HomeMy WebLinkAbout2026-067 AGRMT Hudson Saw and Tool, LLC - Cemetery ' ' " M Goods and Services Agreement
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City Information Contractor Information
City of Ashland Firm Name: Hudson Saw And Tool, LLC
Attn: Robert Halbritter Contact: Jack Adams
Address: 2919 N. Pacific Hwy
Ashland, Oregon 97520 Medford, Or., 97501
Phone: (541) 690-6758 Phone: (541) 772-2293
Email: robert.halbritter@ashland.onus Email: jack@hudsonsawandtooL.com
Contract Summary
Procurement Method: Small
Completion Date: 05/30/2027
Contract Amount: $ 6,615.00
Description of Services: Pressure washer replacement for Cemetery
Supporting Documents: Dated:
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, t S ipporting
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 "NIA
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 Hudson Saw and Tool, LLC
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t 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
1 sooner terminated as provided in Subsection 1.2,
,T 1.1. Time is of the essence. Time is of the essence for Contractor's performance of
'F each and every obligation and duty under this Agreement. City, by written notice to
e 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.
c 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 Hudson Saw and Tool, LLC
business enterprise certified under ORS 200.055, in awarding subcontracts as required by
ORS 279A.110. competitive bidding or negotiation
3.3. Subcontractor Notification. In all solicitations either by including procurements of
made by Contractor for work to be performed under a subcontract,supplier shall be notified by
materials or leases of equipment, each potential subcontractoee �n and Title VI of the Civil
the Contractors of the Contractor's�nondiscrimination discriminatioations under n lawsis 9
Rights Act of 1964 and other federal
uirements. If the amount of this Agreement is $26,429.65 or more.
3.4. Living Wage Req I with Chapter 3.12 of the Ashland Municipal Code by paying
Contractor is required to comp y to ees performing Work under this
a living wage, as defined in that chapter, to all
emp 5o% or more of the Work under this
Agreement and to any Subcontractor who per-forms
Agreement. Contractor is also required to post the noticattached hereto as "Exhibit A
g all employees.
predominantly in areas where it will be seen by
4. Contractor's Compliance with Tax Laws
4.1. Contractor represents and warrants to the City that: g extensioros
4.1.1. Contractor shall, throughout the term of this Agreement, including any
hereof, comply with;
• All tax laws of the State of Oregon, including but not limited to ORS 305.620nd
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 teat to of of Oregon
shall
constitute a material breach of this Agreement. Further, any
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
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5, Insurance. Contractor shall obtain and maintain during the term of this Agreement and until ity s
F 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
3. than $2,000,000 (two million dollars)per occurrence and $3,000,000 (three million dollars)in
,r the aggregate for Bodily Injury and Property Damage.
Page 3 of 8: Goods and Services Agreement between the City of Ashland and Hudson Saw and Tool, 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 en e of the
insurance required by this Agreement, the Contractor shall furnish an acceptable
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 offic"s,.
employees and agents from and against any and all claims, suits, actions, losses, damaes,
liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the
activities of Contractor or its officers, employees, contractcrs, or agents under this Agreement.
8. Notice
Whenever notice is required or permitted to be given under this Agreement, such notice shall be
I given in writing to the other party by personal delivery, by sending via a reputable commercial
E 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
s 20 E. Main Street
G. Ashland, Oregon 97520
Phone:(541)488-5350
3r
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6. Remedies
6.1. In the event Contractor is in default of this Agreement, City may,at its option,pursue any or
IN' all of the remedies available to it under this Agreement and at law or in equity,including. but
Cli 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
Re scheduled completion dates or any Work that have been delivered inadequately or
defectively.
As 6.1.3. Initiation of an action or proceeding for damages,specific performance,or declaratory
pr< or injunctive relief.
en 6.1.4. These remedies are cumulative to the extent the remedies are not inconsistent, and
Ac City may pursue any remedy or remedies singly,collectively,successively or in any order
whatsoever.
St 6.2. Default: The Contractor shall be in default of this Agreement if Contractor: commits any
SE material breach or default of any covenant,warranty,certification,or obligation under the
W 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.
C6.3. 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
C demand provided.
f
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
CContractors 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
f by reference into this Agreement: ORS 2798.220,2796.230 and 2796.235
i 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
F assignment or subcontract without written consent of the City shall be void. Contractor shall
E 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 Hudson Saw and Tool,LLC
7.5. Force Majeure.Neither party to this Agreement shall hold the other responsible for damages
Fa,,, or delay in performance caused by acts of God, strikes, lockouts,accidents,or ocher events
Dep lN• beyond the control of the other or the other's officinterers,employees or agents.
