HomeMy WebLinkAbout1999-155 Grant - Childrens Dental Clinic CITY OF ASHLAND
FINANCIAL ASSISTANCE AWARD CONTRACT
CITY: CITY OF ASHLAND
20 E Main Street
Ashland OR 97520
(541) 488-5300
FAX: (541) 488-5311
GRANTEE: Children's Dental Clinic
Address: 2825 Barnett Road
Medford, OR 97504
Telephone: 541-608-4249
Date of this agreement: July 1, 1999
Amount of grant: $1250
Budget subcommittee: Social Services
Contract made the date specified above between the City of Ashland and Grantee
named above.
RECITAL: City has reviewed Grantee's application for a grant and has determined that
the request merits funding and the purpose for which the grant is awarded serves a
public purpose.
City and Grantee agree:
1. Amount of Grant. Subject to the terms and conditions of this contract and in
reliance upon Grantee's approved application, the City agrees to provide funds in the
amount specified above.
2. Use of Grant Funds. The use of grant funds are expressly limited to the activities in
the grant application with modifications, if any, made by the budget subcommittee
designated above.
3. Unexpended Funds. Any grant funds held by the Grantee remaining after the
purpose for which the grant is awarded or this contract is terminated shall be returned to
the City within 30 days of completion or termination.
4. Financial Records and Inspection. Grantee shall maintain a complete set of books
and records relating to the purpose for which the grant was awarded in accordance with
generally accepted accounting principles. Grantee gives the City and any authorized
representative of the City access to and the right to examine all books, records, papers
or documents relating to the use of grant funds.
5. Default. If Grantee fails to perform or observe any of the covenants or agreements
contained in this contract or fails to expend the grant funds or enter into binding legal
agreements to expend the grant funds within twelve months of the date of this contract,
the City, by written notice of default to the Grantee, may terminate the whole or any part
of this contract and may pursue any remedies available at law or in equity. Such
remedies may include, but are not limited to, termination of the contract, stop payment
on or return of the grant funds, payment of interest earned on grant funds or declaration
of ineligibility for the receipt of future grant awards.
6. Amendments. The terms of this contract will not be waived, altered, modified,
supplemented, or amended in any manner except by written instrument signed by the
parties. Such written modification will be made a part of this contract and subject to all
other contract provisions.
7. Indemnity. Grantee agrees to defend, indemnify and save City, its officers,
employees and agents harmless from any and all losses, claims, actions, costs,
expenses, judgments, subrogations, or other damages resulting from injury to any
person (including injury resulting in death,) or damage (including loss or destruction) to
property, of whatsoever nature arising out of or incident to the performance of this
agreement by Grantee (including but not limited to, Grantee's employees, agents, and
others designated by Grantee to perform work or services attendant to this agreement).
Grantee shall not be held responsible for damages caused by the negligence of City.
8. Insurance. Grantee shall, at its own expense, at all times for twelve months from the
date of this agreement, maintain in force a comprehensive general liability policy
including coverage for contractual liability for obligations assumed under this Contract,
blanket contractual liability, products and completed operations, and owner's and
contractor's protective insurance. The liability under each policy shall be a minimum of
$500,000 per occurrence (combined single limit for bodily injury and property damage
claims) or $500,000 per occurrence for bodily injury and $100,000 per occurrence for
property damage. Liability coverage shall be provided on an "occurrence" not "claims"
basis. The City of Ashland, its officers, employees and agents shall be named as
additional insureds. Certificates of insurance acceptable to the City shall be filed with
City's Risk Manager prior to the expenditure of any grant funds.
9. Merger. This contract constitutes the entire agreement between the parties. There
are no understandings, agreements or representations, oral or written, not specified in
this contract regarding this contract. Grantee, by the signature below of its authorized
representative, acknowledges that it has read this contract, understands it, and agrees
to be bound by its terms and conditions.
GRANTEE CITY OF ASHLAND
BY/'~~'Y'J ~/~/,~ ~/~BY ,~/'
Its ~y,~-~ m ~ c,,N'l' /~irector of Finance
BY
Its
Content review by:
Department Head
Form review by:/""--" (City Attorney)
Coding:
(for City use only)
PAGE 2-GRANT AGREEMENT
II
November 5,1998
Finance Department
Attention: Administrative Assistant
City of Ashland
20 East Main Street
Ashland, OR 97520
Ladies and Gentlemen:
Re: Asante Health System
Certificate of Insurance
Enclosed herewith is an original Certificate of Insurance for the Asante Health System and its
affiliated entities, as it respects the liability of the Named Insured arising from their support of
the Children's Dental Clinic at Rogue Valley Medical Center.
If you have any questions or need additional information, please feel free to contact me at (541)
608-4133.
