - CERTIFICATE HOLDERS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM COMMERCIAL AUTOMOBILE COVERAGE PARTS COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PARTS COMMERCIAL EXCESS/UMBRELLA LIABILITY COVERAGE FORM EMPLOYMENT RELATED PRACTICES LIABILITY POLLUTION LIABILITY COVERAGE ERRORS AND OMISSIONS COVERAGE FORM In the event we cancel this policy, we shall endeavor to also mail to the person(s)or organization(s) listed in the Schedule for this endorsement advance written notice of cancellation. This notification of cancellation of the policy is intended as a courtesy only. Our failure to provide such notification to the person(s)or organization(s)shown in the Schedule will not extend any policy cancellation date nor impact or negate any cancellation of the policy. This endorsement does not entitle the person(s) or organization(s) listed or described in the Schedule below to any benefit, rights or protection under this policy. Failure by us to provide this notice of cancellation to the person(s) or organization(s) listed or described in the Schedule below will not impose liability of any kind upon us. Any of these provisions that conflict with a law that controls the notice of cancellation of the insurance in this endorsement is changed by this statement to comply with the law. Schedule Person(s)or Organization(s) including mailing address: City of Ashland, elected officials, officers, and employees 20 E Main St Ashland, OR 97520-1814 All other terms and conditions of this policy remain unchanged. Change effective 12/09/2024 IL 70 58 02 14 Page 1 of 1 2544074 12/09/2024 Sentry Select Insurance Company 1 00001 0000000000 24344 0 N 3399f064-a5d44f65-8578-8811a6a8a39d