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HomeMy WebLinkAbout2012-066 Contract - Jaco Environmental PROFESSIONAL SERVICES CONTRACT CONTRACT NO. THIS AGREEMENT is entered into by and between The City of Ashland Electric Utilities Department (hereinafter referred to as the "City"), with its principal place of business located at 90 N Mountain Avenue, Ashland, OR 97520, and JACO ENVIRONMENTAL (hereinafter referred to as "Service Provider"), with its principal place of business located at 18323 Bothell-Everett Highway, Suite 220, Bothell, WA 98012. This agreement may be referred to herein as the "Contract" or"Agreement" 1. SCOPE OF SERVICE The Service Provider shall provide the services described in Exhibit A, City Appliance Recycling Program (ARP), which is attached hereto and by this reference is incorporated herein. 2. TERM OF CONTRACT A. The term of this Contract shall be from January 1, 2012 through December 31, 2013. The Service Provider shall complete all specified Contract work, including submission of reports and other required documentation within the term of the Contract. Any revision to the term of the Contract shall be by mutual agreement, in writing, between CITY and the Service Provider. 3. PAYMENT A. CITY shall pay the Service Provider for such services on a unit price basis in accordance with the accepted price shown in Attachment A, Cost Scenario Analysis Summary. CITY makes no guarantee of any minimum number of units to be recycled under the ARP or this Contract. B. The Service Provider shall submit an invoice to CITY monthly for the number of units recycled according to the amounts stated in Exhibit A. Invoices shall be in a format acceptable to CITY. C. CITY shall pay for only those units that the Service Provider has recycled and for which the Service Provider has issued the incentive check to CITY's customer. D. CITY shall pay all invoices from the Service Provider by mailing an CITY warrant, within 30 days of receipt of a properly completed invoice. E. Payment by CITY will be completed on a fee-for-service basis. There shall be no advance payment for services furnished pursuant to this contract. There shall be no minimum payment. F. Payments made to the Service Provider shall not constitute acceptance of the work or any portion thereof which is not in accordance with this Contract. G. If during the course of the Contract, the work performed does not meet the requirements set forth in the Contract, the Service Provider shall correct or modify the work to comply with the Contract requirements and CITY shall have the right to withhold payment for such work until the Service Provider meets the requirements of the Contract. JACO Contract Page 1 4. REPORTS AND INSPECTIONS A. The Service Provider at such times and in such forms as CITY may require, shall furnish to CITY such statements, records, reports, data, and information as CITY may request pertaining to the matters covered by this Contract. B. All statements, reports, data, records and accounts pertaining to this Contract are to be kept available for inspection by representatives of CITY during the course of the Contract and for a period of three (3) years after final payment: Copies shall be made available to CITY upon request. 5. RESPONSIBILITIES OF SERVICE PROVIDER A. Manager. The Service Provider shall appoint a Manager who will be in charge of the Service Provider's responsibilities under this Agreement and have day to day authority to make decisions on behalf of the Service Provider. All notices regarding changes in the Program or revisions to the Scope of Service shall be delivered to the designated Manager. The Service Provider's Manager to CITY's ARP is: Name: Bob Nicholas Title: Program Development Address: P.O. Box 14307 City , State, Zip: Mill Creek , WA 98082 Office Phone #: Cell Phone #: 425.754.4894 Office Fax #: 425.423.7873 E-mail Address: bobnaiacoinc.net B. Any and all employees of the Service Provider or other persons while engaged in the performance of any work or services required of the Service Provider under this Contract shall be considered employees of the Service Provider only and not of CITY, and any and all claims that may or might arise under any Workmen's Compensation Act on behalf of said employees or other persons while so engaged, and any and all claims made by a third party as a consequence of any act or omission on the part of the Service Provider's employees or other persons while engaged in any of the work or services rendered herein, shall be the sole obligation and responsibility of the Service Provider. C. Safety. The Service Provider shall take all necessary precautions for