Sincerely,
Robert B. Doolen
Senior Vice President for Financial Services/CFO
prl
Enclosure
Asante@
HEALTH SYSTEM
Rogue Valley Medical Center. Three Rivers Community Hospital & Health Center
Hearthstone. Rogue Valley Serenity Lane. Southern Oregon Health Trust. Home Medical
2650 Siskiyou Boulevard, Sle. 200. Medford. Oregon 97504,8389 541.1770,4100 Fax: 541.1734,5931
SURED
Health Future/Asante Health System - Rogue Valley Me
2650 Siskiyou Blvd.
Medford, OR 97504
TIllS CERTIFICATE IS ISSUED AS A MATIER OF INFORMATION
ONLY AND CONFERS NO RIGIITS UPON TIlE CERTIFICATE
HOLDER. TIllS CERTIFICATE DOES NOT AMEND, EX'IEND, OR
ALTER TIlE COVERAGE AFFORDED BY TIlE POUCIES BELOW.
TIllS IS TO CERTIFY 'IHAT TIlE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO TIlE INSURED NAMED ABOVE FOR
TIm POUCY PERIOD INDICATED. NOTWTI1ISTANDING ANY REQUIREMENT, TERM, OR CONDmON OF ANY CONTRACT OR OTImR
DOCUMENT WITH RESPECT TO WHICH TIllS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TIm INSURANCE AFFORDED BY TIlE
POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL TIm TERMS, EXCLUSIONS AND CONDmONS OF SUCH POUCIES.
TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTtVE POUCY EXPIRAl10N LIMITS APPLICABLE
DAlE (MMIDDm'l DAlE (MMIDDm'l
EACH OCCURRENCE $1,000,000
COMMEROAL GENERAL UAaUTY
DOCCU_NCE 98K036-MY 08/01/98 08/01/01 ANNUAL AGGREGATE Unlimited
PERSONAL & ADVERTISING INJURY INCL
MEDICAL PROFESSIONAL UABlUlY INCL
DOCCUAFENCE APE: DAMAGE (Anyone Are)
PRCDUCTS-COMPIOPS AGGREGATE Unlimited
EACH OCC Nee A GA
UMBRElLA FORM 98L036-MY 08/01/98 08/01/01 $10,000,000 Unlimited
On-iER lHAN UMBRELlA FO~
OTHER EACH CU N AGGAEGA TE
DESCRIPTION:
The Certificate Holder, Its Offtcers & Its Employees are Additional
Insureds as respects the liability of the Named Insured, arising from their
support of the Children's Dental Clinic at Rogue Valley Medical Center.
PROVIDER INFORMATION:
SHOUlD ANY OF lliE ABOVE DESCRIBED POUCIES BE CANCEllED BEFORE lliE
EXPIRATION DATE lliEREOF, lliE ISSUING COMPANY WIUL ENDEAVOR TO MAIL
30 DAYS WRITI'ENNOTICE TOlliE CERTIFICATE HOLDER NAMED TO lliE RIGHT;
FAll..URE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABIIlTY
OF ANY KIND UPON lliE COMPANY, ITS AGENTS OR REPRESENTATIVES.
City of Ashland
Ashland, Oregon
Alln: Administrative Assistant
Finance Department
Authorized Repr..._
~/Uk~< ./4
CITY OF ASHLAND
FINANCIAL ASSISTANCE AWARD CONTRACT
CITY: CITY OF ASHLAND
20 E Main Street
Ashland OR 97520
(541) 488-5300
FAX: 541 488-5311
GRANTEE: Children's Dental Clinic of
Jackson County
Address: 2825 Barnett Road
Medford OR 97504
Tele hone: 541 608-4249
Date of this a reement: June 19, 1998
1. Amount of rant: $1,040
Contract made the date specified above between the City of Ashland and Grantee
named above.
RECITAL: City has reviewed Grantee's application for a grant and has determined that
the request merits funding and the purpose for which the grant is awarded serves a
public purpose.
City and Grantee agree:
1. Amount of Grant. Subject to the terms and conditions of this contract and in
reliance upon Grantee's approved application, the City agrees to provide funds in the
amount specified above.
2. Use of Grant Funds. The use of grant funds are expressly limited to the activities in
the grant application with modifications, if any, made by the budget subcommittee
designated above.
3. Unexpended Funds. Any grant funds held by the Grantee remaining after the
purpose for which the grant is awarded or this contract is terminated shall be returned
to the City within 30 days of completion or termination.
4. Financial Records and Inspection. Grantee shall maintain a complete set of
books and records relating to the purpose for which the grant was awarded in
accordance with generally accepted accounting principles. Grantee gives the City and
any authorized representative of the City access to and the right to examine all books,
records, papers or documents relating to the use of grant funds.
