HomeMy WebLinkAbout2007-115 Contract - Copeland Construction
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
Contract for PERSONAL SERVICES Less than $25,000
C I T Y 0 f CONSULTANT: GopGtCA.~~ (,C,.lI\J~.\- ~/...f.-- .
ASHLAND CONTACT: ~ IMM.."€C-F~Ic....AJb
ADDRESS: {t' IFtfs/r; U.,,~ .,)J1,.... G ~ (.)/L- 7') 'S'2.i
TELEPHONE: B u.:. - "Z.- ~ I'"
($40 -")ls>::> Cf
DATE AGREEMENT PREPARED:
BEGINNING DATE: &1/0 (1
COMPENSATION: S~~ c.:s-
FAX: 8'UP -/0/"/
COMPLETION DATE: 7/2,('/07
SERVICES TO BE PROVIDED:
ADDITIONAL TERMS: ~.~
FINDINGS:
Pursuant to AMC 2.52.040E and AMC 2.52.060, after reasonable inquiry and evaluation, the undersigned
Contracting Officer finds and determines that: (1) the services to be acquired are personal services; (2) the City
does not have adequate personnel nor resources to perform the services; and (3) the statement of work
represents the department's plan for utilization of such personal services; and (4) the undersigned consultant
has specialized experience, education, training and capability sufficient to perform the quality, quantity and
type of work requested in the scope of work within the time and financial constraints provided.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT
AGREE as follows:
1. Findings I Recitations. The findings and recitations set forth above are true and correct and are
incorporated herein by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services
described above and, unless otherwise specified, furnish all labor, equipment and materials required for the
proper performance of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all
personnel assigned to the work required under this contract are fully qualified to perform the service to which
they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded
by the State of Oregon, are so registered, licensed and bonded.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date
indicated above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum
specified above. Once work commences, invoices shall be prepared and submitted by the tenth of the month
for work completed in the prior month. Payments shall be made within 30 days of the date of the invoice.
Should the contract be prematurely terminated, payments will be made for work completed and accepted to
date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the
property of City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this
contract.
8. Living Wage Requirements: . N/A If the amount of this contract is $15,964 or more, Consultant is required
to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter,
to all employees performing work under this contract and to any subcontractor who performs 50% or more of
the service work under this contract. Consultant is also required to post the attached notice predominantly in
areas where it will be seen by all employees.
9. Indemnification: Consultant 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
dama es resultin from in'ur to an erson includin in'u resultin in death, or dama e includin loss or
G:lpub-wrkslengldept-adminIENGINEERIPROJECT\2007107_04 Sanitary Line Support Repair RFQ 3 07.doc Page 11 of 83
destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by
Consultant (including but not limited to, Consultant's employees, agents, and others designated by Consultant
to perform work or services attendant to this contract). Consultant shall not be held responsible for any los.ses,
expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately
caused by the negligence of City.
10. Termination: This contract may be terminated by City by giving ten days written notice to Consultant and
may be terminated by Consultant should City fail substantially to perform its obligations through no fault of
Consultant.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the
City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall
provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work
pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of
the work without the written consent of City. Any attempted assignment or subcontract without written consent
of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or
subcontractors and of all persons employed by them, and the approval by City of any assignment or
subcontract shall not create any contractual relation between the assignee or subcontractor and City.
13. Incorporation of Standard Contract Provisions. Standard contract provisions required by AMC
2.52.040, set forth in Exhibit A attached hereto and made a part hereof by this reference, are specifically
incorporated into this contract. Any more restrictive provisions of this contract, or the scope of work control
over standard conditions.
CONSULTANT/CONTRACTOR
~~nature ~~ /'
MAM..~lJ CoptAxAJb
Print Name
CITY OF ASHLAND:
BY ~~
FINANCE DIRECTOR "\
TITLE
~J.jt3L
DATE
;;/;(- /~7
I
Cs:,-7-b?
CONT~VIEW:
By:
City .De artment Head Date: /2- J UN 07
ACCOUNT # ~ &7>.08./7. cJO . 7rl-~CJ 1)
(For City p~oses only)
V 'lp 67
DATE
FederallD# 37-/0ooC{2..