the safety of employees and shall comply with all applicable provisions of federal, state and local regulations, ordinances and codes. The Service Provider shall erect and properly maintain at all times, as required by the conditions and progress of the work, all necessary safeguards for the protection of workers and the public and shall post danger signs warning against known or unusual hazards. D. Warranty. The Service Provider shall be responsible for correcting any deficiencies and for completing all the work as described in Exhibit A. E. Nondiscrimination/Equal Protection. The Service Provider agrees not to discriminate against any employee or applicant for employment or any other persons in the performance of this Contract because of race, religion, creed, color, national origin, marital JACO Contract 2 status, gender, age or handicap, or other circumstances as may be defined by federal, state or local law or ordinance, except for a bona fide occupational qualification. The Service Provider agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the Service Provider setting forth the provisions of this nondiscrimination clause. 6. CITY'S PROGRAM MANAGER CITY's Program Manager for CITY's ARP will have the primary responsibility for CITY under this Contract and shall oversee and approve all work to be performed, coordinate communications, and review and approve all invoices, under this Agreement. Name Lee Tunebera Title Interim Assistant City Administrator Address 20 East Main St City , State, Zip Ashland . OR 97520 Office Phone # 541-552-2003 Cell Phone # Office Fax# E-mail Address lee.tunebera(a)ashland.or.us 7. CONFIDENTIALITY/ NON-DISCLOSURE A. Confidential Information. Service Provider acknowledges that it and its employees or agents may, in the course of performing its responsibilities under this Contract, be exposed to or acquire information that is confidential to CITY or CITY's clients. Any and all information of any form obtained by Service Provider or its employees or agents in the performance of this Contract shall be deemed to be confidential information of CITY ("Confidential Information"). Any reports or other documents or items (including software) which result from the use of the Confidential Information by Service Provider shall be treated with respect to confidentiality in the same manner as the Confidential Information. Confidential Information shall be deemed not to include information that (a) is or becomes (other than by disclosure by Service Provider) publicly known or is contained in a publicly available document; (b) is furnished by CITY to others without restrictions similar to those imposed by this Contract; (c) is rightfully in Service Provider's possession without the obligation of nondisclosure prior to the time of its disclosure under this Contract; or (d) is independently developed by employees or agents of Service Provider who can be shown to have had no access to the Confidential Information. B. Non-Disclosure. Service Provider agrees to hold Confidential Information in strict confidence, using at least the same degree of care that Service Provider uses in maintaining the confidentiality of its own confidential information, and not to copy, reproduce, sell, assign, license, market, transfer or otherwise dispose of, give, or disclose Confidential Information to third parties or use Confidential Information for any purposes whatsoever other than the provision of services to CITY hereunder, and to advise each of its employees and agents of their obligations to keep Confidential Information confidential. C. Unauthorized Use. Service Provider shall use its best efforts to assist CITY in identifying and preventing any unauthorized use or disclosure of any Confidential Information. Without limitation of the foregoing, Service Provider shall advise CITY immediately in the event Service Provider learns or has reason to believe that any person who has had access to Confidential Information has violated or intends to violate the JACO Contract 3 terms of this Contract and Service Provider will at its expense cooperate with CITY in seeking injunctive or other equitable relief in the name of CITY or Service Provider against any such person. D. Return of Confidential Information. Service Provider agrees that, except as directed by CITY, Service Provider will not at any time during or after the term of this Contract disclose, directly or indirectly, any Confidential Information to any person, and that upon termination of this Contract or at CITY's request, Service Provider will turn over to CITY all documents, papers, and other matter in Service Provider's possession which