HomeMy WebLinkAbout2008-134 Contract - Univar USA
CITY OF ASHLAND
CONTRACT FOR PURCHASE OF GOODS AND SERVICES
, Contract made this
Ashland ("City") and
7th day of
Univar USA. Inc.
Mav , 2008, between the City of
("Contractor").
City and Contractor agree:
1. Contract Documents: This contract is made as a result of an Invitation to Bid issued by City
entitled "INVITATION TO BID" for CHEMICALS FOR THE WASTE WATER TREATMENT
PLANT. Bid No. #2008-101. Contractor was awarded the bid as the lowest responsible bidder
on Mav 7.2008 . In the event of any inconsistencies in the terms of this contract, the
contract documents defined in the invitation to bid and Contractor's bid, this contract shall take
precedence over the contract documents which shall take precedence over the bid.
2. Scope: Contractor shall produce and deliver the goods and services described in the contract
documents within the time prescribed in the contract documents. The following exceptions, alter-
ations or modifications to the contract documents are incorporated into this contract:
3. Price and Payment: City shall pay Contractor the following prices for the following chemicals:
Chemical #1 Sodium HVDochlorite (Northstar)
Estimated usage - March to November - 1 ,200 Gallons
Delivery charge: N/ A
$4.06/Gallon
Chemical #3 Sodium Hvdroxide (Northstar)
Estimated usage - March to November - 12,800 Lbs
Delivery charge: N/ A "
$0.7313/Lb
Chemical #4 Sodium Bisulfite (Northstar)
Estimated usage - March to November - 17,000 Lbs
Delivery charge: N/ A
$0.7744/Lb
Chemical #7 Calcium HVDochlorite (PPG)
Estimated usage - March to November - 1 ,200 Lbs
Delivery charge: $65.00 FSC
$1.90/Lb
4. Terms: The contract terms will begin on July 1,2008 and expire on June 30,2009. This
contract may be extended annually for two additional fiscal years, for a total of three years, if
mutually agreed upon by both parties.
5. This contract may be cancelled by either party with 30-days written notice.
BY ~t.U-l{.A 0_
S' ature
CITY OF ASHLAND
BY ~e ~berg ~ /
Finance Director
CORPORATE OFFICER
~ hr,wl'\t1~e1 ^" c. l ~ P""-1""h,
Print Name
BY
Title: "^ '4.,,; ,; r'~ 150ft e-. AI i 5r+
Fed 10 # t\, - 1-;A-1~ ~~
epartment Hyad
Oat ~/5L08
Coding ~~ ~ ~ / 'f tfltfl ~. C r GtflZ::;
Purchase Order CJc(i3 6 6
PAGE 1 of 1 - BID FORM/CONTRACT
ADDENDUM TO CITY OF ASHLAND
CONTRACT FOR PURCHASE OF GOODS AND SERVICES
Addendum made this 7th day of May. 2008, between the City of Ashland ("City") and
Univar USA. Inc. ("Contractor").
Recitals:
A. On May 7. 2008, City and Contractor entered into a "City of Ashland Contract for
the Purchase of Goods and Services (further referred to in this addendum as lithe
agreement") .
B. The parties desire to amend the agreement to include insurance requirements that
will apply to the contractor and transport carrier if different then contractor.
City and Contractor agree to amend the agreement in the following manner:
1 . 1. Insurance. Contractor shall at its own expense provide and maintain the following insurance:
a. Worker's Comoensation insurance in compliance with ORS 656.017, which requires
subject employers to provide Oregon workers' compensation coverage for all their subject workers
b. General Liabilitv insurance with a combined single limit, or the equivalent, of not less than
$1,000,000 for each occurrence for Bodily Injury and Property Damage. It shall include contractual
liability coverage for the indemnity provided under this contract.
c. Automobile Liabilitv 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.
d. Notice of cancellation or chanae. There shall be no cancellation, material change,
reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice
from the Contractor or its insurer(s) to the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland,
Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance
policies required herein but only with respect to Contractor's services to be provided under this
Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall
furnish acceptable insurance certificates prior to commencing work under this contract. The
certificate will specify all of the parties who are Additional Insureds. 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.
2. Except as modified above the terms of the agreement shall remain in full force and
effect.
CONTRACTOR:
BltY "M~~I ~t.
5 .tl\lL'l"^ ~f'e~i..li~
CITY OF ASHLAND:
BY
~J ~~
;~~/Jror
Date
Fed. 10 # '11 - 13tt-1" ~ '7
OR Social Security #
CONTENT REVIEW:~ \ ;b~ ~l
I / d (City ept. Head)
Date: 7 7 L/) ~
Purchase Order # C ~ g 0 G
DATE M.4\'1 \~, ")...00 CO Acct. No.: ~'7 ~ C& (1 tJ-{)
Addendum to City of Ashland Contract for Purchase of Goods and Services, Page 1 of 1,
---..r,--" ---
".,. ,..'"....'t'.;,;'~.,;-> "'.,..,""...;.-;......,...,:.,."..,,'.'...
ACORDTM
,,<, ,.-."._:.~.~.,,., ''''~h''''.~, ',' C.........;.~'li,..,;....~. ~.."-',<,
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.
INSR A
LTR INS
PRODUCER . .
