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Home My WebLink About1998-090 Grant - CERVS 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 agreement: June 19, 1998 I]1. Amount of grant: $9,330 ¶2. Budget subcommittee: Social Services GRANTEE: CERVS Address: PO Box 4124 Medford OR 97501 Telephone: (541) 779-8564 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 $100,000 per occurrence for property damage. Liability coverage shall be provided on an "occurrence" not "claims" basis. The City of Ashland, its officers, employees and agents shall be named as additional insureds. Certificates of insurance acceptable to the City shall be filed with City's Risk Manager prior to the expenditure of any grant funds. 9. Merger. This contract constitutes the entire agreement between the parties. There are no understandings, agreements or representations, oral or written, not specified in this contract regarding this contract. Grantee, by the signature below of its authorized representative, acknowledges that it has read this contract, understands it, and agrees to be bound by its terms and conditions. GRANTEE CITY OF ASHLAND Its' -,:~_%/~,.~., f'- -, [~frector of Finance BY.,.~.~,zCz./¢~,~"~-'~ ¢~-'~ Content review by: /~,2._.~- Its" z:¢'~~. ,~ ~-...~..,~/~)..;Z::~ -E?~-~.~/. g-.,~-~ ~ -lb- /f0epartment Form review by: Head (City Attorney) Coding: (for City use only) PAGE 2-GRANT AGREEMENT (G:\BUDGET~Soc,al Services\SS Grant Contracts 1998.wpd) 'ACORD.. GER""lrrl(3~*E(j)F'l..fhXBll..Il""t'lrN$l..JRhXf\J~E8g~t2 DATE (MMIDDIYY) 11/04/98 PRODltr::ET=< THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Reinholdt & O'Harra Insurance HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 383 East Mai.n street ALTER THE COVERAGE AFFORDED 8Y THE POLICIES BELOW, Ashland OR 97520-1896 COMPANIES AFFORDING COVERAGE Russ W. Schweikert COMPANY A Capitol Indemnity Corporation Phone No 541-482-1921 Fax No. INSURED COMPANY 8 COMPANY Community Emergency Resources C PO Box 4124 COMPANY Medford OR 97501 D COVERAGES ".'.'.....'.'."....' < ..'.. < .'.........'... ......' ....... .<> .',... 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 Am 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, CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MMIDDIYY) DATE (MMlDDIYY) GENERAL LIABILITY GENERAL AGGREGATE $ 500,000 f-- 08/04/98 08/04/99 A X COMMERCIAL GENERAL LIABILITY CPOOll1940 PRODUCTS. COMPIOP AGG $ 500,000 I CLAIMS MADE ~ OCCUR PERSONAL & AOV INJURY $ 500,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 500,000 f-- FIRE DAMAGE (Anyone fire) $ 100,000 f-- MED EXP (Anyone person) $ 5,000 AUTOMOBILE LIABILITY f-- COMBINED SINGLE LIMIT $ ANY AUTO 1-- ALL OWNED AUTOS BODILY INJURY I--- $ SCHEDULED AUTOS (Per person) f-- HIRED AUTOS BODILY INJURY f-- $ NON-OWNED AUTOS (Per accident) f-- r-'- PROPERTY DAMAGE $ GARAGE LIABILITY AUTO DNL Y . EA ACCIDENT $ tJ ANY AUTO OTHER THAN AUTO ONLY. < , .... ri EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ I-- ~ UMBRELLA FORM AGGREGATE $ I OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND pNC STATU. I 10TH. .'". '..' TORY LIMITS ER EMPLOYERS' LIABILITY EL EACH ACCIDENT $ THE PROPRIETOR! R'NCL EL DISEASE. POLICY LIMIT $ PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE. EA EMPLOYEE $ OTHER A Property Section CP00111940 08/04/98 08/04/99 DESCRIPTION OF OPERAll0NSlLOCAlloNSNEHICLESlSPECIAL ITEMS Additional Insured: City of Ashland It's Officers, Employees & Agents. CERTIFICArel-lotbER .'.'. ..' .'