HomeMy WebLinkAbout2010-179 Contract - Natl Research Ctr
,
Contract for PERSONAL SERVICES less than $25,000
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONSULTANT: National Research Center
CONTACT: Damema Mann, Director,
National Citizen Survey
ADDRESS: 3005 30th Street, Boulder, CO 80301
TELEPHONE: 303-444-7863, x118
DATE AGREEMENT PREPARED: FAX: 303-444-1145
10/07/2010
BEGINNING DATE: 10/21/10 COMPLETION DATE: Mav 1, 2011
COMPENSATION: $17,400 ($9,900 for base survey plus $7,500 for additional options including demographic
subgroup comparisons, custom benchmarks, one open-ended question, comparison to previous City survey,
scientific survey, non-scientific web survey, return of completed surveys).
SERVICES TO BE PROVIDED: Citizen Survev
ADDITIONAL TERMS: None
FINDINGS:
Pursuant to AMC 2.52.040E and AMC 2.52.060, after reasonable inquiry and evaluation, the undersigned Department
Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have
adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for
utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and
capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and
financial constraints provided; (5) the consultant's proposal will best serve the needs of the City: and (6) the
compensation negotiated herein is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consuitant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service to which they will be
assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of
Oregon, are so registered, licensed and bonded.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified
above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely
terminated, payments will be made for work completed and accepted to date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $18,703 or more, Consultant is required to comply with
chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees
performing work under this contract and to any Subcontractor who performs 50% or more of the service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations,
actions~costs, iudnments, or other damages, directlv, soielv, and oroximatelv caused bv the neolioence of Citv.
Contract for Personal Services, Revised 07/28/2010, Page 1 of 5
10. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. Citv's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
c. For Cause. City may terminate or modify this contract, in whoie or in part, effective upon delivery of
written notice to Consultant, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no ionger eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be heid by Consultant to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Consultant may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other.period as
the party 'giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consuitant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and rem~dies provided by law or under this contract.
e. Obliaation/Liabilitv of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardiess whether such notice is
given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under
this contract, unless expressiy directed otherwise by City in the notice of termination. Further, upon termination,
Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an empioyee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for ali persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work '
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Consultant shall be fully responsibie for the acts or omissions of any assigns or Subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
13. Default. The Consultant shali be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its ORF status pursuant to the ORF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a ORF if
consultant has qualified as a ORF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business
on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or
delegate duties under, the Contract.
14. Insurance, Consuitant shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. Professional Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
c. General Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
d. Automobile Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, ~1 000000, or Not Annlicable for each accident for Bodilv Iniurv and Propertv Damaae,
Contract for Personal Services, Revised 07/28/2010, Page 2 of 5
inciuding coverage for owned, hired or non-owned vehicles, as applicable.
e. Notice of cancellation or chanqe. 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 Consultant or its insurer(s) to
the City.
f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Consultant's services to be provided under this Contract. The consuitant's insurance is primary and
non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish
acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of
the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the City. The
Consultant shall be financially responsible for all pertinent deductibles, seif-insured retentions and/or self-
insurance.
15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (COllectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Consultant that arises from or relates to this contract shali be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted soleiy and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFiCATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTiVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS iT, AND, AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant
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 Consultant, with no further
liability to Consultant.
Certification. Consultant
onsultant:
'fication attached hereto as Exhib'
City of Ashl
By
"-
By
Print Name
~ M5' -::r- fvI. \ LL&t
Print Name'
~,~
Title
OdDW- :;}(p ~otO
Date '
W-9 One copy of a W-9 is to be submitted with
the signed contract.
Funds appropriated for current fiscal year:
\J
Approved as to form:
Legal Department Date
Purchase Order No.' t:J'f'g 6 7
Contract for Personal Services, Revised 07/28/2010, Page 3 of 5
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding, Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
. competent and duly licensed to perforrn the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
a
~
;P-
~
~
(1) I carry out the labor or services at a location separate frorn my residence or is in a
specific portion of my residence, set aside as the location of the business,
(2) Commercial advertising or business cards or a trade association rnembership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing,
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
year.