embody Confidential Information. E. Injunctive Relief. Service Provider acknowledges that breach of this Paragraph 7, including disclosure of any Confidential Information, or disclosure of other information that, at law or in good conscience or equity, ought to remain confidential, will give rise to irreparable injury to CITY that can only be inadequately compensable in damages. Accordingly, CITY may seek and obtain injunctive relief against the breach or threatened breach of the foregoing undertakings, in addition to any other legal remedies that may be available. Service Provider acknowledges and agrees that the covenants contained herein are necessary for the protection of the legitimate business interests of CITY and are reasonable in scope and content. F. Ensuring Confidentiality. Service Provider agrees to comply with all reasonable requests by CITY to ensure the confidentiality and nondisclosure of the Confidential Information, including without limitation (a) obtaining nondisclosure agreements, in a form approved by CITY, from each of Service Provider's employees and agents who are performing work, and providing copies of such agreements to CITY, and (b) performing criminal background checks on each of Service Provider's employees and agents who are performing work, and providing a copy of the results to CITY. 8. COMPLIANCE WITH LAWS A. The Service Provider shall comply with all federal, state and local regulations and ordinances applicable to the work to be done under this Contract, including, but not limited to, all applicable environmental and hazardous materials laws. B. Any violation of the provisions of Paragraph 7 shall be considered a violation of a material provision of this Contract and shall be grounds for cancellation, termination or suspension of the Contract by CITY, in whole or in part, and may result in ineligibility for further work for CITY. 9. TERMINATION OF CONTRACT A. CITY may terminate this Contract by giving at least ten (10) days written notice to the Service Provider. Termination may be effected by serving a notice of termination on the Service Provider's Manager identified in Paragraph 6 of this Contract, or by mailing such notice to Service Provider's business address by certified mail, allowing three (3) business days for delivery. B. In the event this Contract is terminated by CITY, the Service Provider shall be entitled to receive payment only for the number of units recycled, and for which the Service Provider has issued the incentive check to CITY's customer(s), as of the effective date of termination. 10. CLAIMS Any claim against CITY for damages, expenses, costs or extras arising out of the performance of this Contract must be made in writing to CITY within thirty (30) days after JACO Contract 4 the discovery of such damage, expense or loss, and in no event later than the time of approval by CITY for final payment. The Service Provider, upon making application for final payment, shall be deemed to have waived its right to claim for any other damages for which a claim has not been made, unless such application for final payment includes notice of additional claim and fully describes such claim. 11. HOLD HARMLESS AND INDEMNIFICATION A. This is a contract for a pass-through of Bonneville Power Administration (BPA) conservation renewable funding. The refrigerator, freezer and other units to be recycled under this Contract are not, and have never been, the property of, or held in the possession or control of, CITY. Accordingly, the parties hereto agree that CITY shall bear no responsibility or liability of any nature or kind whatsoever for, or relating to, the recycling or disposal of said units. B. To the fullest extent permitted by law, the Service Provider shall indemnify, defend and hold harmless CITY, and its officers, officials, agents and employees from and against any and all claims, actions, suits at law or equity, liability, loss, costs, expenses or damages of any nature or kind whatsoever, including but not limited to environmental liabilities and damages (whether resulting from hazardous materials disposal or otherwise), and further including but not limited to reasonable attorneys' fees and litigation costs, brought against CITY, its officers, officials, agents and/or employees, arising out of, or in connection with, or incident to, the execution of this Contract and/or the performance or failure to perform any aspect of this Contract; provided, however, that nothing herein shall require the Service Provider to hold harmless or defend CITY, its officers, officials, agents or employees from any claims arising from the sole negligence of CITY, its