HomeMy WebLinkAbout2010-123 Contract - Hays Oil Company
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CI TY OF CONTRACTOR: Hays Oil Company
ASHLAND CONTACT: Steven Hays
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 1890 So. Pacific Hwy, Medford, OR 97501
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-772-2053
DATE AGREEMENT PREPARED: 05/25/2010 FAX: 541-779-2602
BEGINNING DATE: OS/25/2010 COMPLETION DATE: 06-30-2011
COMPENSATION: Fuel to be priced using the "Eugene'AM OPIS (Oil Price Index Service) rack average", plus
annlicable taxes and rnarkuo as follows: Unleaded $0.181, Dved B2 BioDiesel $0.181
GOODS AND SERVICES TO BE PROVIDED: Fuel to be delivered bi-weekly and/or as needed to the fuel tank
located at the Ashland Park Shop (Next to Oak Knoll Course) 3070 Hwv 66, Ashland, OR, 97520.
ADDITIONAL TERMS: Types of fuel: E-10 Ethenol Unleaded 87 Octane, Dyed B-2 Bio-Diesel (Not to exceed
B-5\; Fuel tank: 1,500 Gallons - 500 Gallons/Bio-Diesel, 1,000 Gallons/Unleaded
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
materiais 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 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 aiso 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, empioyees 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 (inciuding 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 responsibie 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 by City under any of the following
conditions:
i. If Citv fundino from federal, state, countv or other sources is not obtained and continued at levels
Contract for GOODS AND SERVICES Less than $25,000
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Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 1 of 5
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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 allowabie 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. Oblioation/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.
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.l1 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 ORF 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 Compensation 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 chanae. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverane(s) without 30 days' written notice from the Contractor or its insurer(s) to
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 2 of 5,
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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 C~mtractor'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 (andlor 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 atter 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. CeflifieatiQ~. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
CONT CTO CITY OF
;-ltJAIW[ DIRECTOR
BY
TITLE -t=fJ~
DATE ----1k1tCJ
DATE
CONTRACT AWARD AND FINDINGS DETERMINED BY:
By: - oN' _
<./~ _"L1"-16
City Department Head
Date:
One copy of a W-9 is to be submitted
W-9 with the signed contract and it will be
kept on file in the Finance Department.
ACCOU NT #
PURCHASE ORDER #
(For City purposes only)
tJ~CJ~g
Contract for Goods and Services Less than $25,000, Revised 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 fn 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 r liability insurance relating to the labor or services to be provided.
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 4 of 5
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CITY OF ASHLAND, OREGON
EXHIBIT B
City of Ashland
LIVING
ALL employers described
below must comply with City
of Ashland laws regulating
payment of a living wage.
~.l'
Employees must be paid a
living wage:
~ For all hours worked under a
service contract between their
employer and the City of
Ashland if the contract
exceeds $18,088 or more.
~ For all hours worked in a
month if the employee spends
50% or more of the
employee's time in that month
working on a project or
~p~r ilC;ur effecthM:~t:ne 30t:';2'6~o~;:' ',;
U'h:,::,:,', .....>:..';]iEiEP:;:,..;,'.": ..> "I;
(Increases anriuall v~ '
Consumer Price Index)
portion of business of their
employer, if the employer has
ten or more employees, and
has received financial
assistance for the project or
business from the City of
Ashland in excess of $18,088.
~ If their employer is the City of
Ashland including the Parks
and Recreation Department.
~ In calculating the living wage,
employers may add the value
of health care, retirement,
401 K and IRS eligible
cafeteria plans (including
childcare) benefits to the
amount of wages received by
the employee.
~ Note: 'Employee' does not
include temporary or part-time
employees hired for less than
1040 hours in any twelve-
month period. For more
details on applicability of this
policy, please see Ashland
Municipal Code Section
3,12.020.
For additional information:
Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,
20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.oLus.
Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all
employees.
CITY OF
ASHLAND
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 5 of 5
FROM
(TUE)MAY '820'0 ":S8/ST. ":SS/Ho.S3003S475S P 2
rtk:J
PO BOX 1220 Medford OR 97501
(800)-452-6555
City of Ashland
90 N. Mountain Avenue
Ashland OR 97520
Fax: 541-488-5320
Attn: Purchasing Representative, Karl Olson
Re: Fuel Bid for Ashland Park Shop
The pricing for this bid offering will be based on the following. The prices are quoted without any tax for bid
purposes only. The applicable taxes will be applied at the time of deliver:y/invoice:
. Eugene Oregon OPIS Average 09:00AM EDT report.
