HomeMy WebLinkAbout2012-043 Contract - Quality Fence Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Quality Fence
ASHLAND CONTACT: Brad Rietmann
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: 03/02/2012 FAX: 541-664-2949
BEGINNING DATE: March 19, 2012 COMPLETION DATE: March 29, 2012
COMPENSATION: $6,347.00 per the proposal attached as Exhibit C.
GOODS AND SERVICES TO BE PROVIDED: Contractor to remove and replace the chain link fence and
gates at Lithia Maintenance Shop per the proposal attached as Exhibit 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, 2798.235, 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
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
Contract for Goods and Services Less than$25,000, Revised 06/30/2011, Page 1 of 5
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 Contactor 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 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.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.
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 insurers to
Contract for Goods and Services Less than$25,000, Revised 06/30/2011, Page 2 of 5
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 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 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: City of Ashland
By By Signature Department Head
&d5rin*Vi 6ftr),
Print Name Print Name
104 5-. -5 it VA/--
Title Date
W-9 One copy of a W-9 is to be submitted with 2
the signed contract. Purchase Order No. e5,2-
Contract for Goods and Services Less than $25,000, Revised 06130/2011, 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.
0 (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.
Contractor (Date)
Contract for Goods and Services Less than$25,000, Revised 06/30/2011, Page 4 of 5
,From: / ,� 02103/2012 15:08 #612 P.001 /001
PROPOSAL
QUALITY FENCE COMPANY
CCe # 8936 Find us also al:
497 SW Um-Aw..
114 W.Pine Street (541)664-2281 Grants Pass,OR 97527
...NO JOB TOO LARGE PO Box 3985 1-800-451-8883 2077 NE Dienrond take Blvd.
_NO JOB TOO SMALL Central Point,OR 97502 Fax:(541)664-2949 Roseburg.OR 97470
ROPOSAL SUBMITTED TO PHONE DATE
City of Ashland Parks & Rec 541-951-1014 February 3, 2012
REEi J AME
340 S Pioneer Street
ITY.STATE AND ZIP C008 JOB LOCATION
Ashland, OR 97520 Maintenance Building - Lithia Park .
ENTION FAX
Bruce 541-552-2252 541-488-5314
We hereby submit specifications and estimate for
Remove fabric, top rail, double swing gate, roll gate and 2 -4"posts.
Slip over existing line posts.
Re-use top rail.
Cut existing terminal posts and grout in new terminal posts.
Install 1 -new 6 5/8"gate post.
Set 3-line posts.
Install 368'of 6' high chain link fencing with black fabric, 9 -terminal
posts and PDS slats.
Install 1 - 16'wide single drive gate.
Install 1 - 14'wide double swing gate.
Total: $6,347.00
We Propose hereby to furnish materials and labor--complete in accordance with above specifications,for the sum of:
ayr,w"r ro ma u o ors:
PAYMENT ON COMPLETION
All malarial b 9um.me<d to ere as apaGfled.NI eotk to be comp�med In a workmanake manner aeeodin9 W Authorized
atelldaN praclkes.Am anereaon or deNaaon from abme aperAriwtiona Imdvlaa exva coati wa be execulee Signature
only upon omen odors,end eta become an eon Cho V.oxen and.move me estimate. Aa ag.roo; � —
comlo0em upon adkes,aced.or O.W,beymd our coned. Oanx to cent'the.IorrWO and ernes Brad Rittman. Ib
news imurarce. OurwoAers ms h%owenE by W4tMienY Canpens.aon msuroMe.ndspwosalla
alsowblWbdllemuandmndiuonsfaMa onurorovau sdehenot.
Note- This proposal may be withdrawn by us if fiat a led within 14 days
Acceptance of Proposal—AII prices, specifications and conditions
are satisfactory and are hereby accepted. You are authorized to do the Signature
work as specified. Payment will be made as outlined above. I have read
the entire Contract and spree to Its Content.
Note: Quality Fence Co.not responsible for any damage to anything in or Signature
below the ground or concrete. This includes private water line,electrical
line,sprinkler systems,etc. Your signature indicates that you fully Date of acceptance:
understand the limits of Quality Fence Co.responsibility.