officers, agents or employees. C. The Service Provider agrees that its obligations under this Paragraph 11 also extend to any claim, demand, and/or cause of action brought by, or on behalf of, any of its employees or agents. For this purpose, the Service Provider, by mutual negotiation, hereby waives, as respects CITY only, any immunity that would otherwise be available against such claims under the industrial insurance provision of Title 51 RCW. In the event CITY obtains any judgment or award, and/or incurs any cost arising therefrom, including attorneys' fees to enforce the provisions of this article, all such fees, expenses, and costs shall be recoverable form the Service Provider. D. The provisions of this Paragraph 11 shall survive the termination of this Services Contract. 12. INSURANCE The Service Provider at his/her own cost and expense, shall procure and maintain, for the duration of the Contract, the following insurance policies with insurers possessing a Best's rating of no less than A. Workers' Compensation Coverage: Service Provider shall maintain Workers' Compensation Insurance and Employer's Liability Insurance in an amount not less than one million dollars ($1,000,000), for his/her employees in accordance with the laws of the State of Washington. Any notice of cancellation or non-renewal of all Workers' Compensation policies must be received by CITY at least thirty (30) days prior to such change. General Liability Coverage: Service Provider shall maintain commercial general liability insurance in an amount not less than one million dollars ($1,000,000) per occurrence for bodily injury, personal injury and property damage. If a commercial general liability JACO Contract 5 jnsurance form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this Contract or the general aggregate limit shall be at least twice the required occurrence limit. CITY shall be named as an additional insured under this coverage. Pollution Legal Liability Coveraqe: Service Provider shall maintain Pollution Legal Liability insurance with minimum limits of one million dollars ($1,000,000) per occurrence for death, bodily injury, or property damage to third parties, as well as for environmental remediation of sites damaged by pollution resulting directly or indirectly from the Service Provider's operations under this Contract. Such policy shall be maintained throughout the term of this Contract, and for not less than three (3) years after the date of final acceptance and completion of the work performed under this Contract. CITY shall be named as an additional insured under this coverage. Automobile Liability Coverage: Service Provider shall maintain automobile liability insurance covering bodily injury and property damage for all activities arising out of or in connection with the work to be performed under this Agreement, including coverage for owned, hired and non-owned vehicles, in an amount of not less than one million dollars ($1,000,000) combined single limit for each occurrence. Cancellation: The insurance provided by the policies identified in this Paragraph 12 shall not be suspended, voided, canceled, or reduced in coverage or in limits except after thirty (30) days written notice has been received by CITY. Other insurance requirements: The Service Provider's insurance coverages shall be primary insurance relative to CITY. Any insurance, self-insurance, or insurance pool coverage maintained by CITY shall be in excess of the Service Provider's insurance and shall not contribute to it. All policy coverages required under this Paragraph 12 shall be written on an occurrence basis. The Service Provider will deliver to CITY, no later than ten (10) days after execution of the Agreement by CITY and prior to commencing work, Certificates of Insurance, identified on their face as the Contract Number to which applicable, as evidence that policies providing such coverage and limits of insurance are in full force and effect, which Certificates shall provide that not less than thirty (30) days advance notice will be given in writing to CITY prior to cancellation, termination or alteration of said policies of insurance. Such advance notice of cancellation, termination, or alteration of said policies shall be delivered to CITY's Program Manager. 13. PREVAILING WAGES AND ASHLAND LIVING WAGE The Service Provider shall comply with any applicable Prevailing Wage Rate Requirements in Oregon State. In addition, Service Provider shall comply with Ashland Municipal Code Chapter 3.12, which requires all employers subject to the chapter to pay the Ashland living wage. 14. ASSIGNMENT A. This Contract shall not be assigned or transferred by either party, either in whole or in part, without the prior written consent of the other party. Any attempted assignment or transfer without such written consent shall be void. B. Any work or services assigned hereunder shall be subject to each provision of this Contract. 