Aon R1Sk SerVlces Central, Inc.
fka Aon Risk Services, Inc. of PA
One Liberty place
1650 Market Street
Suite 1000
philadelphia PA 19103 USA
PHONE. 866 283-7122 FAX- 847 953-5390
INSURED
UNIVAR USA INC
500 108th Avenue NE, Suite 2200
Bellevue WA 98004-5580 USA
TYPE OF INSURANCE
POLICY NUMBER
A
~E~~:~~ENERAL LIABILITY
CLAIMS MADE [!] OCCUR
X SIR: $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
~ POLICY D ~ 0 LOC
2802979
Tms CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
19445
19429
23817
..
Q,l
!
III
Q,l
~
...
..
Q,l
~
'is
:=
INSURER A:
INSURER B:
National union Fire Ins Co of pittsburgh
Insurance Company of the State of PA
Illinois National Insurance Co
INSURER c:
INSURER D:
INSURER E:
;~~~,,;~~:,;..
j,.'~~:,;'
POLICY
DA1'E(MM\DD\YY}
03/01/08
POLICY EXPIRATION
DATE(MM\DD\YY}
03/01/09
LIMrrS
EACH OCCURRENCE
S3 ,000 ,000
noo,ooo
S3,ooo,Ooo .-t
00
.
S3,ooo,ooo 0
~
.
S3,OOO,Ooo 00
N
0
0
,...
'"
S5,OOO,Ooo 0
Z
~
C-'
c
1:
Q,l
u
PERSONAL &: ADV INJURY
GENERAL AGGREGATE
PRODUCTS. COMPIOP AGG
A AUTOMOBILE LIABILITY 4806890 03/01/08
ANY AUTO Truckers Li abi 1i ty (AOS
A 4806891 03/01/08
ALL OWNED AUTOS Truckers Liability (MA)
A SCHEDULED AUTOS 4806892 03/01/08
Truckers Liability (VA)
HIRED AUTOS
NON OWNED AUTOS
A
ANY AUTO
EXCESS /UMBRELLA LIABILITY
~ OCCUR 0 CLAIMS MADE
BE7235031
DOEDUCflBLE
KJRETENTlON S5oo,Ooo
B
A
:~~~~~~~ON AND AOS
1591222
ANY PROPRIETOR I PARTNER I EXECUTIVE CA OH OR" WA
OFFlCERlMEMBER EXCLUDED? 1591223
If yes, describe under SPECIAL PROVISIONS WI
below
c
OTHER
03/01/09
03/01/09
03/01/09
BODILY INJURY
( Per penon)
COMBINED SINGLE LIMIT
(Ea 1ICCident)
BODILY INJURY
(per lICCideal)
PROPERTY DAMAGE
(per 1ICCident)
AUTO ONLY. EA ACCIDENT
OTHER THAN
AUTO ONLY:
EAACC
AGG
03/01/08
EACH OCCURRENCE
AGGREGATE
03/01/08
03/01/08
03/01/09
03/01/09
$1,000,000 =
$1,000,000 =
$1,000,000 Iii
~
it
~
ji;
...
c..-
~
;!i
llI:::..l!
8i
~
r:-
ifi
~~sP.-......- ~j~/~ .
-
E.L EACH ACCIDENT
E.L DISEASE-EA EMPLOYEE
E.L DISEASE-POUCY LIMIT
DESCRIPTION OF OPERATIONSILOCA TIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Bid #2008-101 & Bid 2oo8-102~ superfloc N-300 LMWi' Calcium H~pochlorite; caustic soda;. sodium Hypochlorite;
SBS; Location: Portland. City OT Ashland and all emp oyees are lncluded as Additional Insured on the General
Liability and Automobile Liability Policies with respect to written contract. univar is self-insured for physical
City of Ashland
Attn: Kari Olson
90 N. Mountain Avenue
Ashland OR 97520 USA
~.
SHOULD ANY OF TIlE ABOVE DESCRIBED POLlClES.BE CANCElLED BEFORE TIlE EXPIRATION
DATE TIlEREOF, TIlE ISSUING INSURER WIlL ENDEAVOR TO MAIL
30 DAYS WR1TI'EN NOTICE TO TIlE CERTIFICATE HOlDER NAMED TO TIlE LEFT.
BUT FAILURE TO 00 so SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON TIlE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
).
Attachment to ACORD Certificate for UNIVAR USA INC
The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage
afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy.
INSURER
INSURED
UNIVAR USA INC
500 108th Avenue NE, Suite 2200
Bellevue WA 98004-5580 USA
INSURER
INSURER
INSURER
ADDITIONAL POLICIES
INSURER
If a policy below does not include limit information, refer to the corresponding policy on the ACORD
certificate fonn for policy limits.
ADD'L POLICY NUMBER POLICY POLICY
INSR INSRD TYPE OF INSURANCE POLICY DESCRImON EFFECTIVE EXPIRATION LIMITS
LTR DATE DATE
AUTOMOBILE LIABILITY
4806893 03/01/08 03/01/09 Combined
A Convnercial Auto single LiRli S5 ,000 ,000
4806894 03/01/08 03/01/09
A Convne rci a 1 Auto
4806895 03/01/08 03/01/09
A Convne rei a 1 Auto
WORKERS COMPENSATION
1591221 03/01/08 03/01/09
B FL
1591224 03/01/08 03/01/09
C TX
DESCRIPTION OF OPERATIONSILOCATIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
damage to their vehicles.