Dep:
Bee Cli 7.6. Deliveries F.O.B destination. Contractor shall pay all transportation and handling charges
eel 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,
Re and warranties.
7-7. Goods Rejection. The City may reject non-conforming Goods and require Contractor to
As
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
err
a 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),
A[ 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
St Supporting Documents and be free from defects in labor, material and manufacture.
SE Contractor shall transfer all warranties to the City.
W 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
Cthis 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
7 agreement between the parties. No waiver, consent, modification or change of terms of this
i� agreement shalt 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
F 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 Hudson Saw and Tool,LLC
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WITNESS WHEREOF, the parties have executed this Agreement in their respective names by their
Rem I N.1 duly authorized representatives as of the dates indicated below.This Agreement may be executed in
eeo: two counterparts,each of which shall be deemed an original,with equal force and effect as if executed
actch in a single document.
act
CITY OF ASHLAND: Hudson Saw and Tool,LLC(CONTRACTOR):
Re
By:
As Signature By.
prc PSign ture
err
Printed Name -
I Ac Printed Name
Date �✓✓ 1
St
Title
' SE
W
Purchase Order No. Date
(W-9 is to be submitted with this signed Agreement
C APPROVED AS TO FORM:
C
CCity Attorney
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t Page 7 of 8: Goods and Services Agreement between the City of Ashland and Hudson Saw and Tool,LLC
., ,$ I January 1, 1970
8100 NE Parkway Drive,Suite 200 Vancouver,WA 98662
360.328.0700--www.BBSI.com
INSURED: HUDSON SAW & TOOL LLC
Client Address: 2919 N Pacific Hwy, Medford, OR 97501
Re: Barrett Business Services, Inc. ("BBSI )
Letter of Self-Insurance for Workers' Compensation Coverage
As the named addressee of this letter, your company's required Workers' Compensation coverage is
provided through BBSI's state-approved Self-Insured Workers' Compensation Plan by way of your co-
employment contract with BBSI.
Additional information is as follows:
Employer Liability Limits:
State: Oregon $3,000,000 -- Each Accident
Self-Insurance Certification #: 1068 $3,000,000 -- Disease Coverage Limit by Client
Workers' Compensation Limits: Statutory $3,000,000 -- Disease, Each Employee
Certificate Holder: PROOF OF WORKERS'COMP INSURANCE
Effective Dates: 10/1/2010 through 9/30/2027
Project Information:
Q30-Day Cancellation Notice
F1Blanket Waiver of Subrogation
FSpecific Waiver of Subrogation in favor of:
Additionally, BBSI's Self-Insured program is further supported by an excess workers' compensation
insurance policy with ACE American Insurance Co. Copy of certificate is available upon request
For additional information, please contact your local BBSI office at: Medford
u
Best Regards, 2045 Cardinal Ave Suite 100,
Medford, OR 97504
Gary Kramer
President and Chief Executive Officer Rev t
R Request for Taxpayer Give form to the
Form ■■ 9 requester.Do not
(Rev.March 2024) Identification Number and Certification send to the IRS.
Department of the Treasury Go to www.irs.gov/FormW9 for instructions and the latest information.
Infemal Revenue Service
Before you begin.For guidance related to the purpose of Form W-9,see Purpose of Form,below.
1 Name of entilylndividual.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.)
14 U D�24/ 5 4 ' 4 <---
2 Business name/disregarded entity name,if different from above.
3a Check the appropriate box for federal tax classification of the entitylndividual whose name is entered on line 1.Check 4 Exemptions(codes apply only to
m certain entities,not
in on individL als;
only one of the following seven boxes see instructlans onpage 3)i�
a
o
❑ Individual/sole proprietor ❑ C corporation ❑ S corporation ❑ Partnership C] TrusVestale
H ❑ LLC.Enter the lax classification(C-C corporation,S a S corporation,P-Partnership) Exempt payee code(f any)
f o. o Note:Check the"LLC"box above and,in the entry space,enter the appropriate code(C.S,or P)for the tax
u classificat an o{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
code(if any)
❑ Other(see instructions)
au
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,)
y4 this box if you have any foreign partners,owners,or beneficiaries.See instructions , . . . . . .
rn 5 Address(num�street,_afjof apt.or suite np.).See instructions. Requester's name and address(optional)
Z?► f ;0" ¢2 A!1 SURF THRU,INC
6 City,state,and ZIP de 11837 BOLTHOUSE DR SUITE 400
VSJ
c/L 1 7.� r BAKERSFIELD,CA 93311
7 last account number(s)here(optional)
•. Taxpayer Identification Number(TIN)
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 - M
_
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other
entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a or
TIN,later. I Employer identification number
Note;If the account is in more than one name,see the instructions for line 1.See also What Name and 101
Number To Give the Requester for guidelines on whose number to enter.