15. INDEPENDENT SERVICE PROVIDER JACO Contract 6 The Service Provider is and shall be at all times during the term of this Contract an independent Service Provider and not an employee of CITY. 16. GOVERNING LAW Any legal dispute between the parties to this Contract shall be governed by the laws of the State of Oregon, and any action to enforce this Contract shall be brought in Jackson County, Oregon. 17. PARTIAL INVALIDITY Any provision of this Contract which is found to be invalid or unenforceable shall be ineffective to the extent of such invalidity or unenforceability, and the invalidity or unenforceability of such provision shall not affect the validity or enforceability of the remaining provisions hereof. 18. NONWAIVER The failure of CITY to insist upon or enforce strict performance by the Service Provider of any provision of this Contract, or to exercise any right under this Contract, shall not be construed as a waiver or relinquishment to any extent of CITY right to assert or rely upon any such provision or right in that or any other instance; rather, the same shall be and remain in full force and effect. 19. ENTIRE AGREEMENT/ MODIFICATION This Contract, together with the attachments and/or addenda, represents the entire and integrated Contract between the parties hereto and supersedes all prior negotiations, representations, or agreements, either written or oral. This Contract may be amended, modified or added to only by written instrument properly signed by both parties hereto. IN WITNESS WHEREOF, the parties have executed this Contract as of this 29 day of Fes. , 2012. JACO ENVIRONMENTAL CITY OF ASHLAND ELECTRIC UTILITIES DEPARTMENT By: LP (2 By: Z)w Printed Name: 14WN jftosw Printed Name: [b4dzew LEE" %tun/rcdE0�6 Title: F"t iXyaT Title: ler..lc Asrlsro ur C.ry Ap.� uisrrrwr�.� AddressOW6 r4jj (xr,Jc 9., 22a City/ ip: Attest: Attest: Date: I /2 Date: ag i r It- Z36 . Tax ID No.: 1 �, JACO Contract 7 City of Ashland Electric Dept ARP Cost Analysis Confidential a Attachment A 2012-2013 Proposed City of Ashland Electric Dept Appliance Recycling Program (ARP) Market Penetration(Program Volumes) PY 2012 PV 2013 Notes Total Electric Account Dace 9'" 9,000 JACO planning assumption Annual Harvest Rate(AHR) 0.9% 0.9516 scenario assumption Year Fraction Factor 100% 100% assumes 1M12-122013(24 months) Units Bt 81 calculated value Measure Savings Attributes:Refrigerators Refrigerator Fraction of Total Program Volumes 80%JACO estimate for Pacific NW ARPs Refrigerator Net Energy Savings(annual kWNUnit) 482 per NoMwest Power and Conservation Council(NWPCC)Regional Technical Forum(RTF), published summer 2010(most recent as of fall 2011) Refrigerator Net Demand Savings(avg kW) 0.06 based on not energy savings value and 87W hryr Measure Savings Attributes:Freezers Freezer Fraction of Total Program Volumes 20%JACO estimate for Pacific NW ARPs Freezer Net Energy Sayings(annual kWh/unit) 555 per Northwest Power and Conservation Council(NWPCC)Regional Technical Forum(RTF), published summer 2010(mast recent as of fall 2011) Freezer Net Demand Savings(avg kW) 0.06 based on net energy savings value and 8760 hnyr Measure Savings Attributes:Weighted Net Avg(Refrigeralor/Fnaezer) Md.Avg.Net Energy Savings(annual kWhAmd) 497 calculated based on above assumptions Md Avg,Net Demand Savings(avg kW) 0.06 based on net energy savings value and 8760 hrtyr Measure Life(applic,to reflgerators and freezers) 8 per Northwest Power and Conservation Council(NWPCC)Regional Technical Forum(RTF) Per-Unit Cost Assumptions Direct Implementation $ 85.00 comprehensive bnplementation services Marketing E 20.00 provdetl by utility;JACO budget estimate Incentive E 30.00 identical to incentive levels elsewhere regionally Total E 135.00 total of above Macroeconomic Assumption Discount Rate 5.5%JACO estimate for municipal utility systems Annual and]-Year TOtaLProgram Metries.