.'. .",'.. '... <> .... < > ....,.i. i '... i...,'.,..i ."'. > < > ..'. .'.' CITYOFA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL City Ashland ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, of SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Attn: Robert 0, Nelson 20 East Main street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Ashland OR 97520 AUTHORIZED REPRZ Russ W, Sc eikert ACoRD 25-$(1 taS) .' .,'. ..'. ...". .... ."< .'.. .. ..,... '.'ACoROcoRf'oRATloN,t988 PRODll~ .' DATE (MM/DDlYY) 10-23.98 TH CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOlDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR MCFALL GENERAL AGENCY, INC. 6443 SW BEAVERTON-HILLSDALE HWY. PORTLAND, OR 97221 COMPANY A CAPITOL INDEMNITY CORPORATION INSURED COMMUNITY EMERGENCY RESOURCES AND VITAL SERVICES (CERVS) P.O, BOX 4124 MEDFORD. OR 97501 COMPANY B COMPANY C THIS IS TO C!RTII'Y THAT TH! POUCleS OF INSURANCI! LIST!D II!lOW HAV! II!I!N ISSU!D TO TH! INSURED NAMED AIlOV! I"OR THE POLICY PERIOD INDlCAT!D, NOTWITHSTANDING AH'( Rl!QUlR!M!NT. TERM OR CONDITION OJ" AH'( CONTRACT OR OTHER DOCUMI!NT WITH RESPECT TO WHICH THIS CERTII"ICATE MAY II! ISSUED OR MAY Pl!RTAlN, THE INSUMNC! Al'I"ORD!D II Y THE POLICIES D!SCRIIlI!D HERI!IN IS SUIlJECT TO ALL THE TERMS, !XCLUSIONS AND CONDITIONS 01" SUCH POLICIES, UMlTS SHOWN MAY HAV! IIEEN REDUCED IlY PAID CLANS. co LTII TYPI! OJ" INSUMNCI! POLICY NUMIII!R I'OLICY .PPICTMI POLICY U_TION DA~c-am1 DA~~ LIMITS A GI!NI!RAl UABIUTY X COMMERCIAL GENERALlIABJLI1Y CP00111940 CLAIMS MADE [K] OCCUR OWNER'S & CONlRACTOR'S PROT 08-04-98 08-04-99 GENERAL AGGREGATE PRODUCTS - COMPIOP AGG ' $ PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any ono lire) MED EXP (Any ono person) ~TOM08ILI! LIAIIIUTY ~ AH'( AUTO U ALL OWNED AUTOS I SCH!OUL!D AUTOS I HIRED AUTOS NONoOWNED AUTOS THIS CERTIFICATE SUPERCEDES AND REPLACES THE CERTIFICATE I DATED 10-21-98 EXCESS LIABILITY UMIlRELLA P'ORM OTHER THAN UMBRELLA FORM " COMBINED SINGLE LIMrr $ BODILY INJURY $ (Per person) BODILY INJURY $ (Per _idon1) I i PROPERTY DAMAGE $ AUTO ONLY. EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ $ """ ER $ $ EL DISEASE. EA EMPlOYEE $ WOIIKD'I _UTION AND _LOYIIt.. LIUlLITY lHE PROPRIETORJ PARTNERSlEXECUTlVE OFFICERS ARE: D'NCL LJ EXCL I OTHER DESCRIPllOH OF OPERATIONSILOCATlONS/\/EHICLE8I8PEClAL ITEMS NON PROFIT ORGANIZATION PROVIDING GOODS AND SERVICES TO THE HOMELESS AND LOW INCOME FAMILIES LOCATIONS: 601 N, GRAPE, MEDFORD. OR AND 144 N, SECOND STREET, ASHLAND. OR 97520 "~",L,~,c:c.,~~__J!![_.___,~;:::~;;i~~:ii;;;;~~;;;;;:3~;;~,",,:0,,~;-:;,;;;;;;;;;;;;:3'iii;;;L~ _, Iii::,,~:;;;;;",;;;;:;;::;;;;~;;:,,_:::;:::;;~;;;;i~~;;;;;;;;:;;;;;:;~~:i;;;~~ lIHOULD AKr or TN. _ _11_ POL_ . _"'LeD _I TN. ADDITIONAL INSURED UPIllATION DATIl THIIt_. THI IIlIIUIIlGI ~AKr WILL nDU_ TO MAlL ~ DAn WltmeN NOTIClITO TH.cmtTI'lOAT.HOLDIIl_TO THI LI". aUT PAlLUlli TO MAIL aUCH IIDTICIi SHALL IMI'OIIIl NO DeLIGATION DlI LIAalLITY or AKr KIND UPON TIlIl '" AlII.NTS 011 lIi...._TATIVU. AUTHORIZED ATTB: BOB NELSON CITY OF ASHLAND 20 E. MAIN STREET OR 97520 1"11" ACORDm INSURANCE BINDER CSR KT I DATE (MM/DDNY) 10/08/98 THjS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER I rlJgN~o Ex'): 541-482-1921 COMPANY ,I BINDER # 1461 Capitol Indemnity Corporation EXPIRATI N Reinholdt & O'Harra Insurance DATE TIME DATE TIME 383 East Main Street ~ AM -'l12'Ol AM Ashland OR 97520-1896 07/30/98 12: 01 PM 10/30/98 NOON Russ W. Schweikert X I THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE, I SUB CODE: PER EXPIRING POLlCY#: CPOOll1940 ~~~~8~ERID: COMMU-2 DESCRIP110N OF OPERATlONSlVEHICLESfPROPERTY (InCluding Location) INSURED outreach center. Community Emergency Resources Not for profit and Vital Servides PO Box 4124 Medford OR 97501 I COVERAGES liMITS TYPE OF INSURANCE COVERAGE/FORMS DEDUCTIBLE COINS % AMOUNT PROPERTY CAUSES OF LOSS Building 500 90 375,000 I-- BASIC D BROAD ~ SPEC 500 90 50,000 Business Pers I-- EDP 500 90 15,000 I-- GENERAL LIABILITY GENERAL AGGREGATE $500,000 I-- X COMMERCIAL GENERAL LIABILITY PRODUCTS - COM PlOP AGG $500,000 I CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $500,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $500,000 - - FIRE DAMAGE (Anyone fire) $50,000 RETRO DATE FOR CLAIMS MADE: MED EXP (Anyone person) 55 000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 - ANY AUTO BODILY INJURY (Per person) 5 - ALL OWNED AUTOS BODILY INJURY (Per acclden') $ f--- SCHEDULED AUTOS PROPERTY DAMAGE $ f--- HIRED AUTOS MEDICAL PAYMENTS $ f--- NON.OWNED AUTOS PERSONAL INJURY PROT $ '-- UNINSURED MOTORIST $ - $ AUTO PHYSICAL DAMAGE DEDUCTIBLE W ALL VEHICLES U SCHEDULED VEHICLES ACTUAL CASH VALUE R COLLISION: STATED AMOUNT $ OTHER THAN COL: OTHER ~RAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: f-- EACH ACCIDENT $ f--- AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ R UMBRELLA FORM AGGREGATE 5 OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: SELF-INSURED RETENTION 5 I STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT $ AND EMPLOYER'S LIABILITY DISEASE. EACH EMPLOYEE $ DISEASE - POLICY LIMIT $ SPECIAL FEES $ CONDITIONSI TAXES $ OTHER COVERAGES ESTIMATED TOTAL PREMIUM $ NAME & ADDRESS USBANK1 US BANK-SOUTHERN OREGON CONSUMER PRODUCT CENTER PO BOX 1107-L/131 E MAIN ST MEDFORD OR 97501 X MORTGAGEE LOSS PAYEE LOAN # ADDITIONAL INSURED AUTHORIZED REPRESENTATIVE ACORD 75.S (1/97) Russ W. Schweikert NOTE: IMPORTANT STATE INFORMATION ON REVERSE SIDE n ACORD CORPORATION 1993 ACORD", CERIIFICJl\"lEIFLIIBIIwI0FIII~~I.lI~18g=~2 DATE IMMIDDNYI i , 09/21/98 PRmlUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Reinholdt .. O'Harra Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 383 East Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ashland OR 97520-1896 COMPANIES AFFORDING COVERAGE Russ w. Schweikert COMPANY A Capitol Indemnity Corporation Phone No. 541-482-1921 Fax No. INSURED COMPANY B COll1lllunity Emergency Resources COMPANY and Vital Services (CERVS) C PO Box 4124 COMPANY Medford OR 97501 0 CClVERAQESi ...i · '.....TT < '.' i ..'.....< .,'.. .'...,.. i<< i>i i< .iiii ._<< THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUR o NAMED ABOVE FOR THE POLICY PERIOD INDICA TED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED EREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CL IMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRJ TION LIMITS lTR DATE (MMIDDIYVI DATE IMMID NYI GENERAL LIABILITY GENERAL AGGREGATE $500,000 f- A X COMMERCIAL GENERAL LIABILITY CPOO1l1940 07/15/98 07/15 99 PRODUCTS - COMP/OP AGG $500,00Q '. I CLAIMS MADE [!] OCCUR PERSONAL & ADV INJURY $ 500,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $500,000 I--- FIRE DAMAGE (Anyone fire) $ 50,000 I--- MEa EXP (Anyone person) $ 5,000 AUTOMOBILE LIABILITY I--- COMBINED SINGLE LIMIT $ ANY AUTO f- ALL OWNED AUTOS BOOll Y INJURY f- $ SCHEDULED AUTOS (Per person) I f- I-- HIRED AUTOS BODILY INJURY I $ NON-OWNED AUTOS (Per