5. Default. If Grantee fails to perform or observe any of the covenants or agreements
contained in this contract or fails to expend the grant funds or enter into binding legal
agreements to expend the grant funds within twelve months of the date of this contract,
the City, by written notice of default to the Grantee, may terminate the whole or any part
of this contract and may pursue any remedies available at law or in equity. Such
remedies may include, but are not limited to, termination of the contract, stop payment
on or return of the grant funds, payment of interest earned on grant funds or declaration
of ineligibility for the receipt of future grant awards.
6. Amendments. The terms of this contract will not be waived, altered, modified,
supplemented, or amended in any manner except by written instrument signed by the
parties. Such written modification will be made a part of this contract and subject to all
other contract provisions.
7. Indemnity. Grantee agrees to defend, indemnify and save City, its officers,
employees and agents harmless from any and all losses, claims, actions, costs,
expenses, judgments, subrogations, or other damages resulting from injury to any
person (including injury resulting in death,) or damage (including loss or destruction) to
property, of whatsoever nature arising out of or incident to the performance of this
agreement by Grantee (including but not limited to, Grantee's employees, agents, and
others designated by Grantee to perform work or services attendant to this agreement).
Grantee shall not be held responsible for damages caused by the negligence of City.
8. Insurance. Grantee shall, at its own expense, at all times for twelve months from
the date of this agreement, maintain in force a comprehensive general liability policy
including coverage for contractual liability for obligations assumed under this Contract,
blanket contractual liability, products and completed operations, and owner's and
contractor's protective insurance. The liability under each policy shall be a minimum of
$500,000 per occurrence (combined single limit for bodily injury and property damage
claims) or $500,000 per occurrence for bodily injury and $100,000 per occurrence for
property damage. Liability coverage shall be provided on an "occurrence" not "claims"
basis. The City of Ashland, its officers, employees and agents shall be named as
additional insureds. Certificates of insurance acceptable to the City shall be filed with
City's Risk Manager prior to the expenditure of any grant funds.
9. Merger. This contract constitutes the entire agreement between the parties. There
are no understandings, agreements or representations, oral or written, not specified in
this contract regarding this contract. Grantee, by the signature below of its authorized
representative, acknowledges that it has read this contract, understands it, and agrees
to be b nd b its terms and conditions.
1,
CITY OF ASHLAND
-
BY-/fif ~
Irector of Finance
----
BY
Its
Content review bY:-IJ(-
epartment Head
Form review by: v
(City Attorney)
Coding:
(for City use only)
PAGE 2-GRANT AGREEMENT (G:\BUDGEnSocial SBrviceslSS Grant Contracts 1998.wpd)
It'nI Agl.'ncg, Inc.
540 Lakl.' Cook Road
Dl.'l.'rfil.'ld, IL 60015-5290
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICA TE HOLDER. THIS CERTIFICATE DOES NOT AMENO.
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
INSUREO
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
Health Future/Rogue Valley nedical Center
2650 Siskiyou Blyd.
nedford, DR 97504
THIS IS TO CERTIFY THAT 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 CDNDITIONS
OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POliCY EFHCTlIIE
OATE lMM/OO/VYI
POLICV EXPIRATION
DATE IMM/OOIYVI
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
X DOCCURRI'CE
~ER S & CONTAACTORS PROTECTIVE
P"nf I i.h
97K036
1/01/97
GE'ERAl AGGREGATE $
>ROOuCT5COMPI0I'S AGGREGATE $
1/01198 PERSONAL & AOVERTi5"G "JURY $
EACH OCCURRE'CE $
fiRE DAMAGE iANY ONE "REI $
ME01CAl ExPE'5E IANY ONE PERSONI $
C5l
$
800JlY
INJURY
;PEA PERSONI $
_I Y
INJURY
~NTI $
1/01198
eACH
OCCURRENCE
$ 10,000
_RTV
Oo\MAGE
$
97L036
1101197
$ 10,000
AND
EMPLOYERS' LIABILITY
$
$
$
lEACH ACCIDENT)
(OISEASE.POlICY lIMIT)
lOISEASE.EACtt EMPlOYEE I
STATUTORY
OTHER
ol/~y flood
E4I-~jd~ g/; tJ!
DESCRIPTION OF OPERA TlONS I LOCATIONS /VEHICLES! RESTRICTIONS I SPECIAL ITEMS
The Certificate Holder, its Officers & Its [nplogees are Additional
Insureds as respl.'cts the liability of the Haned Insured, arising fron their
support of the C'ildre.'s De.tal Cli.ic at Rogue Valley nedical Center.
