HomeMy WebLinkAbout2009-218 Contract - Brotherton Pipeline Corp
CIT Y OF CONTRACTOR: Brotherton Corporation
ASHLAND CONTACT: Michael Cantrell
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 11 Frontage Road, PO Box 738, Gold Hill,
Telephone: 541/488-6002 Oregon, 97525
Fax: 541/488-5311
TELEPHONE: 541-855-7075
DATE AGREEMENT PREPARED: Seotember 22,2009 FAX: 541-855-7284
BEGINNING DATE: October 5,2009 COMPLETION DATE: November 5,2009
COMPENSATION: $31,780.00 (Includes installation cost for two vauits), plus an additional $4,365 each to
install (2) two additional vaults, for a total of $40,510.00, Per attached DrODosai dated 09/09/2009.
GOODS AND SERVICES TO BE PROVIDED: Contractor to dig out and install (3) three City provided vauits at
the substation end and (1) one City provided vault at North side of driveway. Trench and bore as needed to
install 4- 4" and 1- 2" conduit as described on the City's Electrical Plans. Location: Mountain Avenue
Substation
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. 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 2798.220, 2798.225, 2798.230, 2798.235, 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 8 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. subrogalions, 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 Citv under anv of the followina
Contract for Construction Services
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 1 of 5
cunditions:
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. Obliqation/Liabilitv of 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 dellverables 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 ORF 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
ORF if Contractor has qualified as a ORF 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 Liabil' nce 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 inclu ualliability coverage for the indemnity provided under this contract.
c. Automobile Lia .. rance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,00 ,000,00, r Not Applicable for each accident for Bodily Injury and Property Damage,
includin covera e for ,Ired or non-owned vehicles, as a licable.
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 2 of 5
d. , Notice of cancellation or chanoe. 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. Additionallnsured/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 contractor's insurance is primary and non-contributory. 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,
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, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively 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 BE1WEEN 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 Council or 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.
CONTRACTOR
BY "4~/--~~
Si nature
CITY OF ASHLAND:
BY ~
FINANCE DIREC R
Print Name
TITLE
DATE
/Dj_
DATE
Date:
One copy of a W-9 is to be submitted with the signed
W-9 contract and it will be kept on file in the Finance
Department.
ACCOUNT #
(i.1 t? I r r go 0& 'l t:J ~ r C'J-CJ
(For City purposes only)
Contract for Goods and
PURCHASE ORDER #
.6/ '1 .::2- "7 0
vised 06/30/2008, Page 3 of 5
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:
,/
/
~
(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.
~ 7~~
Contractor e-.vy- (Date)
9-.;:z~-cJJ
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 4 of 5
~OlHERl'O '.
~ .),1"" ';-,~BROTHERTON CORPORATION
t. .. ., 11 Frontage Road. P.O. Box 738 . Gold Hill, Oregon 97525
GOWHILL, OREGON (541) 855-7075. Fax (541) 855-7284. eee 106728
PR.OPOSAl
WE SUBMIT THE FOLLOWING ESTIMATE:
DIG OUT AND INSTALL 1 CITY PROVIDED VAULT AT THE SUBSTATION END AND ONE
CITY PROVIDED VAULT NORTH OF THE DRIVEWAY, TRENCH AND BORED AS NEED TO
INSTALL 3 - 4" 1 - 2" AND 1 - 4" CONDUIT AS DESCRIBED. ON THE PLAN, SWEEP
UP AT THE POLE END AND ENTER EXISTING VAULT WITH ONE CONDUIT,
ESTIMATED TOTAL $31,780
ADDITIONAL VAULTS (provided by cily)
EACH
$4,365
CONDITIONS
cm OF ASHLAND to PROVIDE ALL PERMITS AS NEEDED,
IF ROCK IS ENCOUNTERED THAT CANNOT BE TRENCHED OR BORED AND MUST BE
I:lAMMERED, ADDITIONAL CHARGES WILL BE ADDED FOR THE HAMMER EQUIPMENT,
PRICE WILL BE NEGOTIATED FOR HAMMER EQUIPMENT,
. AUTHORIZEDSIGNATURE~2 . / (\ ~
THIS PROPOSAL MAY BE WITHD WN BY BROTHERl'ON IF NOT ACCEPTED
WITHIN 30 DAYS.
ACCEPTED SIGNATURE
The acceptance oflhis proposal conslllules a binding contract and is subjecl.lo all
applicable slate and local laws. Material and labor in this agreement may be subject to
state lien laws, .
Z:OOIlOO'd
(Xy~)
6Z:g0 600Z:1O 1/60
, Ui/U..OILUU",
IO.;Jf
(rAil)
p ,00 1/00 1
ACORD"
CERTIFICATE OF LIABILITY INSURANCE
OP 10 ME I DATI: (MMIODfYYYVj
9BROTPr 06/08/09
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.
PROOUC!!'R
Hart Insuranoe
J'" - Q. Box 1240
._-ants Pass OR 97528
Phone: 541-479-5521
INSURED
Fax:541-474-1890
INSURERS AFFORDING COVERAGE
Brotherton Pipeline, Inc.