(6) I assume financial responsibiiity 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
/0
(Date)
Contract for Personal Services, Revised 07/28/2010, Page 4 of 5
~
ACORD" CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMtDOIYYVY)
~ 10/0712010
PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION
JEFF OGBURN, STATE FARM INSURANCE ONLY AND CONFERS NO RtGHTS UPON THE CERTIFICATE
6560 GUNPARK DRIVE, STE A HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
~l BOULDER, CO 80301 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A:. Stale Fann Ant and Casualty Camp.my 25143 25143
NATIONAL RESEARCH CENTER INC, INSURER B:
300T5 30TH S1, INSURER c:
BOULDER, CO 80301 INSURER 0:
INSURER E:
COVERAGES
THE POLICIES OF'INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY PERIOD INDICATED. NOT\MTHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE liMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS ADO' POLICY NUMBER 82T~9~~~~~~~i) ~'r\frM~~ UMITS
LTR INSR TYPE OF INSURANCE:
A X ~NERAL UABILlTY 96-BU-3823-8 11/16/2009 11/16/2010 EACH OCCURRENCE . 1,000,000
COMMERCIAL GENERAL LIABILITY PREMISES Ea Dccummce\ S 300,000
I CLAIMS MADE [8] OC~UR MEO EXP (Anyone person) S 10,000
X HIRED AUTO LIABILITY PERSONAL & ArN INJURY S
X NON-oWNED AUTOS GENERAL AGGREGATE . 2,000.000
GEN'LAGG~nE LIMIT AP~t PER; PRODUCTS - CONPfOP AGG .
Xli PRO.
POLICY JECT LOC S
~TOMOBlLE UABIUTY 161-3304-E21-06 11/29/2009 11J29f2010 COMBINED SINGLE LIMIT
S
- ANY AUlO (Eaaccidenl)
- AU OWNED AUTOS HOOIL Y INJURY
S 1,000,000
- SCHEDULED AUTOS (Per person)
- HIRED AUTOS BODLYtNJURY
. 1,000,000
1- NON-OWNED AUTOS (P9raccidenll
r- PROPERTY DAMAGE . 1,000,000
(Poraccident}
RRAOE UAB'U1Y AUTO ONLY- EA ACCIDENT S.
ANYAlfTO OTHER TItAN EA ACe s
AUTO QNL Y; AGG .
EXCE:SS I UMBRELLA UABlUTY EACH OCCURRENCE .
=:J OCCUR D CLAIMS MADE AGGREGATE .
.
=J DEDUCTIBLE .
RETENTION $ .
WORKERS COMPENSATION AND I T~~IrJNs I I OJ!:
EMP1..0YERS' UABILITY
/W'( PROPRIETORJ1>ARTNER,EXECUTIVED E.L. EACH ACCIDI:NT .
OFFICER/MENBER EXClUDEDi
IM.ndalorylnflHj E.L. DISEASE - EA EMPLOYE .
tlyes, cesctibe ...,Cl<< E_l. DISEASE - POllCV LIMIT $
,
OUIER
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSeMENT I SPEClAL PROVISIONS
RESEARCH
THE CITY OF ASHLAND, OR, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES IS LISTED AS ADDTIONAL
INSURED,
CERTIFICATE HOLDER
CANCELLATION
CITY OF ASHLAND SHOULD ANY OF THE ABOVE!. DESCRIBED POUCIES BE CANCEl...L.fD BEFORE TIlE EXPIRATION
20 EAST MAIN STREET DATE TIlEREOF, THE ISSUING INSURER lMLL ENDEAVOR TO MAIL ~ DA VS WRITTEN
ASHLAND, OR 97520 NOTICE TO THE CERTlACATl! HOLDER N......ED TO THE LEFT, BUT fAILURE TO DO SO SHALL
IMPOse NO OBUOATfON OR UABILITY OF" ANY KINO UPON THE INSURER, rTSAGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
JEFF OGBURN
ACORD 25 (2009/01)
@1988-2009 ACORD CORPORATION, All rights reserved.
The ACORD name and logo are registered marks of ACORD 1001466 132849.3 04-06-2009
~.
OP 10: MC1
ACORD. CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMIDDfYYVY)
~ 10107/10
THIS CERTIFICATE IS ISSUED AS' A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMA TIVEL Y OR NEGA TIVEL Y 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 the
certificate holder in lieu of such endorsement(s).