',fFMBFRSHIP
.J.MS ,1;
ASANTE HEALTH SYSTEM
Rogue Valley Medical Cttnter
Tnr" RI~'$ Community Hospital
& Health Centlltr
HearthslonIJ
Genesis R<<oV4ity Center
SouttJl!Hfl Or~ Heatrh Tl\Ist
Home Mediuf
l.,4edtord, OR
ASHLAND COMMUNITY HOSPITAL
Ashland. OR
BAY AREA HOSPITAL
':oos Bay. OR
CIRSTCARE HEN.... TH
4:0dfly. OR
,;000 SAMARITAN HOSPITAl..
';;Jf'Valhs. OR
'AERLE WEST MEDICAL CENTER
".'amatfl Falls, OR
'.'ID-COLUMBIA MEDICAL CENTER
. "e Dalles. OR
'-?[GON HEAL TH SCIENCES
',.''vER$Ir'r
, -"7.3..,d. OR
- CHARE5 MEDICAL CENTER
,.""] OR
:~Q.C1.dIL
'LUMelA MEMORIAL HOSPITAL
. rd. OR
~:JL'GLAS COMMUNITY HOSPITAL
::: 'setJurg. OR
":>00 SHEPHERD COMMUNrTY
. ~'::!:'ITAL
,,'-~.s:['r- OR
;;.:J ,""OE RONDE HOSPITAL
1 G:ande. OR
~WER UMPQUA HOSPITAL
"'ifd5;Jor1, OR
'c"'C Y ,\'E:JICAL CENTER
'_'seblJ'g, OR
"IDV4llEY fifAlTfiCAAf./NC
-:ar-.;:m OR
-KIFIC RETIREMENT SERVICES
C:1Jgue Valley Manor)
'.f<J(Jford. OR
;4CRED HEART MEDICAL
[".TER
::"..'~. OR
~ ... r 4:\' "'-HONY HOSPITAL
',";;1..,_'''. OR
. E~ rO,....l-.fOSP/rAL
,'<J"~cn OR
. .1~:.OWA I;~EMORIAL HOSPITAL
-',.':J"se, OR
heAtrh "
FUTURE, LLC
February 10, 1998
TO WHOM IT MAY CONCERN:
This is to outline the malpractice and general liability policies now in force
and effect for the Asante Health System from January 1, 1997 to August 1,
1998.
These policies are with American Continental Insurance Company,
Deerfield, illinois.
Policy #97K036 (primary policy) ~ $1,000,000 per occurrence, no aggregate
Policy #97L036 (umbrella policy) - $10,000,000 per occurrence, no
aggregate
Policy #97V036G (super excess): $10,000,000 per occurrence, annual
aggregate: $10,000,000
Yours very truly,
825 E. MAIN, SUITE D, MEDFORD, OREGON 97504, (541) 772-3062
II
April 1, 1998
Mr. RobertD. Nelson, ARM
Risk Management Analyst
City of Ashland City Hall
Ashland, OR 97520
Dear Mr. Nelson:
Re: Children's Dental Clinic
Confirmation of the malpractice and general liability insurance coverage for entities of the
Asante Health System is enclosed as requested in your letter of January 8, 1998. Our
policy period was extended from January I, 1997, to August I, 1998.
I apologize for the delay in getting this information to you. If you have any questions or
need additional information, please feel free to contact me at 608-4133.
Sincerely,
~~/~~dv
Paula R. Latvala
Administrative Assistant
Financial Services
Enclosure
Asante@
HEALTH SYSTEM
Rogue Valley Medica! Center. Three Rivers Community Hospital & Health Center
Hearthstone. GeneJis Recovery Center. Southern Oregon Health Trust. Hrmze Medical, Inc.
2650 Siskiyou Boulevard, Ste. 200, Medford, Oregon 97504-8177 541/608-4100 Fax: 541/608-5931
-
--
CITY OF ASHLAND
FINANCIAL ASSISTANCE AWARD CONTRACT
CITY: CITY OF ASHLAND
20 E Main Street
Ashland OR 97520
(541) 488-5300
FAX: 541 488-5311
Date of this a reement: Jul 1, 1997
1. Amount of rant: $1,000
GRANTEE: Children's Dental Clinic of
Jackson County
Address: 2825 Barnett Road
Medford OR 97504
Tele hone: 541 608-4249
Contract made the date specified above between the City of Ashland and Grantee
named above.
RECITAL: City has reviewed Grantee's application for a grant and has determined that
the request merits funding and the purpose for which the grant is awarded serves a
public purpose.
City and Grantee agree:
1. Amount of Grant. Subject to the terms and conditions of this contract and in
reliance upon Grantee's approved application, the City agrees to provide funds in the
amount specified above.
