HomeMy WebLinkAbout2011-034 Contract - Quality Fence Company
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Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Quality Fence Company
ASHLAND CONTACT: John Huffman
20 East Main Street
Ashland. Oregon 97520 ADDRESS: 114 W. Pine Street, Central Point. OR 97502'
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-664-2281
DATE AGREEMENT PREPARED: 02/14/2011 FAX: 541-664-2949
BEGINNING DATE: March 1. 2011 COMPLETION DATE: Februarv 28.2014
COMPENSATION: $600.00 per year ("B" Street Yard - 2 service calls @ $75.00 each; 1155 E. Main - 2
service calls IlJJ $75.00 each; 90 N. Mountain - 2 service calls @ $150.00 each). Plus anv cost for carts.
GOODS AND SERVICES TO BE PROVIDED: Contractor to perform a complete system check on automatic
gates and components and test all parts for proper operation. Parts that are worn or not functioning will be
replaced and the cost of the parts will be charged to the City. Per attached semi-annual service contracts
attached as Exhibits A. B. and C.
ADDITIONAL TERMS:
NOW THEREFORE. pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall. provide all goods as specified above and shall at its own risk and
expense. perform any work described above and. unless otherwise specified. furnish all labor. equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented. and by entering into this contract now represents. that any personnel
assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned
in a skilled and worker-like manner and. if required to be registered. licensed or bonded by the State of Oregon. are
so registered. licensed and bonded. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications. no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed. including costs and
expenses. the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated. payments will be made for work completed and accepted to date of termination.
Compensation under this contract. including all costs and expenses of Contractor. is limited to $25.000.00. unless a
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 279B.220. 279B.225. 279B.230. 279B.235. ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $18.703 or more. Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a
living wage. as defined in this chapter. to all employees performing work under this contract and to any subcontractor
who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached
, hereto as Exhibit B predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor agrees to defend. indemnify and save City. its officers. employees and agents harmless
from any and all losses. claims. actions. costs. expenses. judgments. subrogations. or other damages resulting from
injury to any person (including injury resulting in death). or damage (including loss or destruction) to property. of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to. Contractor's employees. agents. and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not be held responsible for any losses. expenses. claims. subrogations. actions. costs.
judgments. or other damages. directly. solely. and proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. Citv's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
c. For Cause. City may terminate or modify this contract. in whole or in part. effective upon delivery of
written notice to Contractor. or at such later date as mav be established bv Citv under.anv of the followino
Contract for Goods and Services Less than $25.000. Revised 12120/2010. Page 1 of 5
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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 longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied. revoked. suspended. or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice. or within such other period as
the party giving the notice may authorize or require. then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach. may at any time terminate
the whole or any part of this contract if Contractor fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. ObliQation/Liabilitv of Parties. Termination or modification of this contract pursuant to subsections a. b. or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However. upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a. b. cor d of this section. Contractor shall immediately cease all activities under
this contract. unless expressly directed otherwise by City in the notice of termination. Further. upon termination.
Contractor shall deliver to City all contract documents. information. works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City.
Contractor shall have the complete responsibility for the performance of this contract.
11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority. women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts. if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract. including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.11 0 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710. Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all
persons employed by them. and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant. warranty. certification. or obligation it owes under the Contract; if it loses its ORF status pursuant to
the ORF Rules or loses any license. certificate or certification that is required to perform the work or to qualify as a
ORF if Contractor has qualified as a ORF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in.
or delegate duties under. the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017. which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General . ce with a combined single limit. or the equivalent. of not less than Enter one:
$200.000. $500.0 O. $1.000.000. 000.000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall inc c ualliability coverage for the indemnity provided under this contract.
c. Automobile . nce with a combined single limit. or the equivalent. of not less than Enter one:
$200.000. $500.00 $1.000.000. or ot Applicable for each accident for Bodily Injury and Property Damage.
includin covera e fo . or non-owned vehicles as a IicabJe.
Contract for Goods and Services Less than $25.000. Revised 12120/2010. Page 2 of 5
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d.. Notice of cancellation or chanoe. There shall be no cancellation. material change. reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City. 0
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland. Oregon. and its
elected officials. officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract. the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the
parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If .
requested. complete copies of insurance policies. trust agreements. etc. shall be provided to the City. The
Contractor shall be financially responsible for all pertinent deductibles. self-insured retentions and/or self-
insurance.
17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws. rules or doctrines. Any claim. action. suit or
proceeding (collectively. ..the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If. however. the claim must be brought in a federal
forum. then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County. Oregon. Contractor. by the signature herein of its authorized
representative. hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity. based on the Eleventh Amendment to the United
States Constitution. or otherwise. from any claim or from the jurisdiction.
18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BE1WEEN THE
PARTIES. NO WAIVER. CONSENT. MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER. CONSENT.
MODIFICATION OR CHANGE. IF MADE. SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS. AGREEMENTS, OR
REPRESENTATIONS. ORAL OR WRITTEN. NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR. BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE. HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT. UNDERSTANDS IT. AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City.s payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations. or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion. to continue to make payments under this contract. In
the event City has insufficient appropriations. limitations or other expenditure authority. City may terminate this
contract without penalty or liability to City. effective upon the delivery of-written notice to Contractor. with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Councilor the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Contractor:
lilLi<..
City of Ashland
By ~,.Q &Ll
Department Head
,-.,
'<V\-\c..~fh' / G2.,. +-AL~/"'''
Print Name
By
Sig ture
\)"(W1t< 'j e
Print Name
Dwl'le...- Ge., Mqy
Title
:I ;,,/11
Date
W-9 One copy of a W-9 is to be submitted with
the signed contract.
Purchase Order No.
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Contract for Goods and Services Less than $25.000. Revised 12120/2010. Page 3 of 5
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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 10 (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends. or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract. when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents. and has checked four or more of the following
criteria:
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Contractor
(1) I carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence. set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
,
year.
(6) I assume financial responsibility for defective workmanship or for service not provided
as evidenced by the ownership of performance bonds, warranties. errors and omission
insurance or liability insurance relating to the labor or services to be provided.
(1{J.X
2-/1 f/r/
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Contract for Goods and Services Less than $25.000. Revised 12/20/2010. Page 4 of 5
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Quality Fence Company
CCB #8936
114 W. Pine Street P.O. Box 3985
Central Point OR 97502
(541) 664-2281 Fax (541) 664-2949 (800) 451-8883
._NO JOB TlIO lAIC(
...NO JOB TOO SIWl
Automatic Gate Semi-Annual Service Contract
Commercial Roll Gate
QualityFenCewillservicethegatelocatedatlD<t1 {5 :;11(-(.-1-, A~V\I;?lf\d --S s{, y~~
twice a year for $75.00 per visit. (example: 2 - visits x $75.00 = $150.00 per year)
plus any cost for parts needed for gate operation.
Quality Fence will perform a complete system check on automatic gate and components and test all parts
for proper operation. Quality Fence will replace any parts that are worn or not functioning.
I agree to the Semi-Annual Service Contract as describe herein. and understand that it will remain in effect
until cancelled, in writing by me. I may cancel Semi-Annual Service at any time.
Company Name
Authorized Signature
Date
uhj DF h,l'\lcU'1d
List of serviceable items that may apply to your Semi-Annual Service Call :
~ Clean Control Box '0 Check Electrical Connections ~ Service Time Clock
!2f Service Belt IE- Inspect/Adjust Clutch S Antenna Service
ti Adjust Chain it! Lubricate Chain [;l Inspect Sprockets
it Service Gate Wheels ~ Inspect Welds 0 Lubricate Hinges
~ . Lubricate Pivot Points flJ Check Entry Device ~ 0 Check Exit Device(s)
0 Check S.O.S. Device ~ Inspect General Operation -m Perform General Operation
0 Touch Up Standard Paint Colors
Any work performed not on checklist:
"Fencing is our Field"
6ftJG[i- (3
Quality Fence Company
CCB #8936
114 W.Pine Street P.O. Box 3985
Central Point OR 97502
(541) 664-2281 Fax (541) 664-2949 (800) 451-8883
...110 JOI TIIO UJIC(
....0 JOB TOO SAW.I.
Automatic Gate Semi-Annual Service Contract
Commercial Roll Gate
\ \SSr=. t1""IN S;-h
Quality Fence will service the gate located at .police StMoy\, ASh 1J>n.d
twice a year for $75.00 per visit. (example: 2 - visits x $75.00 = $150.00 per year) .
plus any cost for parts needed for gate operation.
Quality Fence will perform a complete system check on automatic gate and components and test all parts
for proper operation. Quality Fence will replace any parts that are worn or not functioning.
I agree to the Semi-Annual Service Contract as describe herein. and understand that it will remain in effect
until cancelled. in writing by me. I may cancel Semi-Annual Service at any time.
Company Name
C.l fL.1 of AsVJ 1~h.c1
Authorized Signature
Date
List of serviceable items that may apply to your Semi-Annual Service Call:
~ Clean Control Box EJ Check Electrical Connections }'1 Service Time Clock
~ Service Belt ~ InspecVAdjust Clutch !! Antenna Service
13 Adjust Chain ~ Lubricate Chain jg Inspect Sprockets
Iil Service Gate Wheels ~ Inspect Welds 0 Lubricate Hinges
!1 Lubricate Pivot Points ~ Check Entry Device 0 Check Exit Device( s)
a 0 Check S.O.S. Device 9 Inspect General Operation IZl Perform General Operation
0 Touch Up Standard Paint Colors ~
Any work performed not on checklist:
"Fencing is our Field"
EyAi6d- ~
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._110" TOO lAIC(
...NO JOB TOO SMW
Quality Fence Company
CCB #8936
114 W. Pine Street P.O. Box 3985
Central Point OR 97502
(541) 664-2281 Fax (541) 664-2949 (800) 451-8883
Automatic Gate Semi-Annual Service Contract
Commercial/Multiple Gate Locations
10 N, MOv..JA\1\J AvE. IS I'::.IZ.'-l ~ C.6 C~tJ'Tl'2:l2.
Quality Fence will service the gates located at +1 S v cx..-f. ASh lancj
twice a year for $150.00 per visit. (example: 2 - visits x $150.00 = $300.00 per year)
plus any cost for parts needed for gate operation.
Quality Fence will perform a complete system check on automatic gate and components and test all parts
. for proper operation. Quality Fence will replace any parts that are worn or not functioning.
I agree to the Semi-Annual Service Contract as describe herein. and understand that it will remain in effect
until cancelled. in writing by me. I may cancel Semi-Annual Service at any time.
Company Name
Authorized Signature
Date
(1-hj of Asl1/antl
s-
.9-
o
o
List of serviceable items that may apply to your Semi-Annual Service Call:
~ Clean Control Box Rt Check Electrical Connections
0" Service Belt ya. InspecVAdjust Clutch
I2f Adjust Chain )Y Lubricate Chain
IEJ. Inspect Welds
0- Check Entry Device
0- Inspect General Operation
,0:
H
Antenna Service
Service Time Clock
I2t Inspect Sprockets
Service Gate Wheels
o
o
r1
~
Lubricate Hinges
Lubricate Pivot Points
Check Exit Device(s)
Check S.O.S. Device
Perform General Operation
Touch Up Standard Paint Colors
Any work performed not on checklist
"Fencing is our Field"
1E5!--Rbe CERTIFICATE OF LIABILITY INSURANCE I DATE IMMlDDfYYYY)
OP 10 AT
QUALI3l 11/15/10
ROOU'CER . . . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
restern States Mc:M.innville HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
.411 NW Adams ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ldMinnville OR 97128
?hone:503-472-2121 Fax:503-434-5B72 INSURERS AFFORDING COVERAGE NAIC#
~SUREO iUH~tI Fence CO INSURER A:. American Hallmark Ins Co
eliab e Electric
Western Vin~l Products INSURER B:
Reitmann En erprises INSURER c:
Steve Reitmann
PO Box 3995 . .. INSURER 0:
Centra~ Point OR 97502
I INSURER E:
~
:OVERAGES
.THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDlNG
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. DATE1~ DArE....MIDDiMY"
TR NSR TYPE OF INSURANCE POlICY NUMBER UMITS
GENERAL LIABlUTY EACH OCCURRENCE 01000000
-
Il X COMMERCIAl GENERAL LIABLrTY 44CL466935 11/19/10 11/19/11 PREMISESi~1 0100000
I CLAJMS MADE [X] OCCUR MEO EXP (Any one pet'S(I'l) 05000
- PERSONAL & MJV INJURY 01000000
- GENERAL AGGREGATE 02000000
~LA~E~E~L1Mrr APnS\PER; PRODUCTS - COMPIOP AGG 02000000
POUCY X ~:8; Lot EmP Ben. 1000000
~TOMOBILE LIABILITY COMBINED SIHGLE LIMIT 01000000
Il 1L PJ/YAUTO . 44CL466935 11/19/10 11/19/11 (Eleocident)
- ALL OWNED AUTOS BODILY INJURY
0
SCHEDULED AUTOS (Par penon)
-
- HIRED AlITOS BODll Y INJURY
(Per acddant) .
- NON-OWNED A\!TOS
,
--I PROPERTY DAMAGE 0
(Per accident}
-
GARAGE UABlUTY AUTO ONLY - EA ACCIDENT 0
R ANY AUTO OTHER THAN EAACC 0
AUTO ONLY: AGG 0
EXCess f UMBRELlA UABlUTY EACH OCCURRENCE 04000000
Il P -OCCUR D CLAIMS MADE 44CU466936 11/19/10 11/19/11 AGGREGATE 0
.
~ ~OUCnBLE 0
X RETENTION 010000 .
WORKERS COMPENSATION ITDRY L1Mm; I IUJ~
AND EMPLOYERS' UABlUTY YIN
ANY PROPRIETORfPARTNERlEXECUT~ E.L. EACH ACCIDENT 0
OFFICERlMEMBER EXCLUDED?
(Mandatory In HH) . .. E.L. DISEASE. EA EMPLOYE 0
~~~~~~NSbekM' E.L. DISEASE. POLICY lIMIT S
OTllER
Il in1and mari.ne 44CL466935 11/19/10 11/19/11 ~eased.eq 25000
A inst fltr 10000
IESCRIPTlON OF OPERATIONS I LOCAOONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVlSJDNS
rhis certificate is provided as evidence of liabi~ity insurance but only as
oo"eo', ''" ,...."" ""',',' ~ .,,,.."', .. ... .. ....., .,
t:he named insured 0 m: @ ~ II W ~
:ERTlFICATE HOLDER iit JAN l li CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCJES BE CANCB..lED BEFORE THE EXPIRATION
BY:..............ee...... --PROOF DATE THEREOF. THE $SUING INSURER Will ENDEAVOR TO MAll ~ DAYS WRITTEN
NOncE TO THE CERTlACATE HOLDER NAMED TO THE LEFT, BUT FAU..URE TO DO so SHALL
IMPOSE NO OBLlGATlON OR UABlUTY' OF ANY KIND UPON THE INSURER, fTS AGENTS OR
Ci ty of Ashland REPRESENTATNES.
20 East Main ~~"f/i""~
Ashland OR 97520
\CORD 25 (2009/01)
~ 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo ere regisi8red marks of ACORD
Page 1/1
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ASHLAN8TY RECORDE
20 E MAIN ST.
ASHLAND. OR 97520
(541) 488-5300
, : -; DArEF<;,.~}~.;
1'.(::, PO NUMBER,'::!-i
3/16/2011
10079
VENDOR: 000649
QUALITY FENCE COMPANY
114 W. PINE STREET
POBOX 3985
CENTRAL POINT. OR 97502
SHIP TO: Ashland Building Maintenance
(541) 488-5358
90 N MOUNTAIN AVENUE
ASHLAND. OR 97520
FOB Point:
Terms: Payable on receipt
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.:
Contact: Dale Peters
Confirming? No
f~;~LQuant'~:.i; ~j~Urilt'm, ~ ,,', ,',: \ ,,::X/"'l: ;~~;;;;~"besctinHorl'1' ";~,,,:.,. . ; ,~;.;!"" ; ::.... .:,..<.~.:- ~. ~'~-h":;~..t.\ 1~ ~:"~l::~"E'xFpHcer~]XA
.."",.Unlt ~r1ce.:,_".
Semi Annual Service Contract for 600.00
Electrically Operated Gates
Maintenance to be performed at:
"B" Street Yard - 1097 B Street
Two (2) Service Calls @ $75.00 Each
Police Department - 1155 E. Main Street
Two (2) Service Calls @ $75.00 Each
Service Center - 90 N. Mountain
Two (2) Service Calls @ $150.00 Each
Contract for Goods & Services
Beginning d.ate: March 1. 2011 .
Completion date: February 28. 2014
Insurance required/On file
, SUBTOTAL 600.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 600.00
ASHLAND. OR 97520
~;;~;r'A'cqcount~Number:trJ~;\1 ~~: __~: P roji;tcf N urn" tJ'e'j-' :?~~~;~ ~~ . :':'~b.;:,:,'Amouri't; "'.If' Acc:oun(Nurii6er.'1. )1f .. .. ')'p,iO)ed::Numb'er.u::-!~~; .~ ~'..1;,L,
',;,;-gn;o"Ui1i~Y4,}h
.. ..
E 41 0.08.24.00.60140 600.00
,
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A~ed Signature
VENDOR COPY
A r~quest for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
THIS REQUEST IS A:
o Change Order(existing PO #
Date of Request: 15 F68 1I 1
Required Date of Delivery/Service: 1 f}{; tY~p~
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
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c...~IL:>"'e..'""IL..- 70:"_" oR <iT- S02..
SOLICITATION PROCESS
Small Procurement
. Less than $5.000
Quotes (Optional)
Intermediate Procurement
o (3) Writlen Quotes
(Copies attached)
o Sole Source
o Written findings attached
o Quote or Pro osal attached
Coooerative Procurement
o State of OR/WA contract
o Other govErnment agency contract
o Copy of contract atlachEd
o Contract #
o Invitation 10 Bid
(Copies on file)
o Reauesllor Prooosaf
(Copies on file)
o Soecial! Exemol
o Written findings atlached
o Quote or Pro sal atlached
o Emeraencv
o Written findings attached
o Quote or Pro osal attached
Description of SERVICES
'5'~W\. 4Nl\.J....."'L- S~vi<Lc--C'O"""{~<L~ .
t:.\GdkICl"\lly Dp~R..I4-l:~i) ~~T;;:S
~
Total Cost
Per attached PROPOSAL
Item # Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
Project Number ___n_. ___
Account Number1Kl.I;e<.'/. C!:!. "_C!.l1.~)O
. Items and services must be charged to the appropriate account numbers for the financials to reflect the actual expenditures acculBtely.
D Per attached QUOTE
.
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 request.
Employee Signat5fe: l..... ~ -,
SupervisorlDept. Head Signature: ~ ~
I
G: Finance\Procedure\AP\Fonns\8_Requisition tonn revised.doc
Updated on: 2f.lI2011