(riots:PY v-program ' PY Y 20 2012 PY 2013 2 PY Totals Unit Volumes(refrigerators and freezers) 81 81 162 Program Costs(excl.Frog.Admin and Still %of Total Direct Implementation $ 6,885 $ 6,885 E 13,770 63% Marketing S 1,620 $ 1,620 E 3,240 15% Incentive $ 2,430 E 2,430 $ 4,850 22% Total $ 10,935 $ 10,935 S 21,870 100% Net tat Year Load Impacts Annual kWh 40,225 40,225 80,449 avg mW 0.00 0.00 0.01 Detailed Year-0y-Year Analysis for 3-Year Total Program Levelized Cost Cabe,(assumes all units in PY X begin accruing benefits on Jan 1 of PY X) PY 2012 PY 2013 PV of Sum for 2 PY's Program Costs 1 $ 10,935 $ 10,935 $ 21,300 Net Annual kWh Load Impact Info PY 2012 PY 2013 Sum for 2 PV's 2012 40,225 40,225 2013 40,225 40,225 00,449 - 2014 40,225 40,225 80,449 2015 40,225 40,225 00.449 2016 40,225 40,225 80,449 2017 40,225 40,225 80,449 2018 40,225 40,225 80,449 2019 40,225 40,225 110,449 2020 40,225 40,225 Total Net Annual kWh Impacts,2012-2020 321,797 321,797 643,594 PV of Net Annual kWh Impacts,2012-2020 523,625 Overall 2012-2013 Program Levelized Costs(]/kWh) $ 0.041 (excl,prog.admin 8 EMSV) JACO Environmental Oclober24,2011 CITY OF ASHLAND Council Communication Approval of a Special Procurement JACO Environmental — Refrigerator/Freezer Recycling Program Meeting Date: February 21,2012 Primary Staff Contact: Lee Tuneberg Department: Electric Dept E-Mail: tuneberl @ashland.or.us Secondary Dept.: Conservation Division Secondary Contact: David Lohman Approval: Larry Patterson Estimated Time: Consent Question: Will Council, acting as the Local Contract Review Board, approve a Special Procurement requesting approval to enter into a two year contract with JACO Environmental to continue to operate a refrigerator and freezer recycling program to Ashland residents as part of the City's overall energy efficiency/conservation incentive program? Staff Recommendation: Staff recommends Council approve the Special Procurement contract with JACO Environmental to continue to operate a refrigerator and freezer recycling program in association with the City's energy efficiency/conservation incentive program. Background: As part of the City's energy efficiency/conservation appliance incentive program, JACO Environmental has been a valuable partner in ensuring that the refrigerators/freezers replaced as part of the City's rebate incentive program are properly disposed of. In the absence of such a program, the inefficient units being replaced could remain in use as a secondary unit or be sold and re-utilized negating the benefits of the incentive/rebate. Additionally, --proper-de-conimissioning-ensures.the-proper-handling-of hazardous-materials and-recycling of as much- of the component materials as possible. JACO performs this service for Pacific Power through the Energy Trust of Oregon, which surrounds the City of Ashland's utility territory, as well as for over 40 other utilities in 19 different states. .Remaining consistent with programs in Ashland's surrounding utility territories provides the City with shared marketing efforts and eliminates customer confusion regarding recycling options. The use of a large multi utility contractor also provides cost benefits that would otherwise be difficult to achieve given Ashland's relatively low volume as a small utility. Costs associated with the program are eligible for reimbursements through Bonneville Power Administration (BPA) and are processed in conjunction with the incentive/rebate resulting in little to no actual cost to the Conservation Division budget. Page 1 of 2 �r, CITY OF FORM #9 -ASH ] D SPECIAL PROCUREMENT REQUEST FOR APPROVAL To: City Council, Local Contract Review Board From: Lee Tuneberg Date: February 21, 2012 Subject: REQUEST FOR APPROVAL OF A SPECIAL PROCUREMENT In accordance with ORS279B.085,this request for approval of a Special Procurement is being presented to the City Council for approval. This written request for approval describes the proposed contracting procedure and the goods or services or the class of goods or services to be acquired through the special procurement and the circumstances that justify the use of a special procurement under the standards set forth ORS 279B.085(4). 1. Requesting Department Name: Electric Department-Conservation Division 2. Department Contact Name: Lee Tuneberg 3. Type of Request: Class Special Procurement X Contract-specific Special Procurement 4. Time Period Requested: From March 1,2012 To: December 31,2013 S. Total Estimated Cost: Costs incurred to the City as part of this contract are limited to staff administrative overhead as the actual customer incentive payments and pick up/recycling of the appliances are reimbursed as"deemed measures" within the City's Energy Efficiency funding allocation from Bonneville Power Administration(BPA) 6. Short title of the Procurement: Pick-up and Recycling of old refrigerators/freezers associated with the City of Ashland's energy _- efficiency appliance incentive/rebate program Supplies and/or Services or class of Supplies and/or Services to be acquired: JACO Environmental will provide pick up and proper recycling/disposal of refrigerators/freezers from City