accident) , I-- I-- PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ I--- ANY AUTO OTHER THAN AUTO ONLY: li.j, I--- EACH ACCIDENT $ , I--- AGGREGATE $./ " EXCESS LIABILITY EACH OCCURRENCE $ R UMBRELLA FORM AGGREGATE If OTHER THAN UMBREUA FORM I WORKERS COMPENSATION AND I r6Rm~WS I 10TH. 1///<<// ER EMPLOYERS' LIABILITY EL EACH ACCIDENT I THE PROPRIETOR/ R'NCl EL DISEASE. POLICY LIMIT $ PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE I OTHER DESCRIPTION OF OPERATIONSfLOCATIONS/VEHICLES/SPECIAL ITEMS Additional Insured: City of Ashland It's Officers, Employees .. Agents. ,lei // ...'....'... // ......//// / / /// /i //i/i .....///.. .<. ....... / CITYOFA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. HE ISSUING COMPANY WIU ENDEAVOR TO MAil 10 DAYS WRITTEN NOTI E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Ashland BUT FAILURE TO MAIL SUCH OTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Attn: Robert D. Nelson PANY, ITS AGENTS !!JI-'IJ'PRES""tATIVES, 20 East Main Street OF ANY KIND UPON THE CO Ashland OR 97520 AUTHORIZED REPRESENTATIVE ~. Russ w. Schweike ~t .^"'.....Z$-$1119$Fi </ '.' , />,."//// //. / ./ ./ //\\/ ".'"." ~~. ---------- ACORD~ INSURANCE BINDER CSR AF DATE (MM/DDIYY) 08/26/98 TI-\IS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER I WgN~o Ex'): 541-482-1921 COMPANY I BINDER # 1461 F,M,'w.i, Ex'): Capitol Indemnity Corporation Reinholdt & O'Harra Insurance DATE TIME DATEEXPIRATlC N TIME 383 East Main Street HAM -112:01 AM Ashland OR 97520-1896 07/30/98 PM 08/29/98 NOON Russ W, Schweikert X I THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE: I SUB CODE: PER EXPIRING POLICY #: PEND ING ~~~~~ER 10: COMMU-2 DESCRIPTION OF OPERA nONSlVEHICLESJPROPERTY (Including Location) INSURED outreach center. Not for profit Community Emergency Resources PO Box 4124 Medford OR 97501 COVERAGES LfMITS TYPE OF INSURANCE COVERAGElFORMS AMOUNT DEDUCTIBLE COINS % PROPERTY CAUSES OF LOSS Building 375,000 500 90 - D BROAD D SPEC BASIC Business Pers 50,000 500 90 - EDP 15,000 500 90 - GENERAL LIABILITY GENERAL AGGREGATE $500,000 - X COMMERCIAL GENERAL LIABILITY PRODUCTS. COMP/oP AGG $500,000 I CLAIMS MADE o OCCUR PERSONAL & ADV INJURY $500,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $500,000 - - FIRE DAMAGE (Anyone fire) $50.000 RETRO DATE FOR CLAIMS MADE: MED EXP (Anyone personl $5.000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - ANY AUTO BODILY INJURY (pe, person) $ - ALL OWNED AUTOS BODILY INJURY (Per accident) $ - SCHEDULED AUTOS PROPERTY DAMAGE $ - HIRED AUTOS MEDICAL PAYMENTS $ - NON.OWNED AUTOS PERSONAL INJURY PROT $ - UNINSURED MOTORIST $ - $ AUTO PHYSICAL DAMAGE DEDUCTIBLE --.J ALL VEHICLES U SCHEDULED VEHICLES ACTUAL CASH VALUE ~ COLLISION: STATED AMOUNT $ OTHER THAN COL: OTHER GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ - ANY AUTO OTHER THAN AUTO ONLY: - EACH ACCIDENT $ - AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ ~ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: SELF~NSUREO RETENTION $ I STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT $ AND EMPLOYER'S LIABILITY DISEASE. POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ , SPECIAL CONOITIONSJ OTHER COVERAGES NAME & ADDRESS ---i MORTGAGEE H ADDIT10NAL INSURED LOSS PAYEE LOAN # US BANK-SOUTHERN OREGON ----. 