Certificate No :
570028460481
.. -.- --...-----.- --.---- --- --- -------- ---.. --- -- ----.- ..._ ___.._._ 0- ._____ .....
ENDORSEMENT FOR
MOTOR CARRIER ,QUelES OF INSURANCE FOR PUBUC LIABILITY
UNDER SECTIONS 21 AND 30 OF THE MOTOR CARRIER ACT OF 1180
Issued to lftlVAR USA.. INe
Form Approved
all. No. 2125-0074
of 6100 CARILLON PT KIRKLAND. WA 98033-7357
~ of FeruarY 2008
Dilled at 101 HUDSON STREET JERSEY CITY NJ 07302
Amending Policy No. CA 48O-88-SIO
~DIIe
this ~
Name of Insurance Company,
Telephone Number L.212.) 770-7DOO CcuItIrIignId by,
The Policy to which thll endorHmerc is attached provides primary or excau lnaurance. . IndIc.aed by ..~.., for the Nmlta
I25JThil insurance II primary and the company Ihall nat be liable far amounIIln exceu of S 6 000 000
for each accident
UThiS inlUrance II UIC8SI and the compMy IhaII not be Mable for Mlounta In excesl of $ for HCh accident
In excess d the undertying Imlt of $ for -=II ac:cident.
Whenever required by the Federal HIgI1wly Admlniltration (FHWA) or the Interstate Cammerce Commission (ICC). the company ag.... to furnish the
FHWA or the Ice I dupllcata of laid policy and all .. endOrAlMrU. The company allo ...... upon telaphone r.quat by an authorized
representative of the FHWA or the Ice. to verify that the policy . in force al of. pertlcullr date.
Clnc.lIation of thil endcnemMt may be effected by the company or thlln..... by giving (1) ~ (35) days notice in wrDIg to the other party
(said 3e days notice to commence from the dIIe the noUce Is milled. proof of mIIIng IhIII be IUfIIcient proof of notice), and (2) lithe lnaured . subject
to the ICC'I jurisdiction, by Pf'O'Iiding thirty (30) days notice to the lee (said 30 days notice to commence from the date the notice . r8C8iv8d by the ICC
at .. oKlClln W.hington. D.C.).
DEFINITIONS AI USED IN THIIINDORIIIIINT
ACCIDENT Includel continuo.. or r8pMted expoIlft to condIIons damage, or deItruction of ....1 resources arlU1g out of the accidan-
which result In bodily injury. property dam.. or ..wonmental dIm- tal dilchllp. ditpernI. ,.... 01 MCIIPIlnto or upon the find, at-
. which the Insured neIher mcpected nor Intended moIphe.... waIercoune, or body of....... d any GOIMIOdIty
~pcHtIId by a motor c:arriw. Thil shaJllncluda the COlt of rwnoval
and the COlt of ...-.ry me...... taken to mlninlze or mligllle
damage to human MaIh, the natanl environment. "h, sheIfIIh. and
wild..
PROPERlY DAMAGE me-. dlmage to or IoIs of &De of__1e
properly.
MOTOR VEHICLE means a "nd vehicle. machine, truck. tractor. trai1-
er, or Mmitraller prapeIIed or drawn by mechanical power and UNCi
on a highway far transporting property, or any combination thereof.
BODilY INJURY mea", lr1ury to the body, slckneaa. or dlleue to
any person, including ct.. rwullng from any of tMH.
ENVIRONMENTAL RESTORATION means ...tlution for the 101..
PUBLIC LIA8IUTY m..... I8bIIty for bodly Injury. property dam-
.. and envIror........ .-oration.
The insurance policy to which this ~ II attached provides
automObIle "billy luurlnce end IIlmned to iliUM complanee
by the insured. within 1M Imits ....ed henIin, a. . motor carrier of
property, with SectIonI 29 and 30 cI the MoIDr Carrier Ad. of 1980
and the rulel and Mgulltlona of the F..... Hlghwly Admlnlatrltlon
(FHVVA) and the Interstate Commerce Commiuion (Ice).
or violation ttweaf. .....u ntIeve the company tram IIabIIly or from
the payment of lIlY tInII judgment, wIhkt the 1mb of labllly herein
. deIcribed, irNIpective of the financial concItion, Insolvency or
b-*nIptcy of the lnIured. However, alii term~, conditions. and Imi-TtaIIanIln the poICy to which the IncIorIImerC IIIlt1ch1d shall...
main In fuI farce and effect. blnclng ~ the insInd and the
COII'IplIny. The InIunId IIgI8U to r81rnburse the company for InV pay-
ment macIIlPi the company on ICcount of any accIdem. clUn, or
suit IrwoIvIng a breach of the tenna of the policy, and far.., pay-
ment .... the CGIIIPMY would not have been obligated to make WI-
der the PIWIIJona of the policy ucapt for the .....nt gontalned
In thiI endonemn
In conalderation of the prMIium atated In the policy to which this en-
dorsement IIl1bched, the In.... (lhe company) agl'Hl to PII)'. wllhln
the 1mb of "billy descri)ed .... any final Judgment recovenMt
agalnlt the Insured for public aabllly f8IUItIng flam negIgenoe In the
operation, maintenance or use of motor vehleln IUbject to the fInan.
ciaI responsIMlity reqWlMtenta of Sections 29 and 30 of lhe Motor
CarrIer At;t of 1880 reg8ldlesa of whether or not _ch motor vehicle
il speciftcally dwaibed In the poley and whether or noasuch negJi.
gence occura on any route or in My territory authorlzecl to be Ierved
by tha Insured or eIIewh... Such In..,rance .11 atrarded. for pub-
lic liability, does not apply to Injury to or death of the lnsUNd's em- The limb of the company's IIabIly for the amoulU pracrIbed In
ployeea while engageclln the COUrH of their employment, or property this ~ent apply .....teIy. to each accident. and any p8y-
transported by the insured. deslgnal8d u cargo. It II uncIeratood and ment under the policy becaUM of MY one ac:cldent ...... not operate
agreed that no condition, provision, stipulation. or imitation contU1ed to reduce the IIabIIty of the company for the payment of final judg.