of Ashland Electric Utility customers who qualify for the Conservation Division energy efficiency/conservation appliance incentive/rebate program. Utility customers receive a rebate check for the purchase of a qualifying high efficiency refrigerator/freezer and agree to allow JACO Environmental,on behalf of the City,to pick up and properly decommission and recycle the old appliance. All costs associated with the rebate,pick up and decommission/recycling are reimbursed to the City by BPA 7.Background and Proposed Contracting Procedure: Provide a description of what has been done in the past and the proposed procedure.The Agency may,but is not required to,also include the following types of documents:Notice/Advertising, Solicitation(s),Bid/Proposal Forms(s), Contract Form(s),and any other documents or forms to be used in the proposed contracting procedure. Attach additional sheets as needed. Form#9-Special Procurement-Request farApproval,Page 1 of 4,2115/2012 The ability of JACO Environmental to serve multiple utility service territories serves and promotes the public interest by being cost effective,consistent in message and operation reducing confusion and added administrative efforts (Please provide specific information that demonstrates how the proposed Special Procurement meets this requirement.) Form#9-Special Procurement-Request forApproval,Page 3 of 4,2115/2012 FY i REVS '(DER Page 1 /1 V I �. CITY OF ASHLAND AiL!il DATE .�. � ": �PO NUMBER. '. 201 E MAIN ST. 3/29/2012 10784 ASHLAND, OR 97520 (541)488-5300 VENDOR: 014695 SHIP TO: Ashland Conservation Dept. JACO ENVIRONMENTAL (541)488-5306 PO BOX 14307 20 E. MAIN STREET MILL CREEK, WA 98012 ASHLAND, OR 97520 FOB Point: Req.No.: Terms: Net Dept.: Req.Del.Date: Contact: Adam Hanks Special Inst Confirming? NO . Quantity Unit _ Descri lion ' unit Price Ext. Price Appliance Incentive Program 5,000.00 Refrigerators and freezers picked up and decommissioned for City of Ashland electric utility customers that quality for the conservation appliance incentive program. Contract based on # of units picked up with total contract not to exceed $21,870.00 for the term of the contract. Special Procurement Approved by Council 02/21/2012 Contract term: Beginning date: January 1, 2012 Completion date: December 31, 2013 FY 2012 -$5,000.00 FY 2013 -$16,870.00 SUBTOTAL 5,000.00 BILL TO:Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 5,000.00 ASHLAND, OR 97520 Account Number ', :Project Number Amount ''. Account Number -`� Project Number;. % .Amount. .. E 690.11.06.00.61011 Q 5,000.00 ALIthorized Signature VENDOR COPY FORM #3 CITY OF >A request for a Purchase Order ASHLAND REQUISITION Date of request: zi23n2 Required date for delivery: Vendor Name JACO Environmental Address,City,State,Zip 18323 Bothell-Everett Highway,Suite 220,Bothell,WA 98012 Contact Name&Telephone Number Robert Nichols 425-754-4894 Fax Number bon lacomc.ne SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Written findings attached ❑ AMC 2.50 Dale approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than$5.000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ❑ Direct Award Dale approved by Council: Contract# ❑.VerbalMritten quote(s)or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract# GOODS&SERVICES ❑ Written Findings(Form attached) ❑ Other government agency contract $5.000 to$100,000 ❑ Written quote or proposal attached Agency . ❑ (3)Written quotes attached ❑ Special Procurement Contract# PERSONAL SERVICES ® Written Findings(Form #9 attached) Intergovernmental Agreement $5.000 to$75.000 ❑ Written quote or proposal attached ❑ Agency ❑ Less than$35,000,by direct appointment Date approved by Council: e7-�--2 r—i Date original contract approved by Council: ❑ (3)Written proposals attached Valid until: F,2 - 9/ - i� Date (Date) Description of SERVICES Total Cost RedrigeratodFreezer pick up,decommission and recycle for City of Ashland Electric Utility customers that qualify for Conservation appliance incentive program . Contract based on#of $21,870 units picked u with total contract not to exceed$21,870 Item #. Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $21,870 Project Number______-___ ZG�2 r T Account Number 690.11 -06.00.610110 '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 Support-Yes/No By signing this requisition form,I certify that the City's public contracting requirements have been satisfied. i A Employee Signature: Department Head Signature: A— :�— ' Additional signatures(if applicable): (Equal to or greater than , 00) Funds appropriated for current fiscal year: a/ NO Finance Director-(Equal to orgy terthan$5,000) Date Comments: Form#3-Requisition