HomeMy WebLinkAbout2010-153 Contract - Asphalt Maintenance
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Asi-H.AND CITY OF ASHLAND
r~' PUBLIC IMPROVEMENT CONTRACT
2010 STREET SLURRY SEAL PROJECT
Project No. 2010-08
This Contract is between the CITY OF ASHLAND, a municipal corporation of the State of
Oregon (hereinafter "City") and Asphalt Maintenance Associates, Inc. (Hereinafter
"Contractor"). The City's Project Manager for this Contract is John Peterson, Street Suoervisor,
Citv of Ashland Public Works Deoartment.
WHEREAS, City caused to be prepared a certain bound Project Manual or Bid Package
(including but not limited to Invitation to Bid, Bid Schedule, Bid forms, Bid, Performance and
Payment Bonds, as applicable, Public Improvement Contract, Contract Standard Terms and
Conditions, Conditions, General Provisions, Technical Specifications, Drawings, and Addenda
. No._ through No. -' more particularly described in Standard Condition 5, (hereinafter
referred to as "Contract Documents") for its project entitled "20 I 0 Street Slurry Seal Project"
and
WHEREAS, Contractor did on the 31 day of August, 2010, file with City a bid to furnish
equipment, labor, material, and appurtenances for construction of said project as set forth in the
Contract Documents and agreed to accept as payment therefore the sums fully stated and set
forth in the bid; and
WHEREAS, the Contract Documents and bid fully and accurately set forth and describe the
terms and conditions upon which the Contractor proposes to furnish said equipment, labor,
material and appurtenances and perform said work, together with the manner and time of
furnishing same; and
NOW THEREFORE, for good and valuable consideration the parties mutually covenant and
agree as follows:
1. Recitals.
This recitals set forth above are true and correct and are incorporated herein by this reference.
2. Effective Date and Duration
This contract is effective on September 1, 2010, or on the date at which every party has signed
this contract, whichever is later. The work under this contract shall, unless otherwise terminated
or extended, be completed on or before date of final comoletion, 2010 or before 45 calendar days
following Contractor's receipt of the Notice to Proceed, whichever is earlier.
3. Statement of Work
The work under this contract is for 2010 slurrv seals. as is more fully described in the Contract
Documents, incorporated herein and made a part heTeof by this reference. The statement of
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work, including the delivery schedule for the work, is contained in the Contract Documents.
Contractor acknowledges receipt of all Contract Documents in existence at the date the Contract
is signed and further acknowledges Contractor has read and fully understands the Contract
Documents, and understands that in signing this Agreement contractor waives all rights to plead
misunderstandings regarding the same.
Contractor shall, at its own risk and expense, perform the work described in the Contract
Documents and furnish all permits, labor, tools, machinery, materials, transportation, equipment
and services of all kinds required for, necessary for, or reasonable incidental to, performance of
the work, that is, the construction of this 2010 Slurry Seal Project for the City of Ashland,
Oregon, as shown in the Contract Documents. Contractor shall secure all Municipal, County,
State, or FedeTal Permits or licenses including payment of permit fees, license fees and royalties
necessary or incident to performance of the work on this contract. The risk of loss for such work
shall not shift to the City until written acceptance of the work by the City.
4. Consideration
a. City agrees to pay Contractor, at the times and in the manner provided in the Contract
Documents, a sum of: $95,803.80 for accomplishing the work required by this contract,
including allowable expenses. This fixed sum cannot be modified except by Change Order
approved in writing by City. Any progress payments to Contractor shall be made only in
accordance with the schedule and requirements in Section 21, Standard Terms and
Conditions.
b. City certifies that sufficient funds have been appropriated to make payments required by this
contract during the current fiscal year. 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.
CONTRACTOR DATA, CERTIFICATION, AND SIGNATURE
Business Name (please print: Asphalt Maintenance Associates,. Inc.
Contact Name: Bruce urn Phone: 541 461-2220 Fax: 541 461-2330
Address: rat' q 7t.; 0
Do Not Write Federal and State Tax ID Numbers 0 this Agreement: One copy of W-9 is to be
submitted with the signed contract to be kept on file in the City of Ashland Finance Department.
AsWand Business License # con~on Contractors Board # 62952
Citizenship: Nonresident alien Yes No
Business Designation (check one): -----.JRdlvidual _ Sole Proprietorship
_ Partnership -.L Corporation _ GovernmentfNonprofit
The above information must be provided prior to contract approval. Payment information will
be reported to the Internal Revenue Service (IRS) under the name and taxpayer J.D. number
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provided above. (See IRS 1099 for additional instructions regarding taxpayer ID numbers.)
Information not matching IRS records could subject you to 31 percent backup withholding.
I, the undersigned, understand that the Standard Terms and Conditions For Public Improvement
Contracts (Exhibit A) together with Exhibits B through E together with all other Contract
Documents as described in Standard Terms and Conditions Section 5 below, and the separately
bound Oregon 2008 Standard Specifications for Construction, as amended, by the City of
Ashland's most recent Addenda to the 2008 Standard Specifications are an integral part of this
contract and agree to perform the work described in the Contract Documents, including Exhibit
A, in accordance with the terms and conditions of this contract. I further understand the City is
prohibited from entering into a contract when the contractor has neglected or refused to file any
return, pay any tax, or properly contest a tax, pursuant to ORS 305.385; I hereby certify, under
penalty of petjury and false swearing, that Umy business am/is not in violation of any Oregon tax
laws; I further certify'that the certification and representations in Standard Term and Condition #
16 [CCB Registration Requirements] are true and correct, and further I certify that I am an
independent contractor as defmed in ORS 670.600.
Signed by Contractor:
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SignatureITitle
Printed Name: 15R..v CcNy YtI J.-'v' Ih
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Date
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NOTICE TO CONTRACTOR: This contract does not bind the City of Ashland unless and until it
has been executed by the Public Contracting Officer or designee as well as City Finance and
Legal Department representatives.
CITY OF ASHLAND SIGNATURE
Approved:
A..--
. t, Director of Public Works, City of Ashland
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- Authorized by Ordinance 3013 and Delegation Order dated June 22, 2010
Coding:
Reviewed:
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Date
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Lee Tuneberg, Financ irector (funds appropriated current fiscal year) Date
Reviewed:
Richard Appicello, City Attorney (approved as to legal form) Date
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CERTIFICATIONS OF REPRESENTATION
Contractor, under penalty of peIjury, certifies that:
(a) The number shown on this 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, and
(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
c07tr t documents, and has checked four or more of the following criteria:
(I) I carry out the labor or serVices at a location separate from my residence or is in a
spec~ portion of my residence, set aside as the location of the business.
\! (2) ommercial advertising ot business cards or a trade association membership are
purchas for the business.
(3tTelephone listing is used fOT the business separate from the personal residence
listing/
~) Labor or services are performed only pursuant to written contracts.
~ (?) Labor or services are performed for two or more different persons within a period of '
on;Y~
V (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.
Contractor
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City of Ashland, Oregon
PROPOSAL AND BID SCHEDULE
TO FURNISH ALL PERMITS, LABOR, TOOLS, MACHINERY, MATERIALS, TRANSPORTATION,
EQUIPMENT AND SERVICES OF ALL KINDS REQUIRED FOR THE CONSTRUCTION OF THIS
PROJECT FOR THE CITY OF ASHLAND, JACKSON COUNTY, OREGON, AS STATED IN THE
COMPLETED BID SCHEDULE, ALL IN ACCORDANCE WITH THE CONTRACT DOCUMENTS,
PLANS, SPECIFICATIONS, AND DRAWINGS WIDCH ARE ON FILE AT THE CITY OF ASHLAND,
CITY HALL, 20 EAST MAIN STREET, ASHLAND, OREGON 97520.
NAME OF BIDDER A~phal1; ~aV1.l!.f ,tksOv.aJeSj :J::j..JO.
CONTACT ",&-Uc.--e. ~'OKl.l-V',\.
ADDRESS 0>DSlD PrtUn-e.1Ccl
CITY ~ STATE ~
TELEPHONE NO. 5 Lf 1- L./ to 1- 2-7-- Z 0
54/- 4/oI-Z"330
ZIP Q-r4o;)."
FAX NO.
EMAILADDRESSo...srhA-Li::.M/1..lY\.-l-@. M5t\.L.O!Y\
To the Honorable Mayor and City Conncil
City Hall
City of Ashland
20 East Main Street
Ashland, Oregon 97520
In response to competitive bidding, this PROPOSAL is submitted as an offer by the nndersigned to enter into
a contract with the City of Ashland for furnishing all permits, labor, tools, machinery, materials,
transportation, equipment and services of all kinds required for, necessary for, or reasonable incidental to, the
purpose of the 2010 Street Slurry Seal Project (hereinafter "Project") for the City of Ashland, Oregon, as
shown in the contract documents on file at City Community Development Building, which are a condition of
this Offer as though they were attached. This offer is subject to the following declarations as to the acts,
intentions and understandings of the undersigned and the agreement of the City of Ashland to the terms and
prices herein submitted.
I. The undersigned has familiarized themselves with the nature and extent of the Contract Documents,
project work, sile, locality, general nature of work to be performed by City or others at the site that relates
to the project work required by the Contract Documents, local conditions, and federal state, and local
Laws and Regulations that in any manner may affect cost, progress, performance, or furnishing of the
project work.
2. The undersigned has obtained and carefully studied (or assumes responsibility for obtaining and carefully
studying) examinations, investigation, exploration, tests, and studies which perlain to the conditions
(subsurface or physical) at or contiguous to the site or otherwise and which may affect the cost, progress,
performa'Dce, or furnishing of the project work as Contractor deems necessary for the performance and
furnishing of the project work at the Contract Price, within the Contract Times, and in accordance with
the other terms and conditions of the Contract Documents; and no additional or supplementary
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examinations, investigations, explorations, tests, reports, or similar information or data are or will be
required by Contractor for such purposes. .
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3. It is understood thai the City shall investigate and determine the qualifications of the apparent low
responsive bidder prior to awarding the contract. The City shall reject any bid by a nonqualified or
disqualified bidder. The City of Ashland reserves the'right to reject for any good canse any or all bids,
waive formalities, or to accept any bid which appears to serve the best inlerests of the City. The City
reserves the right 10 reject any bid not in compliance with all prescribed public bidding procedures and
requirements, and may reject all bids for good cause upon a finding that it is in the public interest to do so.
Evaluation of bids will be based on minimum requirements established by the specifications and
compliance with conditions of the Notice to Contractors and Invilation to Bid, and compliance with City
public contracting rules. Additional evaluation criteria are as follows: None.
4. The deadline to file a written protest or request, pursuant to Instruction to Bidders to change contract
terms, conditions or specificalions is notless than ten (10) calendar days prior to bid opening. Bid closing
may be extended by the City to consider a protest or requesl.
5. All of the contract documents, including all plans, specifications, and drawings have been examined and
an examination of the site of the proposed work, together with such invesligations as are necessary to
determine the conditions to be encountered have been made by the undersigned and the terms and
conditions of the contract and solicitation documents are hereby accepted, and that if this Offer is
accepted, the undersigned will contract wilh the City of Ashland, Oregon, in a form substanlially similar
to that attached Agreement and agree to be bound to the terms and conditions of said contract and
solicitation documents.