In the policy, this endorsement. or any other endonement thereon, merdI ....ding from any other IlCCIdea
The Motor Carrier Ad. of 1880 AIqUireIlmb offtnanclal responllblty according to the type of carriage and commodity tr8nsported by the motor carrier.
It is the MOTOR CARRlER'S obligation to obtain the f'tICIURd 1mb of financial .,onaibilly.
THE SCHEDULE OF UMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE.
The limits .hown In the lChedule .. for Infonnallon purpaua onI'i.
Form MeS"
It II further Wldlrltoocf and agrwd that, upon failure of the company
to pay any InaI judgment recovered against the inlured . provided
hnln the judgment CNdIor may IMIntaIn an aGIIon in any COUIt
of compet8~ jurildk:tion egainlt the company to compel.uch
payment .
IQl8r)
UNFORM PfUNTIIG" SUPPLy, ttC. 1IC1_ (Ed. S-eI)
Type of Carriage
(1) For-hire (In i1terstate or foreign
commerce) . .
(2) For-hire and Private (In Interstate.
foreign, or i1trastate commerce).
(3) For-hire and Private (In interstate or
foreign convnerce: In any quantity)
or (In Intrastate commerce: in bulk
only).
(4) For-hire and Private (In interstate or
foreign commerce).
SCHEDULE OF UMITS
Public UablUly
ComlllOdlty T.....ported
Mlnlmwn
In.urance
Property (nonhazardous).
$
750,000
Hazardoul IUbstances, as defined in 49 CFR 171.8,
trMaported in cargo tanks, portable tanka, or hopper-type
vehlclea with capacitiea in ... of 3,500 water gallonl:
or In bulk Divisions 1.1. 1.2, and 1.3 materials; any quan-
IIty of Division 2.3 Hazard Zone A or Dlvlaion 8.1. Packing
Group 1, Hazard Zone A material; in bulk Division 2.1 or
2.2; or highway route controlled quantities of a Class 7
materiel.. defined in 48 CFR 173.403.
5,000,000
Oil listed In 49 eFR 172.101; haurdoUl materlall and
hazardous substances deftned In 49 CFR 171.8 and IIted
in 49 CFR 172.101, but not mentioned In (2) above or (4)
below.
1,000,000
Any quantity of DIvialon 1.1, 1.2 or 1.3 material; any quan-
tity of . Divlllon 2.3, Huard Zone A. or Division 8.1,
Packing Group 1, Hazard Zone A materi8t or highway
rou18 controlled quantltie. of a Cia.. 7 material a.
defined In 49 CFR 173.403.
5,000,000
Note: The type of carrilge Dated under nwnbera (1), (2), and (3) applies to vehicle. with a gross vehicle weight rating of 10,000
pounds or more. The type of cantage listed under number (4) Ippllel to II vehicles with a gross vehicle weight rating of Ie.. than
10,000 pounds.
SCHEDUle OF UMITS
Pubic LIIblllty
For-hlre motor canters of passengers operItiIg In Interstate or foreign commerce
Vehicle Seating Capacity
MInImum
I..urance
(1) Any vehicle with a seating capacity of 18 pauengers or more.
(2) Any vehicle with a seating capacity of 16 peuengera or Ie...
.. -~_. a._._a......_ -. -..-- --.- ...- --...__... _..__ ..__ __ .._._ ._. _..__. _ ... _._____ _a _
ENDORSEMENT FOR
MOTOR CARRIER POUCIES OF INSURANCE FOR PUBLIC L1ABIUTY
UNDER SEcnONS 28 AND 30 OF THE MOTOR CARRIER ACT OF 18.0
1.1ued to UNIVAR USA INe
Form Approved
OMI No. 2121-0074
of 8100 CARILLON PT. KIRKLAND WA H033-73S7
~ of FeblUMl 2008
Dated at 101 HUDSON S~. JERSEY CITY NJ 07SQ2
thI. 2"
Amending Policy No. CA 48Q.88-91 Effective olte 0310112008
T:::'~peWi =U~SRE~U~--/.~~
ThePolcy"'_lhIsond_Is_~prlnwyor_~. ~
I2SJThi. inlurance is prinary and the COInPMY 1h8l1 not be liable for amounta In .... of S 5 000.000 for each accident
Una Insurance II excell and the com~ny Ihd not be IIIbIe for amounts In UCIII of $ for each accident
In UCla of the undlrlying 11m. of $ for uctI accident.
Whenever required by the Federal Highway Administration (FHWA) or the Interltate Commerce Commlnion (ICe), the can.." IgI8H to fumllh the
FHWA or the ICC a dupbte of uid policy and 811 ita endorHmenll. The company Ilia ...., upon f8Iephone teqUllt by an authorized
repreHntatlve of the FHWA or the ICC. to verfy that thl policy II In foice . of a pertlcullr dete.
