HomeMy WebLinkAbout2010-075 Contract - Footprint Recycling
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Contract for GOODS AND SERVICES Less than $25,000
I
r:.rr-y RECORDER
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONTRACTOR: Footprint Recycling
CONTACT: Andrew Cooper, Owner & CFO
ADDRESS: 4701 West End Road, Arcata, CA 95521
DATE AGREEMENT PREPARED: 05/10/2010
TELEPHONE: 707-826-2606, Cell 707-845-5697
FAX:
BEGINNING DATE: 05/19/2010 COMPLETION DATE: 06/30/2012
COMPENSATION: $0.50 per gallon to be paid to the City of Ashland (Price per gallon will be reviewed
periodically in relation to the price of Bio-Diesel) Payment for used cooking oil, including an accounting of
collections shall be mailed to Ci of Ashland, Attention: Kari Olson, 90 N. Mountain Ave, Ashland, OR 97520.
GOODS AND SERVICES TO BE PROVIDED: Contractor to collect and recycle used cooking oil per the City's
RFP re uirements/s ecifications.
ADDITIONAL TERMS: Contract may be extended for one additional year. Section 4 below is
deleted/Contractor will be com ensatin the Cit for the used cookin oil.
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 b~ registered, .Iicensed or borded. by..the State ofOregon,.ar~.
so registered, licensed and bonded. Contractor must also maintain a current City. business license. ...
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. C-ompensation :-Gity.shall.pay.Gontracler-for-lhe-specified.goods.and.for.any.wor-k-performed,including .costs.and
9l$6Flses,tRe.sum.specified-abovc. Paymcnts shall Be made within 30 days of tRe date-ef-tl1e.invoicc. Should tnc
eeFltract be prematurel) termiMtcd, pa}ff1eAts will Be FRada fGr "Ierk ceFl1ploted and accepted te datc of teFflliAation.
C""'fJ'" ,~"tiulI Ulld", lI,;~ WIlt. ""t, ;,,<.Iud;1 '9 all costs aAd cxpcAses of Contractor, is limited to $25,000.00, u"I,,~~ ".
separate written.coFltraet is entered iAte BY tRe 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 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, sub rogations, 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 by City under any of the following
conditions:
Contract for Goods and Services less than $25,000, Revised 06/30/2008, Page 1 of 5
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/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 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.
1. 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 468A710, 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 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.
c. Automobile Liabilitv 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.
d. Notice of cancellation or chan e. There shall be no cancellation, material chan e, reduction of limits or
Contract for Goods and SeNices Less than $25,000, Revised 06/30/2008, Page 2 of 5
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 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, seif-insured retentions and/or self-
insurance.
17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance witl) 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 BElWEEN 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.
9. 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. Con tor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
CONTRACTO CITY OF ASHLAND:
BY
41
BY
:u 1"'2.W
FINANCE RECTOR
TITLE
DATE
DATE
5.1'6. IV
CONTRACT AWARD AND FINDINGS DETERMINED BY:
By:
City Department Head
Date:
-9
One copy of a W.9 is to be submitted
with the signed contract and it will be
kept on file in the Finance Department.
ACCOUNT #
/(Jrt? r(/fOCY~
(For City purposes only)
PURCHASE ORDER #
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 3 of 5
EXHIBIT A
eERTIFICATIONS/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
:~ontractor as defined in the contract documents, and has checked four or more of the following
criteria:
a
~
(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
insur liability insurance relating to the labor or services to be provided.
s-, r{{, / D
(Date)
.
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 4 of 5
~.. I DATE (MMlDDIYYYY)
-1CO~D CERTIFICATE OF LIABILITY INSURANCE 6/11/2010
. . THIS CERTIFICATE IS ISSUeD AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTifiCATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
__tENTATIVE OR PROOUCER, ANO THE CERTIFICATE HOLOER.
TANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER I ~~~~L:I
JUDY DAVIS INSURANCE SVCS INC I f'(!8NN"o E~' (707) 839-5288 1;~No,(707)839-3877
1933 Central Ave, Ste C IID~ss, judy@jdinsurance.com
McKinleyville, CA 95519
CUSTOMERID#
OF41787 INSURERIS) AFFORDING COVERAGE NAIC/I!
INSURED Footprint Recycling INSURER A : State Fund
INSURER B ,Scottsdale
4701 West End Road INSURER C
Arcata, CA 95521 INSURER 0 .
(707) 826-2606 INSURER E :
INSURER F .
