HomeMy WebLinkAbout2007-269 Contract - Pilot Rock Excavation
10/08/2007 16:33
5418583291
BARRETTBUSINESS
PAGE 02
January I, 2007
EEB
A__-. '<-"""
Rand LeBaron
Pilot Rock Excavation Inc.
650 East Pine Street Suite 102B
Central point OR 97502
Re:
Barrett BusineSG Services, Inc.
Letter of Self-Insurance for Workers' Compensation Plan
8100 ME I'lIIkway on.., Sui1e 200
Vancaun" WI.ll..oglon 98662
360.828.07110
800.494.5669
Dear Mr. LeBaron:
r.x 360.828.0701
The purpose of this letter is to provide documentation
regarding Barrett Business Services' Self-Insured Workers'
Compensation Plan. Barrett has been a qualified self-insured employer
for workers' compensation continuously in Oregon since 1987, in
WaShington, Maryland and Delaware since 1994 and in California since 1995. Our cla.ims
are managed by our third-party administrators, CorVel Enterprise Comp, Inc., dba
Hazelrigg Risk Management, SISCO, or Self Administered depending on your location or type
of claims.
www.borrettbusiness.com
As the named addressee of this letter, your company's required workers'
compensation coverage is provided through Barrett's Self-Insured Plan. Our covered
California customers can also verify our state certification at
www.dir.ca.qov./SIP/sip.html; then, in the middle of the page under "Rosters", click on
Private self insured employers; then scroll down to Barrett (the list is alpha by company
name.) Additional information is as follows:
Self-Insurance Certification Number:
California:
Oregon:
Washington:
Delaware:
Maryland:
2246
1068
706,1l6
152
I1365
Other Comments:
Our Excess Workers' Compensation Insurance Carrier and Policy Number are as
follows: National UnionlAmerican International Group (AIGl, Policy No. WCKS07-3 in
conjunction with Policy No. 460-0723, effective date: 1/1/2007 through 1/1/2008.
For additional information, please contact your local Barrett office.
Very truly yours,
V1M.L(jJ~M--1
Michael D. Mulholland
Vice PreSident-Finance
BBSI Office: Medford
16/68/2667 16:33
5418583291
BARRETTBUSINESS
PAGE 61
BARRETT BUSINESS SERVICES, INC
FACSIMILE TRANSMITTAL SHEET
TO, ~N 1.IhH&
OOMP6.,er.v 411tMh
FAX Nl.lMBER:
-f'!P-6tJtJ~
PHoNE NlJMIlER,
PROM, '~-~~Iu
D^'I'R:~
/b-?~ 7
TOTAL NO. OF PAGES INCLUDING COVER,
SENDER'S R!I'EI\!NCl! NlJMIlER,
RE,
YOUR REFERENCE NtJMIll!R.
o Ul\CllNT 0 FOIlIlEVIEW 0 PLEASIl COMMENT 0 PLEASE REPLY 0 PLEASE RECYCLE
NOTES/COMMENTS:
115 STEWART AVENUE SUITE 102 MEDFORD OR 97501
783 NE 7nI STREET GRANTS PASS OR 97526
(541) 772-5469 OR (541) 471-7828
FAX (541) 772-7446
~~ CERTIFICATE OF LIABILITY INSURANCE I DAlElJIIOOOI'N)
1010812007
PRODUCER Serial # B1786 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
GERALD D. SIMMONS INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2551 PINEHURST DRIVE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MCMINNVlLLE OR 97128 INSURERS AFFORDING COVERAGE
PHONE 503-883-1234
"SURED PilOT ROCK EXCAVATION. INC INSURER A: LEXINGTON
MARYLAND CASUAL TV --------. .~~~-
650 E PINE STREET SUITE 102B INSURER B: _._--~--------~--- ......_--
CENTRAL POINT 97502 INSURER C: .. -.-.-.------- ..----
.'-----
INSURER 0:
. _.~,_..- -.----.--
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IssueD TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NQ'TWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 'MilCH 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 S~~WN...~Y HAVE BE~N REDUCED BY PAID CLAIMS. ... r------ . . ~.-
INSR T'YPE OF INSURANCE POUCY NU.eR POUCY EPFEC1'NE ~ EXPIRAllON IMTS
~NERAL LIABIUlY EACH OCCURRENCE -- .,-.....!BQ2,()ll2..
A x COMMERCIAL GENERAL LIABILITY 41-LX-9272518-O 9/1512007 9/1512008 FIRE DAMAGE (Any cne fire) $ 100.000
I CLAIMS MADE [K] OCCUR _ MED EXP (Any one person) $ 10.000
PERSONAL & AOV INJURY $ 1,000.000
GENERAL AGGREGATE $ 2,000.000
h'L AGG~n UMIT APnS PER: PRODUCTS. COMP,(JP AGG $ 2.000.000
POLICY ':'~.Q: LOC
~LEUABlUTY SCP 042567876 9/15/2007 9/1512008 COMBINED SINGLE LIMIT $ 1,000.000
B (Eaac:ddent)
I- Atff AUTO 1-------..- _..._--"-- -----
I- ALL O'MJED AUTOS BOOIL Y INJURY
$
0- SCHEDULED AUTOS (Per person)
0- HIRED AUTOS BODILY INJURY
$
0- NON..QWNED AUTOS (Paracddll'll)
I- PROPERTY DAMAGE $
(Peracddent)
~__ UAmUTY AUTO ONLY - EA ACCIDENT $ ---.-
ANY AUTO OTHER THAN EAACC e!-.-~-.--
AUTO ONLY: AGG $
:=JESS UABIUTY EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE -- $ ...".-..---".---
--.