6. It is understood that the contract drawings may be supplemented by additional drawings and
specifications in explanation and elaboration thereof and, if they are not in conllict wilh those referred to
in paragraph I above, they shall have tbe same force and effect as Ihough they were attached and they
shall be accepted as part of the contract when issued.
7. The undersigned agrees that upon written acceptance of this bid slbe will, within ten working days, of
receipt of such notice, execute a formal contract agreement with the City. The undersigned further agrees
that s/he will provide the following in order to execute the contract:
Certificates of Insurance for Liability and property damage coverage;
Certificates of Coverage for Workman Compensation and unemployment insurance;
All other bonds, permits, licenses, etc. as required in the contract documents.\
8. It is understood that all the work will be performed under a lump sum or unit price basis and that for
the lump sum or unit price all services, materials, labor, equipment, and all work necessary to complete the
project in accordance with the plans and specifications shall be furnished for the said lump sum or unit price
named. It is understood that the quantities stated in connection with the price schedule for the contract are
approximate only and payment shall be made al the unit prices named for the actual quanlities incorporated
in the completed work. If there shall be an increase in the amount of work covered by the lump sum price, it
shall be computed on a basis of "extra work" for which an increase in payment will have been earned and if
there be a decrease in the lump sum payment, it shall be made only as a resull of negotiation between the
undersigned and the Owner. Furthermore, it is understood that any estimate with respect to time, materials,
equipment, or service which may appear on the plans or in the specifications is for the sole purpose of assisting
the undersigned in checking the undersigned's own independent calculations and that at no time shall the
undersigned attempt to hold the Owner, the Engineer.,or any other person, firm or corporation responsible for
any errors or omissions that may appear in any estimate.
9. The undersigned submits the unit prices as those at which he will perform the work involved. The
extensions of the column headed "ITEM TOTAL" are made for the sole purpose of facilitating bid
comparisons and if there are any discrepancies between the, unit prices and the total amount shown, the unit
prices shall govern.
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10. The undersigned agrees to furnish labor, tools, machinery, materials, transportations, equipment and
services of all kinds required for, necessary for, or reasonably incidental to, construction of this Project with
all appurtenant work as required by tbe plans and specifications of tbis Offer for the unit or lump sum prices
in the "BID SCHEDULE".
11. In stating prices, it is understood that the prices include all materials and work required to complete
the contract in accordance with the plans and specifications. If any material, item or service required by the
plans and specifications has not been mentioned specifically in the "BID SCHEDULE", the same shall be
furnished and placed with the understanding that the full cost to the City has been merged with the several
prices stated in the "BID SCHEDULE."
12. The City reserves the right to reject any and all bids, waive formalities, or accept any bid which
appears to serve the best interests of the City in accordance with ORS 279B.100. The City reserves the right to
reject any and all bids, waive formalities, or accept ;'ny bid which appears to serve the best interests of the ciiy
in accordance with ORS 279B.I00.
13. The foregoing prices shall include all labor, materials. equipment, overhead, profit, insurance. and all
other incidental expenses to cover the finished work of the several kinds called for. Unit prices are to be shown
in both words and figures. In case of discrepancy, the amounts shown in words will. govern.
14. Upon receipt of writlen notice of the acceptance of this bid, Bidder shall execute the formal contract
attached within ten days, and deliver required proof of insurance.
is. If the proposed bid price will exceed $50,000.00 the undersigned, as bidder, acknowledges that
provisions of ORS 279C.SOO - 279C.S70 relating to workers on public works to be paid not less than prevailing
rate of wage shall be included in the contract, or in the alternative, if the project is to be funded with federal
funds and is subject to the Davis-Bacon Acl (40 U.S.C. ~276a) bidder agrees to comply with the Davis-Bacon
Act requirements. "Prevailing Wage Rates for Public Works Contracts in Oregon," which are incorporated
herein by reference, and can be accessed at:
htlp://www.oregon.govIBOLIIWHDIPWRlpwr_book.shtml
16. The undersigned agrees to comply with the provisions of ORS 279C.SOO to 279C.S70, the Oregon
Prevailing Wage law. The undersigned, as bidder, acknowledges that provisions of ORS 279C.SOO - 279C.S70
relating to workers on public works to be paid not less than prevailing rate of wage shall be included in the
contract, or in the alternative, if the project is to be funded with federal funds and is subject to the Davis-
Bacon Acl (40 U.S.C. ~276a), bidder agrees to comply with the Davis-Bacon Acl requirements. The
undersigned Contractor agrees to be bound by and will comply with the provisions of ORS 279C.S3S,
279C.S40 or 40 U.S.C. 3141 to 314S. [OAR 137-049-0200(I)(a)(J)].
-'
17. The undersigned certifies that the undersigned Contractor is not ineligible to receive a contract for a
public work pursuant to ORS 279C.S60. Bidder further agrees, if awarded a conlract, that every
subcontractor will be eligible to receive a contract for a public work pursuant to ORS 279C.S60.
IS. The undersigned certifies Ihat the undersigned Contractor has not discriminated against minorily,
women or emerging small businesses enterprises in obtaining any required subco~tracts. The bidder
understands and acknowledges that it may be disqualified from bidding on this public improvement project as
set forth in OAR 137-049-0370, including but not limited to City discovery a misrepresentation or sham
regarding a subcontract or that the Bidder has violated any requirement of ORS 279A.1l0 or the
administrative rules implementing the Statute.
19. The undersigned agrees that the time of conipletion shall be defined in the specifications, and further,
the undersigned agrees to initiate and complete this Project by the date stated below.
. The work shall be commenced within 30 working days after receipt of the written Notice to
Proceed.
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. The undersigned agrees that the "Time of Completiou" shan be as defined in the specifications
and that the bidder will complete the work within the number of consecutive calendar days stated
for each schedule after "Notice to Proceed" has been issued by the Owner. Bidder furthermore
agrees to pay as liquidated damages, for each calendar day thereafter, the amounts shown in
Standard Conditions, for each day the project remains incomplete.
20. The undersigned bidder is registered with the Oregon Construction Contractors Board (CCB), the
registration is current and valid, and the bidder's registration number is stated below. [OAR 137-049-
0230(1)] Bidder understands that failure to have a current CCB license shan result in rejection of this
bid.
21. The undersigned bidder is licensed by the State Landscape Contractors Board, if applicable, the
license is current and valid, and the bidder's registration number is stated below. [OAR 137-049-
0200(l)(a)(K)] Bidder understands that failure to have a current LCB license shan result in rejection
of this bid.
22. In determining the lowesl responsible bidder, City shan, for the purpose of awarding the contract, add
a percent increase on the bid of a non-resident bidder equal to the percent, if any, of the preference
given to that bidder in the state in which the bidder resides. "Resident bidder" of Oregon means a
bidder that has paid unemployment taxes or income taxes in this state during the 12 calendar months
immediately preceding submission of the bid, has a business address in this state and has slated in the
bid that the bidder is a "residenl bidder" of the State of Oregon. The undersigned represents him/her
self in this bid to be either a Resident or a Nonresident bidder by completing the appropriate blank
below.
. The Bidder is
x
or is not
a resident Bidder as defined in ORS 279A.120.
23. The undersigned hereby represents that no Councilor, Commissioner, officer, agency or employee of
the City of Ashland is personany interested directly or indirectly in this Contract or the compensation
to be paid hereunder and that no representation, statement or statements, oral or in writing, of the
City, its Councilors, Commissioners, officers, agents or employees had indnced himlher to enter into
this Contract, and the papers made a part of its terms;
24. The undersigned has not directly or indirectly induced or solicited any person to submit a false or
sham bid or refrain from bidding. The undersigned certifies that this bid has been arrived at
independently and submitted without connection with any person, firm or corporation making a bid
for the same material and is, in all respects, fair and without collusion or fraud
25. Tbe undersigned confirms that this firm has a Qualified Drug Testing Program for employees in place
and will demonstrate this prior to award of contract. [OAR 137-049-0200(1)(c)(B)]
26. The undersigned confirms that if this contract involves asbeslos abatement or removal, the bidder is
licensed under ORS 468A.710 for asbestos removal. Asbestos abatement is not implicated in this
contract.
27. The City of Ashland may waive minor informalities, reject any bid not in compliance with an
prescribed public bidding procedures and requirements, and may reject for good cause any or an bids
upon a finding that it is in the public interest to do so.
28. The undersigned confirms that this olTer is not conlingent upon City's acceptance of any terms and
conditions other than those contained in the Solicitation and Contract documents.
29. The bidder understands that the City reserves the right to make changes to the Notice to Contractors /
Invitation to Bid and the resulting contract by written addenda, prior to the closing time and date.
The City will not mail notice of addenda but shan publish notice of any addenda on City's website and
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post the notice of addenda at Community Development. www.ashland.or.us The addenda may he
downloaded or picked up at Community Development, 51 Winburn Way, Ashland, Oregon. The
bidder must check the website frequently until closing.
The bidder acknowledges that the Addendum(s) listed below have been reviewed online or a copy
obtained and considered as part of the submillal of this Offer and Bid Schedule.
ADDENDUM NUMBER ~ THROUGH ~ HA VE BEEN REVIEWED
30. The bidder understands thai the City will be awarding the contract to the Responsible Bidder with the
lowest Responsive Bid. OAR 137-049-0200(I)(b)(C). Whether a bidder is responsible will be
determined by ORS 279C.375 and the City's completion of the allached Bidder Responsibility
Determination Form.
31. Instrnctions for First- Tier Subconlractors Disclosure.
Bidders are required to disclose information about certain first-tier snbcontractors (those
subcontraCtors contracting directly with the bidder) when the contract price exceeds $75,000 (see ORS
279C.370)_ Specifically, when the contract amount of a first-tier subconlractor is greater than or
equal to: (i) 5% of the project bid, but at least $15,000, or (ii) $350,000 regardless of the percentage,
you must disclose the following information about that subcontract within two working hours of bid
closing:
. The subcontractor's name and address;
. The subcontractor's Construction Contractor Board registration number, if one is
required, and;
. The subcontract dollar value.
If you will not be using any subcontractors that are subjeCt to the above disclosure requirements, you
are required to indicate "NONE" on the form. Failure to submit this form by the disclosure deadline
will result in a non-responsive bid. A non-responsive bid will not be conside'red for award. THE
CITY MAY REJECT A BID IF THE BIDDER FAILS TO SUBMIT THE DISCLOSURE FORM
WITH THIS INFORMATION WITHIN TWO HOURS OF BID CLOSING.
THIS DOCUMENT SHALL NOT BE FAXED. IT IS THE RESPONSIBILITY OF BIDDERS TO '
SUBMIT THIS DISCLOSURE FORM AND ANY ADDITIONAL SHEETS BY THE DEADLINE.
SEE INSTRpCTIONS TO BIDDERS. The disclosure should be submilled on the First-Tier
Subcontractor Disclosure Form attached to this Invitation to Bid.
32. Bidder Information and Signature
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Fir Name of idder . {Signature of Bidder
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Printed Name of id r
Wi ~mi- .
Official Tille
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CCR Number
3D~
day of ~~*-- 2010.