2. Use of Grant Funds. The use of grant funds are expressly limited to the activities in
the grant application with modifications, if any, made by the budget subcommittee
designated above.
3. Unexpended Funds. Any grant funds held by the Grantee remaining after the
purpose for which the grant is awarded or this contract is terminated shall be returned to
the City within 30 days of completion or termination.
4. Financial Records and Inspection. Grantee shall maintain a complete set of
books and records relating to the purpose for which the grant was awarded in
accordance with generally accepted accounting principles. Grantee gives the City and
any authorized representative of the City access to and the right to examine all books,
records, papers or documents relating to the use of grant funds.
5. Default. If Grantee fails to perform or observe any of the covenants or agreements
contained in this contract or fails to expend the grant funds or enter into binding legal
agreements to expend the grant funds within twelve months of the date of this contract,
the City, by written notice of default to the Grantee, may terminate the whole or any part
of this contract and may pursue any remedies available at law or in equity. Such
remedies may include, but are not limited to, termination of the contract, stop payment
on or return of the grant funds, payment of interest earned on grant funds or declaration
of ineligibility for the receipt of future grant awards.
-
-
6. Amendments. The terms of this contract will not be waived, altered, modified,
supplemented, or amended in any manner except by written instrument signed by the
parties. Such written modification will be made a part of this contract and subject to all
other contract provisions.
7. Indemnity. Grantee agrees to defend, indemnify and save City, its officers,
employees and agents harmless from any and all losses, claims, actions, costs,
expenses, judgments, subrogations, or other damages resulting from injury to any
person (including injury resulting in death,) or damage (including loss or destruction) to
property, of whatsoever nature arising out of or incident to the performance of this
agreement by Grantee (including but not limited to, Grantee's employees, agents, and
others designated by Grantee to perform work or services attendant to this agreement).
Grantee shall not be held responsible for damages caused by the negligence of City.
8. Insurance. Grantee shall, at its own expense, at all times for twelve months from
the date of this agreement, maintain in force a comprehensive general liability policy
including coverage for contractual liability for obligations assumed under this Contract,
blanket contractual liability, products and completed operations, and owner's and
contractor's protective insurance. The liability under each policy shall be a minimum of
$500,000 per occurrence (combined single limit for bodily injury and property damage
claims) or $500,000 per occurrence for bodily injury and $100,000 per occurrence for
property damage. Liability coverage shall be provided on an "occurrence" not "claims"
basis. The City of Ashland, its officers, employees and agents shall be named as
additional insureds. Certificates of insurance acceptable to the City shall be filed with
City's Risk Manager prior to the expenditure of any grant funds.
9. Merger. This contract constitutes the entire agreement between the parties. There
are no understandings, agreements or representations, oral or written, not specified in
this contract regarding this contract. Grantee, by the signature below of its authorized
representative, acknowledges that it has read this contract, understands it, and agrees
to be bound by its terms and conditions.
GRANTEE ~
BY ;? e.~
Its ,P~~. ~-.t- ~~.-. - ",fl." bl
. C~~:,.~;....
BY
Its
CITY OF ASHLAND
BY&'(;;-4A'~/
Irector of Finance
Content review b~
Department Head
Form review by: t----
(City Attorney)
Coding:
(for City use only)
PAGE 2-GRANT AGREEMENT (g;\budget\socialselssgrant.frm)
...
CITY OF ASHLAND
FINANCIAL ASSISTANCE AWARD CONTRACT
CITY: CITY OF ASHLAND GRANTEE: Children's Dental Clinic
20 E. Main St. Address: 2825 Barnett Rd.
Ashland, Oregon 97520 Medford, OR 97504
(541) 482-3211
FAX: (541) 488-5311 Telephone: (541) 770-4249
FAX:
Date of this agreement: July 1, 1996
~1. Amount of grant: $520
~2. Budget subcommittee: Social Services
Contract made the date specified above between the City of Ashland and Grantee
named above.
RECITAL: City has reviewed Grantee's application for a grant and has determined that
the request merits funding and the purpose for which the grant is awarded serves a
public purpose.
City and Grantee agree:
1. Amount of Grant. Subject to the terms and conditions of this contract and in
reliance upon Grantee's approved application, the City agrees to provide funds in the
amount specified above.
2. Use of Grant Funds. The use of grant funds are expressly limited to the activities
in the grant application with modifications, if any, made by the budget subcommittee
designated above.
3. Unexpended Funds. Any grant funds held by the Grantee remaining after the
purpose for which the grant is awarded or this contract is terminated shall be returned
to the City within 30 days of completion or termination.
4. Financial Records and Inspection. Grantee shall maintain a complete set of
books and records relating to the purpose for which the grant was awarded in
accordance with generally accepted accounting principles. Grantee gives the City and
any authorized representative of the City access to and the right to examine all books,
records, papers or documents relating to the use of grant funds.
5. Default. If Grantee fails to perform or observe any of the covenants or agreements
contained in this contract or fails to expend the grant funds or enter into binding legal
agreements to expend the grant funds within twelve months of the date of this
contract, the City, by written notice of default to the Grantee, may terminate the whole
PAGE 1-GRANT AGREEMENT (p:formslgrant.K)
or any part of this contract and may pursue any remedies available at law or in equity.
Such remedies may include, but are not limited to, termination of the contract, stop
payment on or return of the grant funds, payment of interest earned on grant funds or
declaration of ineligibility for the receipt of future grant awards.
6. Amendments. The terms of this contract will not be waived, altered, modified,
supplemented, or amended in any manner except by written instrument signed by the
parties. Such written modification will be made a part of this contract and subject to
all other contract provisions.
7. Indemnity. Grantee agrees to defend, indemnify and save City, its officers,
employees and agents harmless from any and all losses, claims, actions, costs,
expenses, judgments, subrogations, or other damages resulting from injury to any
person (including injury resulting in death,) or damage (including loss or destruction)
to property, of whatsoever nature arising out of or incident to the performance of this
agreement by Grantee (including but not limited to, Grantee's employees, agents, and
others designated by Grantee to perform work or services attendant to this
agreement). Grantee shall not be held responsible for damages caused by the
negligence of City.
8. Insurance. Grantee shall, at its own expense, at all times for twelve months from
the date of this agreement, maintain in force a comprehensive general liability policy
including coverage for contractual liability for obligations assumed under this Contract,
blanket contractual liability, products and completed operations, and owner's and
contractor's protective insurance. The liability under each policy shall be a minimum
of $500,000 per occurrence (combined single limit for bodily injury and property
damage claims) or $500,000 per occurrence for bodily injury and $100,000 per
occurrence for property damage. Liability coverage shall be provided on an
"occurrence" not "claims" basis. The City of Ashland, its officers, employees and
agents shall be named as additional insureds. Certificates of insurance acceptable to
the City shall be filed with City's Risk Manager prior to the expenditure of any grant
funds.
9. Merger. This contract constitutes the entire agreement between the parties.
There are no understandings, agreements or representations, oral or written, not
specified in this contract regarding this contract. Grantee, by the signature below of
its authorized representative, acknowledges that it has read this contract, understands
it, and agrees to be bound by its terms and conditions.
GRANTEE
~~&P~~
Its
BY
Its
CITY OF ASHLAND
BY 1#1I~
Dire or of Finance
Content review ~
Form review by: . ~ ((.ity Attorney)
Coding: (for city use only)
~
PAGE 2-GRANT AGREEMENT (p:formslgrantK)
C I T Y
o F
ASHLAND
C I T Y
HAL L
-
ASHLAND, OREGON 97520
telephone (code 503) 482-3211
July 15, 1996
Michael R. Boldt, DMD, Board President
Children's Dental Clinic
2825 Barnett Rd.
Medford, OR 97501
Dear Michael R. Boldt, DMD, Board President:
The City of Ashland Budget for the 1996-97 fiscal year was
approved by the City Council on May 22nd. Your annual grant of
$520 is included in this budget. One payment is scheduled to be
sent the Friday following the City's receipt of the enclosed
contract with signature.
The City requires grant recipients to supply a certificate of
lnsurance. We appreciate your providing us with an up to date
certificate that names the City of Ashland, its officers and
employees, as additional insureds, and would remind you at this
time that your current certificate expires on 1/1/97.
Sincerely,
J~r
Director of Finance
-
-
CITY OF ASHLAND
FINANCIAL ASSISTANCE AWARD CONTRACT
CITY: CITY OF ASHLAND GRANTEE: Children's Dental Clinic
20 E. Main St. Address: 2825 Barnett Rd.
Ashland, Oregon 97520 Medford, OR 97504
(503) 482-3211 Telephone: (503) 770-4249
FAX: (503) 488-5311 FAX:
Date of this agreement: July 1, 1995
, 1. Amount of grant: $500
'2. Budget subcommittee: Social Services
Contract made the date specified above between the City of Ashland and Grantee
named above.
RECITAL: City has reviewed Grantee's application for a grant and has determined that
the request merits funding and the purpose for which the grant is awarded serves a
public purpose.
City and Grantee agree:
1. Amount of Grant. Subject to the terms and conditions of this contract and in
reliance upon Grantee's approved application, the City agrees to provide funds in the
amount specified above.
