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HomeMy WebLinkAbout2011-286 Contract - Gridley Painting Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: Gridley Painting ASHLAND CONTACT: Clinton Gridley, Owner 20 East Main Street Ashland, Oregon 97520 ADDRESS: 734 Haskell Street, Central Point, OR 97502 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-821-9974 DATE AGREEMENT PREPARED: October 18, 2011 FAX: BEGINNING DATE: October 27, 2011 COMPLETION DATE: November 18, 2011 COMPENSATION: Pressure Washing $185.00, (2) Coats/Materials $1,125.00 and Labor$3,095.00, Total Compensation $4,405.00 GOODS AND SERVICES TO BE PROVIDED: Contractor to pressure wash exterior, scrape, prime and caulk loose paint and cracks, apply exterior paint to full structure, application shall be sprayed and back rolled, refinish wood doors, two colors (main and accent), application_shall be two finish coats to all surfaces, complete clean up of job site. Location: Ashland Community Cenfer'; 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, 2796.225, 279B.230, 27913.235, 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 $18,890 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. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City under any of the following Contract for Goods and Services Less than $25,000, Revised 06/30/2011, Page 1 of 5 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. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination. Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. 10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not disdriminated 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.110 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 QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor has qualified as a QRF 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 Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contract. C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. Contract for Goods and Services Less than$25,000, Revised 06/30/2011, Page 2 of 5 d. 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. 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 fled in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the impersonam 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 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. 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 Council or 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: �j City of Ashland By �G6leL\1 (EF— By _ta_L� Signatuu eT Department Head 16.1.1 6r,31., l`%-t6A*tf R arts kL Print Name Jam— Print Name rit✓ 0O _ \d1 XZ l I / itle I Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. Contract for Goods and Services Less than$25,000, Revised 06/30/2011, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: (1) 1 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. litfd Z i Contractor (Date) Contract for Goods and Services Less than$25,000, Revised 06/30/2011, Page 4 of 5 Sep. 29. 2011 2: 3 1 P M Drake ' s Paint and Supply No. 0526 P. 6 Gridley Painting Clinton Gridley 734 Haskell St. Owner Central Point, Or, (541) 821-9974 97502 CCB# 170445 PROPOSAL 09129/2011 Proposal Submitted To: Karl Olson—Purchasing Rep. Address: 90 N.Mountain Aye, Ashland Or.97520 Phone: 541-488-5354 Job Location; City Of Ashland—Ashland Community Center We hereby submit specifications for: Exterior- - pressure washing of exterior to remove dirt,cobwebs,loose paint,etc, — Scraping,prituing and caulking of loose paint,cracks etc. — Application of Exterior Latex Point to full structure, — Application of body shall be sprayed and back rolled. — Application of trim shall be brushed and rolled. — Re Itulshlog of wood doors. — This proposal included two colors. Main and accent. — Above applications shall be two finish coats to all surfaces. — Complete clean up of job site. We propose hereby to finish material and labor—complete in accordance with the above specifications for the sum of: See Below dollars. Pressure washing: 185.00 dollars. Painting of structure,2 coats:Materials- $1,125.00 dollars.Labor- $3,095.00 dollars, If 3rd coat is needed: Materials- $1,700,00 dollars,Labor- $4.170.00 dollars, Any alteration or deviation item the above specifications involving exim costs will be executed only upon written order,and will become an extra charge over and above the esllmato.NOTE—Thh proposal may be withdrawn by us if not accepted within 30 days, Respectfully Submitted: Clinton Gridley Sep. 29. 