RETENTION $ $
WORKI!RS COMPENSATION AND I T~~ LA~I'fs 1 _.11t -.---..-.. ._---~
EM~ UABIU1Y E.L. EACH ACCIDENT _.___ !.._._~._--~--
E.L. DISEASE - EA EMPLOYE~ $
E.L. DISEASE - POliCY LIMIT $
OTHER
DESCRJPlION OF OPERAlIONS/I..OCAnoNMIEHtC~S ADDED BY ENOOASElENllIPECIAL PROVISIONS
CITY OF ASHLAND OREGON, ITS OFFICERS. EMPLOYEES AND AGENTS ARE ADDITIONAL INSURED IF REQUIRED BY CONTRACT
CERTIFICATE HOLDER II ADIlI110NAL IN....... "SURER InTER, CANCELLATION
SHOULD ANYOF' lMEABOVE DESCRtBED POUCESBE CANCELJ.ED BEFORE TIE EXPlRA110N
CITY OF ASHLAND OREGON DATE THEREOF, THE tsStINO INSURER WIJ. ENDEAVOR to MAIL ~ DAYS WRITTEN
20 E _MAIN STREET N011CI! 10 lME CERl1FJCAlE HOLDER NAMED 10 lItE LEFT, BUT FAILURE TO DO SO ~
ASHLAND. OR 97520 IMPOSE NO 0BUGA11ON OR UABIJ1Y OF ANY KIND UPON lIE INSURER, ITS AGENtS OR
RePRERNTA nvES.
. .l.1~ArtlJ"illAIT"nvE GERALDD. SIMMONS INS.
ACORD 25-S (7/97)
It ACORD CORPORATION 1988
739895P
PERFORMANCE BOND
Contractor and City have entered into a written contract dated
, for the following project:
2007 Utilitv Construction. This contract is further referred to in this bond as the Contract and is
incorporated into this bond by this reference.
The conditions of this bond are:
I. If Contractor faithfully performs the Contract in accordance with the plans,
specifications and conditions of the contract within the time prescribed by the Contract,
as required by ORS 279C. 380 through 279C.385, then this obligation is null and void;
otherwise it shall remain in full force and effect.
2. If Contractor is declared by City to be in default under the Contract, the Surety shall
promptly remedy the default, perform all of Contractor's obligations under the contract
in accordance with its terms and conditions and pay to City all damages that are due
under the Contract.
3. This bond is subject to claims under ORS 279C.380 through 279C.390.
4. This obligation jointly and severally binds Contractor and Surety and their respective
heirs, executors, administrators, successors.
5. Surety waives notice of modification ofthe Contract or extension of the Contract time.
6. Nonpayment of the bond premium shall not invalidate this bond.
POWER OF ATTORNEY n>R
DEVELOPERS SURETY AND INDEMNITY COMPANY
INDEMNITY COMPANY OF CALIFORNIA
PO BOX 19725, IRVIf\;!;:. CA 92623 (949) 263-3300
KNOW ALL MEN BY THESE PRESENTS, that ~XCCpl as CApr(;Ss]y lillliH:d. DEVELOPI::RS SURETY AND INDEMNITY COMPAI\Y and INDl::MNITY
COMPANY OF CALIFORNIA, do each. hereby make, c,mslitu\(; and appoint:
***Blaine D. Williamson, Geri M. Burnett, Morag A. Corey, Lori D. Cunningham, Sean Flinn, Eric Englund,
jointly or severally***
as their true and lawful Attornl:yls)-in-FacL,1O ll1<lkc, CXl;CUlc, ddiwr and ackn\Jwkdgc, f(H and Oil behalf of said corporations. as sureties. bonds, undertakings
and contracts of suretyship giving and granting unto said Allorncy(s)-in-Facl full power und authority to do and to [lcrform every ael ncccSf':'I1Y. requisitc or propcl'
to be done in c{lllnectioll therewith ih c::Jch {lfsaid corporations could do. but n;s('rving to each of said corporations full power of subs tit uti Oil and revocation, and
al] of the acls of said AtlOrney(s)-in~Fac1. pursuant to these pres.:nts, are hereby ratified and confirmed.
This Power of Attorney is granted and is signed by facsimile under and by authority (If the following resolutions adopted by the respective Board of Directors of
DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, etlcclivc as ofNovembcr I, 2000:
RESOLVED, thaI the Chainnan oflhe Board, the President and any Vice President of tile corporation he, and Ihat each of them hereby is, authorized to
eXt'cute Powers ofAltomey, quulitying the allorney(s) named in the Powers of Allomey to execute. 011 behalf of the corporations. bonds, lltldcrtakillgs and COlllraCls
of suretyship; and fhat the Secretary or any Assistant Secretary of the l.'orporatiolls be, and each of them hereby is, alllhorized 10 altestlhe execution of any such
Power of Attorney;
RESOLVED. FURTHER. thatlhe signalures of sllch officers may be aftixcd to any -"uch Power of Attorney or to any ccrtitkat(; relating thereto by
tacsimik', and any such Power of Altorney or certitieate bearing such facsimile signaturc~ shall be valid and binding upon tile ..:orporation when so atlixed and in
the future with rc&pect to any bond, undertaking or contract of sun.~tyship to which it is anached.
IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPi\I'\Y and INDEMNITY COMPi\I'\Y OF CALlFORI'\IA have severally caused
these presents to be signed by their respective Executive Vice President and attested by their respel.'live S..:crclary this 1st day of Dcc(;mber. 2005
C------~ --
By___ ~) .::.~)
David H. Rhodes, Executive Vice-President
......"'''"...,,.
....\'< A.ND I"".....
,"","- ............. ,,"'....
l~ .....;~P01?4>..~.\
:: ,"v <<"'.-~~
lrJf OCT. \~S
~~~ 10 io~
;')\ 1936 /~j
-:..\)lo.... .,' b $
\...,~ .....!OW ~......~~ ....
......Q ........ ~......
"""""~"""""
By:
Walter A. Crowell. Secreta/)'
~~
STArE OF CALIFORNIA
]
COUNTY OF ORANGE
On December 1,2005 bdl.)]'c me, Gina L. Gamer, Notary Public (here insert name :!nd title of the otlicerj, person:!lly ;lppeared David H. Rhodes and
Waltt,1' A. Crowell. personally known to me (or proved to me onlhe basis ofsalisfllctO/)' evidence) to he the person(s) whose name(s) is/are &ubscribed 10 the within
instrument and aeknow]edged to me that he/she/they executed the same in hisl11er/lheir authorized capacily(ies), and thm hy his/herltheir signature(s) on lhe instrument
the person(s), or the entity upon behalf of whieh the person(s) acted. executed the instmmenl.