1l07-L/131 AUTHORIZED REPRESENTATIVE I' PO BOX E MAIN ST MEDFORD OR 97501 Russ W, Schweikert ACORD 75..s (12/93) NOTE:IMPORTANT STATE INFORMAJIONON ATTACHlD PAGE @ACORDCO~ORATION1993 ADDITIONAL PREMISE INFORMATION CSR AF 08/26/98 Community Emergency Resources COMMU-2 Schedule attached to Binder 1461 PAGE 2 PREMISE # 1 BUILOING ## 1 STREET, CITY, COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED 601 N Gra~e j INSIDE ~ OWNER Medford 0 97501 OUTSIDE - TENANT 1960 100% Jackson NATURE OF BUSINESSIOESCRIPTION OF OPERATIONS Non-pr9fit or~anizatio~,(part of the United Way Foundationi which provides essent~a1 goo s & serv~ces to homeless and low income fami ies. PREMISE # 2 BUILDING # 1 STREET, CITY, COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED 144 N. Second Street ==.J INSIDE X OWNER - Ashland OR 97520 OUTSIDE TENANT 1900 100% Jackson - NATURE OF BUSINESS/DESCRIPTION OF OPERATIONS outreach center. PREMISE # BUILDING # STREET, CITY, COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED j INSIDE - OWNER OUTSIDE - TENANT NATURE OF BUSINESS/DESCRIPTION OF OPERATIONS PREMISE # BUILDING # STREET, CITY. COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED j INSIDE OWNER - OUTSIDE TENANT - NATURE OF BUSINESSiDESCRIPTION OF OPERATIONS PREMISE # BUILDING # STREET, CITY, COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED j INSIDE - OWNER OUTSIDE TENANT - NATURE OF BUSlNESSiDESCRlPTION OF OPERATIONS PREMISE # BUILDING # STREET, CITY, COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED j INSIDE - OWNER OUTSIDE - TENANT NATURE OF BUSINESS/DESCRIPTION OF OPERATIONS PREMISE # BUILDING # STREET, CITY, COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED j INSIDE - OWNER OUTSIDE - TENANT NATURE OF BUSINESS/DESCRIPTION OF OPERATIONS PREMISE # BUILDING # STREET, CITY, COUNTY, STATE, ZIP CODE CITY LIMITS INTEREST YR BUILT PART OCCUPIED j INSIDE OWNER - OUTSIDE - TENANT NATURE OF BUSINESSiDESCRlPTION OF OPERATIONS ATTAcH.TOCOMMERCIAL APPI.ICATION PREMISES SCHEDULE CSR AF 08/26/98 Community Emergency Resources PREMISES INFORMATION COMMU-2 Schedule attached to Binder 1461 PAGE 3 SUBJECT OF INSURANCE AMOUNT COINS % VALUATION CAUSES OF LOSS '~'t~O,z DEDUCTIBLE FORMS AND CONDITIONS TO APPLY 1 1 1 1 ADDITIONAL COVERAGES, RESTRICTIONS. ENDORSEMENTS, AND RATING INFORMATION Building 375,000 90 RC SPECIAL SPECIAL 500 500 Business Pers 50,000 90 RC EDP 15,000 90 RC SPECIAL 500 CONSTRUCTION TYPE Joisted Mason BUILDING IMPROVEMENTS WIRING, YR: FIRE DISTRICT/CODE NUMBER Medford City FD PROTo CL. # STORIES # BASM'TS YR. BUILT TOTAL AREA 3 1 1960 OTHER OCCUPANCIES NONE ROOFING. YR: RIGHT EXPOSURE & DISTANCE Christ Unity Church BURGLAR ALARM TYPE Switch & motion dete BURGLAR ALARM INSTALLED AND SERVICED BY S.O.S. of Medford RRE PROTECTION (Sprinklers, S"ndpipes, C02lHalon Systems) Fire & Smoke alarms ADDITIONAL INTERESTS NAME & ADDRESS US BANK-SOUTHERN OREGON PO BOX 1107-L/131 E MAIN ST MEDFORD OR 97501 PLUMBING, YR: HEATING, YR: OTHER LEFT EXPOSURE & OISTANCE None CERTIFICATE # REAR EXPOSURE & DISTANCE None EXPIRATION DATE EXTENT GRADE X CENTRAL STATION WITH KEYS CLOCK HOURLY # GUARDSlWATCHMEN FIRE ALARM MANUFACTURER S.O.S. of Medford X CENTRAL STATION LOCAL GONG NAME & ADDRESS INTEREST Mortagor PREMISES INFORMATION X CERTIFICATION REQUIRED INTEREST CERTIFICATION REQUIRED Building 150,000 90 RC SPECIAL I~MVP-2 DEDUCTIBLE 500 FORMS AND CONDITIONS TO APPLY SUBJECT OF INSURANCE AMOUNT COINS % VALUATION CAUSES OF LOSS 1 2 1 1 ADDITIONAL COVERAGES, RESTRICTIONS, ENDORSEMENTS, AND RATING INFORMATION Business Pers 25,000 90 RC SPECIAL 500 CONSTRUCTION TYPE Frame BUILDING IMPROVEMENTS X WIRING, YR: 60 X ROOFING, YR: 85 RIGHT EXPOSURE & DISTANCE Home BURGLAR ALARM TYPE