2011 2 : 3OPM, Drake - s Palnf and Supply No. 0526 P. 2E(MwDDmyY) �-�- t,r—k i IFILH 1 r yr LIAL51LI 1Y INSURANCE OP ID DS 09/28/11 THIS CERTIFICATE 19 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: the Certificate holder is an ADDITIONAL INSURED.the po Icy ies must be endorsed. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A slalomont on(his certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAME: -PITONR FAX Insurance Marketplace, Inc, Arc No ESI: AIL,No: AIL 1998 Skypark Dr Suite 100 ADDRESS: Medford OR. 97504 CUSTOMERID/: GRILL-1 Fhone:541-779-0177 FaX:FAX 772-8235 INSURER(S)AFFORDING COVERAGE HAIG9 INSURED INSURER A: Austin Mutual Ins 412 Cl}nton Roberip Gridley INSURER a: Gridley Painting 134 S Haskell St INSURER C: Central Point OR 97502 INSURER D: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TMS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED HOWD ABOVE FOR THE POLICY PERIOD INDICATED. NOTWRHSTANDING May REDUMEMENT,TERM OR CONDITIONOF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICH THIS CERTIFICATE AMY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONOmONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PND CLAIMS. SRI LTR TYPE OF INSURANCE WSR WVU POLICY NUMBER (MWDDJYYY'n (MMND LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A COMMERCIAL GENERA.LIA&LrfY BR 170709204 OS/26/11 05/26/13 PREMISES Ea 000mence $50000 MAIMS-MADE OCCUR MED EXP(My One Pe A) 55000 X Business owners PERSONAL A ADV INJURY $1000000 GENERAL AGGREGATE $ 2000000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $2000000 POLICY p JECCT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Be aaddenl) S ANY AUTO BODILY INJURY(Per person) S ALLOWNEOAUTOS BODILY INJURY(Pot AP9dcM) S SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS (Pur socfeenl) S MONL WNEO AUTOS $ 3 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LAB CWALS.AMO AGGREGATE $ DEDUCTIBLE $ RETENTION S S WORKERSCOMPENSATIDN - - AND EMPLOYERS'LABILITY YIN TORY LIMIT ER OFFICCER/MEMBER EXCLUDED currvG--I IA E.L.EACH ACCIDENT y (Mandatory In NH) LJ EL.DISEASE-PA EMPLOYEE S II Yea,desfAbe order DESCRIPTION OF OPERATIONS cal. E.L.DISEASE-POLICY LIMIT S PROPERTY 5000 DESCRIPTION OF OPERATIONS I LOCATIONS I VE141 LEI(Attach ACORD ter,Addillonal Remarks Schedule,If more space is required) Certificate holder is addtdional insured per the attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE ASHLAND THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE VATH THE POLICY PROVISIONS. City of Ashland its Officers and Employees AUTHORIZED REPRESENTATIVE 20 E Main Ave 'Ashland OR 97520 R. Scott Weaver, CIC ®1088.2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD PROGRESSIVE PROGREINIT' P.O.BOX 31260' TAMPA,FL 33631 DIRECT Policy Number. 71219894-1 underwritten by: Progressive Universal Insurance Co September 23,2011 JULIE RICHARDS 189 VASHTI WAY Policy Period: Oct 19,2011 -Apr 19,2012 MEDFORD,OR 97501 Page 1 of 2 progressive.com Online Service Make payments,diedr billing activity,update policy information or check status of a claim. Auto Insurance 1-800-PROGRESSIVE (1-8M77"737) Coverage Summary For oursaday,7ce ysaweesservice, 24 hours a da 7 days a week. This is your Renewal Declarations Page The coverages,limits and policy period shown apply only if you pay for this policy to renew. Your coverage begins on October 19,2011 at 12:01 a.m. This policy expires on April 19,2012 at 12:01 a.m. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy contract is form 9610D OR(06/06). The contract is modified by forms Z357(01/07),4884(10/08),Z538(10/08)and Z616 OR(08109) Drivers and household residents Additional information ............................................................................................................................................................................. JULIE RICHARDS Named insured Outline of coverage 2003 Ford F150 VIN 2FfRX17283CA37648 Primary use of the vehicle: Commute Limits Deductible Premium ............................................................................................................................................................................. Liability To Others $238 Bodily Injury Liability $100,000 each persorV$300,000 each accident Property Damage Liability $100,000 each accident ............................................................................................................................................................................. Personal Injury Protection $25,000 $0 29 ............................................................................................................................................................................. Uninsured/Underinsured Motorist $100,000 each persorV$300,000 each accident 8 ............................................................................................................................................................................. Comprehensive Actual Cash Value $500 8 ............................................................................................................................................................................: Collision Actual Cash Value $500 69 ............................................................................................................................................................................. Rental Reimbursement up t..$30 each day/maximum 30 days 13 ............................................................................................................................................................................. Roadside Assistance 8 ............................................................................................................................................................................. Total 6 month policy premium $373.00 ............................................................................................................................................................................. Discount if paid in full -53.00 ............................................................................................................................................................................. Tata16 month policy premium 1f paid in full $320.00 Premium discounts Policy 71219894-1 Continuous Insurance:Platinum,Paperless,Home Owner,Multi-Polity and Online Quote Form 6489AA OR(07/10) cond nued Date: 10/28/2011 Time: 11:29 AM To: 15415522304 ❑ 2/2 °R°o . CERTIFICATE OF LIABILITY INSURANCE (MmmDryyM 011 10/2e/zo11 THIS CERTIFICATE 13 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: N the cer9Rcate holder Is an ADDITIONAL INSURED,the policypes)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statemerd on this certificate does not corder rights to the certificate holder In lieu of such endorsement(s). PRODUCER WEACT Lena Martindale Wilson-Heirgood Associates (800)852-6140 F C Ng:(541)342-3766 9; .imm—lia2tiondale@vhainsurance.com Chad Drive .lmartindale9Trhainsurance.com PO Box 1421 INSURERISI AFFORDING COVERAGE NAIL I Eugene OR 97440-1421 IMS1JIERA:SA11P Corporation INSURED INSURERS: Selecterw Corp INSURERC: PO Box 71250 11mustEito. INSURER E: Eugene OR 97440 INSIAtERF: COVERAGES CERTIFICATENUMBER:11/12 WC 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 DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYRAVE BEEN REDUCED BY PAID CLAIMS. INSIR LTR TYPEOFINSlRANCE POLICY NUMBER POLICY' ML E)(' LIMITS GENERAL LIABILITY EACH OCCURRENCE f DAMAGE 10 RI,N I ED COMMERCIAL GENERAL LIABILITY f CLAIMS-MADE ❑OCCUR MEDE)F("me,wtt ) f PERSONALS ACV INJURY S GENERAL AGGREGATE f GENT AGGREGATE LIMT APPLIES PER: PRODUCTS COMPAIP AGG f ECT POLICY PRO- LOC f AUTOMOBILE LIABILITY LLUMIT a wxM ANY AUTO GODLY INJUtY(Pw Pwmn) t ALL OSRED SCHEDULED LED A AUTOS AUTOS GODLY INJURY(Per wcidW) f NON ONMIED PROPERTY DAMAGE A1R05 AUTOS U,,n S f UMBRELLA LMB OCCUR EACH OCCURRENCE S EXCESSLIAB CLAIMS-MADE AGGREGATE S LIED I I RETENTIONS S A wORHERS COMPENSATION A ANO 9PLOYERY DABILITY YIN X NITS ANY OFHCE PROPRIEIMPARTNERVEOUTIVE El.EACH ACCIDENT t 500,00 RAK�ISER EXCLUDED'! ❑ NIA lMmtlMarY in aO 16338 0/1/2011 0/1/2012 E1.DISEASE-EA EMPLOYE f 500 000 u yas Mnob0 maw EL.GSEASE-POLICY UMT s 500 000 OESCPoPTION OF OPERATIONS below DESCRIPTIONOFOPERATIONSILOCATIONSIVO MI-ES(AN ACORDNON,AdOWWRmmb StlNatfa,linen m+re ItrepnedJ CERTIFICATE HOLDER CANCELLATION (541)552-2304 SHOULD ANY OF THE ABOVE OESCare81)POUCMS BE CANCELLED BEFORE THE EM"TION DATE THEREOF, NOTICE WILL BE DELIVERED IN Gridley painting ACCORDANCE MTN THE POLICY PROVISIONS. L . Attn: Clint Gridley 743 Haakell Street AUIHOMM REPEWWA7NE Central point, OR 97502 Leesa Martindale/LJM c'''fYr'�����e...z�i ,�•{,y ACORD 25(2010105) ®1988.2010 ACORD CORPORATIOR All rights reserved. INS025unitwisi 1 Tho aCrTRn nameaM Nmnaro ronio}araH mor4cNaMRII Dr, Ste 105 Medf ord, OR 97504 S E L E C E M P 541.773.5733 E M D L 0 Y M E N T SERVICES www.selec-temp.com Staffing Service Agreement for Gridley Painting Position and Rates As a multi-service staffing company, Selectemp is dedicated to providing skilled and reliable employees as detailed below:. All Commercial Painting labor positions to be billed at 54% (Example:$10.00 pay ratel$15.40 bill rate) The above rate includes wage, Workers'Compensation, state and federal payroll taxes, 1-9 verification, W-2&W-4 administration, screening, advertising and interviewing costs. Personnel Placement Selectemp will recruit and screen personnel as requested, at the skill level needed. All temporary employees must successfully pass an in-depth interview that also includes reference checks prior to placement on any assignment with our clients. In addition, SHOULD THE CLIENT REQUEST-all employees will have successfully passed a pre-employment drug screen and/or criminal background check prior to placement. The$15.00 cost of the drug screen and the $25.00 cost of the background check will be billed to the client on the first invoice for the employee. If neither is requested,then neither will be billed. Our Staffing Managers provide expedient, experienced, and efficient placement of employees as needed. Our customized industry software allows us to immediately identify the most qualified candidates for requested positions. We offer a 24-hour dedicated "On-call"system that ensures an immediate call back in the event of an emergency,for order placements and employee status updates. Hiring Options If you would like to hire a Selectemp employee, the employee shall remain on Selectemp's payroll for a minimum period of 480 hours. After that time, you may hire the employee at no additional cost. If you should wish to hire a Selectemp employee prior to the completion of 480 hours, a buy-out option can be negotiated. Employee Bonuses and Benefits To help maintain a large pool of dependable and qualified employees, Selectemp offers incentive bonuses, short-term medical insurance, and vacation pay. Attendance and safety awareness are key criteria in determining employee eligibility of bonuses. -Terms-and-Conditions-­- Employees are paid weekly; therefore, invoices are mailed weekly and are DUE UPON RECEIPT. A carrying charge of 1.5% (18% annual rate)will be charged on the balance past due. In most cases, a completed credit agreement and this signed service agreement will be required before the placement of employees. The above service rate is effective through October 31, 2012. Thankyou for choosing Sete p as your staffing partner/ �f9�Z' t Authorized Signature/Title Date Date: 10/28/2011 Time: 11:29 AM To: 15415522304 D 1/2 WILSON-HE