WITNESS my hand and official seal
Signature
~.~~
(SEAL)
j' . A & A . ~I~~ ~. ~~~~E~ A J
~Q COMM.#1569561 ~
5i NOTARY PUBLIC CALIFORNIA :J
~ ORANGE COUNTY "
~ . .MycC?,"!"-e.xp_ire~~_,1_3..2~.)
..........i.iJ..'#".
CER'f1FICATE
The undersigned, as Assistallt Secretary, ofDEVEL()PERS SURETY Af'\D INDEMf'\ITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,
does hereby eenify thai tht: ti.lrcgoing Power of Altomey remains in fullli.lfee and has 1101 been revoked, and furthermore, thar the provisions of the resolutions of
the respectiw Boards of Directors of said corporations set forth in the Power of At{orncy, are in force as oflhe dat~ of this Certificate.
This Certiticate is ext'cuted in lhe City of Irvine, Ca]ifc)mia. the 8 th day of
October
2007
By. ~I-- ~
Albert Hil]ebrand, Assistant Secretary
ID- I 3RO (Rev. ] 2/05)
c
-'"
'~9
~
COPY
,
,
<
.....~....;.
~
'~'~~::1~:: i
"A:~
iN'."-'
q.\TI. TORY 1'1 RUe WORKS Ilo'\n
','<i-.'
7':'6P;~::C
I t h ,. ,,1' ;l:~pb::\b:<',
'.1 P!~O" HOCK FX~:i~\"';\TrON. JNC .~~ ;',!:'...:n,J, ':ll1d
C:G..,i[L~5~~3_~_S.JR.= TV AND iNqFh.'NITY C:O,./PANY ;, ~'.Irp"l'al,cm _l.l.d,t']::d ;[l:ij ;ILlhOt lil'l~ If ,b
"'.:- 1)-.;".... il .; ',' :';1;1',;' uf \>:--:~'( :1. a:- :.,,!.:)_ ilr,' 1.~'U ~nd ;Inll:y hmlll(~ :'11.1.):/.- "(l!c' nf n-~J.)ll t',w th,' :i";,_" ~ll"C."')~' '.~';it ",f t:,c ():-'::.:Z'Ti
hlr'.':l.l"r ;'IK!1 ;l1h, :ndil~lnl.':" iBOL I, if. ~h' ":H!i ,If lbill\' t:-.C<U",;I;J J./h:-, ~";..;n.ooo) L:\\'(ul mo'..;y (.f II;.; l ,Ii',:,. Sic;:":::'> .1f _"\I~l(:ri...;)
. h.. it,!;: ,I;'. p,,!;. ;dc-J I" ( .'IRS ,:il;:p:",;- iq( ,tS ;:,;];,::1(1,::1 b\ 0: ~~..Jn La'.\'..; :l:l:<'. t'h;;y.~' ,H), \',ll w(u,::'; r.J.',"l:-_..;:rr -,I .~':l :11:\.1 in;l: 1:1 h,;~
I';~,;...: . ,.: hnj Ill.':<:': ','~'~, ~ "It '1i:11:'-. I'(.'r~('ndl rc~r;~~c:llall\'C:'. :..\L''':t::S.~:,),~ ,Lnt: .l.,...~,'-~;I.., .InIal I)' ;~tI(1 :-~\' ':;d[ I:" ;1;-1\11:_ !'y :h... "i:'r,;;-cr,,::nl
\','~' F\<! .\,-i. I:l~' :Ibt.\ t.: :"")l~:tl nril:L~lp,'d \"I~lh,'::<;:1) I'.e ~::gil~k !ll ~';(d, Ol! pnh ;.~ ',mr~" ;,:'",il.',"'I{:..i .;llbk'," ',', Ih:: rnn'i~if11h .11 ()RS ;:!i:lrkr
"e ,j'. ::It(J'!l!t:~i by OI\'.:~lln I.;I>\') :(;O_~. dli'l'h.::; JH't. ;t:d i.., ;!h:r"lon:, fl.:Lt; ;;.;\1 :;) Obi<<il: <\lid jjl~':l :,(l;,!!\l:) pibli\. \\0rkj 1)0:')(:;1
L l,,_;;;d :,:u\ ,,('i~.:I.(JI!;; ".lJ' :-.IC.I; 'h'''l1i'I~'~':;:, ,!lIto;\ ;:~ i~'''iuj:(.J j)'.,-",';al:1 I Ill",''' >.': )!S ,'i'~'::ll,'!';!. \~\~":"l Vi: ,-\.~.~Pl' Ir,",
":11',:), ~_--Ildi!!;n,'~l :','. i:.:\t'lt; :,\:t :~1!'lh
'\t i\\ ilIUU+i )RI., lI''';_'I\-u:.I;J'{\a~;)llh,~ i'W:'~',i:~i' nhil,;;11 01;:- ,in;: 1h.\I~:1(1 :1l'w.,'ip,i~ wi1:. :~;~,m\ :" ~t!1 h';'.j.. dn;A by 1:1;;: p~,:.( 1';,1
'" " ,.,,)1,', ".-l"r ,-," _I; ,..:,.}ll(;:',d,'~ ~l) Pll'"):,;;: \\,();-k,.; rl"1.~~G;;l~l'.), :~)i~lll pay ar ~;;,i.,~l':; (ll"dC'r~.! .~y iV}Ll ;,g2jl.~t ':h.-, rrilli:IP:d In \-,.-,)'kt.:r'~
:),':,,'nntt '.: LWll ;p\1!~ ':l'b]i~' \\ ,lj I;s r; "1,;.'1;<; h)r \l',\fai,1 "~';~gl.:~ ~kl~r:lH:,,:J In h..: d-.\,-, '1 :l.x"r~ianL'C wilL (, :o!{S- d"illr:.,.:r 2~')(". ::, ,:I\lJ;'l:dC'c:
!,> (Ir,':-::w ".'''~ :nt..... d'::;~1;':1 _,(;(1, ~nd O'\lt 1."!1;lr!er ~ 'n). '.h,a U: ~ Ilhlh,,~:\;:'_l:' sl;;!lI t);,: \'nill: n'.h:;,',-i'l~ \11 n~r:J:!in ir: fli:lpln: ,ilIill'f~<'::(1
-. H; 11"'1,1 -", n.., ,:.'\,~1I';:"";- purl',~,"'l~ II" ;),IYI;IL"I, t::' '.\;;I~C ''::Uill,,I, OrdC~(l: [1:-- :~OU:o \'.od<;;r:-. p..:rto!mml.': ;,::)0: ~~pf,:: ,)db:.:.: Wi_d(s
1'~-"I";"'(:-"1' .I::~,,'dall';~~ with f)RS '.+:'11''''1' ....~;)C ;1". ,iln:l1'I(,.; 11\: ()'ernn L,w.~ _>mS, (h,-,.P:LT .:6il
')I:~ I:pqd ,,1'.;1:1 1>-.. ,~:H': ~'.'l1~! . ,b: i': ta":lP;!1 :lllt-! s.:,r-:l',' .;:^c\:~ll...' !:Jl:' ~l:.:r;x,ll,:"'
. ("l:.;':'! :'-' ~- ,Il,'I'lH;:' th... ,.1' ':~al'()ll
11"'.;\l;-:~'~ (,;II\' .tUh:llli\', ~t,~ !';J1n:~,'l1i.JII',\:\ ;~: (:;L: '\t..:..'