Brotherton Corporat~on
11 South Frontage Road
Gold Hill OR 97525
INSURER A:.
INSURER B:
INSURER C:
INSURER 0:
lNSURERE:
Travelers Indemnity Co.
NAIC#
10647
10647
.
Trnvol....b PrcplI"ty Caoua.lt;y Cc
SArF CORP
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY IlEQUIRE/'.IENT, IT:RMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWrTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED llY.fHE POliCIES DESCRIBED HEREIN IS SUWECT TO ALL THE TERMS, l',XCLUSIONS AND CONDtTlONS OF SUCH
POLICIES. AGGREGATE lIMlfS SHOWN.MAY ~IAVE BEEN REDUCED BY PAID CLAIMS.
POLICY NU"lSEJi PDOA~~iM1.iro1f,wlE PO[lt~
LTR N'R TYPE OF INSURANCE OATE'IMMIOO l.IMITS
~NERAL LI,ABIlITY EACH OCCURRENCE !P1,OOO,OOO
A X .2'. :]MMERCIAI. GF.NI:RAI. LIABILITY DTC052 6097 64 06/10/09 06/10/10 PREMISE;S Ell occlJranc(!) , 300 ODD
- CLAIMS MADE 0 OCCUR MED EXP (Any aliI! person) <J.O, ODD
PEItSQNAL & ADV INJURY $1,000 ODD
~~AGGREGATE $ 2,000,000
~L AGG~EnUM\T APAS PER: PRODUCTIi - COMPIOP AGG' $ 2,000 I 000
X POLICY j~8i LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1, 000,000
B .2'. ANY AUTO OTB10526D9764 06/l0/09 06/.10/10 (Eaaccldlllll)
- ALL OWNED AUTOS BDDIL V INJURY -
(Par person) ,
- SCHEDULED AUTOS
- HIRED AUTOS BODILV INJURY
(perllccidenl) ,
~ NON.OWNED AUTOS
-
( ~ PROPERTY DAMAGE ,
(PorllccldclIl)
..
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT ,
R--ANY AUTO OTHER "fHAN EAACC ,
. AUTO ONL V; AGG ,
fJ~SSIUMBRELLA LIABILITY EACH OCCURRENCE , 2, ODD . 000
B X OCCUR 0 CLAIMS MADE OTSMCUP52609764 06/10/09 06/10/10 AGGREGATE $2,000,000
,
8 ~EDUCTI.LE ,
X RETENTION '$10000 ,
WORKERS COMPENSATION AND ~~~WS-r IOJJ7'
C EMPLOYERS' LlABILlTY 8106H lO/01/0B 10/01/09 !:.L. EACH ACCIDENT Sl,OOO,OOO
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L, DISEASE. EA EMPLOYEE $1,000,000
. II Yl;~, IluSC11btllJOlJ1I1 sol,OOO,oOO
SPECIAL PROVISIONS belolY E.L. DISEASE. POLlCY LIMIT
OTHER
DESCRIPTiON OF OPERATIoNS / LOCATIONS I VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certi-ficate Holder is named as 'Additional Insured,
CERTIFICATE HOLDER
CANCELLATION
SrNGSH1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _~ DAYS WRITIEN
~ NOTICE "fa THE CERTIFICATE HOLOER NAMED TO THE LEFl', BUT FA,IJ.,URE TO DO SO SHALL
I, City of Ashland IMPOSE NO OElLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Purchasing Representative
90 N, Mountain Avenue REPRESENTATIVES.
Ashland OR 97520 AUTHORIZED REPRESENTATIVE
Michelle L, Elv
ACORD 25 (2001/0a)
@ACORD CORPORATION 1988
r.,
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
r,iTV RECORDER
Page 1/1
10/1/2009
;.':', ':1801NUMI3ERN'i1
09250
~~Jl.7'~:~:!8AliE~;:;~~
VENDOR, 008118
BROTHERTON PIPELINE CORP
PO BOX 738
GOLD HILL, OR 97525
SHIP TO: Ashland Electric Department
(541) 488-5354
90 N MOUNTAIN
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req, No,:
Dept.:
Contact: Scott Johnson
Confirming? No
~i~QuantiN~ r:~uIliBI] ~J:]':' ~2r::~~11?;!t~1'?~~:{~13:~~tJDe~frfption;~,1:3:~'s7fli~~:0:~!;1.,:E':;I'f4;,~~~(t~~?tj ~!~~Onif:mTCi1~]I;}~~;rE~i:1P.ric~~1iM
Contractor to dig out and install (3)
City provided vaults at the substation
end and (1) one City provided vault at
North side of driveway. Trench and bore
as needed to install 4- 4" and 1- 2"
conduit as described on the City's
Electrical Plans. Location: Mountain
Avenue Substation, Compensation:
Installation of two vaults $31,780 plus
an additional $4,365 each to install
(2) two additional vaults for a total
of $40,510.00. Per attached proposal
dated 09/09/2009, Contract for Work,
Beginning date: 10/05/2009, Completion
date: 11/05/2009
40,510.00
.