ID I N S U R AN C E _�'l 2930 Chad Drive, Eugene, Oregon 97408 (P).541-342-4441 I. (F) 541-484-5434 www.WHAINSURANCE.com Fax Transmittal Form Date: Friday, October 28, 2011 Time: 11:29:35 AM Subject: Pages: 2 Send To: From: Leesa Martindale Attn: Phone Number: 541-284-5838 Phone Number: Department: Fax Number: 15415522304 Message: Policy Disclaimer: This fear,end any attachments thereto,is intended only for use by the addressee (a) named herein and may contain le;*privileged andlor confderdial information. If you we not the inended recipient of this fax (or the person responsible for delivering this document to the intended recipient ,you we thereby notified that any dissemination,dia rbution.printig or copying of this fe),and any attachment thereto,is strictly prohibited. If you have received this fax in error,please respond to the individuel sending the message,end pemanenty delete the arpvhel and eny copy of my fax end prided Hn f. Page 1 / 1 CITY OF �":ITY a C .-7- R �., ASHLAND DATE = ":`PO NUMBER' ,� 20 E MAIN ST. 11/1/2011 10529 ASHLAND, OR 97520 (541)488-5300 VENDOR: 016542 SHIP TO: Ashland Building Maintenance GRIDLEY PAINTING (541)488-5358 734 HASKEL STREET 90 N MOUNTAIN AVENUE CENTRAL POINT, OR 97502 ASHLAND, OR 97520 FOB Point: Req.No.: Terms: Net - Dept.: Req.Del.Date: Contact: Dale Peters Special Inst: Confirming? No ljuanti W 'Descripti'on ' UnitPrice Ext.'Price " Painting -Ashland Community Center 4,405.00 Pressure wash $185.00 (2) Coats/Material$1,125.00 Labor$3,095.00 Contract for Goods and Services Beginning date: October 27, 2011 Completion date: November 18, 2011 Insurance required/On file I SUBTOTAL 4.405.00. BILL TO:Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 4,405.00 ASHLAND, OR 97520 Account Numti'er; �s�.Project Number ';:;'' 'Amount'.- "A ccount Number `;;.'.Project Number ._''' :Amount E 410.08.24.00.70410 E 000078.999 4 405.00 ,I I i Auth ri ed Signature VENDOR COPY FORM #3 CITY OF A request for a Purchase Order ASH LAND REQUISITION Date of request: 44 ©--T 11 Required date for delivery: I t tav t 1 Vendor Name <ofLID�1�V pINTrNCn Address,City,State,Zip 3�} ( F 44 S' V ST Contact Na Fax Nu bemeBTelephoneNumber C.Crm-r'RWL �iorrvT e �iZ C-��raTOn� �o.2:D�4sy SVt 8�l �9 ��{ SOLICITATION PROCESS ❑ Exempt from Competitive Bidding ❑ Emerpencv ❑ Written Findings(Form attached) El Invitation to Bid (Copies on file) ❑ Written findings attached ❑ Quote or Proposal attached Dale approved by Council: ❑ Quote or Proposal attached j� Small Procurement Cooperative Procurement Less than$5.00 ❑ Request for Proposal (Copies on file) ❑ State of Oregon Note:Total contract amount,including any Date approved by Council: Contract If amendments may not exceed$6,000 ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract# GOODS&SERVICES ❑ Written Findings(Form attached) ❑ Other government agency contract $5,000 to$100.000 ❑ Quote or Proposal attached Agency. ❑ (3)Wr tten quotes attached Contract# PERSONAL SERVICES ❑ Special Procurement ❑ Intergovernmental Agreement $5.000 to$75,000 ❑ Written Findings(Form attached) Agency ❑ Less than$35,000,by direct appointment ❑ Quote or Proposal attached' Contract# ❑ 3 Written Rroposals attached Dale approved by Council: Date approved by Council: Description' of SERVICES Total Cost dt7 GAn�O 97✓irn� r /qS �EQ RFP , �44 n,ta h Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTALrCOSTf:+< ® Per attached quotelproposal Project Number c^_c_g;$-999 Account Number ___-__-_— -- y ' Account Number_1q-Q$-2y-OQ-Pp8_y00 Account Number___- - 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date By signing this requisition form,l certify that the information provided above satisfies the City's public contracting requirements,and the documentation can be provided upon request. Employee Signature.- Department Head Signature: Additional signatures(if applicable): Funds appropriated forcurrent fiscal year: YES / NO Finance Director Date Comments: G:FinanceTrocedurMPTormsTorm#3-Requisition.doc Updated on:10/18/1011