:,lu,,:-n. '-': \11 '),\\d~ D:\ U);'k; fOTH
\.~~;y ('.1 AUGUST
~o 01)
'"I', '~r:
De~'elO:lt?l:-: Sr.Jiely /H:~ i.-I(:eliinrty C::.rlf).=l',....y
P il',.ip;;! :,...
Pjior f'<,,':'::K r~XC3<J:;tio;. :n:::
~'cve:'op03;.::; Sure'j P-Il(f 1;;dl::tll,ri;y COf"p.cH'>'
'S':.Ili
\-,,1:',
;,'."
I,...
,.:',,,,;....,,
\-1cl'nq :\, Corev
.';';"'i,:I,:
/.t,.,'nf'::,'~W'~;';C1
'FI:'.
,,;"-1', ".,.'
sl...:nW),"O'l'(k
Cuno;:ntctllJ' ('.1Il11 ~dl)l'. IIl1:1nl
~'() UO\ 1-.;J41)
>;:111-111, Ol~ 97.lIlC).=,"=-1
r~.I"lllulII~'; (:'03, J-::~--I(.ll
;J",
(,'1
.}1{j'i..
!.:r
II
CITY OF ASHLAND
CONTRACT FOR PUBLIC WORKS CONSTRUCTION
Contract made this ~ .J.h day of Q- k>,*--, 7607
between the City of Ashland, ("City") and Pilot Rock Excavation, Inc. ("Contractor").
City and Contractor agree:
I. Contract Documents: This contract is made as a result of an Advertisement for Bid
issued by City for the 2007 Utility Construction. Contractor was awarded the bid as the lowest
responsible bidder. In the event of any inconsistencies in the terms of this contract, the contract
documents defined in the Advertisement for Bid and Contractor's bid, this contract shall take
precedence over the contract documents, which shall take precedence over the bid. This contract
and attached exhibits constitute the entire agreement between the parties. No waiver, consent, or
modification or change of terms of this contract shall bind either party unless in writing and
signed by both parties. Such waiver, consent, modification or change, if made, shall be effective
only in the specific instance and for the specific purpose given. There are no understandings,
agreements, or representations, oral or written, not specified herein regarding this contract.
Contractor, by signature of its authorized representative, hereby acknowledges that he/she has
read this contract, understands it, and agrees to be bound by its terms and conditions.
2. Scope: Contractor shall begin and complete the project described in the contract
documents within the time prescribed in the contract documents. The following exceptions,
alterations, or modifications to the contract documents are incorporated into this contract:
3. Price & Pavment: City shall pay Contractor amounts earned under the contract. All
payments will be made at the times and in the marmer provided in the contract documents.
4. Performance and Pavment Bonds: Contractor shall, within five days after execution
of the contract and prior to doing any work under the contract, furnish bonds to the City of
Ashland in a form and with a surety satisfactory to City in the penal sum of $826,416.00
conditioned upon the faithful payment and performance of this contract upon the part of the
Contractor as required by ORS 279C.380.
5. Indemnification: Contractor 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 contract by Contractor (including but not
limited to, Contractor's employees, agents, and others designated by Contractor to perform work
or services attendant to this contract.) Contractor shall not be held responsible for any losses,
expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and
approximately caused by the negligence of City.
6. Insurance: Contractor shall, at its own expense, at all times during the term of this
agreement, maintain in force:
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\200S\OS-33 Contract Pilot Rock.doc
6.1 General Liability. A comprehensive general liability policy including coverage
for contractual liability for obligations assumed under this Contract, blanket contractual liability,
products and completed operations, owner's and contractor's protective insurance and
comprehensive automobile liability including owned and non-owned automobiles. 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.
6.2 Worker's Compensation. Worker's compensation insurance in compliance with
ORS 656.017, which requires subject employers to provide Oregon workers'
compensation coverage for all their subject workers.
6.3 Automobile Liability. Automobile liability insurance with a combined single
limit, or the equivalent, of not less than $1,000,000 for each accident for Bodily Injury
and Property Damage, including coverage for owned, hired or non-owned vehicles, as
applicable.
The City of Ashland, its officers, employees and agents shall be named as additional insureds on
each required insurance policy. Contractor shall submit certificates of insurance acceptable to the
City with the signed contract prior to the commencement of any work under this agreement.
These certificates shall contain provision that coverage afforded under the policies can not be
canceled and restrictive modifications cannot be made until at least 30 days prior written notice
has been given to City. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the
City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured
retentions and/or self-insurance.
7. Comoliance with Law:
7.1. This contract will be governed by and construed in accordance with laws of the State
of Oregon. Contractor shall promptly observe and comply with all present and future
laws, orders, regulations, rules and ordinances of federal, state, City and city
governments with respect to the services including, but not limited to, provisions of ORS
279C.505, 279C.515, 279C.520 and 279C.530.
7.2. Pursuant to ORS 279C.520(2) any person employed by Contractor who performs
work under this contract shall be paid at least time and a half pay for all overtime in
excess of 40 hours in anyone week, except for persons who are excluded or exempt from
overtime pay under ORS 653.010 to 653.261 or under 29 V.S.C. Sections 201 to 209.