*Completed W9 form must be submitted with contract
PURCHASE ORDER #
Revised 1-9-07
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Page 12 of 83
CERTIFICATIONS OF REPRESENTATION
Contractor, under penalty of perjury, certifies that:
(a) The number shown on this form is its correct taxpayer ID (or is waiting for the number to be issued to it; and
(b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified
by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or
dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and
delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, and
(c) The work under the Contract shall be performed in accordance with the highest professional standards, and
(d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty
of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the
entity designated above and authorized to do business in Oregon or is an independent contractor as defined in the contract
documents, and has checked four or more of the following criteria:
(1) I carry out the labor or services at a location separate from my residence or is in a specific portion of my residence,
set aside as the location of the business.
(2) Commercial advertising or busi,ness cards or a trade association membership are purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one year.
(6) I assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership
of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be
provided.
co#?,~f
~-)-07
Date
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Form W-9
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
Enter your TIN in the appropriate box. For individuals. this is your social security number (SSN).
However. for a resident alien. sole proprietor. or disregarded entity. see the Part I instructions on
page 3. For other entities. it is your employer identification number (EIN). If you do not have a number.
see How to get a TIN on page 3.
Note: " the account is in more than one name. see the chart on page 4 for guidelines on whose number
to enter.
Certification
Under penalties of perjury. I 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. I 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. I am a U.S. person (including a U.S. resident alien).
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 diVidends. you are not required to sign the Certification. but you must
provide your correct TIN. (See the instructions on page 4.)
Sign
Here
(Rev. January 2003)
Depanment 01 the Treasury
Inlemal Reverue Service
N
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155
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Name \
V t'MM.e- l{
Business name. if different from above
L. Co) P cto.../UIJ CCN ~<J.t'Lut.. {~~~
O IndiVIdual!
Check appropriate box: Sole proprietor
Address (number. street. and apt. or suite no.)
II t?A-4/fF
o Corporation
City, state. and ZIP code
w (FI'AA-
List account number{s) here (optionaO
Purpose of For
A person who is required to file an information return with
the IRS. must obtain your correct taxpayer identification
number (TIN) to report. for example. income paid to you. real
estate transactions. mortgage interest you paid. acquisition
or abandonment of secured property. cancellation of debt. or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
(including a resident alien), to provide your correct TIN to the
person requesting it (the requester) and. when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued).
2. Certify that you are not subject to backup withholding.
or
3. Claim exemption from backup withholding if you are a
U.S. exempt payee.
Note: If a requester gives you a form other than Form W-9
to request your TIN, you must use the requesters form if it is
substantially similar to this Form W-9.
Foreign person. If you are a foreign person. use the
appropriate Form W-8 (see Pub. 515, Withholding of Tax on
Nonresident Aliens and Foreign Entities).
L.L". L.
o Partnership ,I8'Other ~ __.'-:-:!::.~.._____ 0 ~1~~~I~:~m backup
Requester's name and address (optional)
I Social security number ~
'I Ie( 1'1 D I l.t5l2.I" I
or
Date ~
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the
terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However. most tax treaties contain a
provision known as a "saving clause." Exceptions specified
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipient
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an
exception contained in the saving clause of a tax treaty to
claim an exemption from U.S. tax on certain types of income.
you must attach a statement that specifies the following five
items:
1. The treaty country. Generally. this must be the same
treaty under which you claimed exemption from tax as a
nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that
contains the saving clause and its exceptions.
4. The type and amount of income that qualifies for the
exemption from tax.
5. Sufficient facts to justify the exemption from tax under
the terms of the treaty article.
