HomeMy WebLinkAbout2008-240 Contract - Waters Consulting Group
r.,
C I T Y 0 F C:TY RECORDER
ASHLAND IT ----~ r
20 E MAIN ST. L 11/24/2008 J l
ASHLAND, OR 97520
(541) 488-5300
Page 1 /1
..o~ 1
VENDOR: 013809
WATERS CONSULTING GROUP
5050 QUORUM DRIVE SUITE 625
DALLAS, TX 75254
SHIP TO: City of Ashland
(541) 488-6002.
20 E MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Depl: ADMINISTRATION
Contact: Tina Gray
Confirming? No
Fire Chief Recuritment Services
Total professional fees $17,500.00
Total not to exceed professional fees
and project related expenses $25,000.
25,000.00
Contract for Personal Services
Date of aQreement 11/06/2008
BeQinninQ date 11/07/2008
Completion date. 05/01/2009
Insurance reQuired/On file
Payment terms per attached contract:
300/0 of the fees will be billed at the
beQinninQ of search; 300/0 at the
implementation of Phase II; 3001<> at the
implementation of Phase III; and the
final 1 001<> upon acceptance of offer by
the candidate.
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
II
~~~~ zY/o
A rized Signature ;p
VENDOR COpy
A request for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
THIS REQUEST IS A:
D Change Order( existing PO #
Date of Request:
Required Date of Delivery/Service:
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
{WAry.,$-(JUJAfJ I
SOLICITATION PROCESS
Small Procurement o Sole Source o Invitation to Bid
o Less than $5,000 o Written findings attached (Copies on file)
o Quotes (Optional) o Quote or PropOsal attached
CooDerative Procurement g:> Reauest for ProDOsal
o State of ORIWA contract (Copies on file)
Intennediate Procurement o Other government agency contract o SDecial1 ExemDt
o (3) Written Quotes o Copy of ~ntract attached o Written findings attaChed
(Copies attached) o Quote or Proposal attached
o Contract # o Emeraencv
o Written findings attached
o Quote or Proposal attached
Description of SERVICES
Per attached PROPOSAL
Total Cost
~~nve- fl.BC~/TW1~1fr SGlLVta,l?S FOfL FI/lG ~H 1/3F?-
Item # Quantity Unit
Description of MATERIALS
Unit Price
Total Cost
Project Number ______. ___
01
Account Number 1 to.. .11. ~~ . J)(}. ~O!:JLDIL
* Items and services must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately.
o Per attached QUOTE
By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can be provided upon request. ~
Employee Signature: Ju1i.PJI~ SupervisorlDept. Head Signature: "t~~
G: Finance\Procedure\AP\Forms\8_Requisition form revised
Updated on: 11/512008
----, -
CITY OF
~SHLAND
Memo
DATE:
TO:
FROM:
RE:
November 5, 2008
Lee Tuneberg, Administrative Services/Finance Director
Tina Gray, Human Resource Manager
Selection of Waters-Oldani Group, Inc.
Last night the City Council gave us authorization to enter into a contract for professional recruitment services
with the Waters-Oldani Group, Inc. We were extremely pleased with all responses from the competitive bid
process, but we ultimately selected Waters-Oldani Group, Inc. because their proposal was able to
demonstrate excellence in several key areas that we feel will have a positive impact on our recruitment
efforts for a successor Fire Chief:
· They have a very in-depth screening process and provide' a very detailed analysis of the
candidates they recommend as finalists.
· They are a recruitment leader throughout the nation and have a broad network of candidates to
draw from.
· They have a high commitment to placement of minority and female candidates.
· They conduct a thorough background investigation on each candidate that is invited to on-site
interviews.
· They assist with developing and customizing the interview process and questions.
Thank you for your assistance with the bid process.
Sincerely,
.
~~
Tina Gray - Human Resource Manager
ADMIN SERVlCESlHUMAN RESOURCES
20 E Main Street
Ashland, Oregon 97520
www.ashland.or.us
Tel: 541-488-6002
Fax: 541-488-5311
T TY: 800-735-2900
1'&'
~-_.-
Contract for PERSONAL SERVICES Less than $25,000
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONSULTANT: Waters-Oldani Executive Recruitment, A
Division of Waters Consulting Group, Inc.