PRODUCER 303.781.6776 CONTACT
NAME:
NEISEN BORTH AGENCY 303.789-4409 : r~~IN:o Ext'; If~ No:
www.nbinsure.com E-MAIL
333 W, Hampden Ave, Ste, 410 ADDRESS:
Englewood, CO 80110 ~~~~~~~~ ID #: NA TI430
INSURER{S) AFFORDING COVERAGE NAIC#
INSURED National Research Center, Inc, INSURER A, Philadelphia Insurance Company
3005 30th Street INSURER B :
Boulder, CO 80301 INSURER C :
INSURER 0 :
INSURER E :
INSURER F :
COVERAGES
CERTIFICATE NUMBER'
REVISION NUMBER'
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DQCUMENT W1TH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ~~ ~.~~!' ':8M~~ ~gT~%~ LIMITS
LTR POLICY NUMBER
~NERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY I ~~~~~S Ea occurrence $
I CLAIMS-MADE D OCCUR MED EXP (Any one person) $
- PERSONAL & ADV INJURY $
i- GENERAL AGGREGATE $
~'L AGG:nE LIMIT APnS PER PRODUCTS - COMP/OP AGG $
POLICY ~89.; LOC $
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
"- ANY AUTO BODILY INJURY (Per parson) $
"- ALL O\fIINED AUTOS BODILY INJURY (Per accident) $
- SCHEDULED AUTOS PROPERTY DAMAGE
$
- HIRED AUTOS (Per accident)
- NON-O\fIINED AUTOS $
$
~ UMBRELLA LIAB R OCCUR EACH OCCURRENCE $
EXCESS LIAS CLAIMS-MADE AGGREGATE $
- DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION ITIo):'g,F'1..r;t!. I 10J);"
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORlPARTNERIEXECUTIVE D NIA E.L. EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEf
(Mandatory in NH) $
~~sc~r~~8~ O~OPERATIONS below E.L. DISEASE. POLICY LIMIT $
A Professional Liab PHSD472568 01/01/10 01/01/11 Prof/E&O 1,000,000
Errors & Omissions Oed 5,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ~ttach ACORD 101, AddItional Remarks Schedule, If more spaca Is requIred)
Certificate holder is The City of Ashland, 0 ,and its elected officials, .
officers and employees. .
CERTIFICATE HOLDER
CANCELLATION
CITYOAS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
20 East Main Street
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
., ~d,~
ACORD 25 (2009/09)
@1988-2009ACORO CORPORATION, All rights reserved,
The ACORD name and logo are registered marks of ACORD
DATE (MM/DDNY)
10107/10
Certificate 10: 259198
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLlClES BELOW.
INSURED
ADP TotalSource I, Inc.
t 0200 Sunset Drive
Miami, Fl 33173
ALTERNATE EMPLOYER
National Research Center Inc
3005 30th Street
Boulder, CO 80301
:iCoVE'R'A'G~5;W1J\!jHlml~,ir~*!',Sful'ii:i:-,ii;;;iii':h.!ilii~l:<.:.'.'i','i,,:,", "!'!"im:jHW::::?'JIJl!:iii:mW.IjIillilmlllllll!l!l1lll""
;h,,,,,;,_.,,i'c~,,,..,<,,,,,,",_.~,,?'w.>>"I'\ffij;!I~,I!fi.Ij!\hJlclh'~'I,;('>/i"L):jjc,;!,;ii;:"L ;<.'.,,,,,i;~;h;'l~ih\MJ !uJd~I~H~,l~flm;nt!ill1'~lU!~OO'!JI
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE
MAY BE ISSUED OR MAY PERTAlN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS, AND
CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED.
..:-,
ACORtI
..........