. Deliveries to Ashland are made on a weekly basis.
. The fuels available for delivery are those that are provided at the Eugene Oregon fuel tennlnaL
o Regular Unlead 10% Ethanol
o 82 biodiesel Dyed
. Price of fuel and markup.
o Regular Unlead
. OPIS Price 2.3146, Markup .181, Total ex tax' 2.4956
n_.____ -0 Dyed.82-Biodiesel.
. OPIS Price 2.3S53, Markup .181, Total ex tax 2.5363
If you have any questions, contact Steven Hays, 541-772-2053 ex 1009 or ern~i1 shays@haysoil.com.
Thanks you for the opportunity to bid on your fuel needs.
~ .'
Steven Hays
1890 So. Pacific Hwy.
Medford OR 97501
541-772-2053
Fax 541-779-2602
529 NE F Street
Grants Pass OR 97526
541-476-2218
Fax 541-476-9936'
191 Bateman Drive
Central Point OR 97502
541-664-6640
Fax 541-664-1364
8290 14th Street
White City OR.97503
541-826-5550
Fax 541-826-3864
www.salf.com
OREGON WORKERS COMPENSATION
CERTIFICATE OF INSURANCE
.!!'i!
CERTIFICATE HOLDER:
CITY OF ASHLAND
90 N. MOUNTAIN AVENUE
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named below for the
policy period indicated. The insurance afforded by the policy described herein is subject to
all the terms, exclusions and conditions of such policy.
POLICY NO.
480084
POLICY PERIOD
07/01/2010 to 07/01/2011
ISSUE DATE
07/08/2010
INSURED:
R W HAYS CO
PO BOX 1220
MEDFORD, OR 97501-0091
BROKER. OF RECORD:
LIMITS OF LIABILITY:
Bodily Injury by Accident
Bodily Injury by Disease
Body Injury by Disease
$500,000
$500,000
$500,000
each accident
each employee
policy limit
DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS:
IMPORTANT:
The coverage described above is in effect as of the issue date of this certificate. Itis subject to change
at any time in the future.
This certificate is issued as a matter of information only and confers no rights to the certificate
holder. This certificate does not amend, extend or alter the coverage afforded by the policies above.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS' WRITTEN
NOTICE TO THE ABOVE NAMED CERTIFICATE HOLDER.
AUTHORIZED REPRESENTATIVE
PJr?}>' Jr RcqAiJ---
--
President and CEO
400 High Street SE
Salem, OR 97312
. p, 800.285.8525
F,503.373.8020
POlicy _Batch_ CertificateOflnsurance
Additional.\nsured Copy
POLICY NUMBER: 9802189
COMMERCIAL GENERAL LIABILITY
CG 32 61 10 05
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OREGON ADDITIONAL INSURED - OWNERS,
LESSEES OR CONTRACTORS - SCHEDULED PERSON
OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Person(s)
Or Organizations Location(s) Of Covered Operations
CITY OF ASHLAND ANY COVER~GE PROVIDED BY THIS
ON MOUNTAIN AVE NDORSEMENT APPLIES ONLY TO THE DELIVERY
ASHLAND OR 97520 OF FUEL TO THE CITY OF ASHLAND.
ADDITIONAL INSURED ALSO INCLUDES CITY OF
ASHLAND, OREGON, AND ITS ELECTED
OFFICIALS, OFFICERS AND EMPLOYEES.
Information required to comDlete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury",
"property damage" or "personal and advertising
injury" caused by your ongoing operations for
the additional insured(s) at the location(s)
designated above and only to the extent that
such "bodily injury", "property damage" or
"personal and advertising injury" is caused by.
your negligence or the negligence of those
periorming operations on your behalf.
RW HAYS COMPANY
PO BOX 1220
MEDFORD OR 97501
CG 32 61 1005
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to "bodily injury"
or "property damage" occurring after:
1. All work, including materials, parts or
equipment furnished in connection with such
work, on the project (other than service,
maintenance or repairs) to be performed by
or on behalf of the additional insured(s) at
the location of the covered operations has
been completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or
subcontractor engaged in performing
operations for a principal as a part of the
same project.