FIRE DISTRICT/CODE NUMBER Ashland City FD PROTo CL. # STORIES # BASM'TS YR. BUILT TOTAL AREA 4 1 1900 1360 X PLUMBING, YR: X HEATING, YR: X OTHER 60 96 siding95 LEFT EXPOSURE & DISTANCE Church CERTIFICATE # OTHER OCCUPANCIES None REAR EXPOSURE & DISTANCE HOME EXPIRATION DATE EXTENT GRADE CENTRAL STATION WITH KEYS CLOCK HOURLY X Smoke alarms CENTRAL STATION LOCAL GONG BURGLAR ALARM INSTALLED AND SERVICED BY # GUARDSlWATCHMEN FIRE PROTECTION (Sprinklers, Standpipes, C02IHalon Systems) FIRE ALARM MANUFACTURER ADDITIONAL INTERESTS NAME & ADDRESS US BANK-SOUTHERN OREGON PO BOX 1107-L/131 E MAIN ST MEDFORD OR 97501 NAME & ADDRESS INTEREST Mortagor X CE:J1a"iJf:~ON ATTACH TO COMMERCIAL PROPERTY APPLICATION INTEREST CERTIFICATION REQUIRED ADDITIONAL HAZARDS CSR AF 08/26/98 , Community Emergency Resources COMMU-2 Schedule attached to Binder 1461 PAGE 4 LOCATION # 1 CLASSIFICATION CLASS PREMIUM TERR PREMIOP:' ~RODUCTS PREMIUM CODE BASIS PREMIOPS PRODUCTS Building premesis office OCC 61225 A 5500 4 Not for profit LOCATION # 1 CLASSIFICA nON CLASS PREMIUM TERR PREM/OP:' ~RODUCTS PREMIUM CODE BASIS PREMIOPS PRODUCTS Caterer 11039 A 5500 4 LOCATION # 2 CLASSIFICATION CLASS PREMIUM TERR PREMIOP:' ~RODUCTS PRE IUM CODE BASIS PREMIOPS PRODUCTS Building premesis office OCC 61225 A 1360 4 Not for profit lOCA TION # CLASSIFICATION CLASS PREMIUM TERR PREMIOP:' ~RODUCTS PREMIUM CODE BASIS PREMIOPS PRODUCTS LOCATION # CLASS/FICA TION CLASS PREMIUM TERR ..!lHE PREMIUM CODE BASIS PREMIOPS PRODUCTS PREMIOPS PRODUCTS lOCATION # CLASSIACA TION CLASS PREMIUM TERR PREMIOP~ ~RODUCTS PREMIUM CODE BASIS PREMIOPS PRODUCTS lOCA TION # CLASSIFICATION CLASS PREMIUM TERR _.!lJ TE PRE IUM CODE BASIS PREM/OPS PRODUCTS PREM/OPS PRODUCTS lOCATION # CLASSIFICATION CLASS PREMIUM TERR RATE PREMIUM CODE BASIS PREM/OPS PRODUCTS PREMIOPS PRODUCTS I LOCA TlVN .. CLASSIFICATION CLASS PREMIUM TERR _it TE PREMIUM CODE BASIS PREM/OPS PRODUCTS PREMIOPS PRODUCTS I LV"" I IV"" " CLASSIACA TION CLASS PREMIUM TERR PREMIOpr ~RODUCTS PREMIUM CODE BASIS PREMIOPS PRODUCTS I LV"" IIVN" CLASSIFICATION CLASS PREMIUM TERR RATE PRE IUM CODE BASIS PREMIOPS PRODUCTS PREMIOPS PRODUCTS ATTACH TO COMMERCIAL GENEAAL LIA$ILITYAPPUCAfION NOTICE OF CANCELLATION DUE TO NON-PAYMENT OF PREMIUM THE MILLERS MUTUAL INSURANCE COMPANY 300 Burnett Street. P.O. Box 2269 . Fort Worth, Texas. 76113-2269 DATE: 5/19/98 MAIL TO: CITY OF ASHLAND, OR ITS OFFIC 20 EAST MAIN ASHLAND OR 97520 INSURED NAME AND ADDRESS: COMMUNITY EMERGENCY RESOURCES POBOX 4124 MEDFORD OR 97501-0000 POLICY NUMBER: POLICY EFFECTIVE DATE: TYPE OF INSURANCE: CANCELLATION DATE: PREMIUM PAST DUE: TOTAL DUE: 01CL101646 9/15/97 COMMERCIAL PACKAGE POLICY 6/01/98 $ 1,662.60 $ 1,662.60 HtCD MAY 28 7998 You are hereby notified in accordance with the terms and conditions of the above mentioned Policy, and in accordance with law, that your Insurance will cease at 12:01 A.M. on the date shown above due to non-payment of premium. Automobile Insurance Plan Information: If the insurance being terminated is automobile insurance, other than insurance obtained under the Oregon Automobile Insurance Plan, you are possibly eligible for automobile insurance through another insurer or under the Oregon Automobile Insurance Plan. Please contact your agent or this company for information on securing insurance through the Automobile Insurance Plan. Replacement of Property (Fire) Insurance: If this notice of cancellation or nonrenewal pertains to a policy providing fire, extended coverage