�9�8 CERTIFICATE OF LIABILITY INSURANCE OP ID AT _ DATEIMMDMYYYY) 1
QUALZ31 11 07 11
RODUCER - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Tests= States'McMinnville HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
.411 NW Adams ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
IcMinnville OR 97128
?hone: 503-472-2121 Fax:503-434-5872 INSURERS AFFORDING COVERAGE NAIC9
ISUREO Quality Fence Co INSURER A American Hallmark Ins Co
Reliable Electric
Western Vinyl Products INSURER B: -
Reitmann Enterprises
Steve Reltmann INSURER C:
PO Box 3985 INSURER M '
_ Central Point OR 97502
INSURER E
:OVERAGES
THE POLICIES OF INSURANCE LISTED BELOW.HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD 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 LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '
POLKtY EFFECTIVE POLICY E
TR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMID01)( Y) DATE MMIDD/YYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE S 1000000
k X COMMERCWLGENERAL LIABILITY 44CL466835 11/19/11 11/19/12 PREMISES Eaomrence $ 100000
CLAIMS MADE 'X❑ OCCUR MED UP(Any.Mrson) s5000
PERSONAL B ADV INJURY $1000000
GENERAL AGGREGATE s2000000
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2000000
POLICY X PRO- LOC Ben. 1000000
AUTOMOBILE LIABILITY
k X ANY AUTO 44CL466835 11/19/11 11/19/12 COMBINED SINGLE LIMIT 51000000
ALL OWNED AUTOS
- � BODILY INJURY ' $
SCHEDULED AUTOS (Per penOn)
HIRED AUTOS
BODILY INJURY $ ,
MON-OWNED AUTOS - - (Per accident)
PROPERTYDAMAGE $
(Per aoriM
dQ
GARAGE u ABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC S. _
AUTO ONLY: AGG S
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 4000000
A OCCUR ❑ CLAUASMADE 44CU466836 11/19/11 11/19/12 AGGREGATE $
s
R DEDUCTIBLE S
X RETENTION $10000 S
WORKERS COMPENSATION
AND EMPLOYERS'LIABILrrY YIN TORY LAIRS ER
ANY PROPRIETOPIPARTNERIEXECUTIVFr--1 EL EACH ACCIDENT $
OFFICERIMEMSER EXCLUDED? u
(Mandatary In NH) - EL DISEASE-EA EMPLOYEE S
G yyes,detK+iDe
SPECIAL PROVISIONS ae. E.L.DISEASE-POLICY LIMIT S
OTHER
A inland marine 44CL466835 11/19/11 11/19/12 leased eq 25000
Al inst fltr 10000
IESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
:ity of Ashland is additional insured as respects liability arising out of
the activities by and on behalf of the named insured
,ERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY AL DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE 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
City of Ashland
Atari Olson,Purchasing Repr REPRESENTATIVES
90 N Mountain Ave AU OR¢ED REPRESENTATIVE
shland OR 97520 VL✓ / —
\CORD 25(2009101) ®1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD fl.�, R ECn� DER
IL,I/ IJ/ LUI I/ NGU UT. L
9QUALFE OP ID:K D
CERTIFICATE OF LIABILITYkINSURANCE °"'E D ;'"
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 3
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES- 5
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INBURERI9), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THECERTIFICATE HOLDER.
IMPORTANT: If the certificate held., Is en ADDITIONAL INSURED, trio POlky(loe) must be andorsed. H SUBROGATION IS WAIVED, subject to
the terms and condWons of the policy, certain policies may require an endomement. A statement on this certificate does not confer rights to.the
certificate holder In Rey Of SUGh endOrsamenl s.
PRODUCER 641-7794232 Lr
1121 Royal Ave. 541-772.396 N NP F, Na:
Medford, OR 87506 0
Hart Insurance I Medford
INSURERM)"FORDINGCOWRAGE NAICe
WUSER A:SAiP Corp
I Nsu Quality Vence Co. Weu R B;
dba: Reliable Electric WBURERC:
P.O.BOX 3985
Central Point,OR 975023985 MEURER O:
N
COVERAGES CERTIFICATE NUMBS • REVISION NUMBER:
THIS IS O 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 HEREIN IS SUBJECT TO ALL THE TERMS,
'EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ).
. . _ ... . .