7.3. Contractor is a "subject employer" as defined in ORS 656.005 and shall comply with
ORS 656.017. Prior to commencing any work, Contractor shall certify to City that
Contractor has workers' compensation coverage required by ORS Chapter 656. If
Contractor is a carrier insured employer, Contractor shall provide City with a certificate
of insurance. If Contractor is a self-insured employer, Contractor shall provide City with
a certification from the Oregon Department of Insurance and Finance as evidence of
Contractor's status.
7.4. Any claim, action, suit or proceeding (collectively, "the claim") between the City
(and/or any other or department of the State of Oregon) and the Contractor that arises
from or relates to this contract shall be brought and conducted solely and exclusively
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2005\05-33 Contract Pilot Rock.doc
within the Circuit Court of Jackson County for the State of Oregon. If, however, the
claim must be brought in a federal forum, then it shall be brought and conducted solely
and exclusively within the United States District Court for the District of Oregon filed in
Jackson County, Oregon. Contractor, by signature herein of its authorized representative,
hereby consents to the in personam jurisdiction of said courts. In no event shall this
section be construed as a waiver by City of any form of defense or immunity, based on
the Eleventh Amendment to the United States Constitution, or otherwise, from any claim
or from the jurisdiction.
8. Default: A default shall occur under any of the following circumstances:
8.lIfthe Contractor fails to begin the work under contract within the time specified, or
fails to perform the work with sufficient workers or equipment or with sufficient
materials to insure the prompt completion of the project, or shall neglect or refuse to
remove materials or perform anew such work as shall be rejected as defective or
unsuitable, or shall discontinue the prosecution of the work.
8.2 If the Contractor shall become insolvent or declared bankrupt, or commit any act of
bankruptcy or insolvency, or .allow any final judgment to stand against the Contractor
unsatisfied for a period of forty-eight (48) hours, or shall make an assignment for the
benefit of creditors.
8.3 From any other cause whatsoever, shall not carry on the work in an acceptable
manner.
8.4 Contractor commits any material breach or default of any covenant, warranty,
certification, or obligation it owes under the Contract;
8.5 Contractor loses its QRF status pursuant to the QRF Rules or loses any license,
certificate or certification that it required to perform the Services or to qualify as a QRF;
8.6 Contractor attempts to assign rights in, or delegate duties under the Contract.
9. Remedies: In addition to the rights and remedies to which the City may be entitled by
law for the enforcement of its rights under this contract, City shall have full power and authority,
without violating this contract, to take prosecution of the work from the Contractor, and
appropriate or use any or all of the materials and equipment on the ground that may be suitable
and acceptable and may cause a contract for the completion of this contract according to its terms
and provisions, or use such methods as required for the completion of the contract, in any
acceptable manner. All costs and charges incurred by the City together with the costs of
completing the work under the contract, shall be deducted from any money due or which shall
become due the Contractor. In case the expense so incurred by the City shall be less than the
sum which would have been payable under the contract if it had been completed by the
Contractor, then the Contractor shall be entitled to received the difference less any damages for
delay to which the City may be entitled. In case such expense shall exceed the sum which would
have been payable under the contract, the Contractor and the surety shall be liable and agree to
and shall pay the City the amount of the excess with damages for delay of performance, if any.
10. Termination:
10.1 Mutual consent. This contract may be terminated at any time by mutual consent of
both parties.
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJEC1\2005\05-33 Contract Pilot Rock.doc
~~-- '-_._--'~---r
10.2 Citv's Convenience. This contract may be terminated at any time by City upon 30
days' notice in writing and delivered by certified mail or in person.
10.3 For Cause. City may terminate or modify this contract, in whole or in part,
effective upon delivery of written notice to Contractor, or at such later date as may be
established by City under any ofthe following conditions:
a. If City funding from federal, state, county, or other sources is not obtained
and continued at levels sufficient to allow for the purchase of the indicated quantity of
services;
b. If federal or state regulations or guidelines are modified, changed or
interpreted in such a way that the services are no longer allowable or appropriate for
purchase under this contract or are no longer eligible for the funding proposed for
payments authorized by this contract; or
c. If any license or certificate required by law or regulation to be held by
Contractor to provide the services required by this contract for any reason denied,
revoked, suspended, or not renewed.
1004 For Default or Breach.
a. Either City or Contractor may terminate this contract in the event of a
breach ofthe contract by the other. Prior to such termination the party seeking
termination shall give to the other party written notice of the breach and intent to
terminate. If the party committing the breach has not entirely cured the breach within
15 days of the date of the notice, or within such other period as the party giving notice
may authorize or require, then the contract may be terminated at any time thereafter
by a written notice of termination by the party giving notice.
b. Time is of the essence for Contractor's performance of each and every
obligation and duty under this contract. City by written notice to Contractor of
default or breach, may at any time terminate the whole or any part of this contract if
Contractor fails to provide services called for by this contract within the time
specified herein or in any extension thereof.
c. The rights and remedies of City provided in this subsection (1004) are not
exclusive and are in addition to any other rights and remedies provided by law or
under this contract.
10.5 Obligation/Liability of Parties: Termination or modification of this
contract pursuant to subsections 10.1, 10.2, 10.3 and lOA above shall be without prejudice to any
obligations or liabilities or either party already accrued prior to such termination or modification.
However, upon receiving a notice oftermination (regardless whether such notice is given
pursuant to subsections 10.1, 10.2, 10.3 and 10.4 of this section, Contractor shall immediately
ceased all activities under this contract, unless expressly directed otherwise by City in notice of
termination. Further, upon termination, Contractor shall deliver to City all contract documents,
information, works-in-progress and other property that are or would be deliverables had the
contract been completed. City shall pay Contractor for work performed prior to the termination
date if such work was performed in accordance with the Contract.
11. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year
budget. Contractor understands and agrees that City's payment of amounts under this contract
attributable to work performed after the last day of the current fiscal year is contingent on City
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2005\05-33 Contract Pilot Rock.doc
-~--~-.-1
appropriations, or other expenditure authority sufficient to allow City in the exercise of its
reasonable administrative discretion, to continue to make payments under this contract. In the
event City has insufficient appropriations, limitations or other expenditure authority, City may
terminate this contract without penalty or liability to City, effective upon the delivery of written
notice to Contractor, with no further liability to Contractor.