@ ISO Properties, Inc., 2005
Page 1 of 1
Third Party Copy
#BWNDHBS
#CENTPRTCST804XX1 #
CITY OF ASHLAND
90 N MOUNTAIN AVE
ASHLAND, OR 97520
fii! A CORo.:' [;:~f!fti:Jj(i!#ljjiTi!iiiEEf!i;) F;i.~f~iJtilit~fi.SJ:l8~N~it;i' ;;~'~;5:,~;,t. ;';~;)Zi1 DO~I,~~~YYI
v~o~~~....~"" ~ , , '~" ".<;- --,,,,, , ,~"l'~>>~'h)', ;U'~. .. " <~";;~,~~':~""'" ';;;I~ CERTiFI2;liE' IS' I'SS~~E~~~S;"~' ~ATTER ~F INF~RMAnoN ",
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
8-711 HOLDER THIS CERTIFICATE DOES NOT AMElIlD. EXTE1\ID OR
, ELLIOTT POWELL BADEN , ALTER THE COVERAGE AFFORDED BY THE POUCIES BElOW_
; 1521 SW SALMON STREET COMPANIES AFFORCiNG CPVERAGE
, PORTLANDOR 97205 I COMPANY FEDERATEDSERVlCEINSUAANCECOMPANY OR
A FEDERATED MlfnML INSURANCE: CO~ANY
-- --
314-757-61 COMPANY
B
~te: 5/28/2010
. .
INSURED
RW HAYS COMPANy
PO BOX 1220
MEDFORD OR 97501
Time: 10:32 AM
Page: 002-
To: City of AShland @ 1-541-488-5320
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D6CRIPTtON OF OJ1'fRATION..Vl.OC-AnONSN&IICLES!SPECIAl fTEh1S
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3147578
CITY OF ASHLAND
90 N MOUNTAIN AVE
ASHLAND OR 97520
':~EW1
101
5HOIJl.P ANY OF ruE ABOVE OEGCRI8EO pOUCttS rd:: CANCIUED BEFOfl,E THE
EXPlR"-'nOtJ DAn; THEREOF. THE 1S$UING COMPAffY WILL f:Nl.\&AVOR TO MNl
-30..... DAYS WmTI9" NOTICE TO THE C.ER11f=lCATE: HOl.l>EH nAMED TO TIlE u:rr,
flUT F.AllU~, 10 MAR SUCH NOTICE SHAll Itii"'OSE taD OBUGAnON OR llABlUrv
OF ANY KIND UPON THE COMPANY. ITS ;lJ3ENTS Of< REPRIOSENTATIV[f,.
... ....7'm1Ejil1m;,'~:;;:\;:i:;:;~i?~~qQtnEPQBr9iU\[@N!~'i!mll
'~~~1W2~'rs:~m~~i*~t11?~M:wam[:WHtH~n~ntnm:i;;~)
l.te: 5/48/2010
. .
Time: 10:32 AM To: City of Ashland @ 1-541-488-5320
Page: 001- ~
~p
Insurance
Elliott~ Powell, Baden & Baker, Inc.
1521 SW Salmon St., Portland, OR 97205 503-227-1771
Commercial Insurance
Personal Insurance
General Liability
Professional Liability
Workers Comp
Commercial Auto
Auto
Homeowners
Umbrella
Flood/Earthquake
Bonds
Life & Health
To: City of Ashland Fax Number: 1-541-488-5320
.
From: LoriJ Fax Number: 503-445-8493
Pages: 6 Date: Friday, May 28, 2010
Time: 10:32:10 AM
Subject:
This comrnunication is intended for the sole and exclusive use of the addressee and rnay contain proprietary,
confidential and/or privileged information. If you are not the intended recipient, any use, copying, disclosure,
dissemination or distribution of the information is strictly prohibited. If you are able to idenfity and forward this
comrnunication to the intended recipient, please do so. If you are not able to identify the intended recipient,
destroy this message.
CITY RECORDER
Page 1/1
Ashland Park Commission
iDATE'.-"':,""
7/27/2010
""RoTNOMBERY,,hfl
00038
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 000414 SHIP TO:
HAYS OIL COMPANY, RW HAYS OIL COMPANY D
PO BOX 1220
MEDFORD, OR 97501
FOB Point:
Terms: net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.:
Contact: Steve Gies
Confirming? No
:~~R~taliiitv.::f~ ~unih~:; [?ifil';'. ;':-"X-. : -' .. .::. '., '~'~DescriDiioh',>':.: ' "". '::::: .A-,. . -. . .... !-:~ ';Unft;p.rfc~f;~a jitlffEXi~p.~
Contractor to deliver fuel as needed to , 7,500.00
the tank located at the Oak Knoll Golf
Course
Types of fuel:
E-10 Ethenol Unleaded 87 Octane
Dyed B-2 Bio-Diesel (Not to exceed B-5)
Fuel Tank: 1,500 Gallons I
500 Gallons/Bio-Diesel
1,000 GallonslUnleaded
.
Fuel to be priced using the "Eugene AM
OPIS (011 Price Index Service) rack
average", plus applicable taxes and
markup as follows: Unleaded $0.181,
Dyed B2 BioDiesel $0.181
Contract for Goods and Services ,
Beginning date: May 25, 2010
Completion date: June 30, 2011
SUBTOTAL 7 500.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 7.500.00
,.~.::~i;'Ac_c'oui)rrijumiJ~er.il\:~~';;j 1'7';_ !rP.r6Jecl~Numb'er:.~.: >: I'.,; ";:Am'"c)Jrfi "F' ')f.Ac'c(iunt:ijIHntl'er?~~;i; ;';:'_1 , ~"1p,101e:ct:Jiumbe!jT~~'i~ ~~m_ouni_
, , j'"
E 21 1 .1 2.04.00.60212 7 500.00
~ '1 /? ~~o
Autholizdd Si nature VENDOR COPY
9
,.
CITY OF
ASHLAND
A request for a Purchase Order
REQUISITION FORM
Date of Request:
1t7~P7 -(f
I : ~ I
THIS REQUEST IS A:
o Change Order(existing PO #
Vendor Name
Address, City, State, Zip
Contact Name & Telephone Number
Fax Number
cv~:]~~
Required Date of DeliverylService:
~.,!;
SOLICITATION PROCESS
D Exemot from Comoetitive Biddina
Reason for exemption:
D Invitation to Bid (Copies on file)
Date approved by Council:
D Emeraencv
D Written findings attached
D Quote or Proposal attached
CooDerative Procurement
D State of Oregon
Contract #
D State of Washington
Contract #
D Other government agency contract
Agency
Contract #
D Intergovernmental Agreement
Agency
Contract #
Date approved by Council:
D Small Procurement
Less than $5.000
Note: Total contract amount, including any
amendments may not exceed $6,000
Intermediate Procurement , (3.-.)
GOODS & SERVICES ;. 4" . t, J .
50000 100000 t<.J'" e,,,,
(3) Written quotes attached 9f' 1', C.
PERSONAL SERVICES P /V-, #Of\-~
$5.000 to $75.000 cf.U
D Less than $35,000, by direct ap~
D 3 Written pro osals attached
Description of SERVICE
L&-4t 1!--r?l~ ~ 29-"" C/c_LL UV<J __ 51 u ~
(2"$' /.-,J ~ cf <-e_cL '6- 0 &JL.<1C: ~/t ~
cO t!JL .(2.~-S-e - (?t1-?r.~~~y2 C2~"-~ $
Item # Quantity Unit Description of MATERIALS
D Reauest for Prooosal (Copies on file)
Date approved by Council:
D Sole Source
D Written findings attached
Q te or Proposal attached
Total Cost
7 t7"d-~ ,
TO:TAL,COST
0 Per attach ed QUOTE $ '.: -::;>fD.t~~~'<;
:
.' ; ~;',: ",: :
e~;; ,
It -
Unit Price
Total Cost
Project Number __ ____ - ___
pl'l' r.:20</poGc.::z/~
Account Number ___' __' __' __' ______ Account Number
. . . .
--- -- -- -- ------
Account Number ___' __' __' __' ______ Account Number ___' __' __' __' ______
'Expenditure must be charged to the appropriate account numbers for Ihe Iinancials to reflect the acluat expenditures accurately. Affach extra pages If needed.
By signing this requisition form, I ceriily Ihat the informalion provided above meets Ihe City's public conlracting requireme
upon request
and the documenlalion can be provided
Employee Signature:
h.~
Department Head Signature:
Additional signatures (if applicable):
Funds appropriated for current fiscal year: @ NO
h-.;;z,. ':!:::r-
Finance Director
0-7~i)
I Date
Comments:
G: Finance\Procedure\AP\Forms\Fonn #3 - Requisition.doc
Updated on: 7127/2010