Cancellation of thiI endorHmlnt m8y be eIrected by the CGmJ)My or the InIUNd by giving (1) thirty.Iw (35) dap notice In writing to the other party
(said 35 days notice to commence from the date the notice II m8led. proof of mailing Ihd belUfllcient proof of naIIce), Ind (2) If.... iIIIIINd .IUbject
to the ICO'I jurlldlctlon. by providing thirty (30) dayI notice to the ICC (MId 30 daya notJca to cammence from the date the notice II recMd by the ICC
at Itl afflce In Wahlngton. D.C.).
....J
DEFlNmONl AI USED .. THIS ENDORSEMENT
ACCIDENT Includel contInuoua or ,.pelted .....,. to conditions dim.. or deltructIon of nat&n1...oUIWI ...Ing out of the acdden-
which ...ulln bodily ir$Uy, property clam..." or environmental dn- till dllcharge, cIIperuI, ....... or IIcape Into or upon the land. It-
age which the In.. ......r expecIed nor Inlended 1IIOIphIre, --=aura, or body of "WI of.., canamodlty
tranIported by a malar carrier. Thlllhalllncluda the COlt of rwnoval
Ind the COlt cf MCIUIfy meaures taIc8n to mlr*nize or mitigate
damage to tun.. ....... the natul'lll environment. fiIh. lheIIfIIh. and
wIIlIIIit.
PROPERTY DAMAGE means dam. to or l01I cf UII of tlnglbIe
property.
MOTOR VEHICLE meanl a land whicIe, machine, truck, tractor, iraI-
ere or ..-nltraller propeIed or drawn by mechanical power and used
on a highway for transporting property. Of any cambiMtIon theNof.
BODILY INJURY means Injury to the body. Iickn.... or d...... to
any pe..on, Inckldlng death resulting from any of theM.
ENVIRONMENTAL RESTORAnoN IMInII'IIlItuUon for the lon,
PU8UC LIAIIUTY me.. IIabIity for bodily ""IY. PIQPIIty dwn-
age. and envinnnental fIItorItion.
The insurance poley to whlc:h thIIendcnMlent fa attached ~
automobile liability Insurance and II amended to ...... c:ompIiance
by the Inlured. within thelmlll ItnKt ........ . . motor CIn'IIr of
property, with Sections 29 and 30 oftlle Motor Carrier Act of 1880
and the rules and reguIItlons of the Federal Highway Adminlltration
(FHWA) and the In........ Commerce Cammlllion (lCC).
In consideration of the premium 1t8ted In the policy to which this en-
donem.,t II attached. the IMurer (the campany) 11II.... to ~, wthln
the 11mb of "billy delcrtbed herein. any trill judgment recovered
agaInlt thl '..ufld for public; IiabIlty ....,lIIng fram negligence In the
operation. maintenance or use d motor whIdes aubject to the flnan-
cllI reaponll)lIty requlreme_ of Section8 29 and 30 of the Motor
CarrIer NA. of 1880 NIl.... of whIIw or not each motor vehicle
is speclically deIcrIbed In the policy and wheth. or not such neg1i-
gence occurs on any route Of In lAY tenIory authoriad to M IIrvecI
by the Inaured or elMWhere. Such Intnnee _ 1I1ffon1ed. for pub-
lic liability, does not apply to Injury 10 or death of.... Inlurad'1 em-
ployees while _"Ned In the cou,.. of their amplayment. or praperty
transported by .... Inaured. dellgnaIed . cargo. It " uncleratood and
agreed that no concItIon. provision, 1*,,1atton. or limitation cam.Ined
In the poUc:y. thll endorsement. or any other endcnement theNOn,
or violation thereof, ...11 ..u.v. the company from IiIIbIty or from
the payment of any ftnII jUdgm... wII*\ the IImIIa of IiabQy herein
cIeIcrtbed. imtIpectlve of tile IInIncIaI condIIon, InIoIvency or
bar*ruptcy of tile inauNd. Howwr, all terma. condIJonl, and tin!-
tItionstn the policy to which the ~ II attached ..... ..
mail In ful foD and etrect . blndklg bItwaen thllnlurecland the
eompany. The InIUR1d ag....1D relmburle the campany for any pay-
ment made by the company on ICCaIft 01 any acc:ident. claim.. or
lUll InvoIeIq a bleach of the tennI of the pot_. and for any pay-
ment that the cam~ would not have been obIgated to mllel un-
der the prcwtalanl of the policy -=apt for the agr88lMnt contained
In this endorIemelt
It " further understood and ag,.... that. upon falu,. of the company
to pay any flnll judgment recovered against the InIUNd a provided
herIIn the judgment cncIltor mllY mUDin an ac:IIon in any court
of competM1t JurlldlcIIon against the company to compellUCh
payment
The 1mb of the company-. llabilty for the amcudl prescribed In
this endorIM\ent ..",ey 1II*atIIY. to each ICClIcIIN. and My pay-
ment under the poIlq bICIu. cI any one accident thai not operate
to reduce the IIabiay of the company far the peyment of final judg-
menta IelUIing fram any other accident.
The Motor Carrier Act of 1UO nMlufrea 11mb of ftnancIaIlWPOnIIbIIy ICCOIdmg to .. type of carriage and commodity tranIpoIted by th. mDtor c:.m.r.