2. Use of Grant Funds. The use of grant funds are expressly limited to the activities
in the grant application with modifications, if any, made by the budget subcommittee
designated above.
3. Unexpended Funds. Any grant funds held by the Grantee remaining after the
purpose for which the grant is awarded or this contract is terminated shall be returned
to the City within 30 days of completion or termination.
4. Financial Records and Inspection. Grantee shall maintain a complete set of
books and records relating to the purpose for which the grant was awarded in
accordance with generally accepted accounting principles. Grantee gives the City and
any authorized representative of the City access to and the right to examine all books,
records, papers or documents relating to the use of grant funds.
5. Default. If Grantee fails to perform or observe any of the covenants or agreements
contained in this contract or fails to expend the grant funds or enter into binding legal
agreements to expend the grant funds within twelve months of the date of this
contract, the City, by written notice of default to the Grantee, may terminate the whole
or any part of this contract and may pursue any remedies available at law or in equity.
PAGE 1-GRANT AGREEMENT IG:\JILLIWP\BUDGETlHRGRANTS.DOC)
-
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Such remedies may include, but are not limited to, termination of the contract, stop
payment on or return of the grant funds, payment of interest earned on grant funds or
declaration of ineligibility for the receipt of Mure grant awards.
6. Amendments. The terms of this contract will not be waived, altered, modified,
supplemented, or amended in any manner except by written instrument signed by the
parties. Such written modification will be made a part of this contract and subject to
all other contract provisions.
7. Indemnity. Grantee agrees to defend, indemnify and save City, its officers,
employees and agents harmless from any and all losses, claims, actions, costs,
expenses, judgments, subrogations, or other damages resulting from injury to any
person (including injury resulting in death,) or damage Oncluding loss or destruction)
to property, of whatsoever nature arising out of or incident to the performance of this
agreement by Grantee (including but not limited to, Grantee's employees, agents, and
others designated by Grantee to perform work or services attendant to this
agreement). Grantee shall not be held responsible for damages caused by the
negligence of City.
8. Insurance. Grantee shall, at its own expense, at all times for twelve months from
the date of this agreement, maintain in force a comprehensive general liability policy
including coverage for contractual liability for obligations assumed under this Contract,
blanket contractual liability, products and completed operations, and owner's and
contractor's protective insurance. The liability under each policy shall be a minimum
of $500,000 per occurrence (combined single limit for bodily injury and property
damage claims) or $500,000 per occurrence for bodily injury and $100,000 per
occurrence for property damage. Uability coverage shall be provided on an
"occurrence" not "claims. basis. The City of Ashland, its officers, employees and
agents shall be named as additional insureds. Certificates of insurance acceptable to
the City shall be filed with City's Risk Manager prior to the expenditure of any grant
funds.
9. Merger. This contract constitutes the entire agreement between the parties.
There are no understandings, agreements or representations, oral or written, not
specified in this contract regarding this contract. Grantee, by the signature below of
its authorized representative, acknowledges that it has read this contract, understands
it, and agrees to be bound by its terms and conditions.
GRANTEE ~ CITY OF ~HLAND
BY k<. BY ~f'U' ~
Its ~ DirQflor ill ,nonce
BY Content revlew1iY)
Its . Form review ~
Coding: or ity use on
PAGE 2-GRANT AGREEMENT IG;IJILLIWP\BUDGEnHRGRANTS.DOCI
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C IT Y
HAL L
C I T Y
o F
ASHLAND
ASHLAND, OREGON 97520
telephone (code 503) <482-3211
May 24, 1995
Michael R. Boldt, DMD, Board President
Children's Dental Clinic
2825 Barnett Rd.
Medford, OR 975dt
Dear Dr. Boldt:
The City of Ashland Budget for the 1995-96 fiscal year was
approved by the City Council on May 16th. Your annual grant of
$500 is included in this budget. One payment is scheduled for
July 28, 1995.
Please complete the enclosed contract and return it to me prior
to July 24, 1995.
The City requires grant recipients to supply a certificate of
insurance that names the City of Ashland, its officers and
employees as additional insureds, and would remind you at this
time that your current certificate expires January 1, 1996.
Sincerely,
Jill Turner
Director of Finance
--
......."
CITY OF ASHLAND
FINANCIAL ASSISTANCE AWARD CONTRACT
.
CITY: CITY OF ASHLAND GRANTEE: Children's Dental Clinic
20 E. Main St. Address: 2825 Barnett Rd.
Ashland, Oregon 97520 Medford, OR 97501
(503) 482-3211 Telephone: (503) 773-6281 ext 4249
FAX: (503) 488-5311 FAX:
Date of this agreement: July 1, 1994
, 1. Amount of grant: $420
'2. Budget subcommittee: Health and Human Resources
Contract made the date specified above between the City of Ashland and Grantee
named above.