Cat. No. 10231X
Form W-9 (Rev. 1-2(03)
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Page 14 of 83
JUL/UL/LUU//MU~ UL:J/ ~M
1 NSUR. MKT PLACE
FAX No. 541 772 8235
P. 002/003
A CORD_ CERTIFICA TE OF LIABILITY INSURANCE OP 10 D~ DATE (MMIDDIYYYY)
COPJ:[-l 07/02/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance Marketp1ace, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1998 Skypark Dr Suite 100 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504
Phone: 541-779-0177 Fax: FAX 772-8235 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Ohio Casua1ty 24074
INSURER B
Cope1and Construction, LLC IflSURER C
Jimmie Cope1and
119 Eaj1e View Dr INSURER D
Eag1e oint OR 97524
Ir~SURER E
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PD~E iMMIOD~1: DATET (~M'iDD~)"" LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 500,000
I---
A ~ COMMERCIAL GENERAL LIABILITY BHO 53366906 06/03/07 06/03/08 PREMISES (Ea occurance) $ 100,000
- ~ CLAIMS MADE ~ OC':UR MED EXP (Anyone person) $ 10,000
PERSONAL & ADV IN~IURY $ 500 ,000
GENERAL AGGREGATE $ 1,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/CiP AGC_ $ 1,000,000
II n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea aCCident)
-
ALL OWNED AUTOS 80DIL Y INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODIL Y INJURY
- (Per aCCident) $
NON-OWNED AUTOS
-
- PROPERTY OAMAGE $
(Per aCCIdent)
GARAGE LIABILITY AUT') ONL Y - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
tJ OCCUR D CLAIMS MAOE AGGREC,ATE $
$
R DEOUCTI8LE $
RETENTIOr~ $ $
WORKERS COMPENSATION AND ITO~\L:~"TS I IUER
EMPLOYERS' LIABILITY E L EA<~H ACC IOENT $
Ar~Y PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E L DISEASE - EA EMPL')YEE $
If yes, descnbe under E L OISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
City of Ash1and
Pub1ic Works Engineering
488-6006
20 E Main
Ash1and OR 97520
ASHLAND
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlOI
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001108)
Insurance Marketp1ace Inc.
@ ACORD CORPORATION 1
r~'
C I T Y 0 F CITY RECORDER'S COpy
ASHLAND ~
20 E MAIN ST. ~
ASHLAND, OR 97520
(541) 488-5300
Page 1 / 1
~
VENDOR: 012365
COPELAND CONSTRUCTION
119 EAGLE VIEW DRIVE
EAGLE POINT, OR 97524
SHIP TO: Ashland Public Works
(541) 488-5587
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date: 6/20/2007
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
BLANKET PURCHASE ORDER
Sanitary sewer support repair on
Ashland Creek
8,875.00
Contract for Services
Date of aQreement: 06/12/2007
BeQinninQ date: 06/20/2007
Completion date: 07/20/2007
Insurance required/Certificate for Gen
Liab
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
tJ ~
4:w- ",..J ~
SUBTOTAL
TAX
FREIGHT
TOTAL
87 .00
0.00
0.00
8,875.00
AM ~ ~/r:7
Au orlzed Signature
VENDOR COPY
CITY OF
ASHLAND
REQUISITION
No. PW - FY 2007
Department Public Wodes
Vendor COPELAND CONSTRUCTION LLC
119 EAGLE VIEW DRIVE
EAGLE POINT OR 97524
Account No. 675.08.17.00.704200
Date June 27,2007
Requested Delivery Date
Deliver To
Via DAWN LAMB
(' Note: Please allow opproximalely two(2) wedcs fur delivery on items not
genenJly caried in storod, and opproximalely two (2) monlhs on printing jobs.)
ASAP
PAULA BROWN
Item No. Quantity
Unit
Description
Use ofPun:hasin Office On
Unit Price Total Price PO No.
SanitaJy sewer support repair on Ashland Creek
S 8,875.00
TOTAL
$
$ 8,875.00
Job No.
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7-~ ~7
V l'1.~y(A.. t! tl
I corlitY that tile iIems ..., IlOOOSSaly fur tile operation
~.._--- ~
/ Head or Authorized Person
,
Issued By
Date
Received By
r~'
G:Pubwrks\engldeptadminlengiooerlprojectI07.{)4 Copeland Requislion 6 07.xls