and possibly vandalism and malicious mischief insurance and you wish to replace your policy, you should make an effort to obtain insurance through another company in the normal market. If you have difficulty procuring replacement coverage in the normal market, you possibly may obtain coverage through the Oregon Fair Plan Association, For further information, please contact your agent or this Company. AGENT NAME AND ADDRESS HART INSURANCE AGENCY 03769 PO BOX 1299 GRANTS PASS OR 97526-0000 X03720R (1095) ADDITIONAL INSURED'S COPY COMMERCIAL LINES 0001 .~v~ ~ MIII--=GRDUP. THE MILLERS MUTUAL FIRE INSURANCE COMPANY . 300 Burnett Street . P.O.BOX 2269 . Fort Worth, Texas. 76113-2269 NOTICE OF REINSTATEMENT DATE: 5/05/98 Mail To: CITY OF ASHLAND, OR ITS OFFIC 20 EAST MAIN ASHLAND OR 97520 Insured Name and Address COMMUNITY EMERGENCY RESOURCES POBOX 4124 MEDFORD OR 97501-0000 POLICY NUMBER: TYPE OF INSURANCE: POLICY EFFECTIVE DATE: REINSTATE EFFECTIVE DATE: 01CL101646 COMMERCIAL PACKAGE POLICY 9/15/97 4/26/98 You are hereby notified that the above policy which was set to cancel or lapse, or has already cancelled or lapsed, is hereby reinstated as of the above effective date and the policy remains in force as originally written, Agent Name and Address HART INSURANCE AGENCY PO BOX 1299 GRANTS PASS OR 97526-0000 03769 ADDITIONAL INSURED'S COPY X0423 AA(1095) NOTICE OF CANCELLATION DUE TO NON-PAYMENT OF PREMIUM THE MILLERS MUTUAL INSURANCE COMPANY 300 Burnett Street. P.O. Box 2269. Fort Worth, Texas. 76113-2269 DATE: 4/13/98 MAIL TO: CITY OF ASHLAND, OR ITS OFFIC 20 EAST MAIN ASHLAND OR 97520 INSURED NAME AND ADDRESS: COMMUNITY EMERGENCY RESOURCES POBOX 4124 MEDFORD OR 97501-0000 POLICY NUMBER: 01 CL 1 0 1646 POLICY EFFECTIVE DATE: 9/15/97 TYPE OF INSURANCE: COMMERCIAL CANCELLATION DATE: 4/26/98 PREMIUM PAST DUE: $ TOTAL DUE: $ PACKAGE POLICY 1,662,60 1,662,60 You are hereby notified in accordance with the terms and conditions of the above mentioned Policy, and in accordance with law, that your Insurance will cease at 12:01 A.M. on the date shown above due to non-payment of premium. Automobile Insurance Plan Information: If the insurance being terminated is automobile insurance, other than insurance obtained under the Oregon Automobile Insurance Plan, you are possibly eligible for automobile insurance through another insurer or under the Oregon Automobile Insurance Plan. Please contact your agent or this company for information on securing insurance through the Automobile Insurance Plan. Replacement of Property (Fire) Insurance: If this notice of cancellation or nonrenewal pertains to a policy providing fire, extended coverage and possibly vandalism and malicious mischief insurance and you wish to replace your policy, you should make an effort to obtain insurance through another company in the normal market. If you have difficulty procuring replacement coverage in the normal market, you possibly may obtain coverage through the Oregon Fair Plan Association. For further information, please contact your agent or this Company. AGENT NAME AND ADDRESS HART INSURANCE AGENCY 03769 PO BOX 1299 GRANTS PASS OR 97526-0000 X03720R (1095) ADDITIONAL INSURED'S COPY COMMERCIAL LINES 0001 - .- 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: $9,000 GRANTEE: CERVS Address: 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, sub rogations, 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 $100,000 per occurrence for property damage. Liability coverage shall be provided on an "occurrence" not "claims" basis. The City of Ashland, its officers, employees and agents shall be named as additional insureds. Certificates of insurance acceptable to the City shall be filed with City's Risk Manager prior to the expenditure of any grant funds. 