COVERAGES
CERTIFICATE NUMBER
REVISION NUMBER
THIS IS TO CERTIFY THAT 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 MA.Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE = ~~/~8~-r{{1 MMIDDrYYYY' LIMITS
"" INSR WVD POLICY NUMBER
GENERAL LIABILITY EACH OCCURRENCE $
-
COMMERCIAL GENERAL LIABILITY PREMISES lEa occulTence\ $ 100,000
I CLAIMS-MADE ~ OCCUR MED EXP (Anyone person) $ 5,000
B - CPS1115405 2/8/2010 2/8/2011 PERSONAL & ADV INJURY $ 2,000,000
- GENERAL AGGREGATE $ 2,000,000
~'L AGG~nE LIMIT AFlS PER. PRODUCTS - COMPIOP AGG $ 2,000,000
POLICY ~r~T LOC $
OMOBILE L1AB!L1TY COMBINED SINGLE LIMIT $
(Ea accident)
- ANY AUTO BODILY INJURY (Per person} $
- ALL OWNED AUTOS BODILY INJURY (Per accident) $
- SCHEDULED AUTOS PROPERTY DAMAGE
$
- HIRED AUTOS (Per accident)
- NON-OWNED AUTOS $
$
- UMBRt:LLA L1AB ~IOCCUR EACH OCCURRENCE $
EXCESS LIAS CLAIMS-MADE AGGREGATE $
- DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION I T~~]IfJNs I IOJ~-
AND EMPLOYERS' LIABILITY YIN 1844660-2010 3/11/2010 3/11/2011 1,000,000
A ANY PROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? "A 1,000000
IMlIlldlltory In NHI E_L. DISEASE - EA EMPLOYEE $
If yes, describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Evidence of ~nsurance, Certificate holder is hereby named additional ~nsured as respects the operations of
the named insured. Ten days notice applies to cancellation for non payment of premium.
CERTIFICATE HOLDER
CANCELLATION
City of Ashland SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Attn: Kari Olson THE EXPIRATION DATE THEREOF, NOTICE WILL BE DeLIVERED IN
90 North Mountain Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
. Ashland OR 97520
541-488-5354 AUTHORIZED REPRESENTATIVE
,
ACORD 25(2009/D9)
@1988.2009ACORDCORPORATION. All rights reserved.
The ACORD name and logO. are registered marks of ACORD
POLICYHOLDER COPY
NH
.
STATE
COMPENSATION
INSURANCE
P.o. BOX 420807, SAN FRANCISCO,CA 94142-0807
FUND
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE, 06-11-2010
GROUP,
POLICY NUMBER' 1844660-2010
CERTIFICATE ID: 1
CERTIFICATE EXPIRES: 05-01-2011
05-01-2010/05-01-2011
CITY OF ASHLANO
ATTN, KARl OLSON
90 N MOUNTAIN AVE
ASHLAND OR 97520-2014
NH
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named b"elow for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement. term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms. exclusions, and conditions. of such policy.
.
thorized Representative
)~V~
Interim President and CEO
EMPLOYER'S LIABILITY LIMIT INCLUOING OEFENSE COSTS: $1.000,000 PER OCCURRENCE.
ENDORSEMENT #0015 ENTITLEO AOOITIONAL INSUREO EMPLOYER EFFECTIVE 2010-06-11 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF AOOITIONAL INSURED,
CITY OF ASHLANO
ENOORSEMENT #1600 - COOPER, OAVID A PRESIDENT - EXCLUOEO.
ENDORSEMENT #1600 - KOGER, MICHAEL VICEPRES C EXCLUOEO.
ENOORSEMENT #1600 - FRISBEE, TOOD VICEPRES - EXCLUDEO.
ENDORSEMENT #1600 - WATERHOUSE, AMY SEC,TP.ES - EXCLUDED.
EMPLOYER
.
FOOTPRINT RECYCLING
4701 W ENO RO # A
ARCATA CA 95521
NH
[B11,NH]
(REV.1-2010)
PRINTEO 06-11-2010
06/21/2010 17:21 FAX 530 242 1311
STATE FARM
I4J 002
~. CERTIFICATE OF LIABILITY INSURANCE \ DATE iMMIDOfTYTY)
..
A:.C~RD 06/21/2010
P~OOUC;:E!R THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION
TIIS FOSTER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4 LLTOP DRIVE STE B HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
R NG. CA 96003 530-242-1411 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
~ INSURERS AFFORDING COIIERAGE NAIC'
-
INSUIilED INSURER A: State Farm Mut.ual Auto Ineurance COffiEany 25178
HUMBOLDT BIODIESEL SYSTEMS
DBA FOOTPRINT RECYCLING INSURER B:
4701 W END RD STE A INSUReR c:
MCATA, CA 95521 IN$UIilER D~
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICy PERIOD INDICATED. NOTWITHSTANDING
ANY REQuiReMENT. TERM OR cONOITION OF ANY CONTAACT OR OTHER DOCUMENT WITH RESPECT TO WHICH iHIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE. INSURANCE AFFORDEO BY Tt-tE POLICIES oESCRIBED HEREIN IS SUBJE:CT TO ALL THE TERMS, ~XCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY tiAVe BEEN REDUCED BY' PAID CLAIMS.