TIT OF INSURANCE LIMITS'
G6NeRAL1,AeMY - FACH
COMMENCE I I
COLVAIDMIAL GEI�FRAL LABILITY FYiEAII 6 E It
CLAIMS44AOE ❑CCCU ... WED E (AV ant DNieR - i
... -. PEES&.PDVWARY I
GENERAL AGGPEGATa I
Ol AGGREGATE LIMIT APPLIES PER: .- PROOl1Cm-CDWNP AI.G .S .•. -
POLICY PRO LOC
11ROIMOBILe LAea.ITY Ee b
MY AVID
. 6ODILY WARY(PwPe ) i ..
ALL OYY"m �SCIE�ULED BODILY WARY(Pw-a d) i
HIRED MHOS ALM'sWNED IM deN t
i
UMBRELLA LAB �� EACHOCCUWENCE I
EACBROWe LTA .M DE •• AGGREGATE S
11A89WOMERS COMPENSATION A I 0
ANDEMrLOYBRWI AWUIY
-5320
AN,(PROPRETOR.PAR1N RE4CiI11VE Y❑ NIA 718878 10/01111 10/01112 EL EACHALCIDENr f 600,0
OFFICQLMEA�ER excLUCon ELDAE-AE-EAE OYES i `00,00
(N•ndelorY to hW7 -
II •a d.eeMe�.Ar M E.L DISEASE-POLICY LIMIT 80000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Karl Olson, Purchasing
Representative AUTHOR=RO-ReeeNY•nvE
City of Ashland Hart Insurance/Medford
90 N Mountain Ave
®1988-7010 ACORD CORPORATION. All rghte reaer.od.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
1
CITY RECC DER Page 1 / 1
Ashland Park Commission I DATE, I PO NUMBER
20 E MAIN ST. 3/13/2012 00082
ASHLAND, OR 97520
(541)488-5300
VENDOR: 000661 SHIP TO:
QUALITY FENCE COMPANY
PO BOX 3985
CENTRAL POINT, OR 97502
FOB Point: Req.No.:
Terms: net Dept.:
Req.Del. Date: Contact: Bruce Dickens
Special Inst Confirming? NO
.. .. ..
`.,Q uariti � Unit - � Description � � - - Unit Price Ext.Price'
Contractor to remove and replace chain 6,347.00
link fence and gates at Lithia
'Maintenance Shop per attached proposal
Contract for Goods and Services
Beginning date: March 19, 2012
Completion date: March 29, 2012
Insurance required/On file
SUBTOTAL 6 347.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 6,347.00
Account Number . Project Number`'; Amount Account Number . Project Number . f Amount
E 211.12.02.06.60240(1 6 347.00
Autriorized Signature VENDOR COPY
FORM #3. CITY OF
I t ASHLAND
-i� (i?'�,i;`'.4?�. �i�ti"� a �"��)!':.�il�t>,s'x'; 'l,.a l�d+ia3•
REQUISITION Date of request:
Required date for delivery:
V Name I Art I '
Address,City,State,Zip ,
Contact Name&Telephone Number Fax Number !-I'GZl sPO 514I -(PGJa- 22-Sr)
SOLICITATION PROCESS
,❑ Exempt from Competitive Bidding ❑ Emergency
❑ Written Findings(Form attached) ❑ Invitation to Bid (Copies on file) ❑ Written findings attached
❑ Quote or Proposal attached Date approved by Council: ❑ Quote or Proposal attached
❑ Small Procurement Cooperative Procurement
Less than$5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon
Note:Total contract amount,including any Date approved by Council: Contract#
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 El Quote or Proposal attached Agency
(3)Wtten 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#
- - — - -Date approved b Council:----- -
------ - -
3Written proposals attached Date aroved ti-Couricil:---- - PP y
Description of SERVICES Total Cost
t
Item # Quantity Unit Description of MATERIALS Unit Price Y Total Cost
/tic 3 17.
s
- 'TOTAL'.COST�
❑ Per attached quote/proposal g
Project Number---------- Account Number--------------------
Account NumbeP- 60.,�gco Account Number___-__•_
`Expenditure must he 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 requireT✓'S'
no the documentation can be
provided upon request. AA A -
Employee Signature: Y A ( /�QrS�A/� Department Head Signature:
Additional signatures(if applicable):
Funds appropriated for current fiscal year: YCS NO
Finance Director Date
Comments:
G:FinancelProcedurMPTormsTorm#3-Requisition.doc Updated on:824/2011