It Is the MOTOR CARRIER'S obIgation to obtain the requRd 1mb of 1nIncIa118lJM)nllllty.
THE SCHEDULE OF UMITS SHOWN ON 1lE REVERSE Sa: DOES NOT PROVIDE COVERAGE.
The limits shown in the schedule a,. for in~n..atiran pu,.. en,.
Form MCS-80
pur)
UNIFORM PRINTING & SUPPlY.1NC. 1IC1~ (Ed. 3-86)
Type of Canlage
(1) Foroohlre (In Interstate or foreign
commerce) .
(2) For-hire and Private (In Interstate,
foreign, or intrastate commerce).
(3) For-hire and Private (In interstate or
foreign commerce: In any quantity)
or (In intrutIte commerce: in bulk
only).
(4) For-hlre and Private (In Interstate or
foreign commerce).
SCHEDULE OF LIMITS
PubUc UIlblntv
Commodity T.....ported
"nlmum
.......nce
Property (nonhazardous).
$
760,000
Hazardous substances, 8S defined in 49 CFR 171.8,
transported In cargo tanka, portable tanks, or hopper-type
vehiclea with clpec:itiea in exceaa of 3,500 water galon8;
or in bulk DIvision. 1.1, 1.2, and 1.3 m8terIII8: any quan-
tity of Dlviaion 2.3 Hazard Zone A or DNilion 8.1, Packing
Group 1, Hazard Zone A mlterial; In bulk Division 2.1 or
2.2; or highway route controlled quantities of a CIaa 7
material II defined In 49 CFR 173.403.
5,000,000
01 lilted in 49 CFR 172.101: hazardous IMteriaII and
hazardous aubetancea defined In 49 CFR 171.8 and listed
In 49 CFR 172.101, but not menloned In (2) 8bove or (4)
below.
1,000,000
Any quantity of Dlvlllon 1.1, 1.2 or 1.3 malerial; any quan-
tity of a Division 2.3, Hazard Zone A, or Division 6.1.
Pecking Group 1. Hazard Zone A m81.....; or highway
route controled quantities of a Class 7 meteri8I a.
defined In 49 CFR 173.403.
5,000.000
Note: The type of carriage Ii8ted under numbers (1), (2). and (3) applies to vehicles with a grosl vehicle weight rIti\g of 10.000
pounds or more. The type of carriage Bsted under number (4) appl.. to all vetKies with 8 gross vehicle weight rating of leas than
10.000 pound.. .
SCHEDULE OF UMITS
Public Uablllty
For-hlre motor carriers of pasaenge,.. opet1lting In i1terstate or foreign commerce
Vehicle Seating Capacity
Minimum
Insurance
(1) Any vehicle with a seating capacity of 18 PMlengell or more.
(2) Any vehicle with a Beating capadty of 16 panenge... or I....
ENDORlI!MENT FOR
MOTOR CARRIER POUCE8 OF INSURANCE FOR PUBLIC UABlUTY
UNDER SECTIONS 21 AND ~O OF THE MOTOR CARRIER ACT Of 1'80
Islued to UNIVAR USA INC
Fonn Approved
0118 No. 2126-0074
at 8100 CARILLON PT ICIRKLAND WA 98033-7357
dly of Februarv 2008
Dated at 101 HUDSON STREET JERSEY CITY NJ 07302
this 29"
Amending Policy No. CA 480.&8-92 EfJective oate O3IOtI2D08
Nameofl_Coonpooy ~UNIOtiFnlEINSlIWCeCOllPANY ~~. .'.- . ~-f:. ___ _,..
T_ N_UW 77O-!!!!!L ~ Irt -!-- --' J~:J..~~~ ~
The Policy to which this endorsement illttacMd provides primary or a:eu Insurance, _indicated by -101", for the Imits 1hcMri.
ICJThIs Insurance is primary 8I\d the company Iha. not be lilbll for amountlln exceIl 01 S 5 ODD 000 far each aCCIdent
UThls NUf1nC:8 II excess and the company lhall not be IIbIe for amountlln IXICeII of S for Nett acddtnt
in excesl of the undeftying lima of $ for each ac:cideM.
Whenever required by the Fed.,.1 Highway Administration (FHWA) or thllnlerstate CoIIIrmeI'Ce Commllllon (Ice). the compeny ag.... to fumIIh the
FHWA or the ICe a duplicele of said policy ... .. its endcnernentI. The COfn.-.y ~ IgrMI, upon telephone rwquest by an IUthorizled
reprn.-etatNe of the FHVVA or the ICe, to v.rify that the potq II in bee ..of a particu_ ....
Cancellation 01 thIt endOl'l-.nt may be decled by.... COIIII*1Y or the inlurwd by giW1g (1) thirty-fiw (35) .. noUcIln writing to.... other p..ty
(said 35 days notice to commence from the dlle the nota II m.... proof 01 mlllno aMII be IUfflcieIt proof of notice). and (2) If the insured ilsubjec:t
to the ICC's jurtldlction, by pnMding thirty (30) clays notice to the ICC (Aid 30 daya notice to commence from the cia. the noIIce .. ~ by the Ice
at its office in W.hington. D.C.). '
DEFINITIOHI AI WED IN nil ENDORSlEMENT
ACCIDENT IncIudaI continuoul or repealed upoaure to condllfonl damage. or dIItructIon of natlnl ~ arising out of the ICCiden-
which result In bodily Injury. property Urnage, or anvironmental dim. ... dllchllp" dIIperuI, ....... or IlClpe Into or upon the lind, at-
age which the Inlured neither expected nor Intended ........., ........rae, or body of...., of any cammodIty
"-peNd by a motor cwrIer. This IhIIII tncIud8 the COlt of removal
and the COlt of......ry rneaMnI tlk8n to minimize or mltlgale
dim. to ~ ....h. the Mlural environma. fiIh, "'h, II'\d
wildlife.