INsa &DO~ POt.I~::~FFE~~ POUC~I~~!RAT~
Lm INSRP TYPE OF INSURANCE fOuCY NUMBER. DATE MMIOD DATE MMIDDIYT UMml
~ERAl. LIABILITY EACH OCCURRE:NCe .
- ~r."ERCIAL GENe:RAt.. L.IAEUL.ITY PREMises (e::~~anool .
- ClAlM5 MADe 0 OCCUR MED EXP (Anv one DAl'IIOl11 .
PERSONAL 110 AOV INJURY .
GENERAL AGGREGATE .
GEN'lAGGREGAlC I..MT APPLJES Pm: PRODUCTS. COMP,op AM .
Ilpouc~n~~~ nLOt .
A 80MOBlLE L1ABILlr< 220-2963-A18-S5A 01/19/2010 01/19/2011 COMBINeo Sll'rlGl,E LIMIT
(ED acckllmt) $ 2,000,000
ANY AUTO
~ ALL OWNED AUTOS BOOII. Y INJURY .
(Perpel'1lOfl)
- SCHEDULED AUrOS
~ IoIIRED AUTOS 80DlL Y INJURY .
~ NON-OWNED AUTOS (P/ilrlll~denl)
X ALL OWNED TRAILERS PROPERTY DAMAGE .
(p.rad:i&lnt)
==rGE L"'BILlr< AUTO ONLY - Eft. ACClpeNT .
ANY AUTO OTHER THAN eAACC .
AUTO ONL T:
Aoo .
p~!WMeREL.L.A I.I,ABILllY EACH OCCURReNCE .
OCCUR D CLAIMS MADE AGGREGATe .
$
R ~EDUCTI.L' .
RETENTION . .
WOIiICERS COMPENSAnON AND ~':'" STATU;,I Ion..
EMPLOYERS' LIABILITY DRY UMJ'rn ER
At<< PAOPRIEITOR/PARTNERltXECUTIVE E.l. EACH ACCIOeNT .
OI"FICEFUME:M6ER E.XCLUOED? E..L. DISEASE. EA EMPLOYEE: 5
~PEc~t&r:o~~~~s oelow EL DISEASE - pOLle.,. L.IMIT .
OTHER
peSCRIPTlON OF OpERATioNS I LOCATIONS I VEHICLeS 1 EXCLUSIONS aDDED 9.,. EjrIlDORSEMENT 1 SPECIAL PROVISIONS
COMPREHENSIVE DEDUcTI5LB $1000 / COLLISION DEDUCTIBLE $1000 APPLIES TO ALL VEHICLES 'AND TRAILERS,
CERTIFICATE HOLDER
CITY OF ASHLJ\ND. OR,EGON
FAX# 541-488-5320
CANCELLATION
e regls a Ion no lees In ca e owners Ip
SHOULD ANY OF THE ABOVE DescRIBED POUCIES BE CANCELlEC BEFOFtS Tl1E EXPIRATION
DATE THEREOF. THE IssUING. INSURER WILL ENDEAVOR TO MAIL ..ML DAYS WRITTEtl
NOTICE TO THE CERTIFICATE HOLDEFt NAMED TO THE I....!!FT. BUT FAILURE TO DO SO SHALL
IMP06E NO O!lllGATION OR UABII.ITY OF Y KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED RePRESENTATIVE
BRIANNE LANE, LSA-4
e mar s Y @Ir respe e owners
All rights reserved
.
132B4g 03-13-2007
06/21/2010 17:21 FAX 530 242 1311
STATE FARM
I4i 001
e
e
e.
, .
. .
.:- STATE FARM INSURANCE - TRAVIS FOSTER, AGENT <-
AGENT lICENSE #OE48638
40 HILLTOP DRIVE, SUITE B
REDDING, CA 96003
'A
...u'...."'c-...
,) PHONE: 530-242-1411 + FAX: 530-242-1311,)
To: CITY OF ASHLAND-ATTN:
KARl OLSON
Fax: 541-488-5320
From: BRIANNE
Date: 6/21/2010
Re: HUMBOLDT BIODIESEL
Pages: 2
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