CONTACT: Charles Anderson, CEO
ADDRESS: 5050 Quorum Drive Suite 625, Dallas, TX 75254
TELEPHONE: 972-481-1950
DATE AGREEMENT PREPARED: November 6,2008 FAX: 972-481-1951
BEGINNING DATE: November 7,2008 COMPLETION DATE: May 1,2009
COMPENSATION: Total Professional Fees $17,500.00, Total Not-to-Exceed Professional Fees and Project
Related Expenses $25,000.00
SERVICES TO BE PROVIDED: Fire Chief Recruitment Services (Per proposal submitted October 9, 2008.)
ADDITIONAL TERMS: Per the professional fees (Page 18-19 of proposal) 30% of the fees will be billed at the beginning of the search; 30%
at the implementation of Phase II; 30% at the implementation of Phase III; and the final 10% upon acceptance of offer by the candidate.
FINDINGS:
Pursuant to AMC 2.52.040E and AMC 2.52.060, after reasonable inquiry and evaluation, the undersigned Department
Head 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; (3) the statement of work represents the department's plan for
utilization of such personal services; (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; (5) the consultant's proposal will best serve the needs of the City; and (6) the
compensation negotiated herein is fair and reasonable.
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: If the amount of this contract is $18,088 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 500/0 or more of the service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B 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 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 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 losses, expenses, claims, subrogations,
actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
Contract for Personal Services, Revised 07/01/2008, Page 1 of 9
--,-----
10. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. 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.
c. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
written notice to Consultant, or at such later date as may be established by City under any of the following
conditions:
i. 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;
ii. 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
iii. If any license or certificate required by law or regulation to be held by Consultant to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Consultant may terminate this contract in the event of a breach of the 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 the 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.
ii. Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. ObliaationlLiabilitvof Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Consultant 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 Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
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. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify asa QRF if
consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business
on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or
delegate duties under, the Contract.
14. Insurance. Consultant shall at its own expense provide the following insurance:
a. 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
b. Professional Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1.000.000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
c. General Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1.000.000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
d. Automobile Liabilitv insurance with a combined single limit, or the eQuivalent, of not less than Enter one:
Contract for Personal Services, Revised 07/01/2008, Page 2 of 9
-----,----
$200,000, $500,000, $1.000.000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
e. 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 Consultant or its insurer(s) to
the City.
f. Additional Insured/Certificates of Insurance. Consultant 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 Consultant's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Consultant 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 Consultant shall be financially responsible for all pertinent
deductibles, self-insured retentions andlor self-insurance.
15. 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, lithe claim ") between the City (and/or any other or department of the State of Oregon) and
the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively 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. Consultant, 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.
16. 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.
CONSULTANT, 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.
17. Nonappropriations Clause. 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. Consultant
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 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 Consultant, with no further
liability to Consultant.
Certification. Consultant shall si n the certification attached hereto as Exhibit A and herein incor orated b reference.
CONSUL ~N~ CITY OF ASHLAND:
BY BY
TITLE
.
~eV\\ ovVP Df- Op.L.voch~
DATE
DATE
, \ III J ;).-0 Ot)
I
CONTRACT AWARD AND FI DINGS DETERMINED BY:
By: ) 1- ZY-V~
Date:
City Department Head
Approved as to
form by Legal:
FederallD#
15 - dd l~\3 Y
ACCOUNT #
-( r ~ tfJ I ~ 9 tJ-...t7 t!l ~ r CJ-O
(For City purposes only)
*Completed W9 form must be submitted with contract
PURCHASE ORDER #
tCt16f76
Contract for Personal Services, Revised 07/01/2008, Page 3 of 9
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 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, (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:
~
V
i/
.....
Contract for Personal Services, Revised 07/01/2008, Page 4 of 9
----,----- -
Fo"" W-g
(Rev. Octpb<< 2007)
Department arthe Treasury
Internal Revenue $erviC.e
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
Business name, if different from above
,. T/'tc-
Check appropri1ate box: 0 Individual/Sole proprietor Corporation 0 Partnership
o Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) ~ _ _ c _. _ _
o Other ($&& in$lructionlS) ~
Addr&$$ (number, atre . nd apt. or suit& no.)
50~ Dv. :5~ (P;J5""
Cit)!
C\i
CI)
Ol
co
a.
c
o
CI) III
i~
t5!:l
....i
Cc
'1:_
l1.(.)
!E
(.)