PROPERTY DAMAGe mea.. daagelo or Ian 01 u.. of tangIJIe
praperty.
MOTOR VEHICLE melna IIMd vehicle, machine, truck. tracIor. trill-
-, or .....Itra.... prapeIIed or dl'llWf1 br mechanical paww II1d UHd
on I highway for tranlPOf1lng prgpeIty, or any combination therwof.
BODILY INJURY mea.. i"'ry to the body, 11ckneI1, or dIIeIIe to
any p81"1Oft, including delllh resulting from any of theM.
ENVIRONMENTAL RESTORATION mnna ratltutJon for the loll,
PUaIC LlABLITY meanslilbillty for bodily injury. property dam-
., and emlnnnental NItcnUon.
The Inaur8nce policy to Which this endarHment 18 IttIlched pravid8I
aut0m0biie labllIy insurance and Is amended to auure complance
by the insand, wIIhln the .mltl stated haMln, U a mator carrier of
property, wIIh Sectlona 29 and 30 01 the Motor Canter Act of 1980
and the ruIu and reguletfons of the Feder8' HIghwBy AdmfniIntian
(FHWA) and the Interstate Commerce Commission (ICe).
or violation tMMof, shall relieve the company flam IIebaty or from
the payment of 11ft final JudgmeN, within the 1mb of liability herein
dHcrIMNI, inespecttve of the flnMciaI condllon, inIohMncy or
bankruptcy afthe Inaw'ed. However, aU tenna, oondIIona, and lini.
tations In the paley to which the encIcnement II attached .... re-
main in fuI farce and e<<ect . binding ...... the InIUIed and the
comPMY. TllBInIured agrIU to rMnbUrMlhe cam'*'Y for any pay-
ment made .., the con'IPIftY on lcaount of any ICCIdent, cIUn, or
lUll 1nvoMng. -.ch of the tlrml of the pollet, and for 11ft ~
ment that the aampany would nat have been obIgIled to make &11-
der the provIIionI of the poley except for the IgIWTIent contained
In thll..~t
In conlkWation of the prM11urn Ilated In the poley to which thII ..
dol'HfMl1t is attached, the lnaurer (the GOmpuy) ....10 ~. .....
thelinita of Milly _cribecI her8in. my final judgment IKGVenId
aglinlt the InIwed for public Iiabi8y .-..1tIng from neglgeuoe In the
operation, maintenance or use of motor vehiclu lubJect to the Inan-
dal ....pontiblt)' ,.quirements of SeeIIona 29 and 30 of the Malor
C.m.r Act of 1980 regardless of whether or not each malor whicIe
II speclficaly described In the polley and whether or not such negli-
gence OCCUI'I on any route Of' In any terrltory authorized to be MMd
by the insured or .......... Such insuranc. . II afforded. for pub-
lic lilbility, does not apply to I"wy to or death of the InIUr8d'l em- The Imltt of.. company'11abIity for the IInOUIU ~ In
pIoyees whit engaged In the course of their employment. or praperty thll ~ apptj lepll'ltet{. to each ac:c:ldn. and any pay-
transported by the lnIured, deligMled .. cargo. It Is underItood and rnent under'" poley because of any one acddent IhII not operata
agreed that no condition, provIaion, 1~1Iion, Of' IIrnlation contained to ntduce the WIIay of the company far the payment of final judg-
In the policy, this endOlMnHtnt, Of any other endorsement thereon. menta _uIIiIrJg tom ""I other eccicIeIL
The Motor CarrIer Ad of 1980 NqUIrelIimIta of financial ~ 8CCOIding to the type of CMiage and commodity transported by the motor carrier.
It Is the MOTOR CARRIER'S obligation to obtain the rlquild ImIII rI hncIaI......-,.
THe SCHEDUlE OF lIMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE.
"fM, IIml1e ehown In the cchedule are for lnIonnatlan purpo... only.
PonD uet.1O
It .. further ~ and .... that, upon .... of the company
to PlY any ftnII judgment ~ apinIt the ill..... u pnMd8d
herIln the juIJgmem CHditor may maintain In ICtlon In any court
of competR jurildiction againat the comp8ny to compel such
paYll*ll
(Over)
UNFORM PRINTING & SUPPLy, Me. MC1122a (Ed. 3.)
Type of CalTlage
(1) For..,lre (In interstate or foreign
commerce) .
(2) For...,ire and Private (In irterat8te,
foreign, or Intrastate commerce).
(3) For-hlre and Private (In interstate or
foreign commerce: in any quantity)
or (In Intrastate commerce: in bulk
only).
(4) For-hlre and Private (In tnterstate or
foreign commerce).
........ ... ... .-... I' ..--
SCHEDULE OF UMITS
Public Uabillty
Commodity Tran.ported
Minimum
lnaurance
Property (nonhazardous).