9. Merger. This contract constitutes the entire agreement between the parties. There are no understandings, agreements or representations, oral or written, not specified in this contract regarding this contract. Grantee, by the signature below of its authorized representative, acknowledges that it has read this contract, understands it, and agrees to be bound by its terms and conditions. CITY OF ASHLAND ByR~A4lA Irector of Finance Content review bY:,IrJ'- epartment Head .--' Form review by: 0-- (City Attorney) Coding: (for City use only) PAGE 2-GRANT AGREEMENT (g:lbudget~lselssgranlfrm) ..... ACORD ..,."."",.,.....",.... IlrcllP:IC:IIE~I::IwIIBIL;IIIIISISIIII~Eb$R$d DATE IMMIDDIYY) '.'. .'.'..'.,'. '..'.. .",.~ .,... ...". .".... . .".'....,..,""',...,...............,9CI~VS"" 10/27/97 ..,., PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hart Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 25 N. Holly ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97501 COMPANIES AFFORDING COVERAGE HART INSURANCE AGENCY COMPANY A MILLERS Phone No. 541-779-4232 Fax No. 541-772 -3963 INSURED COMPANY B C.E.R.V.S. COMMUNITY EMERGENCY RESOURCES COMPANY AND VITAL SERVICES C P.O. BOX 4124 COMPANY MEDFORD OR 97501 D ,,,. '."~. ..i. ...,.. ...'..../,."...'.'..i .i ........'..'..i .. ...iii .....i.. .,...i ..i'.."'.ii..i.. ..'.'.'.'.i/ii/ii.ii 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. co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE IMMIDDIYY) DATE (MMIDDIYYI GENERAL LIABILITY GENERAL AGGREGATE $ 500,000 - A X COMMERCIAL GENERAL LIABILITY 01CL1016461 09/15/97 09/15/98 PRODUCTS. CaMP/Of AGG $ 500,000 i I CLAIMS MADE [iJ OCCUR PERSONAL & ADV INJURY $ 500,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 500,000 - FIRE DAMAGE (Anyone fire) $ 100,000 - MED EXP (Anyone person) $ 5,000 ~TOMDBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO - ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per personl - HIRED AUTOS BODilY INJURY - $ NON-OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONL V - EA ACCIDENT $ - .. ,ii - ANY AUTO OTHER THAN AUTO ONLY: - EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ ~ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FOAM $ WORKERS COMPENSATION AND I foCRm~\!rS I 10TH. >i//>.. ER EMPLOYERS' LIABILITY EL EACH ACCIDENT $ THE PROPRIETORI R'NCL EL DISEASE. POLICY LIMIT $ PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE. EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS THIS NAMES CERTIFICATE HOLDER AS ADDITIONAL INSURED ONLY AS THEIR RESPECTIVE INTEREST MAY APPEAR. ,,,,"".,...', />....> /i/> .'.'./i .'... .'...'.. "<7" ."....'......,'.....'.................> >> ...ii.....ii/i ......./' ASHLCIT SHOULD AllY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF ASHLAND, ORE ITS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL OFFICERS, EMPLOYEES, AND ...!L DAYS WRmEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, AGENTS BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 20 EAST MAIN ASHLAND OR 97520 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE ~ -,_9-ec~ HART INSURANCE AGENCYj. p./,uA p / ..~~~~. ~~..". ..,.i>> /> //< .ii .."../>>.,.,..i./i >ii/ii,.....>. ....,','."','. MTION,198a V