Certification
Under penalties of perjury,1 certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding because(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and,generally,payments
other than interest and div' ends,you arg,not required t ign the certification,but you must provide your correct TIN.See the instructions for Part 11,later.
Sign Signature of 01
Here u.s,person Date ' !�
General Insiguctions New line 3b has been added to this form.Aflow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise foreign partners,owners,or beneficiaries when it provides the Form W-9
noted. to another flow-through entity in which it has an ownership interest.This
Future developments.For the latest Information about developments change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions,such as legislation enacted regarding the status of its indirect foreign partners,owners,or
after they were published,go to www.Irs,gov/FormIN9. beneficiaries,so that It can satisfy any applicable reporting
requirements.For example,a partnership that has any indirect foreign
What's New partners may be required to complete Schedules K-2 and K-3.See the
Line 3a has been modified to clarify how a disregarded entity completes Partnership Instructions for Schedules K-2 and K-3(Form 1065).
this line.An LLC that is a disregarded entity should check the Purpose of Form
appropriate box for the tax classification of its owner.Otherwise,it An individual or entity(Form W-9 requester)who is required to file an
should check the"LLC"box and enter its appropriate tax classification. information return with the IRS Is giving you this torm because they
Cat.No.10231X Form W-9(Rev.3-2024)
'4C R CERTIFICATE OF LIABILITY INSURANCE DATE 0511313I2026/ 026 )
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 ADD1710NAL INSURED,the policy(iss)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 or.
this certificate does not confer rights to the certificate holder in lieu of such endorsements,
PRODUCER CONTACT
NAME: Mali SeVlerl
Sevied Insurance Group.LLC PHONE 208-884-1700 FAX
(AJC,No,Extt. (Arc,No(
19D0 N Lakes Place,Ste. 100 E-MAADDRESS, matt.Sevieri@american-nalional.com
Meridian,ID 83646 INSURERISI AFFORDING COVERAGE NAIL:
—-- -- --- - _ _. IN A.SURER A American National
INSURED - -
INSURER B
Hudson Saw and Tool LLC NSVRER c
2919 N Pacific Hwy _INSURER D
Medford,OR 97501-1362 INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 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 TER(O',
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR ---- --`--- T— --— POLICY E F F POLICY EXP - -
LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDD"Y ! MM'..%YV LIMITS
_COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000
_ CLAIMS-MADE OAMAGETT OE-NTED OCCUR PREMI5E5_(Ea_a_ cwnence)_.S 100-000
--• .-__ _— - --- _—_ _MED EXP(An o person) •S 5.000
A _ Y Y 3601X0547 i 09/27/2025 0912712026 PERSONAL A ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIE S PER ! ` IF GENERAL AGGREGATE S 4,000.000
X POLICY ,J COT � LOC i I PRODUCTS•GOMP)OPAGG 5 4,000.000
OTHER I I r - S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S
ANY AUTO rBOOILY INJURY(Per persona 5
OWNED SCHEDULED { BODILY INJURY IPer ah.d-L, S
AUTOS ONLY .,J AUTOS .
14IREDi NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY 1 Ler awdent)_
I
UMBRELLA LIAB OCCUR EACH OCCURRENCE .S
EXCESS LIAR ,CLPJMS4AADE _AGGREGATE__
DED RETENTIONS F 5
WORKERS COMPENSATION PER CTH-
ANDEMPLOYERS'LIABILnY YIN I STATUTE ER
JANYPROPRitTORfPARTN N ERfEXECUTE E.L.EACH ACCIDENT 5
OFFICER/MEMBER EXCLUDED? ❑ NIA --- — ------
!(Alanda"inNH) .E L.DISEASE-EA EMPLOYEE_$
X yam,de a,be undo I EL.DISEASE-POLICY LIMIT $�
DESCRIPTION OF OPERATIONS below
I
DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe atl acn orl if more space is required
The certificate holder is additionally insured per blanket AI endorsement.
I
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE !
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED L'
184-231-9 ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ashland AUTHORIZED REPRESENTATIVE ;
90 N Mountain Ave
Ashland,OR 97520-2014
Q 1988-2015 ACORD CORPORATION. All rights reservrn
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD