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CITY OF CITY RECORDER
ASHLAND DATE .h•. PO NUMBER
20 E MAIN ST. 7/1/2011 .10155
ASHLAND, OR 97520
(541)488-5300
VENDOR: 015984 SHIP TO: Ashland Planning Department
JTS DESIGN, JASON TODD SCOTT DBA (541)488-5305
101 W OLYMPIC PL, APT 601 51 WINBURN WAY
SEATTLE, WA 98119 ASHLAND, OR 97520
FOB Point: Req.No.:
Terms: Net Dept.:
Req.Del.Date: contact: Derek Severson
Special Inst: - confirming? Yes
': .Quanti .. Unit .. '. Description - ' : Unit Price. �Ext.Price'
THIS IS A REVISED PURCHASE ORDER
Revise and expand Ashland's existinq 10,000.00
Historic District Design Standards per
the detailed scope of work attached as
Exhibit C to the contract. Not to
exceed $10,000
Contract for Personal Services
Beginning date: 02/18/2011
Completion date: 08/15/2011
Insurance required/On file
Note: See PO 10154, Julie M. Koler
Processed change order 09/01/2011
The date of completion is beinq
extended to September 30, 2011.
Processed change order 09/28/2011 750.00
Increased amount of this purchase order
$750.00. Actual amount for PO 10154,
Julie Koler is$1,050.00. Total of
both PO s are within the total
contracted amount of$12,000.00.
SUBTOTAL 10 750.00
BILL TO:Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 10,750.00
ASHLAND, OR 97520
Account Number:, - -- `- _ _
_ _. :Pro/ect Numtier .;Amount . Account,Number. .., Project Number :•::. •`Amountr„
E 110.09.27.00.610700 E 000201.999 10 750.00
Authoriled Signature VENDORCOPY.
FORM #10 CITY OF
CONTRACT AMENDMENT APPROVAL REQUEST FORM �S H LAN D
Request for a Change Order
Name of Supplier 1 Contractor 1 Consultant:JTS DESIGN Totallamourit.of.this
contract amendment'
Purchase Order Number:#10155
O-p
Title 1 Description:Revise and expand Ashland's Historic District Design Standards.
❑ Per attached contract amendment
Contract Amendment
Original contract amount $10.000 %of original contract
Total amount of re0 vious contract amendments %of original contract
Amount of this contract amendment $750 %of original contract
TOTAL AMOUNT OF CONTRACT $10.750 %of original contract
In accordance with OAR 137-047-0800:1)The amendment is within the scope of procurement as described in the solicitation documents,Sole Source notice orapproval of Special
Procurement.2)The amendment is necessary to comply with a change in law that affects performance of the contract 3)The amendment results from renegotiation of the terms and
conditions,including the contract price,of a contract and the amendment is advantageous to the City of Ashland,subject to all of the following conditions:a)goods and services to be
provided under the amended contract are the same as the goods and services to be provided under the unamended contract b)The City determines that with ail things considered,the
amended contract is at least as favorable to the City as the unamended contract c)The amended contract does not have a total term greater than allowed in the solicitation document,
contract or approval of a Special Pmcurement.An amendment is not within the scope of the procurement if the City determines that if it had described the changes to be made by the
amendment in the procurement documents,it would likely have increased compefl6on or affected award of contract.
Contract amendment is within the scope of procurement: YES X NO* (If"NO",Council approval is required)
Sourcing Method:
SMALL PROCUREMENT-Less than$5.000 INVITATION TO BID or COOPERATIVE PROCUREMENT,QRF or
❑Total amount of contract and cumulative REQUEST FOR PROPOSAL EXEMPTION PURSUANT TO AMC 2.50
amendments s$6,000. YES 1 NO ❑ Total amount of cumulative amendments ❑Total amount of original contract and cumulative
❑If'NO',amount exceeding authority requires :5 25%of original contract amount or$250,000 amendments 15 $100K for Goods&Services,
Council approval.Attach copy of Council whichever is less.YES I NO s$75K for Personal Services,<$50K for Attorney
Communication. ❑If'NO',amount exceeding authority requires Fees. YES/NO
❑ Exempt—Reason: Council approval.Attach copy of Council ❑If"NO',amount exceeding authority requires
Communication. Council approval.Attach copy of Council
❑ Exempt—Reason: Communication.
❑ Exempt—Reason:
INTERMEDIATE PROCUREMENT SOLESOURCE EMERGENCY PROCUREMENT
Goods&Services-$5,000 to$100,000 ❑ Total amount of cumulative amendments ❑ Written Findings:Document the nature of the
Personal Services -$5,000 to$75,000 s 25%of original contract amount or$250,000 emergency,including necessity and circumstances
❑ Total amount of cumulative amendments whichever is less.YES 1 NO requiring the contract amendment
s 25%of original contract amount.YES 1 NO ❑If"NO',amount exceeding authority requires ❑ Obtain direction and written approval from City
❑If'NO',amount exceeding authority requires Council approval.Attach copy of Council Administrator
Council approval.Attach copy of Council Communication. ❑ If applicable,attach copy of Council
Communication. ❑ Exempt—Reason: Communication
❑ Exempt—Reason: ❑ Exempt—Reason:
SPECIAL PROCUREMENT INTERGOVERNMENTAL AGREEMENT
❑Total amount of original contract and cumulative amendments are ❑Or ginal contract approved by City Council. YES 1 NO
within the amount and terms initially approved by Council as a Special Provide date approved by City Council: (Date)
Procurement. YES 1 NO If'NO",Council approval is required.Attach copy of Council Communication.
❑ If'NO',amount exceeding authority requires Council approval. ❑ Contract amendment approved and signed by City Administrator.
Attach copy of Council Communication.
Project Number: 000201.999 Account Number: 110.09.27.00.610700
*Expenditure must be charged to the'appropriate account numbers for the financials to reflect the actual expenditures tely. A ch xt pages if needed.
Employee Signature: LA �' CVCIL' Department Head Signet
Funds appropriated for current fiscal year: YES NO
Finance Direct Date
Comments:
Form#10—Contract Amendment Approval Request Form, Request for a Change Order, Page 1 of 1,9/26/2011