Dated this
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Name of Bidder 1b.pho...Lt f\1tu.nkvla"nc..-:e. IbSOCl. ~ S I .:TtJ(I_
Address .;1D8D Pr{U;Gti, ~ (~ ({)R. q,t.{O.;;l
Telephone No. .54/ ~ 4 to ( ~ 1-2 Z 0
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BID SCHEDULE
2010 STREET SLURRY SEAL PROJECT
Proiect No. 2010-08
-,-- UNIT PRICE i
NO DESCRIPTION OTY. : UNIT , AMOUNT ..
r (FIGURES) ;
SECTION 00200 TEMPORARY FEATURES & APPURTENANCES
Mo~aWi' Jf, hundruJ $Z50De CJO
I for () CU54fl Ve. Dollars I LS $.;1,500-
SECTION 00220 - ACCOMMODATIONS FOR PUBLIC TRAFFIC
Tem~ary Work Zone ~ Traffic Control, Compiete (,.,('3~.7D -CfI
for ,~f)-fi,t~ ~~s sl Q5//fih .;l
2 I LS $ '7/705. $ , C'< ../
SECTION 00280 - EROSION AND SEDIMENT CONTROL - - l.o';r).5S
L (,.~4.- ()
For '01 'l hu...nUe. d Dollars $ (p OD QD.. crt>
3 i LS $ lllcm-
SECTION 00700 - WEARING SURFACES
SECTION 00706 - EMULSIFIED ASPHAL T SLURRY SEAL SURFACING
Hillview Dr. - peaCha' Rd. to Sisk~Jlvd. SQ $ I, tJS
for-l:e.h-thoU5D.J1. -fi:w. hLll\ Dollars. $ I/) ,-/I..{D,:3 0
4 ~'"'301''''' 5,354 YD
0
Crei}~i~! ,Dr ~ J.r;~re st~ Dollars SQ , ,- - .~ iO
fa u.n ou~ nil'\€..
5 YV I:) II':'; ~ I J, 1.1--'
Beswick W+h Peachey ~d to S~;J 4.968 SQ
:i'r Nl"'~ DU.~ '5IX ,Dollars q I (p<J '1 . &0
6 l~\ L _~"-~oll{)b-- YD $ 1,95 $
o ~
vetJt ~iire ~ Iuu1d.r. d SQ
for () OIX ~We.. ~ Dollars 1,q5 J I q 105. q 5
7 Sl-~v<c .. q 5-"""'" 1.521 YD $ $
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Tei"!3...Ave. -entir~~ ~r.1 SQ
I"" 1e.n~OLL'5 \Je. Dollars $' ,qS 10, 5<{3. ipS
8 a <'5'10;:. 5,407 YD $
T
Linda Av - entire ~ -tOOx hu.n~ d SQ
for -I::eV\4-h~ e Dollars $ I. CIS $IO,~~~, IS
9 ..L.~ =0-;;[ ofl'iT,&> 5,345 YD
"-'
Mary~~,~:-#;entir~~t kwuL-d SQ
for U ous ene Dollars $I.QS $ <6, Il-LJ . 40
10 _-o-;:uf<F <JOJID~- 4,192 YD
Walker ~L~E. Wain ~~ SQ $33,23Y.~5
I ~otkhL\' -4ttr... ;~g'l'f $ I. q5
II O'c.IA.\. '-H--lU" Jl '" ft5b 17,351 YD
"U
Total Bid 11 e ' q~,803.S() 1 iJI
$" ,71/.50
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A5phiL-6 1VlCl.lf1{enanee A-cDoClCLks, ~e...
~'. J,DIO '5\ya+ SLu.rrlj Seal f}o~
City of Ashland
FIRST-TIER SUBCONTRACTOR DISCLOSURE FORM
(As Required by ORS 279C.370 and OAR 137-049-360) 2010 Street Slurry Seal Project
PROJECT 2010-08
Bid Closing Date: August 31, 2010
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NAME OF SUBCONTRACTOR
2.
3
4
5
6
7
8
9
10
DOLLAR V ALl
. List above the Name, Dollar Value and Category of Work of each subcontractor that will be furnishing
labor or labor and materials and that is required to be disclosed, the dollar value of the subcontract and
the category of work that the subcontractor will be performing. Enter "NONE" if there are no
subcontractors that need to be disclosed. (ATTACH ADDITIONAL SHEETS IF NEEDED).
~1uglJsJ 10.2010
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EXHIBIT C
PUBLIC IMPROVEMENT CONTRACT INSURANCE REQUIREMENTS
To: Insurance Agent. Please provide Certificates of Insurance to the Project Manager. During the
term of the contract, please provide Certificates of Insur,ance prior to each renewal. Insurance shall be
without prejudice to. coverage otherwise existing. During the term of this contract, Contractor shall
maintain in force at its own expense all insurance noted below:
Workers Compensation insurance in compliance with ORS 656.017. All employers, including
Contractor and any subcontractors, that employ subject workers who work under this Contract in the State
of Oregon shall comply with ORS 656.017 and provide the required Workers' Compensation coverage,
unless such employers are exempt under ORS 656.126. Contractor shall ensure that each of its
subcontractors complies with these requirements.
Commercial General Liability insurance on an occurrence basis, with a combined single limit of not less
than. $1,000,000 or 0 $3,000,000 for each occurrence of bodily injury, personal injury and property
damage. It shall include coverage for broad form contractual liability; broad form property damage;
personal and advertising injury; owners and contractor protective; premises/operations; and
products/completed operations. Coverage shall not e,xclude excavation, collapse, underground, or
explosion hazards. Aggregate limits shall apply on a per-project basis.
. Required by City
o Not required by City
Commercial Automobile Liability insurance with a combined single limit, or the equivalent of not less
than. $1,000,000 or 0 $3,000,000 for each accident for Bodily Injury and Property Damage, including
coverage for owned, hired and non-owned vehicles. "Symbol One" coverage shall be designated.
. Required by City
o Not required by City
o Builders Risk (Check here if required) insurance during construction to the extent of 100 percent of the
value of the work for the benefit of the parties to the Contract as their interest may appear. Coverage shall
also include: (1) form work in place; (2) form lumber on site; (3) temporary structures; (4) equipment; and
(5) supplies related to the work while at the site.
Notice of Cancellation or Change. 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. This notice provision shall be by endorsement physically attached to the certificate
of insurance.
Additional Insured. For general liability insurance and automobile liability insurance the City, and its
agents, officers, and employees will be Additional Insureds, but only with respect to Contractor's services
to be provided under this contract. This coverage shall be by endorsement physically attached to the
certificate of insurance.
The Contractor shall defend, indemnify, and hold harmless, the City and the City's officers, agents, and
employees against any liability that may be imposed upon them by reason of the Contractor's or
subcontractor's failure to provide workers' compensation and employers liability coverage.
Certificates of Insurance. Contractor shall furnish insurance certificates acceptable to City prior to
commencing work. The certificate will include the deductible or retention level and required
(;;ty vf fIsh/21m)
:f] of,,;:
'~'.J9iJst 10. 2010
endorsements. Insuring companies or entities
insurance policies shall be provided to the City.
insured retention's, and/or self-insurance.
are subject to City approval. If requested, copies of
Contractor shall be responsible for all deductibles, self-
Citvof;l,;I,!i-Il'l.:!
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American Safety Casualty Insurance Company
444 Ocean Blvd., Long Beach, CA, 90802
Bond No. 20-SUR-208466
Premium: $2,874.00
Performance Bond
The language in this document conforms to. the language used in American Institute of Architects (AlA)
Document A312. December. 1984 edition. Third PrInting, March. 1987.
Any singular reference to Conlractor, .Surety, Owner or other party shall be considered plural Where appliea,bre,
CONTRACTOR (Name and Address):
Asphalt Maintenance Associates, Inc.
2080 Prairie Rd
Eugene, OR, 97402
OWNER (Name and Address):
City of Ashland
20 East Main Sl.
SURETY (Name andPrinclpal Place of Business):
American Safely Casually Insurance Company
444 Ocean Blvd.
Long Beach, CA, 90802
Ashland, OR, 97520
CONSTRUCTION CONTRACT
Date:
Amount: Ninety Five Thousand Eight Hundred Three Dollars and Eighty Cents (S
Description (Name and Location):
2010 Slurry Seal, Location:Ashland, OR
BONO ,11\lll"IY
Date (Not ea~ler than Constnictlon Cont,,~ l;)~~:r\'~' 1Jj,1),i
Amount: Ninety Five Thousand Ei9h~~Htree"I!hi'1I~~~9hty Cents { S
Modifications to Ihts Bond: ~~"'O. ~ PO 09.... "9' ~one
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CONTRACTOR AS PRINCIPAL ::: Iii: <>~ (l\..llll~
Company: .:.c : ( I ~ny:
. :-'tj'~
Asphalt M . nce Asso- ~,Inc. 1989 .: ~rican Safe
.- ...~ture:
;'... ............ T
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'/111 regon \\\"
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95,803.80
95,803.80
See Page 3
Signalure:
Name and Title: Bruce W. Yokum,
(Corporate Seal)
ranee Comp~ny
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The Contractor-and the Surety"jolntly and severally.
bind themsetves. their heirs. executors, administrators.
successors and assigns to the Owner for the performance of
the Construction Contract, whiCh is incorporated herein by
reference,
2 If the,Contractor perfo,nns the, Constructicm -Contract.
the Surety and the Contractor shall have no obligation under
this Bond. except to participate [n conferences as provided in
Subparagraph 3;1,
3 'fthere-is no OWner Default, the Surety's obligation
under this Bond shall arise after;
3.1 TIle Owner has notified the Contractor- and the
Surety 'at its' address shown' on 1!'e cover page lhat the
'Qi..vner -Is considering declaring a Contmctor Defau[t
aOd has reQuested and attempted to arrange a
conference wilh the Contractor and the Surety to be
held not later than fifteen days after receipt of such
notice- to discuss methods of performing the
Construction Contract If the Owner. the Contractor and
the Surety agree, the Contractor shall be allowed a
reasonable time to perform the Construction Contract.
but such an agreement shall not waive the Owner's
right. if any. subseQuently 10 declare a Contractor
Default; and
3.2 The Owner has declared a' Contractor Default and
formally terminated the Contractors right to complete
the contract Such Contractor Default shall not be
declared eartier than twenty days after the Contractor
and the Surety have received notice as provided In
.Subparagraph 3.1; arld
3.3 The Owner has agreed to pay the Balance of the
Contract Price to the Surety In accordance with the
terms of the Construction Contract or to a contractor
selected to perform the Construction Contract In
accordance with the terms of the contract with the
Owner,
4 II the Owner has satisfied the conditions of Paragraph,
the Surety shall promptfyand at the Surety's expense take
one of the following ~ctions: .
4.1 Arrange for the COf1trac~or, with consent of the
Owner. to perform and complete the Constructron
Contract; or
4.2 Undertake to perform and complete the
Construction Conlract, itself, through its agents o.r
through Independent contractors;,or
-4.3 Obtain bids or negotiate proposals from qualified
contractors acceptable to the OWner for a contract for
perfonnance and completion Of the Construction
Contract. arrange for a contract to be prepared for
execution by ,the Owner arid the contractor selected
lNlth the Owner's concurrence. to 'be secured with
performance arid payment bonds executed by a
quamled surety eQuivalent to the 'bonds Issued on the
Construction Contract. i)nd pay to the OMler the
amount> of damages as described in Paragraph 6 ,in
excess of the Balance of the Contract Price incurred.by
the OWner resulUng from the Contractor's defaUlt; Dr
4.4 Waive its right to perform and complete. arrange for
completion, or obtain a new contractor and with
reasonable promptness under the circumstances:
4.4;1 Afterinvestigalion, detemilnethe amount of
Which it may be liable to the Owner andi8s soon as
practicable after the amount Is determined, tender
payment therefore to the Owner; or
4A.2 Deny liability in whole Or in part and notify the
~er citing reasons therefor.
5 If the Surety does not proceed as provided [n
Paragraph 4 with reasonable promptness, lhe Surety shall
be deemed to be in default on this Bond fifteen days after
receipt of an additional Written notice from the Owner to the
Surety demanding that the Surety perform lis ob[lgations
under this Bond. and the OWner shall beentllled to enforce
any remedy available to the Owner. 11 the Surety proceeds
as provided in Subparagraph 4.4, and the Owner refuses the
payment tendered or the Surety has denied \lability, in whole
or in part. without further notice the Owner shall be entitled
to enforce any remedy available to the Owner.
6 If the Owner has terminated the Contractor's r1ght to
complete the Construction Contract. and if the Surety elects
10 act under Subparagraph 4.1, 4.2. or 4.3 above. lhenthe
responsibilltiesof the Surety to the Owner shall not be
greater than those of the Contractor under the Construction
Contract, and the responsibilities. of the Owner to the Surety
shall not be greater than those of the Owner under the
Construclion Contract. To the limit of the amount of Ihis
Bond, but subject to commitment by the Owner of Ihe
Balance of the Contract Price 'to mitigation of costs and
damages on Ihe Construction Contract, the Surety Is
Obligated Without duplication for:
6;1 The responsibilities of the Contractor for correction
of defective work and completion of the Construction
Contract;
6,2 Additional legal, design professionalan~ delay
costs resulting trom the Contractor's Default, and
resulting from the actions.or failure to act of the Surety
under Parag.raph 4; and
6.3 Uquidated damages. or if no liquidated damages
are specified in the Construction Contract, actual
damages caused by delayed perfonnance or
nonperformance of the Contractor.
7 The Surety shall not be liable to the Owner or others for
obligations of the Conlractor that are unrelated to the
Construction Contract, anclthe Balance of the Contract Price
shail not be reduced or. set off. on - account of any such
unrelatedobllgations, No right oraction,shall accrue on this
Bond to 'any person or entity other than the Owner or its
heirs. executors. administrators or successors.
8 The Surety hereby waives notice of any change,
including changes of time.~to the Construction Contract or to
related subcontracts. purchase orders and om Obligations.
9 Any proceeding, tegal or equitable, under this Bond
maybe instituted in any court of competenl jurisdiction in the
location in which the worn or part of the work is located and
shall be instituted within two years after Contractor Defauft Of
within two years after the Contrador ceased working or
within two years after the Surety refuses or fails to perform
Its obDgatlons under this Bond, whiChever occurs first. If. the
provlsions of this Paragraph are vol" or prohibited by law,
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the minimum pefiod of limitation available to sureties as a
defense in the juriSdiction of the sUit. shall be applicable.
10 Notice to the SUrely, the Owner, or the Contractor shall
be majledor delivered to the address showr:,-on the cover
page,
11 When this Bond has been furnished to compty Vwilh a
statutory or other legal requirement In the location .where lhe
construction was to be performed, any, provision in this Bond
conflicting with said statutory or legal requirement shall be
deemed'deleted here from- and pro....isions conforming 10
such statutory or other logal requirement shall be- deemed
Incorporated herein. The Intent Is that this Bond shall be
construed as a statutory bond and not as' a common law
bond,
12 DEFINITIONS
12,1 Balance of the Contract Price; The total amount
payable by the Owner to .t.!1e. Contractor under the
Construction Contract after all proper adjustments have
MODtFtCATlONS TO THIS BOND ARE AS FOLLOWS:
Any change which materially alters the contract or the
eon_tract price by more than 10% will require notice to the
Bonding Company
been made including allowance to' the Contractor of any
amounts re<:eived or to be received by the Owner in
seitlement oflnsurance or other claims for damages 10 which
the Contractor is' entlUed. reduced bY all valid and proper
payments made to or on behalf of the Contractor under the
Construction Contraet.
12.2 Construction Contract: The agreement between
the Owner and the Contractor identified on the cover
page. IncludIng an Contract Documents and changes
thereto,
12,3 Contractor Oefault; Fallure at the Contractor.
whleh has neither been remedied nor waived, to
perform or otherwise to rompty with the terms of the
Construction Contract.
12.4 Owner Default: Failure of the Owner. which has
neither been remedied nor wal....ed. to 'pay the
Contractor as required by the Construction Contract or
to perform and complete or comply with the other terms
thereof, '
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Bond No: 20-SUR-208466
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American Safety Casualty Insurance Company
444 Ocean Blvd., Long Beach, , 90802
Premium: Included In Performance Bond
Payment Bond
The language in this docume,nt confonns 10 the language used In American Institute of Architects (AlA)
Document A312. December. 1984 edlUan, Thtrd Printing. March. 1967.
Any singular reference to Contractor. Surety. OWner_or other party shall be considered plural where applicable,
CONTRACTOR (Name and Address):
Asphalt Maintenance Associates, Inc.
2080 Prairie Rd
Eugene, OR, 97402
SURETY
American Safety Casualty Insurance Company
444 Ocean Blvd.
Long Beach, CA, 90802
OWNER (Name and Address):
City of Ashland
20 East Main St.
Ashland, OR, 97520
CONSTRUCTION CONTRACT
Date:
Amount: Ninety Five Thousand Eight Hundred Three Dollars and Eighty Cents ($ 95,803.80
Description (Name and-Location):
20 I 0 Slurry Seal, Location:Ashland, OR \ \ \ \" 111 t II/II
BOND ", en an I,
Date(Nol earlier lhan cons,lru~cti ~",O.lBl:; Cl!l!:l [{~10
Am9unt: Ninety Five Thousand ~13~~na~9"fd'~hIY Cents ( S 95,803.80
Modifications to lhis Bond: ~gOJ' - "I.... II' ~
.:::-....:(J ~~~c.P-::.
CONTRACTOR AS PRINCIPAL: CO; C 14' ^ T ~~~'t1
Company: = r.: (C~ C9~"!!i': (Corporate 5eoQ
Asphalt ~ance Ass~;'.lny~ ~an Safetv..Gasual~urance Company
Sjgn.l~reL2~~~ .~'!!Jre: /~{/- .
NameandTitJe: BruceW Yokum 4'J ... ..... ...~ T;~unnjng Attorney-in-Fact '\. \
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1 The Contractor and the Surety, jointly and severally, bind
themselves, their heirs, 'executors, administrators, successors
and assigns to the Owner to pay for labor, materials and
equipment furnished for use in ~the performance -of the
ConstrlictlonContract, which is incorporated herein by
reference.
2 With respect to the Owner, this obligation shall benull and
void If the Contractor.
2,1 Promptly makes payment, directly or Indirectly, for all
sums due_ Claimants, and
2.2 Defends, indemnifies and holds harmless the Owner
from claims, demands, liens or suits by any p.erson or entity
whosedaim, demand, lien or suit is for the payment for labor,
materials-or equipment furnished for'use in the-performance of
the Construction Contract, provided the Owner hes promptly
notified the Contractor and the Surety (at the address on the
cover page) of any claims. demands, liens or suits and
tendered defense of such claims, demands, liens or suits to the
Contractor and the Surety, and provided there Is no Owner
Default.
3 With respect to Claimants, this obligation shall be null and
void if the Contractor promptly makes peyment, directly or
indirectly, for all sums due,
4 The Surety shall have no obligation to Claimants under this
Bond until:
4.1 Claimants who are employed by or have' a direct
contract with the Contractor have given notice to IheSurety
(at the address on the cover page) and sent a copy, or notice
thereof, to the Ovmer, stating that a claim is being made
under this Bond and, with substantial accuracy, the amount
of the claim.
4.2 Claimants who do not have a direct contract with the
Contractor:
4.2:1 Have furnished written notice to the Contractor
and sent a copy, or notice thereof, to the
Owner, within 90 days after having last
performed labor or last furnished materials or
equipment Included in the claim stetlng, with
substantial accuracy, the amount of the claim
and the . name of the party to whom the
materials were furnished or supplied or for
whom the labor was done or P!3rformed; and
4,2.2 Have e~he(recelved a rejection In whola or In part
from the Contractor, or not reCeived within 30 days
of furnishing the above notice any communication
from the Contractor bywhich the Contractor has
irdicated the claim -.111 be pai:J diredly or indirectiy; and
4,2.3 Not having been paid within the above 30
days, have sent a written notice to the Surety
(at the address on the cover page) and sent a
copy, or notice thereof, to the Owner, stating
thsta Claim is being mede under this Bond and
enclosing a copy of the previOUS written notice
furnished to the Contractor.
5 If a notice required by Paragraph 4 is given by the Owner to
the Contractor or to ,the Surety, thal.is'sufficient compUance.
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6 If the Claimant has satisfied the conditions of Paragreph 4,
the Surety shall promptly and at the Surety's expense take the
following actions:
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6:1 Send an answer to the Claimant, with a copy to the
Owner, within 45 days after receipt of the claim, stating the
amounts that are undisputed and the basis for challenging
any amounts that are disputed. '
6.2 Payor ariange for payment of 'any undisputed
amounts.
7 The Surety's total obligation shall not exceed the amount of
this Bond, and the amount of this Bond shall be credited for
any payments made In good faith by the Surety.
8 Amounts owed by the Owner to the Contractor under the
Construction Contract shall be used for the performance of the
Construction Contract and to satisfy claims, if any, under any
Construction Performance Bond. By the Contractor furnishing
and the Owner accepting this Bond, they agree that all funds
earned by the Contractor in the performance of the
Construction Contract are dedicated to satisfy obligations of
the Contrsctor and the Surety under this Bond, subject to the
Owner's priority to use the funds for the completion of the
wor\(,
9 The Surety shall not be liable to the Owner, Claimants or
others for obligations of the Contractor that are unrelated to the
Construction Contract. The Owner shall not be liable for
payment of any costs or expenses of any Claimant under this
Bond, and shall have under this Bond "? obligations to make
payments to, give notices on behalf of, or otherwise have
obligations to Claimants under this Bond,
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10 The Surety hereby waives notice of any change. including
changes of time, to the Construction- Contract or to related
subcontracts. purchase orders and other obligations.
11 No suit or action s~all be commenCed bye Claimant und/?r
this Bond other than In a court of competent jurisdiction in the
location In which the wor\( or part of the work is located or after
the expiration of one year from the date (1) on which the
Claimant gave the notice required by Subparagraph 4.1 or
Clause 4.2.3, or (2) on which the last labor or service was
performed by anyone or the last matenals or equipment were
furnished by anyone under the Construction Contrac~
whichever of (1) or (2) first occurs, If the provisions of this
Paragraph are void or prohibited by law, the minimum perla,d of
limitation available to sureties as a defense in the jurisdiction of
the, suit shall be applicable,
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12 Notice to the Surety, the Owr'ler or the Contractor shall be
mailed or delivered to the address shown on the - cover page.
Actual receipt of notice by Surety, the Owner or the Contractor,
however accomplished, shall be sufficient compliance as of the
date received at the add~s shown ,on the cover page.
13 When this Bond has been furnished to comply with a
statutory or other legal requirement in the location where the
c9nstruction was to be performed, any provision In this Bond
conflicting with said statutory or legal requirement shall be
deemed deleted here from and provisions conforming to such
statutory or other legal requirament shall be deemed
incorporated herein. The intent is that this Bond shall be
construed as a statutory bond and not as a common law bond.
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15,1 Claimant An individual or entity having a direct
contract witl1 tl1e Contractor or witl1 a subcontractor of the
Contractor to furnish labor, materials or equipment for use
in the performance of the Contract The intent of this
Bond shall be to include without limitation in the
terms -labor, materials or equipment" that part of water,
gas. power, light, heat. oil, gasoline. telephone service
or rental equipment used in the Construction Contract,
architectural and engineering services required for
performance of the work of the Contractor and the
Contractor's subcontractors, and all other items for
which a mechanic's lien may be asserted in the
jurisdiction where the labor, materials or equipment
were furnished,
15.2 Construction Contract: The agreement between
the OWner and the Contractor identified on the cover
page, including all Contract Documents and changes
thereto,
14 Upon request by any person or entity appearing to be a
potential beneficiary of this Bond, the Contractor shall promptly
furnish a copy of this Bond or shall permit a copy to be made.
15 DEFINITIONS
15.3 Owner Defaull: Failure of the Owner, which has
neither been remedied nor waived, to pay the
Contractor as required by Ihe Construction Contract or
to perform and complete or comply with the other termS
thereof.
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
Any changewhich materially alter~thecontract or the contract price by more than 10% will require notice to the Bonding Company.
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_I!.SI POWER OF ATTORNEY
;~;S;~ymi:~;~~~~~' :;~~~~.~~~
Tyler Running
NUMBER
2~-208466
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its true and lawful attomey-in.(act. for it.aod ita name. p1acc:. aDd stead. to execute 011 behalf of the said Company, as surety, boods. tmdertaling and contracts of suretyship
10 be giVCD to .
AlLOBUGEES,
provided that no bond or tmdatakiag or COnbact d suretyShip executed lioder this atdhority shall ex.a:cd ill aroourd: me sum of
Ninety Five ThousandEightHundred Three Dollars andEigbty Cents ($95,.803.80)
This Pow..- of A_ is granted ami is signed aDd scaled by _Ie lIDdcr ami by lh< autborily of Ibe following Resolutioo adoplod by lh< Board of DUa:uxs of Ibe Company
em Ibe 1!igbd1 day of Sept<mbct, 2003.
RESOLVED. that the Pn::sidcat: in caljunetion withlhe SecreIaJy or IIIIY Assistant Secretar)'may appoint auomcys.in-fact or &galls willi authority as defined or.limited in the
iDsbumeut evidencing me .ppnintmrnl in, cacb case. for and 011 behalf of Ihe Company. to cxecun: and deliver and affb. the seal Qf the Company to bond$:,- undertatiap;
recognizances. and suretyship obliga~ of aD kinds; and said ofIia:rs may f'CID()vC aDy ~cb ~y-iD-fact or agent and revoke any power of anomey previously panled to
such persons.
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,JIESOLVED nJKI1IER.1hat aD)' boo<i,.UlIdct1aIcilJg.IOCOgllizancc:. or .urot)'shq>obligatioo shall b. .a1idaud binding upoI> lh< ~y;... ~ 'n ~ " ,
~~~~~:~~~~~~1~~;!=r~1~~f~~~~:;Z:;~~;:r~;:~I~=tA
'"'..i..f....~(u._bi:~lij._.or""'"'._!fUi-W:r.or&PJi ~...axidwillilii.tliftiDWs.i]fIlic-..,.nnri";~.....b'j ....I"'....<<~ ;",''''l'
by Ibe Company to.ucIJ penon "'_
JIESOLVIlD FUIn'IIEIl, tI1at lh< slgDaImo of any an_ officer aud lh< seal of lh< Company may be affixed by flOsimil. 10 any ""'""' of ......y ... cortificatioo _
authoriziq the'execution aDd delivery of.any bood. undertaking. JCCOgOizana:. Or otbcr suretyship obligations of the Company; and sQcb signature and seal wheD $0 used shall
have the same fon:c and affeds as though. manually affixed.
~~
IN wrrNESS WHEREOF. AmeriatD Safely Casoalty Insurance Company has caused its official seat to be hereouto affixed, and these presents CO be signed by its Presideot and
a...ted.by ill s.a-y this 1!igbd1day ofScpccmbcr, 2003,
At....
~
Randolph L Hutto, 5acfetaJy
~'R.~
Stqlhen R. Grim. Prcsidcol:
STATE OF GEORGIA
COUNTY OF COBB }....
On Ithis Eighth day,or,September, :wo3. before me penaDa.lly came SIcpben R. Crim. to me known. who. beiug by me doly swom~ did'depose ami say that'he is the -PIui,dernof
, AMerican Safety'Casualty Insurance Company, the corporation described in and wbieb executed the aboYC iDstnnnent; that he knoWs theseaJ Of the said corporal.ion;,lhat the seal
affixed to Ibe said instrument is such corpcntt seal; that it was 50 affixed by ClI1b oflbc Board of Directors of said corporatioa and that he signed his aamc thereto by like order.
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I, the undonigoed, s.a-y of Aincrican SIlfay casuallY ".un,,"'" Company, on Okl.i.o~ ~tioo, DO HEREBY CElmFY lila, Ihc, foqaing..dattochcd
Powrr of JUlmJeY remains in full forCe and has om. bec:o revoked; aDd fmtIJt:nJxR Iba1 the Rr.so1ution of the Board of Dirccun, set forth in the said Power of Aumuey.'is now
in force.
~~
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Dal.,jlbe 15 day of SefJ~ 2.:0 ( D
Signed and Sealed at die City of Atlanta, in 1!1e State of GeoIJia.
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ORlGli'hlLs OF TEllS 1'f)WERUf'.tITOR.\7i'f ARE PH4V'fED DTTH /I1SD snlJi:RlC-IL SLMJIERS.
DCPlJotTES SHALL lLH'F; nmSA.\lE FORa;A.\1J E;BECT ttS _-L~ ORlGIX4LDJiLI' H-HC!USSt-W [:ttmXJUNt~:rQ:V 1I1TH'81E ORlGhJ,-4L
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ACORH CERTIFICA TE OF LIABILITY INSURANCE I DATEIMMIOOIYYVYI
\",."...---' 9/3/2010
lHlS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON ntE 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
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED. the policy(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 Ute
certificate holder in lieu of such endorsement's')'
PRODUCER I ~~.k:At,;1 Kristy Hartin, CISR, ere
Beecher Carlson Insurance Agency LLC I :nc?N9n i=yt~ (541.) 485-6633 I r~ Nol: (5411)485-35146
59 E l1~h Ave I i~~b; kristy. marti.n8beechercarl.son, com
PO Box 70206 PRODUCER 00016007
Euaene OR 97401 INSURER S AFFORDING COVERAGE NAIC"
INSURED INSURER A :SAIF 52412
INSURER B:
Asphalt Maintenance Assoc Inc INSURER c:
20BO Prairie Rd INSURER 0:
INSURER E:
Eugene OR 97402 INSURER F :
COVERAGES
CERTIFICATE NUMBER:CLI0B3190526
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED. NOT\MTHSTANDlNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTI-lER" DOCUMENT \lVlTI-l RESPECT TO VVI-IICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, niE INSURANCE AFFORDED BY THE POuaES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IM8R TYPE OF INSURANCE AOOLSUBR If~~~ ~Y~ LIMITS
LTR INSR WVD POLICY NUMBER
GEflERAL UABllorTY EACH OCCURRENCE .
COMMERCIAL GENERAL UA81LlT'f ~~~~~O~~E~nr;e' .
I C~MS-MADE I OCCUR MED EXP (Anyone person) .
- PERSONAL & ADV INJURY .
GENERAL AGGREGATE .
~~ "'GG~~E~L1MIT APFSIPER PRODUCTS-OOM~PAGG .
POLICY ~~ lOC .
AUTOMOBILE L.IABILITY COMBINED 3NGLE UMlT .
(Eaaetident)
- ANY AUTO BODlLY INJURY (Per pltrson) .
ALL O'vVNED AUTOS BODlLY INJURY (Per I'Ccident) .
- SCHEDULED AUTOS PROPERTY DAMAGE
HIRED AUTOS (Pllril~idllnt) .
NO""'O'M\IED AUTOS .
- .
UMBRB...LA lIAB ~ OCCUR EACH OCCURRENCE .
- EXCESS LIAB
CLAIMS-MADE AGGREGATE .
- DEDUCTIBLE .
RET9lTION S .
A WO~KERSCOMF'E:NSAT1ON . I,wc STATU.S I 10TH.
AND EMPLOYERS' LIABILITY V<N X TORY UMIT$ ER
ANY PROPRIETORIPARTNERIEXECUTlVE D E,L. EACH ACCIDENT . 1 000 000
OFl"ICERIMEMBER EXCLUDED? NIA 0/1/2010 10/1/20U
[Mandatory In NH) 440262 E,L. OlseASE - EA EMPLOYEE . 1,000,000
U~~I~ro~ ~#~ERATIONS below E L. DISEASE - POLICY lI~IT . 1 000 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHCLES (Attach ACORD 1 01, Additional Remar1l.$ Schedule, If mo1'9 space 15 l'9qured)
Re: '2010-08 - 2010 Slurry Seal City of Ashland Street Improvements
The Ci ty of Ashland and its agents, officers and employees
CERTIFICA TE HOLDER
CANCELLATION
)
SHOULD ANY OF THE ABOVE DESCR.IBED POliCIES BE CANCELLED BEFOR.E
THE EXPIRATION DATE THEREOF, NonCE WilL BE DELIVERED IN
Ci ~y of Ashland ACCORDANCE WITH THE POLICY PROVISIONS,
Public Works Department AUTHORIZED REPRESENTATIVE
20 East Main Street
Ashland, OR 97520
K Godfrey, CIC/IIl\DYAL rm,~ q/J~".r
ACORD 25 (2009109)
INS025 (>lO9O~
@1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Beecher Carlson
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Fax Server
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BEECHER:.,(/tARLSON
/,., Insurance Agency, LLC
FAX TRANSMITTAL
NAD4C80DDB63D75
Date:
9/3/201011 :36:10 AM
Num of Pages:
(including
DOver)
From:
Phone:
Fax:
Email Address:
15
To:
Company:
Phone:
Fax:
John Peterson
City of Ashland
Nadya Alami
(541 )284-3091
(541 )284-3191
nadya.alami@beechercarlson.com
541-488-6006
Please find attached the Certificate(s) of Insurance issued for Asphalt Maintenance
Associates Inc.
Thank you,
Nadya
59 East 11. Ave Eugene, OR 97401 (541)485-6633 Main (541 )485-3946 Fax
CA License #QF09618 OR Ucense #816307 WA Ucense #252204
ThiS 'fa~-irml(' rnO;:;~1(J is r,:+:Jnlioj.:n!,ai and is intenced sol('lv ter thO' us..:; 01 ino in::!i'....idt)(;\ll1arrto::! o.bo"c. If V'JU ar.J not. "tho inlflmicd
r():~ipient. (),".;:I :::'N':C'; auth:rizr'J(.lIL1 o"I'Jlh/','lt i1l<,;'ll1c inl(~:K1(:,:.1 r(!(:ir.~nnt :i'Cti ,:h'l hWGbj ;;)<j,:i~li'l:.i th,:)1 dis,::;);niil;;)!iDil, cli-:trtlu1!NI
or
e:]I::,:(i1O cf thi:::. :::(lmrnl)"ir:~'II!on" prohbilo(\ Ii" h:~'",,(> l'I~Cf)i;:od th!~ fOiC':iirl1iln '\I"al'!!::rni,,:<:.ion b:i' pl(i:::!!}C1 11cl.il':;, tJ'iO !xln::lnl
il'l1lrl(~d!(;:V:-I, l~':" t()Jo:.~hcn9 ';11'1[1 (s",turn tr)': orin::'I;::!! t1'all~l1'1i,~:;;i(.1i'1 10 th) Ss"H'j,j,:)r by U.S, mad
Beecher Carlson
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ACORH CERTIFICA TE OF LIABILITY INSURANCE I DATECMMlDDrYYYYj
lo......--' 9/3/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATJVELY 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
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lithe certificate holder is an ADDITlONAL INSURED, the policy(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 endorsemenUst
PRODUCER ~~tk:,",1 Kristy Martini eISR, ere
Beecher Carlson Insurance Agency LLC ~N9.. FlIt~ (541) 485-6633 I fM Nol: (~411485-3ri146
S9 E 11t:h Ave i~Jb; kristy. martin8beechercarlson. com
PO Box 70206 PRODUCER 00016007
Euaene OR 97401 INSURER 'SI AFFOROING COVERAGE NAIC1I
INSURED INSURER A :Bi tuminous Casualty Corp
Asphalt Maintenance INSURER B:
Assoc Inc INSU RER C :
2080 Prairie .Rei INSU RER 0 :
INSU RER E :
Eugene OR 97402 INSURER F :
COVERAGES
CERTIFICATE NUMBER:CL10210B0943
REVISION NUMBER'
lHlS IS TO CERTIFY THAT lHE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICAlED. NOlWITHSTANDlNG ANY REQUIREMENT, TERM OR CONDlTlON OF ANY CONTRACT OR OlHER DOCUMENT \IVITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES 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 ADDL SUBR ~&1v~~\ ~L~y~
erR INSR WVD POLICY NUMBER LIMITS
GEIlERAL UABILlTY EACH OCCURRENCE S 1.,000,000
~ ~MMERCIAL GENERAL UABL!TY g~:~J9~==~rar\ s 100,000
A CLAlMS-M/l.DE rx- OCCUR CLP3271297 /26/2010 2/26/2011 MED EXP (Anyone perwn) S 5,000
PERSOI'4AL & ADV INJURY S 1,000,000
GENERAL AGGREGATE S 2,000,000
~~ AOORE~EFLlMIT AP~S PER PRODUCTS. COMPIOP AGO. S 2,000,000
POLICY X ~~ LOC S
AUTOMOBILE LIABILITY COMBINED SINGLE UNIT S 1,000,000
(EaOlecident)
~ ANY AUTO
CAP3S36100 /26/2010 2/26/2011 BODILY rr-L!URY (Per perwn) S
A ALL OWNED AUTOS
BODILY [!'UURY (Per ilICcidunt) S
X SCHEDULED AUTOS PROPERTY' DAMAGE
HIRED AUTOS (Pefilccident) S
~ NON-O'J'vNED AUTOS QriveottlerC41! S 1.,000,000
Spec:trlecl Cau&e 01 Loss S
~ UMBRaLA LIAB ~ OCCUR EACH OCCURRENCE S 1,000,000
EXCESS LIAS CLAIMS-MADE AGGREGATE S 1,000,000
X DEDUCTIBLE S
A RETeITlQN S 10 000 ctJP2!586486 /26/2010 2/26/2011 S
WO~KERSCOMPeNSAnON I, V'JC STATU. d 10TH.
AND EMPLOYERS' LIABILITY VI. TORY UMITS ER
ANY PROPRIETORIPARTNERIEXECUTlVE D E,L. EACH ACCIDENT S
OR'ICER/MEM8ER EXCLUOED? .,A
(MandatorylnNH) E,L. DISEASE - EA EMPLOYS S
~~~I~:b~ ~~~ERATIONS bel<;M' EL. DISEASE. POLICY LIMIT S
DESCRIPTION OF OPERA TIONSI LOCATIONS / VEHCLES (Attach ACORD 101, Additional RemalU Schedule, 11 more 5pil.C8 Ii requrvcl)
Re: '2010-0B - 2010 S1urry Seal City of Ash1and street Improvements
The City of Ashland and its agents, off~cers and employees are included as a~tianal ~nsured as respects general and
auto liability Where requ~red by written contract. Per Praject Aggregate appl~es. This farm 1 s subject to policy
terms , COnditioIUII, and e.xc1ueiaIUII,
CERTIFICA TE HOLDER
CANCELLATION
-
SHOULO ANY OF THE ABOVE OESCRIBED POliCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOnCE WILL BE DELIVERED IN
Ci t:y of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
Public Works Department AUTHORIZED REPRESENTATIVE
20 East Main street
Ashland, OR 97520
1M Godfrey, CIC/NADYAL '7'1,~ -9 /J~,";r
ACORD 25 (2009109)
INS025 C=OO~
@1988-2009ACORDCORPORATION. All rights reserved.
The ACORD name and logo are registered mark5 of ACORD
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by an "occurrence" or "personal and advertising injury" caused by an offense, is an insured,
provided thai no other similar liability insurance is available to that partnership or joinl venture.
B. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE
SECTION II . WHO IS AN INSURED is amended 10 include:
Any "owner", "contractor", "construction manager", "engineer" or "architect" if it is required in your
written contract or written agreement executed by you and all other parties to the contract or
agreement prior to any loss that such person(s) or organization(s) be added as an addilional insured
on your policy but only for the project designated in your written contract or Ivritten agreement and
only with respect to "bodily injury," "property damage" or "personal and advertising injury" caused, at
least in part, by your negligence and with respect to liability resulling from:
A. Your ongoing operations forthe addilional insured(s), or
B. Acts or omissions of the addilional insured(s) in connection with their general supervision of
such operations.
Wth respect to the insurance afforded such addllional insureds pursuant to this endorsement and the
above referenced General Liabilily Form, t~e following additional provisions apply to Iimil that
coverage:
1. We wi,l have no duty to defend the addilional insured against any "sull" seeking damages for
"bodily injury," "property damage" or "personal and advertising injury," until we receive written
notice from the addilional insured requesting that we defend iI in the "suil,"
2. The Limils of Insurance applicable to the addilional insureds under this endorsement are the
minimum limits specified in the written contract or agreement requiring this coverage, or as
stated in SECTION 111- LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABILITY
COVERAGE FORM, whichever is less. These Limils of Insurance are inclusive of and not in
addition to the Limils of Insurance described in SECTION III of that form.
3. As additional conditions of coverage under this form, an additional insured under this
endorsement will as soon as practicable:
a. Gi'/e written notice to us of an "occurrence" or an offense which may result in a claim, This
shall include:
(1) How, when and where the "occurrence" or offense took place:
(2) The names and add resses of any injufed persons and wilnesses: and
(3) The nature and location of any injury or damage arising out of the "occurrence" or
offense.
b. Gi'/e written nOlice to us of a claim or "suit" brought against the additional insured including
specifics ofthe claim or "suil" and the date iI was received.
c. Give written notice of such claim or "suit," including a demand for defense and indemnity,
to any other insuref who had coverage for the claim or "suit" under its policy(ies), eilher at
the lime of, or at any time subsequent to the occurrence of the "bodily injury," "property
damage" and/or the offense causing the "personal and advertising injury," which is the
basis for such claims or "suit".
(1) Such notification must demand the full coverage available under that policy: and
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(21 The addrtional insured shall not take any action to waive or lim~ such other coverage
available to it.
4. This insurance does not apply to:
a. "B,)dily injury" "property damage" or "personal and advertising injury" occurring after:
(1) All work on Ihe project (other than service, maintenance, or repairs) to be performed
by you or on your behalf forthe addrtional insured(s) has been completed; or
(21 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.
b. "Bodily injury" "property damage" or "personal and advertising injury" resulting from any act
or omission of the addilional insured(s) or any of their employees, other than Ihe general
sUJervision of work perfOrmed fOfthe addilional insured(s) by you.
c. "Bodily injury" "property damage" or "personal and advertising injUlY" resulling from work
performed on a project where other valid and collectible insurance is available to the
ad:lilional insured under an Owner Controlled Insurance Program or Consolidated (wrai>-
UP) Insurance Program.
d. "Bodily injury," "property damage" or "personal and advertising injury":
(11 Arising out of the rendering or failure to render any professional services by any
insured. or on their behalf, but only with respect to either or both of the following
operations;
(al Providing engineering, archilectural or surveying services to others in the
insured's capacily as an engineer, archilect or surveyor, and
(b) Providing, or hiring independent professionals to provide, engineering,
architectural or surveying services in connection with work the insured performs.
(2) Subject to paragraph (3) below, professional services include:
(a) The preparing, approving or failing to prepare or approve maps, shop drawings,
opinions, reports, surveys, field orders, change orders, or drawings and
specifications; and
(b) Supervisory or inspection activities performed as part of any related archilectural
or engineering activilies, but does not inctude the general supervision of your
operations on such project.
(3) Professional services do not include services wilhin construction means, methods,
techniques, sequences and procedures employed by you in connection wilh your
operations as a construction conlractor
For the purpose of this endorsement, Ihe following definitions are added:
"Owne~' means a person or organization who has ownership in the project pfemises, designated
in your written contract or written agreement, at which you are performing operations.
"Contracio~' means a person or organization wilh whom you have agreed n a written contract or
written agreement to perform operations for at the project designated in the written contract or
written a~reement.
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"Construction Manage~' means a person or organization designated as "co1struction manage~' in
your written contract or written agreement, and has management or supervisory responsibilities
over YOUf operations fOf the project designated in your wfitten contract or written agreement.
"Enginee~' means a person or organization who has been engaged by the "owne~', "contracto~'
or "construction manage~' to perform engineering services fOf the pfOject designated in your
wfitten contract or written agreement and ,has a contractual respons biltty for supervising,
directing or controlling your operations on such project.
"Archttect" means a person or organization who has been engaged by the "owner", "contracto~'
or "construction manager" to perform arcMectural services for the project designated in your
wrttten conlract or written agreement and has a contractual respons biltty for supervising,
directing or controlling your operations on such project.
Any coverage pfOvided herein will be excess over any other valid and collectable insurance available
to the add~ional insured(s) whether primary, excess, contingent or on any other basis unless you
have agreed In a written contract or written agreement executed prior to any loss that this insurance
will be primary, However, any other insurance specifically purchased for a designated project(s),
Including but not IIm~ed to add~ional insured coverage, owners contractors protective coverage, etc.,
will be primary w~h the insurance provided by this endorsement being excess. If this insurance is
determined to be primary, we agree not to seek contribution from such other insurance only if you
tlav~ su HYIl:t:lU III ttle wrltttlrl contnlct ur written ayreernellt.
C. AUTOMATIC WAIVER OF SUBROGATION
Item 8, of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and
replaced w~h Ihe following:
8. Transfer of Rights of Racovery Againsl Others 10 Us and Aulomatic Waiver of '
Subrogation.
a. If the insured has rights 10 recover all or part of any payment we have made under this
Ccverage Form, those rights are transferred to us. The insured must do nothing after loss
to impair those rights. AI our request, the insured will bring "suW' or transfer Ihose rights to
us and help us enforce them.
b, If required by a written contract executed prior to loss, we waive any right of fecovery we
may have against any person or organization because of paymenls we make for injury or
damage arising out of "your work" for that person or organization.
D. EXTENDED NOTICE OF CANCELLATION, NONRENEWAL
Item A.2.b. cf the COMMON POLICY CONDITIONS, is deleted and replaced wtth the following;
A.2.b. 60 days before Ihe effective dale of the cancellation if we cancel for any other reason.
Item 9. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and
replaced wtth the following;
9. WHEN WE DO NOT RENEW
a, If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured
sh'lwn in the Declarations written notice of the nonrenewal not less than 60 days before the
ex~iration date.
b. If we do not give notice of our intent to nonrenew as prescribed in a, above, tt is agreed that
YOJ may extend the period of this policy for a maximum addttional sixty(60) days from its
scheduled expiration date. Where not otherwise pfOhibited by law, the existing lerms,
c01dttions and rates will remain in effect during that extension period. It Is further agreed
GL-3086 (01/06)
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that so long as ~ is not othelWise prohibited by law, this one time sixty day extension is the
soe remedy and liquidated damages available to the insured as a resutt of our failure to
gi\'6 the notice as prescribed in 9. a. above.
E. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Although we relied on your representMions as to existing and past hazards, if unintentionally you
should fail 10 disclose all such hazards at the inception date of your policy. we ",ill not deny coverage
under this Coverage Form because of such failure.
F. BROADENED MOBILE EQUIPMENT
Item 12.b. of SECTION V - DEFINITIONS. is deleted and replaced w~h the following:
12.b, Vehicles maintained for use solely on or next to premises, sites or locations you own, rent or
occupy.
G. PERSONAL INJURY - CONTRACTUAL COVERAGE
Exclusion 2.e. of SECTION I, COVERAGE B is deleled.
H. NONEMPLOYMENT DISCRIMINATION
Unless "personal and advertising injury" is excluded from this policy:
Item 14. of SECTION V - DEFINITIONS, is amended to include:
"PefSonal and advertising injury" also means embarrassment or humiliation, mental or emotional
distress, physical illness, physical impairment, loss of earning capacily or monetary loss, which is
caused by .discrimination,"
SECTION V - DEFINITIONS, is amended to include:
23. "Discrimination" means the unlawful treatment of individuals based on race, color, ethnic
ori~in, age, gender or religion.
Item 2, Exclusions of SECTION I, COVERAGE B, is amended to include:
"PefSonal and advertising injury" arising out of "discrimination" directly Of i1directly felMed to the
past employment, employment or prospective employment of any person Dr class of pefSons by
any insured;
"PefSonal and advertising injury" arising out of "discrimination" by or at your, your agents or your
"employees" direction or wilh your, your agents or your "employees" knowledge or consent;
"PefSonal and advertising injury" arising out of "discrimination" directly or i1directly related to the
sale, rerlal, lease or sub-lease or prospective sale, rental, lease or sub-lease of any dwelling,
permanent lodging or premises by or at the direction of any insured; or
Fines, penalties, specific performance or injunctions levied or imposed by a governmental entity,
or governmental code, iaw, or statule because of "discrimination."
I. LIQUOR LIABILITY
Exclusion 2,0. of SECTION I, COVERAGE A, is deleted.
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J.. BROADENED CONDITIONS
Items 2.a. and 2.b. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, are
deleted and replaced with the following:
2. Duties In The Event Of Occurrence, Offense, Claim Or Suit:
r
a. You must see to ~ that we are notified of an "occurrence" or an offense which may result in
a claim as soon as practicable after the "occurrence" has been repo~ed to you, one of your
officers or an "employee" designated to give notice to us. Notice shoJld include:
(1) How. when and where the "occurrence" or offense took place;
(2) The names and addresses of any injured persons and w~nesses; and
(3) The nature and location of any injUlY or damage arising out of the "occurrence" or
offense.
b. If a claim is made or "su~" is brought against any insured. you must:
(1) Record the specifics of the claim or "suit" and the date received as soon as you, one
of your officers, or an "employee" designated to record such infonnation is notified of
~;and
(2) Notify us in writing as soon as practicable after you, one of your officers, your legal
department or an "employee" you designate to give us such notice leams of the
claims or "sufi."
Item 2.e. is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS:
2.e. If you report an "occurrence" to your workers compensation insurer which develops into a
liability claim for which coverage is provided by the Coverage Form, failure to report such
"occurrence" to us at the time of "occurrence" shall not be deemed in _iolation of paragraphs
2.a., 2.b., and 2.c. However, you shall give written notice 01 this "occurrence" to us as soon as
you are made aware of the fact that this "occurrence" may be a liabiliy claim rather than a
workers compensation claim.
K. . AUTOMATIC ADDITIONAL INSUREDS - EQUIPMENT LEASES
SECTION II - WHO IS AN INSURED is amended to include any person or organization w~h whom
you agree in a written equipment lease or rental agreement to name as an add~ional insured with
respect to liability for 'bodily injury," "property damage" or "personal and advertising injury" caused, at
least in part, by your maintenance, operation, or use by you olthe equipmentleased to you by such
person or organization, subject to the following additional exclusions.
The insurance provided to the add~ional insured does not apply to:
1. "Bodily injury" or "property damage" occurring after you cease leasing the equipment.
2. "Bodily injury" or "property damage" arising out of the sole negligence of the add~ional insured.
3. "Property aamage" to:
a. Property owned. used or occupied by or rented to the additional insured; or
b. Property in the care, custody or control of the add~ional insured or over which the
ad:l~ional insured is for any purpose exercising physicai control.
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l. SUITS AGAINST DREDGES AND BARGES
We agree that any "suit" in rem against any dredge or barge ownec, operated by or for you, and used
in your operations, shall in all respects be treated in the same manner as though the "suit" were
against you.
This coverage is excess over and above any specific insurance on any dredge or barge owned,
operated by ~r for you, and used in your operations.
M. INSURED CONTRACT EXTENSION - RAILROAD PROPERTY AND CONSTRUCTION
CONTRACTS
Item 9. of SECTION V - DEFINITIONS. is deleted and replacec with the following.
9, "Insured Contract" means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of
premises that indemnifies any person or organization for damage by fire to premises while
rented to you or temporarily occupied by you with pelll1ission of the owner is not an
"insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as requirec by ordinance, to indemnify a municipalrty, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
f, That part of any other contract or agreement pertaining to your business Qncluding an
indemnification of a municipality in connection with work perfolll1ec for a municipalrty)
un:ler which you assume the tort liability of another party to pay for "bodily injury" or
"property damage" to a third person or organization provided the "bodily injury" or "properly
damage" is caused, in whole or in part, by you or those acting on your behalf. Tort liability
means a liabilrty that would be imposed by law in the absence of any contract or
agreement.
Paragraph t, does not include that part of any contract or agreement:
(1) That indemnifies an archrtect, engineer or surveyor for injury or damage arising out of:
la) Preparing, approving, or failing to prepare or approve, maps, shop drawings,
opinions, reports, surveys, field orders, change ordErs or drawings and
specifications: or
(b) Giving dirEctions or instructions, or failing to give them, if that is the primary
cause of the injury or damage; or
(2) Under which the insured, if an arcMect, engineer or surveyor. assumes Iiabilrty for an
injUlY or damage arising out of the insured's rendering or failure to render professional
services, including those listed in (1) above and supervisory, inspection, architectural
or engineering activities.
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N. CONSTRUCTION PROJECT GENERAL AGGREGATE UMITS
This modifies SECTION III " LIMITS OF INSURANCE_
A. For all sums which can be attributed only to ongoing operations at a single construction project
for which the insured becomes legally obligated to pay as damages caused by an "occurrence"
under SECTION I " COVERAGE A, and for all medical expenses caused by accidents under
SECTION I " COVERAGE C:
1. A separate Construction Project General Aggregate Limn applies to each construction
project, and that limit is ecual to the amount of the General Aggregate Limn shown in the
Declarations.
2. The Construction Project General Aggregate Limit is the most we wiD pay for the sum of all
damages under COVERAGE A, except damages because of "bodily injury" or "property
damage" included in the "products-completed operations hazard," and for medical
expenses under COVERAGE C'regardless ofthe number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing "suits."
3. Any payments made under COVERAGE A for damages or under COVERAGE C for
medical expenses shall reduce the Construction Project General Aggregate Limn for that
C01struction project. Such payments shall not reduce the General Aggregate Limn shown
in the Declarations nor shall they reduce any other Construction Project General Aggregate
Limn for any other construction project.
4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical
Expense continue to apply. However, instead of being subject to the General Aggregate
Limit shown in the Declarations, such limns will be subject to the applicable Construction
Project General Aggregate Limit.
B. For all sums which cannot be attributed only to ongoing operations at a single construction
project for which the insured becomes legally obligated to pay as damages caused by an
"occurrence" under SECTION I " COVERAGE A, and for all medical expenses caused by
accidents under SECTION I "COVERAGE C:
1. Any payments made under COVERAGE A for damages or under COVERAGE C for
medical expenses shall reduce the amount available under the General Aggregate Limll or
the Products-Completed Operations Aggregate Limit, whichever is applicable; and
2. Such payments shall not reduce any Construction Project General Aggregate Limit.
C. Payments for damages because of "bodily injury" or "property damage" included in the
"products-completed operations hazard" will reduce the Products-Completed Operations
Aggregate Limn, and not reduce the General Aggregate Limn nor the Construction Project
General Aggregate Limll.
D. If a C01struction project has been abandoned, delayed, or abandoned a1d then restarted, or if
the authorized contracting parties deviate from plans, blueprints, desgns, specifications or
timetables, the project will still be deemed to be the same construction project.
E. The provisions of SECTION III " LIMITS OF INSURANCE not otherNise modified by this
endo~ement shall continue to be applicable.
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O. FELLOW EMPLOYEE COVERAGE
Exclusion 2.e. Employers Liability of SECTION I, COVERAGE A, is deleted and replaced with the
following:
2.&. "Bodily injury" to
(1) An "employee" of the insured arising out of and in the course of:
(a) Employment by the insured; or
(bl Performing duties related to the conduct ofthe insured's business; or
(2) The spouse, child, parent, brother or sister of that "employee" as a consequence of
paragraph (1) above.
This exclusion applies:
(1) Whether the insured may be liable as an employer or in any other capaclly; and
(2) To any obligation to share damages w~h or repay someone else who must pay damages
because of the injury.
This exclusion does not apply to:
(1) Liabillly assumed by the insured under an "insured contract"; or
(2) Liabil~y arising from any action or omission of a co-"employee" while that co-"employee" is
eit1er in the course of his or her employment or performing duties related to the conduct of
YOJr business.
Item 2.a. (1)(a) of SECTION 11- WHO IS AN INSURED, is deleted and replaced with the following:
2.a. (1l(a) To you, to your partners or members (if you are a partnership or joint venture) or to your
members (if you are a limited liabil~y company), or to your "vol.mteer workers" while
performing duties related to the conduct of your business.
P. PROPERTY DAMAGE LIABILITY - ELEVATORS
"Property damage" liability is changed as follows:
1. Exclusions 2.j.(31 and 2.j.(4) of SECTION I, COVERAGE A. do not apply to the use of
elevators,
2. The insurance afforded by reason of this provision is excess over any valid and collectible
property insurance (including any deductible portion thereof) available to the insured whether
primar(, excess, contingent or on any other basis, and the OTHER INSURANCE cond~ion is
changed accordingly.
Q. PROPERTY DAMAGE TO THE NAMED INSURED'S WORK
Exclusion I oJ! SECTION I, COVERAGE A. is deleted and replaced wllh the following:
I. Damage to Your Work
"Property damage" to "your work" arising out of II or any part of II and included in the "products
completed operation hazard,"
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This exclusion applies only to that portion of any loss in excess of $50,00) per occurrence if the
damaged work and the work out of which the damage arises was performed by you.
This exclusion does not apply if the damaged work or the work out of which the damage arises
was performed on your behalf by a subcontractor.
R. CARE, CUSTODY OR CONTROL
Exclusion 2J.4 of SECTION I, COVERAGE A. is deleted and replaced w~h the following:
2.j.4 Personal property in the care, custody or control of the insured. However, for personal property
in the care, custOdy or control of you or your "employees," this exclusion applies only to that
portion of any loss in excess of $25,000 per occurrence, subject to the following terms and
conditions; -
(al The most that we will pay under this provision as an annual aggregate is $100,000,
regardless oflhe number of occurrences.
(b) This provision does not apply to "employee" owned property or any property thai is missing
where there is not physical evidence to show what happened to the property.
(c) The aggregate limit for this coverage provision is part of the General Aggregate Limn and
SECTION III - LIMITS OF INSURANCE is changed accordingly.
(d) In the event of damage to or destruction of property covered by this exception, you shall, if
requested by us, replace the property or furnish the labor and materials necessary for
repairs thereto, at actual cost to you, exclusive of prospective profit cr overhead charges of
any nature.
(el $2,500 shall be deducted from the total amount of all sums you became obligated to pay as
damages on account of damage to or. destruction of all property of each person or
organization. including the ioss of use of that property. as a result of each "occurrence,"
Our limit of liabimy under the endorsement as being applicable to each "occurrence" shall
be reduced by the amount of the deductible indicated above; however, our aggregate limn
of Iiabilny under this provision shall not be reduced by the amount of such deductible. The
c01dnions of the policy, including those with respect to duties in the event of "occurrence,"
claims or "sun" apply irrespective of the application of the deductible amount. We may pay
any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon
notification of the action taken, you shall promptly reimburse us for such part of the
de:luctible amount as has been paid by us,
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS ADDITIONAL INSURED ENDORSEMENT - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following;
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SECTION II - WHO IS AN INSURED is amended to include:
Any "owner''', "contractor", "oonstruction manager". "engineer" or "architect" if it is required in your written
contract or written agreement executed by you and all other parties to the contract or agreement prior to
any 1055 that such person(s) or organization(s) be added as an additional insured on your policy for
completed operations but only for the project deSignated in your written contract or written agreement
and only wilh respect to "bodily injury" or "property damage" included in the "products-completed
operations hazard" and caused, at least in part, by your negligence and with respect to liability resulting
from;
A. "Your work" performed for Ihe additional insured(s), or
B. Acts or omissions of the additional insured(s) in connection with their general supervision of .your
work".
With respect to the insurance afforded such additional insureds in connection with this endorsement and
the above referenced Commercial General Liability Form, the following additional provisions apply to limit
that coverage:
1. We will have no duty to defend the additional insured against any "suit" seeking damages for "bodily
injury" or "property damage" until we receive written notice from the additional insured requesting
that we defend it in the llsuit."
2. The Limits of Insurance applicable to the addiHonal insureds under this endorsement are the
minimum limits specified in the written contract or agreement requiring this coverage, or as stated in
SECTION III - LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABILITY COVERAGE
FORM, whichever is less. These Limits of Insurance are inclusive of and not in addition to the
Limits of Insurance described in SECTION III of thai form_
3. As additional conditions of coverage under this form, an additional insured under this endorsement
will as soon as practicable:
a. Give written notice to us of an "occurrence" which may result in a claim. This shall include:
(1) How, wh,m and where the "occurrence" took place;
(2) The names and addresses of any injured persons and witnesses; and
(3) The nature and location of any injury or damage arising out of lhe "occurrence".
b. Give written notice to us of a claim or "suir' brought against the additional insured including
specifics of the claim or "suit" and the date it was received.
c. Give written notice of such claim or "suit," including a demand for defense and indemnity, to
any other insurer who had coverage for the claim or "suit" under its policy(ies), either at the
time of, or at any time subsequent to the occurrence of the "bodily injury" or "property damage"
which is the basis for such claims or "suit."
(1) Such notification must demand Ihe full coverage available under that policy; and
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(2) The additional insured shall not take any action to waive or limit such other coverage
available to it.
4. This insurance does not apply to:
B. IlBodily injury'l or .property damage" resulting from any act or omission of the additional
insured(s) or any of their employees, other than the general supervision of work performed for
the add~ional insured(s) by you;
b. "Bodily injury" or "property damage" resulting from "your work" performed on a project where
other valid and collectible insurance is available to the additional insured under an Owner
Controlled Insurance Program or Consolidated (wrap-up) Insurance Program;
c. "Bodily injury" or "propo;.rty demage"
(1) In connection with a project where "your work" on the project was completed prior to the
effective date of this policy, unless the written contract or written agreement includes a
specific time requirement for completed operations coverage to be provided by you for the
add~ional insured for "bodily injury" or "property damage" occurring during the policy
period.
(2) In connection with a project where ';Your work" on the project was completed and where
the duration of the additional insured coverage requirement in the written contract or
written agreement governing "your work" on that project had expired by the time that the
injury or damage first occurred.
(3) In connection with a project where "your work" on the project was completed more than
thirty six (36) months prior to the effective date of this policy.
For the purpose of this endorsement, "your work" will be deemed completed as set forth in the
"products-completed operations hazard" definition.
d. "Bodily injury" or 'property damage":
(1) Arising out of the rendering or failure to render any professional services by any
insured, or on their behalf, but only with respect to either or both of the following
operations;
(a) Providing engineering, arcMectural or surveying services to others in the
insured's capacity as an engineer, architect or surveyor, and
(b) Providing. or hiring independent professionals to provide, engineering,
architectural or surveying services in connection with work the insured
performs.
(2) Subject to paragraph (3) below, professional services include:
(a)
The preparing, approving or failing to prepare or approve maps, shop drawings.
opinions, reports, surVeys, field orders, change orders, or drawings and
specifications; and
(b)
Supervisory or inspection activ~ies performed as part of any related
architectural or engineering activities, but does not include the general
supervision of your operations on such project.
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(3) Professional services do not include services within construction means, methods,
techniques, sequences and procedures employed by you in connection with your
operations as a construction contractor.
For the purpose of this endorsement, the foliowing definitions are added:
"Owner" means a person or organization who has ownership in the project premises designated
in your written contract or written agreement, at which you are performing or performed work.
IIContractor" means a person or organization with whom you have agreed in a written contract or
written agreement to perform work for at the project designated in the written contract or written
agreement.
"Construction Manager" means a person or organization designated as "construction manager" in
your written contract or written agreement, and has management or supervisory responsibilities
over "your work" for the project designated in the written contract or written agreement.
"Enginee~' means a person or organization who has been engaged by the "owner", "contractM' or
"construction manager" to perform engineering services for the project designated in your written
contract or written agreement and has a contractual responsibility for supervising, directing or
controlling "your work- on such project.
"Architect" means a person or organization who has been engaged by the "owne~', "contracto~' or
"construction manager" to perform architectural services for the project designated in your written
contract or written agreement and has a contractual responsibility for supervising, directing or
controlling "your worK" on such project.
Any coverage provided herein will be excess over any other valid and collectable insurance available to the
additional insured(s) whether primary, excess, contingent or on any other basis unless you have agreed in a
written contract or written agreement executed prior to any loss that this insurance will be primary. However,
any insurance specifically purchased for a designated project(s), including but not lim~ed to additional
insured coverage, owners contractors protective coverage, etc., will be primary with the insu rance provided
by this endorsement being excess. If this insurance is determined to be primary I we agree not to seek
contribution from such other insurance only if you have so agreed in the written contract or written
agreement.
In no event will any coverage provided under this endorsement extend beyond the expiration date of this
policy.
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CITY RECORDER
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
'...:, DATE(~ '"',',;Y
9/23/2010
"~:"'" po: NUMBER;lJ":'
09812
VENDOR: 004331
ASPHALT MAINTENANCE ASSOCIATES
2080 PRAIRiE ROAD
EUGENE, OR 97402
SHIP TO: Ashland Public Works
(541) 488-5587
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.:
Contact: Mike Faught
Confirming? No
:"' .;(ii.railiiiVf~ :~.uhit"t,:. .r;:;~{::~~P;('::~:< .~".~.:"',: :- ':~:'~.~j;,: ,", . ," Desc:riptioh",'; :.' "... ,. .. " .'; Un if Price , .f:'xt','Rrir:e'ii.;f;lli
.. ,,' ,
2010 Stree) Slurry Seal - Project 95,803.80
2010-08
.
SUBTOTAL 95 803.80
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 95,803.80
ASHLAND, OR 97520
\~',~. Acc'ou"nFNulnh'er': :;. .., T. :';~,Pr_ojec(Numtie'r ~-:-,;. . " ::"AmoLiift',;, Acc'ountNumber/:,', _~,:.,'<! Project 'Number., "" " ::~~::~Amouni~;;fffi~:
~,.- , .. ,-,
E 260.08. 12.00.70420 95 803.80
dK.:1
t? ~ ~ruf cJ
Aut~zed Signal re
VENDOR COPY
,
,
CITY OF
ASHLAND
REQUISITION
No. PW_-FY2010
Department PWIENGINEERING
Vendor Asphalt Maintenance Assoc.
2080 Prade Road
Eugene, OR 97402
Account No. 260.08.12.00.704200
Date September 21,2010
Requested Delivery Date
Deliver To Jim Olson
Via
(+ Note; Please allow approximately two(2) weeks for delivery on items nol
generally caried in stored, and approximately two (2) months on printingjobs.)
Item No. Quantity Unit Description Use of Purchasing Office Only
Unit Price Total Price PO No.
2010 Street slurry seal
TOTAL $ 95,803.80
for Kari:
BID IRFP / EXEMPT:
Contract Start Date: 27-Sep-lO
Contract Completion Date: 10-Nov-10
Insurance on file: IYES INO
P~oiect No: 2010-08
Job No.
Unit No.
I hereby certify that the above items are necessary for the operation
of this department and life budgeted
Issued By
Date
Received By
r~'
G:\pub-wrks\eng\ 10-08 2010 Sluny Seal Streets\ 10-08 Asphalt Maint. Requisition.xls