12. Prevailing Wage Rates: The Contractor shall pay a fee equal to one-tenth of one percent
(0.1 percent) of price of this Contract. The fee shall be paid on or before the first progress
payment or 60 days from the date work first begins on the Contract, whichever comes first. The
fee is payable to the Bureau of Labor & Industries and shall be mailed or otherwise delivered to
the Bureau at the following address:
Bureau of Labor & Industries
Wage & Hour Division Prevailing Wage Unit
800 N.E. Oregon Street #32
Portland OR 97232
The Contractor shall fully comply with the provisions of ORS 279C.800 through 279C.870
pertaining to prevailing wage rates.
13. Living Wage Rates: If the amount of this contract is $15,964 or more, and Contractor
is not paying prevailing wage for the work, Contractor must 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
work under this contract. Contractor must post the attached Living Wage notice predominantly in
areas where it will be seen by all employees.
14. Before starting Work, the Contractor and subcontractor shall each file with the
Construction Contractors Board, and maintain in full force and effect, a separate public works
bond, in the amount of$30,000 unless otherwise exempt, as required by ORS 279C.836 and
OAR 839-025-0015. The contractor shall verify subcontractors have filed a public works bond
before the subcontractor begins Work.
15. Assignment and Subcontracts: Contractor shall not assign this contract without the
written consent of City. Any attempted assignment without written consent of City shall be void.
Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors
and of all persons employed by them, and the approval by City of any assignment or subcontract
shall not create any contractual relation between the assignee or subcontractor and City.
Contractor may not substitute any subcontractors from the submitted list of First-Tier
Subcontractor Disclosure Form without written consent of the City, or by following the
procedures ofORS 279C.585 and OAR 137-049-0360.
16. Governing Law: Jurisdiction: Venue: This contract shall be governed and construed in
accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of
laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim")
between the City (and/or any other or department of the State of Oregon) and the Contractor that
arises from or relates to this contract shall be brought and conducted solely and exclusively
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJEC1i2005\05-33 Contract Pilot Rock.doc
~-~-- ..-.-------,.----
within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must
be brought in a federal forum, then it shall be brought and conducted solely and exclusively
within the United States District Court for the District of Oregon filed in Jackson County,
Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to
the in personam jurisdiction of said courts. In no event shall this section be construed as a
waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the
United States Constitution, or otherwise, from any claim or from the jurisdiction.
17. MERGER CLAUSE: THIS CONTRACT AND ATTACHED EXHIBITS
CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER,
CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH
WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE
ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN.
THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL
OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY
ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT,
AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS.
18. Prior Approval Reauired: Approval of the City of Ashland Councilor Public Contracting
Officer is required before any work may begin under this contract.
CONT~ . //:'
BY:~~
Signature
~b4~
Printed Name
Its: ~ifi:S / LG"a
CITY OF ASHLAND
/~'~'7
'By: ~.,j.~ .t'~ ~_
Lee Tuneb
Administrative Services Director
REVI
ORM:
REVIEWED AS TO CONTENT:
By: ~ ./'
/-. Date:
Department Head If>pcr 'N"7
Coding:
(For City use only)
G:\pub.wrks\eng\deptMadmin\ENGINEER\PROJECT\2005\05-33 Contract Pilot Rock.doc
Project o. .
I QTY. I UNIT UNIT PRICE AMOUNT
NO DESCRIPTION (FIGURES)
Mobilization and Traffic Control
Mobilization $ $10,000.00
Dollars
1 for LS
Temporary Work Zone & Traffic Control, Complete $ $2,300.00'
2 for Dollars LS
Erosion & Sediment Control $ $1,500.00
for Dollars LS
3
Roadwork
Removal of Structures and Obstructions $7,500 $7,500.00
4 for Dollars LS
Earthwork $26 $6,292.00'
5 for Dollars 242 CY
Subgrade Geotextile Dollars $1.50 $1,090.50
6 for 727 SY
Utilities
6" HOPE Storm Drain Pipe $30 $150.00
7 for Dollars 5 LF
12" HOPE Storm Drain Pipe $60 $1,140.00
8 for Dollars 19 LF
18" PVC Storm Drain Pipe $80 $880.00
9 for Dollars 11 LF
18" HOPE Storm Drain Pipe $65 $1,820.00
10 for Dollars 28 LF ----""-"'-.. ______..._.____....."_m.__._________._....
..---
24" PVC Storm Drain Pipe $95 $7,885.00
11 for Dollars 83 LF
24" HOPE Storm Drain Pipe $88 $76,032.00'
12 for Dollars 864 LF
36" HOPE Storm Drain Pipe $200 $2,000.00
13 for Dollars 10 LF "__'._"._,_.__....m.. ...'....'-.-."......-......--,-,--"
n_.m.__......."....._.__.. .......-..
8" PVC SDR-35 (03034) Sanitary Sewer Pipe 601 $56 $33,656.00
14 for Dollars LF --'''''''-- --....--...-- -.............--"---"-................---....- .-.-....-------...-...........
48" Concrete Sanitary Sewer Manhole ! $3600 $3,600.00
15 for Dollars 1 EA
---.-- -------..-
48" Concrete Storm Sewer Manholes $3200 $12,800.00
16 for Dollars 4 EA
60" Concrete Storm Sewer Manholes $4000 1 $12,000.00
17 for Dollars 3 EA ..---------...,-......_- --------~.__.-..-,_..._---"._._---,-"._-----
REVISED AS NEGOTIATED ON 9/07/2007
BID SCHEDULE A
2007 Utility Construction
8th Street/Blaine/E. Main Improvements
N 2005 33
G:lpub-wrkslengldept-adminIENGINEERIPROJECTI2005105_33 Negociated Sch A & B 9 707.doc
----1'
DESCRIPTION QTY. UNIT UNIT PRICE AMOUNT
NO (FIGURES)
72" Concrete Storm Sewer Manhole I $7200 $7,200.00
18 for Dollars 1 EA
Area Drains $875 $1,750.00
19 for Dollars 2 EA
Sanitary Sewer Lateral Relocate (21 X 10') $450 $9,450.00.
20 for Dollars 21 EA
.-- t--.