$
750.000
Hazardous substances, 88 defined in 49 CFR 171.8,
transported In cargo tanka, portable tanka. or hopper-type
vehicles with capecltiea in excelS of 3,500 water gallons:
or In bulk Dlvlslonl 1.1. 1.2, and 1.3 materials; any quan-
tity of Division 2.3 Hazard Zone A or Division 6.1. Picking
Group 1, Hazard Zone A material; in bulk Dlvilion 2.1 or
2.2; or highway route controlled quanllllel of 8 Clasa 7
material al defined In 49 CFR 173.403.
5.000,000
OiIlsted in 49 CFR 172.101: hazardous materials and
hazardoullubltancel delned in 48 CFR 171.8 and u.ted
in 49 CFR 172.101., but not mentioned In (2) above or (4)
below.
1,000,000
Any quantity of Dlvlalon 1.1. 1.2 or 1.3 mat8ria1: any quan-
tily of a DivllIon 2.3, Hazard Zone A, or DlviIion 6.1,
Pecking Group 1, Hazard Zone A material; or highway
route controhd quantitiea of a Clan 7 mat.rial .1
defined in 49 CFR 173.403.
5.000,000
Note: The type of carriage lilted under numbers (1), (2). and (3) appliel to vehicles with 8 grosl vehicle weight retlng of 10,000
POUndl or more. Thelype of carriage listed under number (4) apples to al vehicles tMth a gl'Oll vehicle weight rating of IeI8 than
10,000 pound..
SCHEDULE OF UMITS
Public Liability
For-hlre motor carriers of paaaengera operati1g In Interstate or foreign commerce
v..... SeatIng CapacIty
Minimum
....urane.
(1) Any vehicle with a seating capacity 0'18 passengers or more.
(2) Arty vehicle with a seating capacity of 15 paasengers or leu.
CITY RECORDER
Page 1 / 1
r.,
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
DATe
7 n /2008
I I
PQi,Nt..1MSER
08386
VENDOR: 000191
UNIVAR USA INC, ACCT#146175
FILE #56019
LOS ANGELES, CA 90074
SHIP TO: Ashland WWTP
(541) 488-5348
1295 OAK STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net 30 days
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: David Gies
Confirming? No
>. ....i. .... ...Unit , Q,.enpti()rl l.JmtPJ~ice ~iPttQe
> ,.....i ..
1.00 Load WWT Chemicals, Invitation to Bid 2,509.60 2,509.60
2008-1 01
Sodium Hydroxide (270 Gallon/Load)
Price per pound $0.7313, Approximately
12.71 Lbs per Qallon, Delivery chO: N/A
2.00 Load Sodium Bisulfite (270 Gal/Load) 2,299.97 4,599.94
Price per pound $0.7744, Approximately
11.00 Ibs per oallon, Delivery cho: N/A
7.00 Load Sodium Hypochlorite (350 Gal/Load) 1,421.00 9,947.00
Price per oallon $4.06, Delivery chO:
N/A
SUBTOTAL 17 056.54
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 17,056.54
ASHLAND, OR 97520
Ac:cquotN..uno.1' f'rOjectNUlllber Am()IJnt .. Account Numtier ProjeetNiJr'I'd:t"r Amourit
E 675 08 1 9 .00 60 1 50C 1 7.056 54
~ .:4.- - ~ed !:'fnf-m1f
VENDOR COpy
for a
CITY OF
ASHLAND
REQUISITION FORM
THIS REQUEST IS A:
D Change Order(existing PO #
Dale of Request: l~t~?F~
Required Dale of DeliverylService: I" I
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
i/ /II V It I?
uSt9 ..rye
"
SOLICITATION PROCESS
Small Procurement
o Less than $5,000
o Quotes (Optional)
Reauest for ProDosal
(Copies on file)
SDeCia11 ExemDt
o Written findings attached
o Quote or Pro sal attached
Emeraencv
o Written findings attached
o Quote or Pro sal attached
Intermediate Procurement
o (3) Written Quotes
(Copies attached)
o Copy of contract attached
o Contract #
Invitation to Bid
(Copies on file)
Description of SERVICES
Osed rlJ c/eqfIL "'1P;,i~Q'1l-s,
Total Cost
o Per attached PROPOSAL
Item #
Quantity
I
~
7
Unit
/oaof
L f; ads
'Description of MATERIALS
S ~ a!,v,..., fA I'D )(lcI e (,< ? 1) 'Ci /
5ocOcI~ 13,.>u!.f,f/::.. (;;}O a/ ~
5tJ 1(./ ^"- 0 c h 0 (',-Ie
Unit .Price
Total Cost
/0 qe/S
c2 SOl. faD
'"I
~;) 99.~7
~tj~/.OO
~ StJ9t&O
Lf;597.9Y
~9Lj7.0o
o Per attached QUOTE
Project Number _ _ _ _ _ _ . _ _ _
Account Number~li.Qt.Ltt .tl.Q~OLSj).1J
It Items and services must be charged to the appropriate account numbers for the financials to ref/ect the actual expenditures accurately.
By signing this requisition form, I celtify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can ~rovided uTquest. ~ . A_
Employee Signature: {)~ g~ SupervisorlDept.HeadSignature: ~'J1tu.Q ~
G: Finance\Procedure\AP\Forms\B_Requisition form revised.doc
Updated on: 412912008
-----------TTr.