CI)
i
CI)
~
Nam~ (8$ shown on your incom~ tax retu~ _
/h.L W ~Y'.S LUJ I'L6 u..L-h
'Ix
List account Olmber(s) here (optional)
75;)5
Taxpayer Identification Number (TIN)
o Exempt
payee
Requester's name and address (optionaQ
I Social 887 num~r
or
Enter your TIN in the appropriate box. The TIN provided must match the name given on Une 1 to avoid
backupwithholQing. 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 (EI N). If you do not have a number, see How to get a TIN on page 3.
Note. If the aC90unt is in more ~han one name, see the chart on page 4 for guidelines on whose
number to enter.
Certification
Under penalties of pe~ury, I certify that:
1. The number shown On this form is my correct taxpayer identification number (or I arn 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 ama U.S. citizen or other U.S. person (defined below).
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.
~~~ I ~-:;f~ ~-I)'~
,
General Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
Purpo.s, of Form
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
Use Form W~g only if you are a U;$, person (including a
resident aIiEm). 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 fora number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claimexemption from backup wijhholding if you are a U.S.
exempt payee. If applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income from
a U.S. trade or business is not subject to the withholding tax on
foreign partners' share of effectively connected income.
Note. If a requester gives you a form other than Form W-g to
request your TIN,. you must use the requester's form if it is
substantially similar to this Form W:.g.
Contract for Personal Services, Revised 07/01/2008, Page 5 of 9
Em oyer identification n~lber
:5': r1l f) 1 ~ / 3 V"
Dat& ~
/II 17 ja-oOI
Deftnhlon of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
. An individUal who is a U.S. citizen or U.S. resident alien,
. A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
states,
. An estate (other than a foreign estate), or
. A domestic trust (as defined in Regulations section
301. 7701 ~7).
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners' share of income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner isa foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner ina
partnership conducting a trade or busineSS in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding
on its allocable share of net income from the partnership
conducting a trade or business in the United states is in the
fOllowing cases:
. The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231X Form W-9 (Rev. 10-2007)
----,-- ....
ACORD.. CERTIFICATE OF LIABILITY INSURANCE OPID xo I DATB CMMIDD.'VV'N)
lIUD.-l 11/13/08
PIIODUCI!R THIS CEJmFlCATE IS ISSUED AS A MAnER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERnFlCATE
Lewis IleDderson Insurance AqeIl HOLDER. THIS CERTIFICATE DOES NOT AIEND. EXTEND OR
12..5 Sout:.hridp Ct. '101 ALTER THe COVERAGE AFFORDED BY THE POLICIES BB.OW.
lluJ:at D 16053
Pbofte:81'-282-3234 ~ax:811-282-9046 INSURERS AFFORDING COVERAGE NAJC .
.._~- . . -
INIUMD INSURSR/4;. ~ LLOm8 ~ co
INSURER B; ADMIRaL INS'O'lWtCB CDR>>rr
!rile Waters C0D8u1 tUia~oF INSURER c: IIM'1'rOlm UMDaIRWlU1'Ul IMI co
~O ~tJH DtaVB, S 2 INSURER 0:
1... U 15254
INSURER i:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOlN HAVE BEEN ISSllEO TO THE INSURED NAAED ABOvE FOR THE POUCY PERIOO INDICATED. NOTWmlSTANOING
ANY REQUlREMENT. TERM OR CONDITION OF ANY CON"TRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlFtCATE MA.Y BE ISSUED OR
Mt\Y PERTAIN, 1lE INSURANCE AFFORDED BY THe POLICIES DESCRIBED HEREIN IS SUBJECT 10 AU THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POUCIES. AGGREGATE UMlTS SHOWN MAV HAVE BEEN REOUCED BY PAlO CI..AIMS..
~ ~ -. ~
TYPE ~ INSUMIICIi POUCV NUMBEft DAn UIITI
GaNBAL UARJTY EACH oeCl...IAAENCE , 2000000
- 05/08/08 I;EMiSis (Ea 0CCUlWC*)
A X~ COMMERCIAL GENEAAL. UA8IlITV .6SBARK0324DX-TX 05/08/09 . 300000
1- =:J CLAIMS MADE 00 OCCUR I MED EXP (Anyone .-.on. . 10000
PERSONAl & N:JV INJURY . 2000000
- ------.-
GENERAl. AGGREGATE S 4000000
- -----.---.. ----
GEN'L AGGREGATE l.IMlT APPt.IES PER: PRODUCTS - COMPIOP Aoo . 4000000
~ POUCY r-l ~i n LOC
AU'TOM<*LE LIA8IUTY I CO_NED SINGLE LIMIT
A X =i ANY "UTO 46SBUK0324DX 05/08/08 05/08/09 lEa~ $ 2000000
-I ALl. OWNED AUTOS 800lL Y INJURY .