Bypass Pumping Sanitary Sewer Dollars $6500 $6,500.00
21 for LS
Connect to Existing Sanitary Sewer Manhole $1200 $1,200.00
22 for Dollars 1 EA
Bases I $8,470.00
3/4" -0 Aggregate Base Dollars $35
23 for 242 TON
Wearing Surfaces
Level 3, 1/2 Inch HMAC Mixture $112 $13,776.00
24 for Dollars 123 TON
Concrete Drop Curb Dollars $25 $325.00
25 for 13 LF -- --~---------_.
Concrete 16" Standard Curb $25 $325.00
26 for Dollars 13 LF
Trench Patching $56 $13,496.00
27 for Dollars 241 SY I
SCHEDULE A BID TOTAL $243,137.50
ORIGINAL BID TOTAL $280,735.50
DIFFERENCE - $37,598.00
* Price negotiated from original bid
ENGINEER'S ESTIMATE $237,865.50
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2005\05_33 Negociated Sch A & B 9 707.doc
------,-- --
Project No. .
I OTY. I UNIT UNIT PRICE AMOUNT
NO DESCRIPTION (FIGURES)
Mobilization and Traffic Control
Mobilization $20,000 $20,000.00
Dollars
1 for lS
Temporary Work Zone & Traffic Control, Complete $35,000 $35,000.00'
2 for Dollars lS
Erosion & Sediment Control $3,500 $3,500.00'
for Dollars lS
3
Roadwork
Removal of Structures & Obstructions Dollars $7,500 $7,500.00
4 for lS
Earthwork $26.36 $70,000.00'
5 for Dollars 2655.5 CY
Minor Adjustment of Manholes Dollars $750 $750.00
6 for 1 EA
Adjusting Boxes Dollars $150 $1,200.00
7 for 8 EA
Replace Survey Monument & Monument Box $250 $1,250.00
8 for Dollars 5 EA -.------
Subgrade Geotextile $1.50 $4,603.50
9 for Dollars 3069 SY
Utilities
4" PVC SDR-35 (D3034) Storm Drain Pipe $28 $2,604.00
10 for Dollars 93 IF
6" HDPE Storm Drain Pipe $32 $2,560.00
for Dollars 80 IF
11
12" HDPE Storm Drain Pipe $42 $19,404.00
12 for Dollars 462 IF
8" PVC SDR-35 (D3034) Sanitary Sewer Pipe $58 $5,684.00
13 for Dollars 98 IF
15" PVC SDR-35 (D3034) Sanitary Sewer Pipe 746 $64 $47,744.00
14 for Dollars IF
18" PVC SDR-35 (D3034) Sanitary Sewer Pipe $52 $1,716.00
15 for Dollars 33 IF --.--- -.------.
48" Concrete Sanitary Sewer Manholes $3,500 $24,500.00
16 for Dollars 7 EA
60" Concrete Sanitary Sewer Manholes $5,600 $5,600.00
17 for Dollars 1 EA .~ --_.~-_._-
BID SCHEDULE B
2007 Utility Construction
A Street Improvements
2005 33
G:\pub-wrks\engldept-adminIENGINEER\PROJECT\2005\05_33 Negociated Soh A & B 9 707.doc
OTY. UNIT UNIT PRICE AMOUNT
NO DESCRIPTION (FIGURES)
- --
48" Concrete Storm Sewer Manholes $3,200 $19,200.00
18 for Dollars 6 EA
4" Storm Drain Clean Out $300 $1,200.00
19 for Dollars 4 EA --
Concrete 4A Curb Inlet $1,300 $2,600.00
20 for Dollars 2 EA ---.-.----.--
Concrete 2 1/2A Curb Inlet $1,100 $1,100.00
21 for Dollars 1 EA
Lynch Type CB Dollars $950 $1,900.00
22 for 2 EA
5" Channel Drain $86 $4,730.00
23 for Dollars 55 LF
12" Channel Drain $170 $3,400.00
24 for Dollars 20 LF
SS Lateral Relocate $90 $27,810.00
25 for Dollars 309 LF
Bypass Pumping Sanitary Sewer Dollars $,5000 $5,000.00
25a for 1 LS ----- -----..--.--
Connect Roof Drain $500 $1,500.00
26 for Dollars 3 EA
Trench Patching Dollars $56 $6,160.00
27 for 110 SY
Bases
3/4"-0" Aggregate Base Dollars 1023 $30 $30,690.00
28 for TON . . ---- ----.--.-.....---
4"-0" Aggregate Base Dollars 3973 $27 $10,7271.00
29 for TON
Wearing Surfaces
Level 3, Y, Inch HMAC Mixture Dollars $100 $84,400.00
30 for 844 TON
Concrete Curb and Gutter $25 $6,725.00
31 for Dollars 269 LF ..--....-.--.--.. ----------- -- ------
Concrete Mountable Curb and Gutter $25 $1,325.00
32 for Dollars 53 LF
Concrete 16" Standard Curb $25 $2,825.00
33 for Dollars 113 LF
Concrete Valley Gutter Dollars $15 $4,995.00
34 for 333 SOFT -"-- ----------
Concrete Sidewalks $6.50 $8,216.00
35 for Dollars 1264 SOFT -'---. "---'--
Concrete Sidewalks With Thickened Edge $7.50 $750.00
36 for Dollars 100 SOFT
Concrete Sidewalks Ramps Type B $675 $2,700.00
37 for Dollars 4 EA -------~-----_._.._-_._---- .'-.-- ----
G:lpub-wrkslengldept-adminIENGINEERIPROJECT\200SIOS_33 Negociated Sch A & B 9 lOl.doc
. -------r..-
NO DESCRIPTION ! OTY. UNIT UNIT PRICE AMOUNT
(FIGURES)
Commercial Driveway Apron $9.5 $3230.00
38 for Dollars 340 SOFT
._-_..,._.~._- -.'._..______.._...n____.___n___...___..___
Extra For AC Approaches $400 $400.00
39 for Dollars 1 EA
Stri~ng
Painted Permanent Pavement Striping, Complete Deleted $0.
39 for Dollars 1112 LF (by_~t.ti__
r---------------------
Painted Curb Deleted $0.
