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HomeMy WebLinkAbout2008-256 Contract - Bertocchi Builders Contract for GOODS AND SERVICES Less than $25,000 CITY OF ASHLAND 20 East Main Street Ashland, Oregon 97520 Telephone: 541/488-6002 Fax: 541/488-5311 CONTRACTOR: Bertocchi Builders CONTACT: Mark Bertocchi ADDRESS: 2010 Skyview Drive, Medford, OR 97501 TELEPHONE: 541-944-7137 DATE AGREEMENT PREPARED: 12/11/2008 FAX: BEGINNING DATE: 12/03/2008 COMPLETION DATE: 01/18/2009 COMPENSATION: $6,400.00 Per attached proposal dated 11/19/2008 GOODS AND SERVICES TO BE PROVIDED: Contractor to remove and replace select cabinets. Build new cabinets to new specs and install with new laminate counter tops. ADDITIONAL TERMS: NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work 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. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Goods shall be paid for within 30 days of an invoice after delivery of goods conforming to the standards and specifications. 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. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 279B.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $18,088 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 8. 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 proximately caused by the negligence of City. 9. 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 Contractor, or at such later date as may be established bv City under any of the following Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 1 of 9 . -~'~'T 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 Contractor 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 Contractor 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 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. 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. Obliaation/Liabilityof 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, Contractor shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the 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. . 10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any requirement of ORS 279A.11 0 or the administrative rules implementing the Statute. 12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 13. Assignment and Subcontracts: Contractor 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. 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. 14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor 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. 16. Insurance. Contractor shall at its own expense provide 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 Liability 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. c. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $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. Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 2 of 9 -----~-__-_-~n--r 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. AdditionallnsuredlCertificates 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 andlor self-insurance. 17. 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 Contractor 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. 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. 18. 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. 19. 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. 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 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. 20. Prior Approval Required Provision. Approval by the City of Ashland Councilor the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. CONTR CITY OF ASHLAND: BY TITLE L)~//I~ DATE /~7 (:)/ DATE /~ - /~ - C) ~ CONTRACT AWARD AND FINDINGS DETERMINED BY: By: Date: FederallD# :It -2.1g'rSJ/20 ACCOUNT # /,/,tl CJ ~ r;z. "c; (For City purposes only) PURCHASE ORDER # t7 18 7 ;L ~ *Completed W9 form must be submitted with contract Contract for Goods and Services Less than $25,000, Revised 06/30/2008, 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 10 (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: (1) I carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or 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. (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. //?/ /\~~')--/.t-/2-0r Contractor (Date) Mb- m!2 ~ ,116 Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 4 of 9 -----------------~ 'T Form W-g Request for Taxpayer Identification Number and Certification Give fonn to the requester. Do not send to the IRS. (Rev. o.ctober 2007) Department of the Treasury Internal Revenue Servic,e Name ( ~ Check appropriate box: D Individual/Sole proprietor Corporation D Partnership D Limited liability company. Enter the tax classification (D=disregarded entity. C=corporation, P=partnership) ... __ D Other (see instructions) ... AddreS$ (number, street, and apt. or suite no.) / (,) S~ / Enter your TIN in the appropriate box. The TIN provided must match the name given on Une 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get 8 TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Certification Under penalties of perjury, I certify that 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal RevenUe Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. 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 repOl"t 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 inst ions on pa e 4. C\i CD Cl co a. c o CD III ~j ~g cil 'C -E D..CJ :e CJ CD i Q) ~ Taxpayer Identification Number (TIN) o Exempt payee Requester's name and address (optional) I Social eecurity number . . or Sign Here Date ~ /2." /2-0 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose 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~9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and. when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claimexemption from backup withholding 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-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Deftnltlon 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 is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a 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) Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 5 of 9 T - Binder of Insurance Pending issuance and delivery of a policy pursuant to the application of the insured and to all the terms and conditions of the policy issued by the company the State Farm Mutual Automobile Insurance Company Does hereby insure: MARK BERTOCCHI DBA BERTOCCHI BUILDERS 2010 SKYVIEW DR MEDFORD, OR 97501-4239 Policy Number: 002 6612-E25-37J Year Make 2005 CHEVROLET K2500 PICKUP Vehicle Identification Number (VIN) 1GCHK23235F847007 Liability 100/300/50 Coverages Comprehensive $250 Collision Ded $1000 Effective December 16, 2008, expiring not to exceed thirty (30) days hence and to become void immediately upon the issuance of a policy in place hereof. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES. Date ~. (bt/A ,'JCX)?i -----~ r OP 10 JM DATE (MMJDDIYYYY) BBRTO-2 12 15 08 THIS CERTIFICATE IS ISSUED AS A MATTER 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. ACQf1D.. CERTIFICATE OF LIABILITY INSURANCE PRODUCER Rainier Insurance, Inc. PO Box 2562 Corvallis OR 97339-2562 Phone: 541-760-1929 Fax:54l-754-7182 INSURERS AFFORDING COVERAGE Bertocchi Builders, Inc. Mark Bertocchi 2010 Skyyiew Dr Medford OR 97501 INSURER A: INSURER B INSURER INSURER 0 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POtlCIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS TYPE OF INSURANCE POLICY NUMBER GENERAL UABILlTY COMMERCIAL GENERAL LIABILITY I BINDER CLAIMS MADE [!] OCCUR 04/12/08 EACH OCCURRENCE l)AMA\;i1: I V HI:N I I:U ~~REMISES (E8 oceurence MED EXP_(Anyoneperson! PERSONAl & ADV INJURY GENERAl AGGREGATE PRODUCTS - COMPIOP AGG Em Ben. COMBINED SINGLE LIMIT (Ea accident) ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY. EA ACCIDENT OTHER THAN AUTO ONLY EXCESS/UMBRELLA LIABILITY OCCUR [~J CLAIMS MADE NAIC# LIMITS $ 1, qoo, 000 $ 100,000 $ excluded -------- $ 1,000, OOO_._~ $ 2 # OOO_!J?gQ___. $2,000,000 excluded $ $ $ EA ACC $ EACH OCCURRENCE $ -....--.---..--..-.....-..--------- ---y_.._,-~~..^,._-_.-~---._,....~-_._-- AGGREGATE $ AGG $ DEDUCTIBLE l RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I ANY PROPRIETORIPARTNERJEXECUTIVE j OFFICERJMEMBER EXCLUDED? If yes. describe under SPECIAl PROVISIONS below OTHER E.L. DISEASE. POLICY LIMIT $ \ I OESCRIPTION OF OPERATIONS I LOCATIONS' VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS City of Ashland is additionally insured per endorsement that straight from the carrier. 1(541)488-5354 olsonk@ashland.or.us will follow CERTIFICATE HOLDER $ $ $ $ CANCELLATION SHOULO ANY OF THE ABOVE DESCRIBED POUCI~, CANCELLED BEFORE THE EXPIRA nON VOR TO MAIL ~ DAYS WRITTEN City of Ashland Kari Olson 90 N. Mountain Ashland OR 97520 Jered Meade ACORD 25 (2001/08) ------'--'T PROPOSAL Bertocchi Builders Inc. F R o M Page No. of Pages 2010 Skyview Drive Medford. OR 97501 Cell 541-944-7137 PROPOSAL SUBMITTED TO: NAME STREET CITY 951-0292 DATE 11/1912008 of AlhlancllD8le Peters PHONE JOB NAME STREET Police Cabnet work 1155 East Main St. 90 N. Mountain Ave. Ashlancl STATE . 97520 CITY AMIand STATE 0 n We herebv submit soeciflcations and estimate for: Fabricate and install new Cabinetry and counter tops as per walk though with Dale Peterson. We hereby propose to fumish labor and materials-complete in accordance with the above specifications. for the sum of $6400.00 with payment to be made as follows: To be paid upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. All agree nts contingent upon 'kes. accident, or delays beyond our control. This proposal Is subject to acceptance n N/A ys it is ereafter at the option of the undersigned Authorized Signature The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Accepted: Signature: Date: Signature: -------~-~--T ~.. ...~ CITY RECORDER CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 Page 1 / 1 DATE 12/16/2008 PO NUMBER 08724 VENDOR: 013674 BERTOCCHI BUILDERS INC 2010 SKYVIEW DRIVE MEDFORD, OR 97501 SHIP TO: City of Ashland - Police Dept. 1155 E MAIN STREET ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: Speciallnst: Req. No.: . Dept.: POLICE Contact: Dale Peters Confirming? No QUinlity Unit . Discription Unit Price Ext.:Price , Remove and replace select cabinets. 6,400.00 Build new cabinets to new specs, install with new laminate counter tops. Per attached proposal dated 11/19/2008 Contract for Services Date of aQreement: 12/11/2008 BeQinninQ date: 12/03/2008 Completion date: 01/18/2009 Insurance reQ.uired/On file Certificates of Insurance: Gen Liab/Auto Workers' Comp - N/A - No employees per contractor - SUBTOTAL 6400.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 6,400.00 ASHLAND, OR 97520 Ac,cQ,Y,nI:~u,rrih'er project Number Amount Account Number Pr9jec:t Number Amount E 1 1 0.06. 1 2.00.7041 OC E 0001 20.999 6.400.00 -6iK ~ /~~r Auth rized Signature VENDOR COpy -'--- 1 A REQUISITION FORM CITY OF ASHLAND THIS REQUEST IS A: o Change Order(existing PO # Date of Request: I ~ Dee. oS I Required Date of Delivery/Service: I \ ~ ~"-l 09.1 Vendor Name Address City, State, Zip Telephone Number Fax Number Contact Name ~ e:\,-~\-\-:r.. ~\ &_:'0 vz.~ z...c \ 0 SK. r v \e:v:> d> f<.l\f f!. ~ Et>roi2.l) t C> R. q 1-5'"0 1 S'lI-9 '4Q- rl3r M 1'\ ~ li<. 1M ~12..1~H- ':t:.. SOLICITATION PROCESS Small Procurement D Sole Source D Invitation to Bid D Less than $5,000 D Written findings attached (Copies on file) D Quotes (Optional) D Quote or Proposal attached Coooerative Procurement 0 Reauest for Prooosal D State of ORfWA contract (Copies on file) Intermediate Procurement D Other government agency contract D Soeciall Exemot pI- (3) Written Quotes D Copy of contract attached D Written findings attached (Copies attached) - D Quote or Proposal attached D Contract # D Emeraencv 0 Written findings attached 0 Quote or Proposal attached Description of SERVICES " 006: IIq,uO ~pl~~e se\ec.t CL~~l"'~1'S. ~u.'"\ \d ....:sEW etA-a t '-..h::"TS -be ~ (a. \.U ~, l ~ ST ~L..L- lJ..) 1 Tft N ~ lU . Lt.4 <<\ ~ ~..q ,...\~ Q,ou.-... ~ e-n- "'\;0 t S't o Per attached PROPOSAL Item # Quantity Unit Description of MATERIALS Unit Price Total Cost Project Number~!~~ .<jj9 Account Number ! l~ .l?~. !?~.1~JQQ ,. 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 Signa;;;;: ~ SupervisoriDept. Head Signature: 2~ J/-~ G: Finance\Procedure\AP\Forms\8_Requisition form revised.doc Updated on: 12/3/2008 --~--~-------~~-----------~ ---- - -~------ 1