~ SCHEDUlED AUTOS (Per pertOI'I)
X HIRE1) AUTOS BOD II. Y INJURY
~ NON-oWNED AUTOS (Per 8Cddtnl) .
Ii PROPERTY DAlAAGE S
(Ptr ICCident)
GMAGE 1.IABIlJTY AUTO ONlY - EA ACCIDENT S
==J ANY AUTO - OTHER THAN EAACC $
AUTO ONLY: AGG ,
. EXCESSlUIIBRELLA LWIILI'1Y EACH OCCURRENCE $
o OCCUR D CLAIMS ~DE AGGREGATE $
i $
R= $
$ .
WOIIKERS COWDISA'nON AND X IrorrvClUNWS I xlueR
~ IJAIILITY
C ANY PROPRETQRJPARTNERJEXECUTlVE 4611BCGD9092 04/16/08 04/16/09 E.L. EACH ACCIDENT ,$ 1000000
OFFICERIMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ 1000000
If,.s. deIa'lh undet
SPECIAL PftOVISlONS below E.L DISEASE - POUCY uurr . 1000000
OTHER
B BRRORS &. OtMXSSION BOOOOOOO738-1.2 11/07/08 11/07/09 BA CLaIM 1000000
* (SBB BBLOIf) AGeJUcaD 1000000
DaCNPl10N OF OPEUTlONS I LOCA11CINS I VEHIClES' EXCLU8ION8 ADDl!O .., ENDOIltSEMINT I '..ClAL PIlOYl8ION8
* CLAI:MS ImDB 1'0_ REftO DABS: 11-1-97
12-12-00
RlD': UCRU~ FOR nRB CHDr
crrr 01' ASHLAND, 0RZGMf AND ns OITXCBRS AU SHOIIR AS ADDnIOJ.G\L IBstJUD AS
RBSPBCTS ~ GBNBRAL LiABJ:L7TY/AD'.rO
CERTIFICATE HOLDER
CrrY or ASHLAND
20 BAST NaD SlfSItBBT
ASHLAND OR 91520
CANCELLATION
CZOI"ASB SNOlA.D ANY Oil THE AIIOVB DII~ID IIOLICIH.. ~_t t eft IIIIFORR THa IXPIRATION
DAD THDE01. THE 18SU8tG IN8UItEIt WILL ElllDMVOft TO 11M. ~ DAYS WIITTiN
NOTICE 10 THI cm\TlllCATIE HQt.DI!R NAIII!D TO". LIPT,IIUT PM.UIII1O DO 10 ,"AU.
IMPOS NO 0MJeaA'nQN OIl ~ OF NIV UPOI THI Oft
~"TIVU.
AUTHOftIZI!D RE........ "
ACORD 25 (2001108)
-~'':.'" ....... -..:::':=:...
.. 4-"..E~~..~~
~, .; :~:.~~~ .'
**om.y - usPBC.'i ~ m ~R' S' SBllVICBS m BB PROVlDm UlIDBR
BaS COJr.l'RAC1' (AOOnXORAL DISUltBD).
PI.USB BB ADVISBD ~ nil IlIStJIWltCB COMPANY W%LI. ~ ALLOW TBB
~Olf CLAUD TO BB ALDRBD. DB1UI XS ALSO NO BlIDORSENID1'l ALLOWBD !'O
TBB ~OB CONDI'%IORS !'OR 'lBB POLXC'!'
~ I'OLLOIIDlG GIU1BRAL LrABILIn COVBRAGB PART INCLUDBS 'lHB ADDrrIONAL
INStJBBD WORDING, 1iAXVBR 01' StJ.BllOGMlION AND J?lU:JARY-NOR CON'nlJ:BtJI1IORy
lIOaDntG
-..- 4~'~:'"...~
. .;;._::/~.;.a
~ - ~:?f~