40 for Dollars 264 LF (by City)
Thermoplastic, non-profile, 120 MIL, extruded Deleted $0.
41 for Dollars 101 LF (by City)
Pavement Line Crosswalks Deleted $0.
42 for Dollars 432 SF (by City)
Type .W11-2" Signs in Place $52 $650.00
43 for Dollars 12.5 SF
Type .W16-2" Sign in Place $62 $186.00
44 for Dollars 3 SF
Pipe Sign Posts $700 $700.00
45 for Dollars LS
SCHEDULE B BID TOTAL $583,278.50
ORIGINAL BID TOTAL $638,216.50
DIFFERENCE . 54,938.00.00
* PrIce negotIated from original bid
ENGINEER'S ESTIMATE $469,454.50
G:lpub-wrkslengldept-adminIENGINEERIPROJECT\200SIOS_33 Negociated Sch A & B 9 707.doc
--~'--1'
BID SUMMARY
SCHEDULE A: 8TH /BLAINE/E. MAIN IMPROVEMENTS
SUBTOTAL $ 243,137.50
SCHEDULE B: A STREET IMPROVEMENTS
SUBTOTAL $ 583,278.50
REVISED PROJECT 2005-33 TOTAL BID: $ 826,416.00
ORIGINAL TOTAL BID: $ 918,952.00
DIFFERENCE: $92,536.00
Acknowledged by a~~
Pilot Rock Representative
Accepted by City of Ashland by
~~
~aula Brown
Public Works Director
lollV' '1h'J
G:lpub-wr1<slengldepl-adminIENGINEERIPROJECT\2005105_33 Negocialed Sch A & B 9 7 07.doc
Page 1/1
r~'
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
!;lATE
11/9/2007
PQ:l\ll:JMBIlR
07930
VENDOR: 010462
PILOT ROCK EXCAVATION
650 E PINE STREET SUITE 102B
CENTRAL POINT, OR 97502
SHIP TO: Ashland Public Works
(541) 488-5587
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
Q~antitv Unit Destrleilon Unit Price Ext Price
THIS IS A REVISED PURCHASE ORDER
Provide construction services for the 243,137.50
2007 Utility Construction Project 05-33
E. Main Street & 8th Street Sanitary
Sewer Replacement & Blaine Alley
Sanitary Sewer & Storm Drain .... ------------ - -
A Street Storm Drain & Sanitary Sewer 583,278.50
RFP
Contract start date: October 22, 2007
Contract completion date: June 30, 2007
Insurance required/On fHe
Approved by Council: 10/0212007
Project No. 200533.120
SUBTOTAL 826416.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 826,416.00
ASHLAND OR 97520
,
A~~-Ql,lnt-'N,um}:)l!lr . Project Number Amoullt' / Ac~c;umrN.l,lrn~'r ProjectNjJm~F Am,Qunt
E 260.08.17.00.70420 E 200533.120 338 830.58
E 260.08.34.00.70420 E 200533.120 82641.60
E 675.08.17.00.70420 E 200533.120 330 566.36
E 675.08.38.00.70420 E 200533.120 74377.46 .
I
/I~J
.&>1 ~ ~7
Authorized Signature
VENDOR COpy
CITY OF
ASHLAND
PROJECT ACCOUNTING WORKSHEET
PROJECT NUMBER (YEAR XX)
PROJECT TITLE
PROJECT DESCRIPTION
Department
Project Manager
Department Head
BUDGET INFORMATION
Identify fiscal year I potential splits
Identity Funding Code
and Funding Code name
DESIGN .100
Engineer Name
PO
COST
Change Orders
CONSTRUCTION .120
contractor name
PO
budget estimate
bid I contract total
changes
total
CONSTRUCTION MANAGEMENT .150
engineer name
PO
budget estimate
bid I contract total
changes
total
PERMIT COSTS (Building Dopt) .170
budget estimate
final costs
2005331
12007 MISCELLANEOUS UTILITY CONSTRUCTION PROJECT
The scope of this project will include the engineering and construction for several streets.
A Street Sanitary Sewer Replacement; Blaine Alley Sanitary Sewer and Storm Drain; Granite
Street Waterline Replacement
Public Works - Water SUP:~
Jim Olson J J'Ct?". /
Paula Brown
h06
IFY07
IFY08
s 675.08.39.00.704200 -12%
675.08.17.00.704200 - 30%
675.08.34.00.704200 - 3%
260.08.17.00.704200 - 12%
670.08.38.00.704200 -15%
670.08.38.00.704100 - 28%
s Wastewater, Street, Water Contracted Proiects
Hardey Engineering
$
1 $
2
4
6682
54,250.00
32,500.00
A Street Reconstruction! Blaine St Alley Storm Drain Extension
$
86,750.00
Pilot Rock Excavation Bid Schedule A - E Main, Blaine, 8th St
Pending 260.08.34.00.704200 $ 24,313.75 10% SD SDC
675.08.38.00.704200 $ 21,882.38 9% SS SDC
$ 826,416.00 260.08.17.00.704200 $ 99,686.38 41% STOPS
675.08.17.00.704200 $ 97.255.00 40% SS FEES
$ 826,416.00 $ 243.137.50 100%
Bid Schedule 8 - A Street Reconstruction
260.08.12.00.702400 $ 239.144.19 41% ST OPS
260.08.35.00.704200 $ 52,495.07 9% ST SDC
675.08.38.00.704200 $ 204.147.48 35% SS SDC
675.08.17.00.704200 $ 87.491.78 15% ST COl
$ 583.278.50 100%
$ 826,416.00
~~,
G:Pub-wrksJengldePt-adminJengineer/pro;ectlO5-33 Proj Acct Worksheet.xIs
---~ I
Page 26
CERTIFICATIONS OF REPRESENTATION
Contractor, under penalty of perjury, certifies that:
(a) The number shown on this form is its correct taxpayer lD (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:
"
--I<f.tL.. (I) 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.
1Zl+t..- (2) Commercial advertising or business 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.
fZ#t...- (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.
l1'LoT TaX./L ~4"Ti 0#-1
Contractor
t5//0107
, ,
Date
G:\pub-wrkslengldept-adminIENGINEERIPROJEC1\2005105-33 2007 Utility Canst Bid Document 7 07.doc