RECITAL: City has reviewed Grantee's application for a grant and has determined that
the request merits funding and the purpose for which the grant is awarded serves a
public purpose.
City and Grantee agree:
1. Amount of Grant. Subject to the terms and conditions of this contract and in
reliance upon Grantee's approved application, the City agrees to provide funds in the
amount specified above.
2. Use of Grant Funds. The use of grant funds are expressly limited to the activities
in the grant application with modifications, if any, made by the budget subcommittee
designated above.
3. Unexpended Funds. Any grant funds held by the Grantee remaining after the
purpose for which the grant is awarded or this contract is terminated shall be returned
to the City within 30 days of completion or termination.
4. Financial Records and Inspection. Grantee shall maintain a complete set of
books and records relating to the purpose for which the grant was awarded in
accordance with generally accepted accounting principles. Grantee gives the City and
any authorized representative of the City access to and the right to examine all books,
records, papers or documents relating to the use of grant funds.
5. Default. If Grantee fails to perform or observe any of the covenants or agreements
contained in this contract or fails to expend the grant funds or enter into binding legal
agreements to expend the grant funds within twelve months of the date of this
contract, the City, by written notice of default to the Grantee, may terminate the whole
or any part of this contract and may pursue any remedies available at law or in equity.
PAGE 1-GRANT AGREEMENT (p:formolgrant.KI
-.
~
Such remedies may include, but are not limited to, termination of the contract, stop
payment on or return of the grant funds, payment of interest earned on grant funds or
declaration of ineligibility for the receipt of future grant awards.
6. Amendments. The terms of this contract will not be waived, altered, modified,
supplemented, or amended in any manner except by written instrument signed by the
parties. Such written modification will be made a part of this contract and subject to
all other contract provisions.
7. Indemnity. Grantee agrees to defend, indemnify and save City, its officers,
employees and agents harmless from any and all losses, claims, actions, costs,
expenses, judgments, subrogations, or other damages resulting from injury to any
person (including injury resulting in death,) or damage (including loss or .destruction)
to property, of whatsoever nature arising out of or incident to the performance of this
agreement by Grantee (including but not limited to, Grantee's employees, agents, and
others designated by Grantee to perform work or services attendant to this
agreement). Grantee shall not be held responsible for damages caused by the
negligence of City.
8. Insurance. Grantee shall, at its own expense, at all times for twelve months from
the date of this agreement, maintain in force a comprehensive general liability policy
including coverage for contractual liability for obligations assumed under this Contract,
blanket contractual liability, products and completed operations, and owner's and
contractor's protective insurance. The liability under each policy shall be a minimum
of $500,000 per occurrence (combined single limit for bodily injury and property
damage claims) or $500,000 per occurrence for bodily injury and $100,000 per
occurrence for property damage. Liability coverage shall be provided on an
"occurrence" not "claims" basis. The City of Ashland, its officers, employees and
agents shall be named as additional insureds. Certificates of insurance acceptable to
the City shall be filed with City's Risk Manager prior to the expenditure of any grant
funds.
9. Merger. This contract constitutes the entire agreement between the parties.
There are no understandings, agreements or representations, oral or written, not
specified in this contract regarding this contract. Grantee, by the signature below of
its a'uthorized representative, acknowledges that it has read this contract, understands
it, and agrees to be bound by its terms and conditions.
CITY OF ASHLAND
BY r;Iil{lil.~/
Di c of Finance
Content review by: << (Dept. Head)
Form review by: v-L-- (City Attorney)
Coding: . (for city use only)
PAGE 2-GRANT AGREEMENT Ip:formslgrant.KI
C I T Y
o F
ASHLAND
C I T Y
HAL L
ASHLAND, OREGON 97520
lelephone (code 503) 482-3211
May 25, 1994
Children's Dental Clinic
Michael R. Boldt, DMD, Board President
2825 Barnett Rd.
Medford, OR 97501
The Ashland City Council approved the
1994-95 fiscal year on May 17, 1994.
$420 is included in this budget. You
receive one payment on July 22, 1994.
budget for the
Your grant of
are scheduled to
Please complete the enclosed contract and return it to
me prior to June 24, 1994. Additionally, the City is
requesting that your agency provide insurance certifi-
cation indicating liability coverage of not less than
$500,000 per occurrence. The City of Ashland, its
officers and employees should be named as additional
insureds. If you already have a certificate on file
with the City, please remember to send us an updated
certificate upon renewal.
Sincerely,
Jill Turner
Director of Finance
H: Villlwplbudgetlhrbgt94 .Itr