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Aon Risk Solutions, Inc. of FL
1001 Brickell Bay Drive. Suite #1100
Miami, FL 33131-4937
Phone: 800-743-8130 Fax: 800-522-7514
INSURERS AFFORDING COVERAGE
INSURER A: New Hampshire Ins Co
INSURER B:
INSURER C:
INSURER D:
INSURER E:
NAIC#
23841
COMBINED SINGLE LIMIT $
(Eaaccident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA $
ACC
AUTO ONLY: AGG $
EACH OCCURRENCE $
AGGREGATE $
$
$
$
I8IWCSTATU- o OTHER
07/01110 07/01/11 TORY LIMITS
E.L. EACH ACCIDENT $ $2,000,000
E.L. DISEASE - EA EMPLOYEE $ $2,000,000
E.L. DISEASE - POLICY LIMIT $ $2,000,000
INSR AOD'l
LTR INSRD
POLICY NUMBER
POLlCY EFFECTIVE POLlCY EXPIRATION
DATE IMMIOD/YVVYj DATE IMMIODIYYYY)
TYPE OF INSURANCE
D GENERAL UABILITY
o COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MEO EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
o CLAIMS MADE 0 OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
o POLICY 0 PROJECT 0 lOC
o AUTOMOBILE LIABILITY
D ANY AUTO
o ALL OWNED AUTOS
o SCHEDULEO AUTOS
D HIRED AUTOS
D NON OWNED AUTOS
o GARAGE LIABILITY
o ANY AUTO_
EXCESS I UMBRELLA LIABILITY
D OCCUR 0 CLAIMS MADE
DDEDUCTISLE
DRETENTION
A
WORKERS' COMPENSATION AND
EMPLOYERS' LIABILITY
WC 058339956 CO
'"
ANY PROPRIETOR I PARTNER I EXECUTIVE
OFF"ICERIMEMBER EXCLUDED?
(M.nd.torylnNHI
IlYes,describeundel
SPECIAL PROVISIONS below
OTHER
UMITS
$
$
$
$
$
$
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS
All worksite employees working for the above named client company, paid under ADP TOTALSOURCE, INC.'s payroll, are covered under the above stated policy. The above
named client is an alternate employer under this policy.
Yci:R1if~icME i-jQiITii:R1\!!f;:,~"""~\E":"'::'.1V':
City of Ashland
20 East Main Street
Ashland, OR 97520
"'ACORD 25 (2do9)61):::~~
:~::":,(:::'i'J: :".!',!!"fk\\CANCi:1!i!At'fO'N:
- SHOULD ANY OF THE ABOVE DESCRI8ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS INRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ffton,(fi.ip'lcr8olatl:Oiu,Qn.l!.. of (ft
.~' iIi 'iii, ,. @1988!2009"'CORD CORP.ORA1HON, "'II n9~ts rese"'e6.
The ACORD name and logo are registered marks of ACORD
.-----.,
OP ID: MCl
PRODUCER
I DATE (MMlDDfYYYYJ
10/07/10
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
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 the
certificate hOlder!n lieu of such endorsementls'l. . :... -. -..
CONTACT
NAME: .
I fl}gNJo Ext':
E.MAIL
ADDRESS:
~~g~~~~~ ID': NA 11430
INSURER(5} AFFORDING COVERAGE
INSURER A; Philadelphia Insurance Company
CERTIFICATE OF LIABILITY INSURANCE
ACORD"
~
NEISEN BORTH AGENCY
www.nbinsure.com
333 W. Hampden Ave. Ste. 410
Englewood, CO 80110
303-781-6776
I 303-789-4409
,
'-" ,
I rt~ Nol:
NAIC#
INSURED
National Research Center, Inc.
3005 30lh Slreel
Boulder, CO 80301
INSURER B :
INSURER C :
INSURER 0 :
INSURER E :
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~M TYPE OF INSURANCE ~~~i ~~ POLICY NUMBER &SMg~1 ~~6%~, LIMITS
GENERAL LIABILITY
-
~ ~MMERCIAL GENERAL LIABILITY
-I---J CLAIMS-MADE D OCCUR
- -0- ' ."
- .
~'L AGGRE~E ,LIMIT AP~S PER:
I POLICY I . I ~~RT I I LOC
AUTOMOBILE LIABILITY
-
_ ANY AUTO
_ ALL OVvNED AUTOS
_ SCHEDULED AUTOS
_ HIRED AUTOS
_ NON-Q'NNED AUTOS
f--
UMBRELLA WAB
EXCESS WAB
I I OCCUR
n CLAIMS-MADE
. _._----~
r'~ (~\{=~ L~.:; ~ Vi@(
X ' _.nH \
ilnll OCT 12 2010 '.\
IU U\ ,l
i
EACH OCCURRENCE $
~~~a~~s Ea occurrence $
MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMPtO? AGG $
, $
COMBINED SINGLE LIMIT $
(Eaaccidenl}
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
(Pereccident)
$
$
EACH OCCURRENCE $
AGGREGATE $
$
$
IT~;r~JI~s I IOJ~-
E.L. EACH ACCIDENT $
EL DISEASE - EA EMPLOYE $
E.L. DISEASE - POLICY LIMIT $
ProfJE&O 1,000,00
Oed 5,00
I-- DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABIWTY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE 0
OFFICER/MEMBER EXCLUDED? N I A
(Mandatory in NH)
~~st~~~~ O~bPERA TlONS below
A Professional Liab IPHSD472568 01/01110 01/01/11
Errors & Omissions
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ~ttach ACORD 101, Additional Remarks Schedule, jf more apace Is required)
Certificate holder is The City of Ashland, OR, and its elected officials,
officers and employees. .
CERTIFICATE HOLDER
CANCELLATION
CITYOAS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
, ~d,~
ACORD 25 (2009/09)
@1988.2009ACORDCORPORATION, All rights reserved.
The ACORD name and logo are registered marks of ACORD
DATE (MM/DDNY)
10107/10
Certificate 10: 259198
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
--.
ACORd
~
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Aon Risk Solutions, Inc. of FL
1001 Brickell Bay Drive, Suite #1100
Miami, FL 33131-4937
Phone: 800.743-8130 Fax: 800-522-7514
INSURED
ADP TotalSource I, Inc.
10200 Sunset Drive
Miami, FL 33173
ALTERNATE EMPLOYER
National Research Center Inc
3005 30th Street
Boulder, CO 80301
INSURERS AFFORDING COVERAGE
INSURER A: New Hampshire Ins Co
INSURER B:
INSURER C:
INSURER D:
INSURER E:
-REGEIVED
OCT 13 '2010
NAIC#
23841
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE
MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND
CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ll~11TS SHOWN ARE AS REQUESTED.
INSR ,6.00'L
L,R INSRD
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
O"'TElMMIOON'\'YY} DATElMfolIDOIYYY'()
TYPE Of INSURANCE
D GENERAL LIABILITY
a COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrel1Ce)
MED EX? (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
a CLAIMS MADE a OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER
a POLICY a PROJECT Cl LaC
PRODUCTS - COMPIOP AGG
D AUTOMOBILE LIABILITY
[J ANY AUTO
o ALL OWNED AUTOS
COMBINED SINGLE LIMIT
(Eaaccident)
BODilY INJURY
(Per person)
a SCHEDULED AUTOS
o HIRED AUTOS
[J NON OWNED AUTOS
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
o
GARAGE LIABILITY
o ANY AUTO
AUTO ONLY - EA ACCIDENT
EA
ACC
AGG
OTHER THAN
AUTO ONLY:
EXCESS I UMBRELLA LIABILITY
EACH OCCURRENCE
AGGREGATE
o OCCUR
o CLAIMS MADE
[JDEOUCTIBLE
DR"'!"E!a~C~1
A
WORKERS' COMPENSATION AND
EMPLOYERS' LIABILITY
07/01/11
181 WC STATU. D OTHER
TORY LIMITS
'"
WC 058339956 CO
07f01/1 0
ANY PROPRIETOR I PARTNER I EXECUTIVE
OFFICERlMEMBEREXCLUDED1
lMendelorylnNH)
IfYes.describeuroi.,
E.L EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L DISEASE - POLICY LIMIT
SPECIALPROVlSlDNSbeKlw
OTHER
LIMITS
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$2,000,000
$2,000,000
$2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
All INOrksite employees working for the above named client company, paid under ADP TOTALSOURCE, INC.'s payroll, are covered under the above slated policy. The above
named client is an alternate employer under this policy.
CERTII:IC.<ITEHOLDER
City-of AShla;d "
20 East Main Street
Ashland, OR 97520
"' CANCELLA liON
I','. :,fl;'SHOUU;- ANY ClF-T~E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
, I CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION
OR LIABiliTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES,
I I AUTHORIZED REPRESENTATIVE
)!
ACORD 25(2009/01)
(/Ion. d@1c 8olutio~. qn.... of cfl
. ' . .. ~988.20()9ACORD CORPORATION: Ail rlghiS,,,.rerved:
The ACORD name ;ndlogo-;;;'egiste-;:ed ~arks of ACORD -."'-.-
National'Citizen Survey
Page I of5
ICMA Results Networks I Surveying / National Citizen Survey
National Citizen Survey
The first and last measure of good government is citizen satisfaction
WHAT IS THE NATIONAL CITIZEN SURVEY~?
Developed by lCMA and National Research Center, lnc" The National x::
Citizen Survey~ (The NCS) is a low-cost citizen survey service for
allonal C~lzen survey, ..
local governments, Tested, flexible, affordable, and efficient, The NCS
lets you survey citizen opinion for
. Program Planning
. Budgeting
. Goal Setting
. ,Performance Measurement
Staff can use the results of The NCS to improve service delivery, Elected officials can use the results to
set spending priorities, The manager can use the results to measure progress and chart future steps,
You select from a set of standard questions to assess citizen opinion about basic services and
community life, Additional customized questions let you tailor the survey to your unique needs, A
new feature of The NCS' basic service is the Key Driver Analysis, which helps you identifY those
attributes most likely to increase resident opinion of your local government's performance,
An additional benefit to NCS participants who also participate in the ICMA Center for Performance
Measurement'" (CPM), is that The NCS was designed to coordinate with the CPM data collection, Thus,
local governments can submit citizen satisfaction data ~btained through The NCS survey instrument
to CPM along with their other performance measurement data,
THE NCS BASIC SERVICE OFFERED BY ICMA AND NRC INCLUDES:
. Customized survey form plus up to three optional questions
. Customized cover letter
. Three mailings to 1,200 randomly selected households, which include the pre-survey postcard and
two mailings ofthe survey instrument
. A margin of error (95 percent confidence interval) of no more than +j- 5 percentage points around
any percent
. Data input and cleaning
. Data weighted to reflect population norms
. Three reports: executive summary, statistical analysis of survey results, optional comparison with
national norms (all in electronicformat)
. NEW! Key Driver Analysis
. Certificate of participation
. Technical assistance by phone and e-mail
http://icma,orglen/results/surveying/nationa\_ citizen_survey
10/26/2010
National Citizen Survey
Page 2 of 5
. Entry to win top honors for Voice ofthe People Awards
. Access to Best Practices of winners of The Voice of The People Awards for Excellence and
Transformation
Additional Options:
. Larger mailings
. Customized norms by region, population, or other factors
. Spanish-language version of survey
. Addition of open-ended question
. Comparisons to results from surveys you've conducted in the past
. Demographic and geographic cross-tabulation
. Phone survey
. Presentation of results to elected officials
THE NATIONAL CITIZEN SURVEV'"- OPTIONS AND PRICES MATRIX
The price for The NCS Basic Service is $9,900, Additional options are available for the following
ad jtitmm ees: ~_.
Ad~itional Option Fe~
Basic service $9,900
Demographic
cross tabs report
Geographic
crosstabs reports
Custom norms
Comparison to
prior NCS results
Comparison to
prior (non-NCS)
results
Expanded mailing
Spanish
$900
$1,100
$1,100
$0
$1,750
$7,000
$1,450
Description
The basic turn-key process that covers all bases of the mailed survey
administration: creating the survey and survey documents, randomly
selected a sample or address list of 1,200 unique addresses, printing,
!TIailing, data entry and analysis and creating both a report of results
and a report of normative comparisons (with US jurisdictions),
Crosstabs of questions 1-15 by 4 demographic variables on survey to
be provided under separate cover from report,
Crosstabs of questions 1-15 by geographic variable to be provided
under separate cover from report.
Through worksheet options, jurisdiction selects criteria for set of
custom norms usually by population size OR region of the country,
Custom norms will be provided alongside national norms in report
tables, Graphs will include either custom or national norms but not
both,
Comparisons in report of results of prior NCS results,
Tables include comparisons to previous years' service evaluation
ratings in jurisdiction - up to three previous years,
Survey is mailed to 3,000 residents instead of 1,200,
Includes Spanish paragraph on cover letters asking those who wish to
complete the survey in Spanish to contact the jurisdiction and request
Spanish copy of survey, Jurisdiction will be mailed envelopes-
outbound and return - and surveys to mail out to those individuals
http://icma,org/ en/results/ surveying/national_ citizen_survey
10/26/2010
N,ational Citizen Survey
Page 3 of5
One open-ended $1,500
question
Includes one open-ended question added to survey, Responses will be
categorized and reported in a table under separate cover,
accompanied by a complete Iist'ofverbatim responses,
400 completed interviews
Phone data $6,000
collection
On-site $2,800
presentation
Creation of PowerPoint presentation and on-site presentation of
materials by National Research Center, Inc, staff person
* Please note that prices are subject to change,
The NCS Sample Timeline 2010
RELIABILITY OF THE SURVEY: CREDIBLE, COMPARABLE RESULTS
Since The NCS was introduced in 2001, local governments in over 41 states h'ave participated, The
survey process is being continually refined to ensure that your local government receives the best
information possible per dollar spent on your citizen survey, Your results can be compared, at your
option, with norms based on the results of more than 350 surveys administered throughout the
country,
The NCS gives you results with the highest credibility from independent professional survey
specialists, You get the satisfaction of personal service, the benefit of comparability with other
jurisdictions, and the efficiency of a standardized process,
We are now in more than 40 states and norms are available from over 500 surveys administered
throughout the country,
FOR MORE INFORMATION
For answers to your frequently asked questions (FAQ), click here,
To meet The NCS team, click here,
For more information, a list of participants, and to learn how your community can use The National
c;itizen Survey'", send an e-mail to ncs@icma,org,
Many other materials on the subject of citizen surveying and The National Citizen SurveyTM are
available on this site in the downloads section below:
. The National Citizen SurveyTM Power Point, suitable for presentations to elected officials and other
decision makers
. Why Survey? Some Talking Points
. NCS Survey Instrument
. NCS Enrollment Form
. Sample Report of Results
. Article: "An Affordable Citizen Survey Now Available for Small Cities" (Betsy 8ean) - The Mayor,
MarjApril2002
. After the Survey: Planning Next Steps
. Perspectives, a newsletter about survey research for local government managers and elected
officials
http://icma,org/en/results/surveying/national_ citizen_survey
10/26/20 10
N,ational Citizen Survey
Page 4 of5
HOW TO ENROLL
Print out and complete the enrollment form (see Downloads section below) and fax it or mail it to:
ICMA/NCS, 777 North Capitol St., NE, Ste" 500, Washington, DC 20002-4201.
DOWNLOADS
NCS 2010 Enrollment Form
.......~""
~~~'l,
~. -~
......., -
fi7'---';::-
,t'
The NCS Sample Timeline 2010
2010 City Survey Instrument
,,-~....., 2010 County Survey Instrument
_. NCS Brochure
if..'
-
...
~ NCS Information Guide
~
. .x:--
Sample Report - Dover, DE
.x:--
Demographic Subgroup Comparisons Report
.x:--
Sample Report of Results-Town of Needham, MA
~'::.__~ Sample Benchmark Report-Needham, MA
htlp:/ /icma,org/en/results/surveying/national_ citizen_survey
10/26/2010
National Citizen Survey
.
.
NCS Presentation of Results for Novi, MI 2009
Why Survey? Some Talking Points
After the Survey: Planning Next Steps
International City/County Management Association
777 North Capitol Street NE, Suite 500
Washington, DC 20002,4201
202.289.lCMA I fax 202.962.3500
[31] ..lm ~ l5:
hltp://icma,org/en/results/surveying/national_citizen _survey
Page 5 of5
10/26/20 I 0
Page 1/1
CITY RL:.~ ,_JER
r~'
CITY OF
ASHLAND
20 E'MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
. : DATE'.,.:,...'.
10/26/2010
, P0.NUMBER.'.;.,
09869
SHIP TO: City of Ashland
(541) 488-6002
20 E MAIN STREET
ASHLAND, OR 97520
VENDOR: 015606
NATIONAL RESEARCH CTR INC, NATIONAL CITIl
ATTN; DAMEMA MANN
.3005 30TH STREET
BOULDER, CO 80301
Req. No.:
Depl.:
Contact: An n Seltzer
Confirming? No
FOB Point:
Terms: Net
Req. Del. Date:
Speclallnst:
-. ,: -"Unj(Prlce. ,.:: ~"i; \ ExfPflce ~;':
11,500.00
i:;{.Qua'ntitV;;~: ~~,j.Jnii:::: ~F/-,.-, ..~:... :,,:~,.'.j~;~' ,;,~': ;,'.~,:
- O'escrintion.'
Citizen Survey - $17,400
Base survey $9,900, plus $7,500 for
additionaloptionsincludinq
demographic subgroup comparisons,
custom benchmarks, one open-ended
question, comparison to previous City
survey, scientific survey,
non-scientific web survey, return of
completed surveys,
Contract for Personal Services
Beginning date; October 21, 2010
Completion date; May 1, 2011
Insurance required/On file
Approved by City Council on 09/21/2010
Note; $17,400 less payment of $5,900
paid October 4, 2010
11 500.00
0.00
0.00
11,500.00
SUBTOTAL
TAX
FREIGHT
TOTAL
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
_. :::;' ''Accolrrit'.Nurri6er", ~;~l :.;', 1~ R'rojecfNU'robe'r;. ~.. :.\.. ~"::.;:.;-HAmo_u-"t_":'" . Accoi.intNumbert'~l'"; ,.~: Il;ProJectNun1be~"-' ';"; ',';'( ~i}'""Amoi.Jni' ".
'~ .
E 710.01.02.00.60410 11 500.00
,
r J A11:fktu ;1. thYlkf.l
U Authorized Signature /tl. VENDOR COPY
v
A request fOl' a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
THIS REQUEST IS A:
D Change Order(existing PO #
Date of Request: I JO / J, 14 / If)
,..... I
Required Date of Delivery/Service: 111'-.,.1/0
, .
(I.1f.,\<jil~Lee~QlfrJA, C{UA~/
3ncu> 30N ,fJrvp.<iT ~,
~O~IA4~ CO~~c Y<O~I
.3 ~ L ~I{ - ~:? X.Il~ fr.~
-/'YLlVlllmA (Y\llflnj f)l/(4!foi
3~J'-1.-/1f~- 1111,')
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
SOLICITATION PROCESS
Small Procurement
o Less than $5,000
o Quotes (Optional)
Sole Source
Written findings attached
o Quote or Pro osal attached
CooDerative Procurement
o State of ORIWA contract
o Other government agency contract
o Copy of contract attached
o Contract #
o Invitation to Bid
(Copies on me)
Intermediate Procurement
o (3) Written Quotes
(Copies attached)
Oft*, .Iv r~
- -&te- a;tf--ocl6t~ CA9f\trt.at iU -(vII
cWCI~phM .$ 17 L{O 0
- 51'ClOD (fcJJ... &rTll,IJ'~
Description of SERVICES
Per attached PROPOSAL
Item # Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
Project Number _ _ ___ _' ___ .
D Per attached QUOTE
Account Number7LO, L9J /ll-.DiJ. .~f}H.LQD
. Items and seNices must be charged to the appropriate account numbers for the ftnanciats to reflect lI,e actual expenditures accuratety.
By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can be provided upon req est.
Employee Signature:
SupervisorlDept. Head Signature~5
G: Finance\Procedure\AP\Forms\8_Requisition form revised.doc
Updated on: 7/7/2009
CITY OF
ASHLAND
Memo
DATE:
TO:
FROM:
Cc:
RE:
October 26, 2010
Kariann Olson, Purchasing
Ann Seltzer, Management Anal~st Vi
Martha Bennett, City Administrato .
Sole Source, Citizen Survey
The National Citizen Survey was developed by the National Research Center, Inc, and ICMA
(International Cityl County Managers Association) to provide a statistically valid survey of resident
opinions about their community and the services provided by local government.
The National Research Center has a database of survey results from more than 500 jurisdictions
throughout the country. This is the only survey administered with a database of that size and therefore
our results can be compared to other jurisdictions,
The City of Ashland wants to evaluate how Ashland "measures up" when compared to other
communities.
Page I of I
1026 10 memo sole source.doc
~..
.._~