BILL TO: Account Payable
20 EAST MAiN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
40510.00
0.00
000
40,510.00
~dAC'c~uDm~umbe:~Il~ ~P.rorectrNtmber~~~ !iIfi;7Affiounf~s~ ;:;~cc(i"unfrNumh-er:;ur~ ~~~P.1OJ~f!NumJ)er&,~i~ f~1J1,l?~m()itni~
E 690.1 1 .1 8.00.70410 E 000132.999 40 51 0.00
~~ "d/~9
Aut zed Signature
VENDOR COPY
F?RM#10 I
CONTRACT APPROVAL REQUEST FORM
CITY Of
ASHLAND
Contractor/Consultant: h " .
~ t1. ~~p~ !t~r- L-L--"-e...---
r;a.r;er attached contract P 0 ~ Z;; q :?- <s CJ
PUBLIC CONTRACTING REQUIREMENTS - Solicitation Process
D Exempt from Competitive Biddina D Invitation to Bid (Copies on file) D Emeraencv
Reason for exemption: D Written findings attached
D Quote or Proposal attached
o Small Procurement & Personal Services D Reauest for Proposal (Copies on file) Coooerative Procurement
Less than $5,000 Please check one: D State of Oregon
Note: Total contract amount, including any D Goods & Services Contract #
amendments may not exceed $6,000 D Personal Services D State of Washington
Intermediate Procurement D Sole Source Contract #
GOODS & SERVICES D Written findings attached D Other government agency contract
$5 000 to $75 000 D Quote or Proposal attached Agency
[H"'{31 Written Quotes Conlract #
PERSONAL SERVICES D Soecial Procurement D Interagency Contract
$5,000 to $50,000 D Written findings attached Agency
D (3) Written Proposals D Quote or Proposal attached Conlract #
Have all public contracting requirements been satisfied?
YES
V""
NO
If "NO", City Council approval is required, City Council approval was received on
(Date)
Have funds been budgeted for the purpose of this contract?
YES
~..
NO
If "NO", City Council approval is required, City Council approval. was received on
(Date)
Please provide: Account Number
- -
-- -- -- ------
Is the amount of the contract less than $25.000? YES NO .......--
If "NO", Legal review is required.. Contract was "Approved as to form" by the Legal Department on/P - ~ t' - t9'9mate)
/
Is the amount of the contract less than $75,000 for Goods & Services
or $50,000 for Personal Services?
YES
/
NO
If "NO", City Council approval is required. City Council approval was received on
(Date)
Is the contract for a period of 24-months or less?
YES
/'
NO
If "NO", City Council approval is required. City Council approval was received on
. rt? fj ~/t:9'7~
Please provide terms: Start date: t7"1( ~ ( .' -) ~etion date:
(Date)
~,r/c 6'/0./
Can the contract be terminated for convenience thirty (30) or fewer days
following delivery of written notice to the contractor? YES
./
NO
If "NO", City Council approval is required. City Council approval was received on (Date)
"p"'"by, ~&~/-'~Pro..o I N.<App....
Department: d~--r' ~ . ~ ~ _ -? -~
Lee Tuneberg
Date: '( v- c:? / ~ ~ Date: / 6 ~~ .9-
Form #10 - Contract Approval Request Form, Page 1 of, , 10/1/2009 '
A r,?quest for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
Date of Request:
9-21-09
THIS REQUEST IS A:
o Change Order(existing PO #
Required Date of DeliverylService:
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
RRnTHi=RTON r.ORPORATlnM
11I=RONTAr,1= ROAn PO Rnx 7~R
GOI 0 Hili ORFGON 975?5
(5418557075) FAX (541 855.7284)
MIKE CANTRELL
SOLICITATION PROCESS
Small Procurement D Sole Source D Invitation to Bid
D Less than $5,000 D Written findings attached (Copie~ on file)
D Quotes (Optional) D Quote or Proposal attached
Cooperative Procurement D Reauest for Proposal
D State of ORlWA contract (Copies on file)
Intermediate Procurement D Other government agency contract D Special I Exemot
I2?J (3) Written Quotes D Copy of contract attached D Written findings attached
(Copies attached) D Quote or Proposal attached
D Contract # D Emeraencv
D Written findings attached
D Quote or Proposal attached
Description of SERVICES
Per attached PROPOSAL BEGINNING DATE: 10-5-09 COMPLLETION DATE 11-5-09
Total Cost
DIG OUT AND INSTALL (3) City of Ashland PROVIDED VAULTS@SUBSTATION SIDE & (1)
PROVIDED VAULT @NORTH SIDE OF DRIVEWAY, TRENCH & BORE (4) 4' and (1) 2" as
DISCRIBED ON City of Ashland ELECTRICAL PLANS.
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Item # Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
Projecl Number 000132.999
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o Per attached QUOTE
Account Number 690-11-18-00-704100
. Items and selYices musl be charged 10 tire appropriate accounl numbers for lire financials to re"ecl tire actual expenditures accurately,
By signing this requisItIon form. I cerlify that the information provided above meets the City of Ashland public contracting requirements.
and the documentation can be provided upon request.
Employee Signature: 'David Tvaerson
SupervisorlDept. Head Signature: