HomeMy WebLinkAbout2012-099 Contract - Douglas McGeary PERSONAL SERVICES CONTRACT whichever event occurs first. However, such expiration shall not
extinguish or prejudice City's right to enforce this contract with respect to:
This contract is between City of Ashland, a political subdivision of the (a) any breach of a Contractor warranty; or (b) any default or defect in
State of Oregon, hereinafter called "City", and Contractor hereinafter Contractor's performance that has not been cured.
called"Contractor". The parties agree m follows:
5. Contract Documents: This contract between the parties consists of
1. Contractor's information: this Personal Services Contract, Scope of Work (Exhibit A), General
Conditions (Exhibit B) Compliance with Applicable Laws (Exhibit C)
NAME(tax filing): Douglas M.McGeary,Attorney at Law and the following attached documents, if checked, which contain all the
terms and conditions of the contract and are incorporated by this
ADDRESS: 2 N.Oakdale Ave, Medford,OR 97501 reference:
doug @douglasmmcgeary.com ❑ Exhibit D Supplementary Conditions
CITIZENSHIP,if applicable: ❑ Exhibit E Required Federal Terms and Conditions
Non-resident alien ❑ Yes X No
6. Amendments: The terms of this contract shall not be waived,
BUSINESS DESIGNATION(check one): altered, modified, supplemented or amended, in any manner whatsoever,
❑ Corporation ❑ General Partnership except by written instrument signed by the parties.
❑ Limited Partnership ❑ Governmental/Non-Profit
❑ Limited Liability Company ❑ Limited Liability Partnership IN WITNESS WHEREOF, THE PARTIES OR THEIR DULY
X Sole Proprietorship AUTHO R
REPRESENTATIVES HAVE SIGNED THIS
Federal Tax ID#: 26-1417718 CONTRACTt
_ 2S3 � 512,111Z
SSN#:N/A Contractor He as M. cGeary ( ate)
(Contrattor must pronde Contractor's Social Security Number uvleu it provides a fedml TM number).
t a:.Attorney at La i 5/
Oregon Business License#: N/A Zt 1 a
City ofAshland City Manager (Date)
CERTIFICATIONS/REPRESENTATIONS: Contractor, under
penalty of perjury, certifies that(a)the number shown on this form is its
correct taxpayer ID (or is waiting for the number to be issued to it and
2. Description of Contractor's Services, Delivery Schedule and (b)Contractor is not subject to backup withholding because(i)it is exempt
Compenstation: ❑ ExhibitA Scope of Work 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
3. Compensation by City: Payment for all work performed under this of a failure to report all interest or dividends,or(iii)the IRS has notified it
contract shall be made as set forth below from available and authorized that it is no longer subject to backup withholding. Contractor further
City funds, and shall not exceed the maximum sum of Payment for all represents and warrants to City that (a) it has the power and authority to
work performed under this contract shall not exceed the maximum sum of enter into and perform the work, (b) the Contract, when executed and
See Exhibit A. Travel and other expenses of the Contractor shall not be delivered, shall be a valid 'and binding obligation of Contractor
reimbursed by City unless specifically provided herein as a supplementary enforceable in accordance with its terms, (c) the work under the Contract
condition. shall be performed in accordance with the highest professional standards,
a. Interim payments shall be made to Contractor following City's, and(d)Contractor is qualified,professionally competent and duly licensed
review and approval of billings submitted by Contractor. Contractor will to perform the work. Contractor also certifies under penalty of perjury
also submit copies of other billings for work performed under the contract that its business is not in violation of any Oregon tax laws, and it is a
when such bills are in be paid by other parties. These other billings are corporation authorized to act on behalf of the entity designated above and
not subject to the maximum compensation amount of this contract. authorized to do business in Oregon or is an independent contractor as
b. Contractor shall not submit billings for, and City will not pay, any defined in the contract documents, and has checked four or more of the
amount in excess of the maximum compensation amount of this contract, following criteria:
including any travel and other expense when noted below. If the X (1) 1 carry out the labor or services at a location separate from my
maximum compensation amount is increased by amendment- of this residence or is in a specific portion of my residence, set aside as the
contract, the amendment must be fully effective before Contractor location of the business.
performs work subject to the amendment. Contractor shall notify City's X (2) Commercial advertising or business cards or a trade
supervising representative in writing 30 calendar days before this contract association
expires of the upcoming expiration of the contract. No payment will be membership are purchased for the business.
made for any services performed before the beginning date or after the X (3) Telephone listing is used for the business separate from the
expiration date of this contract. This contract will not be amended after personal residence listing.
the expiration date. X (4) Labor or services are performed only pursuant to written
c. Contractor shall submit bi-weekly billings for work performed. The contracts.
billings shall describe all work performed with particularity,by whom and X (5) Labor or services are performed for two or more different
on the date it was performed, the number of hours spent performing such persons within a period of one year.
work,and shall itemize and explain all expenses for which reimbursement X (6) 1 assume financial responsibility for defective workmanship or
is claimed.Billings shall be sent to the supervising representative. for service not provided as evidenced by the ownership of performance
bonds, warranties, errors and omission insurance.or liability insurance
4. Effective Date and Duration: This Contract shall become effective relating to the labor or services to be provided.
on duration from May 11,2010 or the date this Contract is fully executed
and approved as required by applicable law. Unless earlier terminated or
extended, this contract shall expire on No Specified Date, or when ontractor (Da e)
Contractor's completed performance has been accepted by City, I Ak^�
Exhibit A SCOPE OF WORK
D D. Attendance at any City Council meetings, and
Description of Contractor's Services, Delivery
other meetings as necessary.
Schedule and Consideration:
Provide legal advice and/or services in areas of $95.00/hour, no retainer.
municipal law to assigned city departments, and E. Monitor pending and current State and
mayor and city council. Federal legislation and case law as appropriate.
Rate: No charge.
A. Review, charge and prosecute municipal Travel is charged at $30/hour for any travel exceeding
criminal and code violations. one half hour and is charged in lieu of standard legal
services rate.
$95.00/hour, no retainer.
After six month from effective date of contract,
B. Routine legal advice, consultation and Contractor reserves opportunity to adjust its rates.
opinions of the City Council and staff,
Hours:
$95.00/hour, no retainer.
Contractor's hours shall not exceed twenty (20) hours a
C. Assistance in the preparation and review of week unless first notifying city or interim city attorney
ordinances, resolutions, agreements, contracts and and additional time is approved.
related documents:
$95.00/hour, no retainer. Total Contract not to exceed$120,000.00
Exhibit B GENERAL CONDITIONS appropriate for purchase under this contract or are no longer eligible for
the funding proposed for payments authorized by this contract;or
1. Independent Contractor;Responsibility for Taxes and iii. If any license or certificate required bylaw or regulation to be held by
Withholding; Retirement System Status: Contractor to provide the services required by this contract is for any
a. Contractor shall perform the work required by this contract as an reason denied,revoked,suspended,or not renewed.
independent contractor. Although the City reserves the right (i) to d. For Default or Breach.
determine (and modify) the delivery schedule for the work to be i. Either City or Contractor may terminate this contract in the event of a
performed and (ii) to evaluate the quality of the completed performance, breach of the contract by the other. Prior to such termination the party
the City cannot and will not control the means or manner of the seeking termination shall give to the other,party written notice of the
Contractor's performance. The Contractor is responsible for determining breach and intent to terminate. If the party committing the breach has not
the appropriate means and manner of performing the work. entirely cured the breach within 15 days of the date of the notice,or within
b. The Contractor represents and warrants that Contractor (i) is not an such other period as the party giving the notice may authorize or require,
employee of City of Ashland, Oregon, (ii) is not currently employed by then the contract may be terminated at any time thereafter by a written
the Federal Government, and (iii)meets the specific independent notice of termination by the party giving notice.
contractor standards of ORS 670.600, as certified on the foregoing ii. Time is of the essence for Contractor's performance of each and
Certification Statement for Corporation or Independent Contractor. every obligation and duty under this contract. City, by written notice to
Contractor is not an`officer","employee",or"agent"of the City,as those Contractor of default or breach, may at any time terminate the whole or
terms are used in ORS 30.265. any part of this contract if Contractor fails to provide services called for by
c. Contractor shall be responsible for all federal or state taxes• this contract within the time specified herein or in any extension thereof.
applicable to any compensation or payments paid to Contractor under this iii. The rights and remedies of City provided in this subsection dare not
contract and,unless Contractor is subject to backup withholding,City will exclusive and are in addition to any other rights and remedies provided by
not withhold from such compensation or payments any amounts(s) to law or under this contract.
cover Contractor's federal or state tax obligations. Contractor is not e. Oblieation/Liability of Parties. Termination or modification of this
eligible for any federal Social Security, unemployment insurance, or contract pursuant to subsections a, b or c above shall be without prejudice
workers' compensation benefits from compensation or payments paid to to any obligations or liabilities of either party already accrued prior to such
Contractor under this contract,except as a self-employed individual. termination or modification. However, upon receiving a notice of
termination (regardless whether such notice is given pursuant to
2. Subcontracts and Assignment: Contractor shall not enter into any subsections a,b,c or d of this section 6 Contractor shall immediately cease
subcontracts for any of the Work required by this Contract or assign or all activities under this contract, unless expressly directed otherwise by .
transfer any of its interest in this Contract without City's prior written City in the notice of termination. Further, upon termination, Contractor
consent.Any proposed use of a subcontractor which is located outside the shall deliver to City all contract documents, information, works-in-
United States or use of subcontract labor or facilities located outside the progress and other property that are or would be deliverables had the
United States must be called to the specific attention of City. City's contract been completed. City shall pay Contractor for work performed
consent to any subcontract shall not relieve Contractor of any of its duties prior to the termination date if such work was performed in accordance
or obligations under this Contract. with the Contract.
3. Successors and Assigns: Neither party shall subcontract, assign or 7. Records Maintenance; Access; Ownership of Work Product;
transfer its interest in this Contract without the express written consent of License:
the other party, and such consent shall not be unreasonably withheld. In a. Records Maintenance: Access. Contractor shall maintain records
addition to any other provisions,Contractor shall include in any permitted pertinent to this contract in such a manner as to clearly document
subcontract under this Contract a requirement that the subcontractor be Contractor's performance hereunder. Contractor acknowledges and agrees
bound to the same provisions herein as if the subcontractor were the that City and its duly authorized representatives shall have access to such
Contractor.The provisions of this Contract shall be binding upon and shall fiscal records and to all other books, documents, electronic files, papers,
inure to the benefit of the parties hereto, and their respective successors - plans and writings of Contractor that are pertinent to this contract for the
and assigns. Consent of City given to a subcontractor does not relieve the purpose of performing examinations and audits, and making excerpts and
Contractor of any obligations and responsibilities under this Contract, transcripts. Contractor further acknowledges records generated as a result
including Contractor's responsibility for any goods and services to be of this Contract may be subject to disclosure pursuant to the Oregon Public
provided by any subcontractor. Records Act.
b. Ownership of Work Product: License. All work products of the
4. No Third Party Beneficiaries: City and Contractor are the only Contractor that result from this contract ("the work products") are the
parties to this contract and are the only parties entitled to enforce its terms. exclusive property of the City. In addition, if any of the work products
Nothing in this contract gives, is intended to give,or shall be construed to contain intellectual property of the Contractor that is or could be protected
give or provide, any benefit or right, whether directly, indirectly or by federal copyright, patent, or trademark laws, or state trade secret laws,
otherwise, to third persons unless such third persons are individually Contractor hereby grants City a perpetual, royalty-free, fully paid-up,
identified, by time herein and expressly described as intended nonexclusive and irrevocable license to copy, reproduce, deliver, publish,
beneficiaries of the terms of this contract. perform, dispose of, use and re-use, in whole or in part, and to authorize
others to do so, all such work products, including but not limited to any
5. Funds Available and Authorized: City has sufficient funds information, designs, plans or works provided or delivered to the City or
currently available and authorized for expenditure to finance the costs of produced by the Contractor under this contract.
this contract within the City's fiscal year budget.
6. Termination:
a. Mutual Consent. This contract may be terminated at any time by
mutual consent of both parties.
b. Parties' Convenience. This contract may be terminated at any time
by either Party 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, 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
8. Compliance with Applicable Law: Contractor shall comply with contract is declared by a court of competent jurisdiction to be illegal or in
all federal, state and local laws and ordinances applicable to the work conflict with any law, the validity of the remaining terms and provisions
under this contract, including, without limitation, the provisions of ORS shall not be affected, and the rights and obligations of the parties shall be
279B.220, 279B.230, and 27913.235, and as well as other statutes as set construed and enforced as if the contract did not contain the particular tern
forth in the attached Compliance With Applicable Law,which is by this or provision held to be invalid.
reference made a part hereof. Without limiting the generality of the
foregoing, Contractor expressly agrees to comply with: (i)Title VI of the 15. Survival: The terms, conditions, representations and all warranties
Civil Rights Act of 1964; (ii)Section V of the Rehabilitation Act of 1973; contained in this Contract shall survive the termination or expiration of
(iii) the Americans with Disabilities Act of 1990 (Pub L No. 101-336), this Contract.
ORS 659A.142, and all regulations and administrative rules established
pursuant to those laws; and (iv) all other applicable requirements of 16. Waiver: The failure of either party to enforce any provision of this
federal, state and local civil rights and rehabilitation statues, rules and contract shall not constitute a waiver by either party of that or any other
regulations. provision.
9. Foreign Contractor: If the Contractor is not domiciled in or 17. Execution and Counterparts: This contract may be exercised in
registered to do business in the State of Oregon,Contractor shall promptly several counterparts,each of which shall be an original, all of which shall
provide to the Oregon Department of Revenue and the Secretary of State constitute but one and the same instrument.
Corporation Division all information required by those agencies relative
to this Contract. The Contractor shall demonstrate its legal capacity to 18. Prior Approval Required: Approval by the City of Ashland City
perform these services in the State of Oregon prior to entering into this Council or the City Manager is required before any work may begin under
contract. this contract.
10. Governing Law; Jurisdiction; Venue: This contract shall be 19. Notice: Notices required by this contract must be given in writing by
governed and construed in accordance with the laws of the State of personal delivery or mail, at the addresses given by the parties on the first
Oregon without resort to any jurisdiction's conflict of laws, rules or page of this contract, unless some other means or method of notice is
doctrines. Any claim,action,suit or proceeding(collectively,"the claim") required by law. Each party will notify the other of any change of address.
between the City (and/or any other City or department of the State of
Oregon)and the Contractor that arises from or relates to this contract shall 20. Confidentiality: Contractor acknowledges and agrees it is
be brought and conducted solely and exclusively within the Circuit Court responsible for ensuring compliance with all applicable confidentiality
of Jackson County for the State of Oregon. If,however,the claim must be laws, including but not limited to the Health Insurance Portability
brought in a federal forum, then it shall be brought and conducted solely Accountability Act (HIPAA) and Family Educational Rights and Privacy
and exclusively within the United States District Court for the District of Act(FERPA).
Oregon filed in Jackson County, Oregon. Contractor, by the signature
herein of its authorized representative,hereby consents to the in personam 21. Merger Clause: THIS CONTRACT AND ATTACHED EXHIBITS
jurisdiction of said courts. In no event shall this section be construed as a CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES.
waiver by City of any form of defense or immunity,based on the Eleventh NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS
Amendment to the United States Constitution, or otherwise, from any OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN
claim or from the jurisdiction. WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER,
CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE
11. Insurance: EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE
a. Insurance. Contractor shall at its own expense provide the following SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS,
insurance: AGREEMENTS,OR REPRESENTATIONS,ORAL OR WRITTEN,NOT
i Worker's Compensation insurance in compliance with ORS SPECIFIED HEREIN REGARDING THIS CONTRACT.
656.017, which requires subject employers to provide Oregon workers' CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED
compensation coverage for all their subject workers. REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE
ii Professional Liability insurance with a combined single limit,or the HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES
equivalent, of not less than $200,000 for each claim, incident or TO BE BOUND BY ITS TERMS AND CONDITIONS.
occurrence. This is to cover damages caused by error, omission or
negligent acts related to the professional services to be provided under this
contract.
iii General Liability insurance with a combined single limit, or the
equivalent,of not less than N/A for each occurrence for Bodily Injury and
Property Damage. -
iv Automobile Liability insurance with a combined single limit,or the
equivalent, of not less than $N/A for each accident for Bodily Injury and
Property Damage, including coverage for owned, hired or non-owned
vehicles,as applicable. .
V. Umbrella/Excess Liability insurance with combined single limits/
annual aggregate of not less than $N/A for Bodily Injury and Property
Damage.
C. 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.
12. Left for insertion.
13. Force Majeure: Neither City nor Contractor shall be held
responsible for delay or default caused by fire, riot, acts of God, or war
where such cause was beyond, respectively, City's or Contractor's
reasonable control. Contractor shall,however,make all reasonable efforts
to remove or eliminate such a cause of delay or default and shall,upon the
cessation of the cause, diligently pursue performance of its obligations
under this contract.
14. Severability: The parties agree that if any term or provision of this
Exhibit C COMPLIANCE WITH APPLICABLE LAW hours in any one day or in excess of 40 hours in any one week,whichever
. (Public Non Improvement Contracts) is greater. [HB 2214]
ORS 2798.220 Conditions of public contracts concerning payment of ORS Chapter 244. Contractor shall not provide or offer to provide any
laborers and materialmen,contributions to Industrial Accident Fund, appreciable pecuniary or material benefit to any officer,employee or agent
liens and withholding taxes. Every public contract shall contain a of the City in connection with this contract in violation of ORS Chapter
condition that the Contractor shall: 244 or City's personnel rules.
vi. Make payments promptly, as due, to all persons supplying to such
contractor labor or material for the prosecution of the work provided for in ORS 670.600 provides in part: "As used in various provisions of
such contract. ORS Chapters 316, 448, 656, 657, 671 and 701,an individual or business
vii. Pay all contributions or amounts due the Industrial Accident Fund entity that performs labor or services for remuneration shall be considered
from such contractor or subcontractor incurred in the performance of the to perform the labor or services as an `independent contractor' if the
contract. standards of this section are met." ORS 670.600 also provides standards
viii. Not permit any lien or claim to be filed or prosecuted against the for satisfying the designation of an independent contractor:
state, county, school district, municipality, municipal corporation or 1. Free from direction and control over means and manner of providing
subdivision thereof,on account of labor or material furnished. labor or service.
ix. Pay to the Department of Revenue all sums withheld from employees 2. Responsible for obtaining all necessary business registrations and
pursuant to ORS 316.167. professional occupation licenses.
3. Furnishes its own tools and equipment for the work.
2798.225 Condition concerning salvaging, recycling, composting or 4. Has the authority to hire and fire employees to perform the work.
mulching yard waste material. Every public contract for lawn and 5. Registered under ORS Chapter 701.
landscape maintenance shall contain a condition requiring the contractor 6. Filed federal and state income tax returns in the name of its business
to salvage, recycle, compost or mulch yard waste material at an approved or a business Schedule "C" as part of the personal income tax return, for
site,if feasible and cost-effective. the previous year, for labor or services performed as an independent
contractor in the previous year.
ORS 2798.230 Condition concerning payment for medical care and 7. Represents to the public that the labor or services are to be provided
providing workers'compensation. (1) Every public contract shall also by an independently established business.
contain a condition that the contractor shall promptly, as due, make 8. The labor or services are primarily carried out at a location that is
payment to any person, co-partnership, association or corporation, separate from my residence,or is primarily carried out in a specific portion
furnishing medical, surgical and hospital care or other needed care and of my residence,which is set aside as the location of the business.
attention, incident to sickness or injury, to the employees of such 9. The business has purchased business cards or commercial
contractor,of all sums which the contractor agrees to pay for such services advertising.
and all moneys and sums which the contractor collected or deducted from 10. A telephone listing and service is used for the business that is separate
the wages of employees pursuant to any law,contract or agreement for the from the personal residence listing and service.
purpose of providing or paying for such service. 11. Labor or services are performed only pursuant to written contracts.
(2) Every public contract also shall contain a clause or condition that all Labor or services are performed for two or more different persons within a
employers working under the contract are subject employers that will period of one year.
comply with ORS 656.017 or are exempt under ORS 656.126. 12. Assumes financial responsibility for defective workmanship or for
service not provided as evidenced by the ownership of performance bonds,
ORS 2798.235 Condition concerning hours of labor. (1) Except as warranties, errors and omission insurance or liability relating to the labor
provided in subsections (3) to (6) of this section, every public contract or services to be provided.
subject to this chapter must contain a condition that a person may not be
employed for more than 10 hours in any one day, or 40 hours in any one
week, except in cases of necessity, emergency or when the public policy
absolutely requires it, and in such cases, except in cases of contracts for
personal services designated under ORS 279A.055,the employee shall be
paid at least time and a half pay: (a)(A)For all overtime in excess of eight
hours in any one day or 40 hours in any one week when the work week is
five consecutive days, Monday through Friday;or(B)For all overtime in
excess of 10 hours in any one day or 40 hours in any one week when the
work week is four consecutive days, Monday through Friday; and(b)For
all work performed on Saturday and on any legal holiday specified in
ORS 279B.020.(2)An employer must give notice in writing to employees
who work on a public contract, either at the time of hire or before
commencement of work on the contract, or by posting a notice in a
location frequented by employees, of the number of hours per day and
days per week that the employees may be required to work.(3)In the case
of contracts for personal services as described in ORS 279A.055, the
contract shall contain a provision that the employee shall be paid at least
time and a half for all overtime worked in excess of 40 hours in any one
week, except for individuals under personal services contracts who are
excluded under ORS 653.010 to 653.261 or under 29 U.S.C. 201 to 209
from receiving overtime. (4) In the case of a contract for services at a
county fair or for other events authorized by a county fair board, the
contract must contain a provision that employees must be paid at least
time and a half for work in excess of 10 hours in any one day or 40 hours
in any one week. An employer shall give notice in writing to employees
who work on such a contract, either at the time of hire or before
commencement of work on the contract, or by posting a notice in a
location frequented by employees, of the number of hours per day and -
days per week that employees may be required to work. (5)(a)Except as
provided in subsection (4) of this section, contracts for services must
contain a provision that requires that persons employed under the
contracts shall receive at least time and a half pay for work performed on
the legal holidays specified in a collective bargaining agreement or in
ORS 279B.020 (1)(b)(B) to (G) and for all time worked in excess of 10
CITY.RECORDER Page 1 / 1
�. CITY OF
ASHLAND :. DATE :' ��Cr i-'-�";PO NUMBER.
,_ 20 E ASHLAND, 97 5/25/2012 10882
ASHLAND, OR 97520
(541).488-5300
VENDOR: 015851 SHIP TO: City Of Ashland
MCGEARY, DOUGLAS M 20 E MAIN STREET
2 N OAKDALE AVE ASHLAND, OR 97520
MEDFORD, OR 97501
FOB Point: Req.No.:
Terms: Net Dept.:
Req.Del.Date: Contact: Dave Lohman
Special Inst: - Confirming? NO
; Quan6 <'Unit ." - '. Descri tion - . Unit Price Ext.Price.
.. ..
Legal Services- Balance of FY 2012 20,000.00
Contract for legal services approved by
City Council on May 15, 2012
SUBTOTAL 20 000.00
BILL TO:Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 20,000.00
ASHLAND, OR 97520
�-
„-Account Number, '..'-Prgecf Number Amoun1-t ���'Account Number ProjedNumbec':�'.'; '. .� Amount .-�_j
E 710.01.03.00.604100 20 000.00
Authoriz nature VENDOR COPY
FORM #3 CITY OF
A request for a Purchase Order ASHLAND
REQUISITION Date of request: sn6/2ot2
Required date for delivery:
Vendor Name Dougin RA mer eary
Address,City,State,Zip 2 N OakdaleAvenue Medford OR 97501
Contact Name&Telephone Number Douglas M.McGeary,541-7794647 or 541-552-2105
Fax Number
SOURCING METHOD
❑ Exempt from Comoetitive Bidding ❑ Emergencv
❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form#13,Written findings and Authorization
X AMC,2.50 Date 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) ❑ Slate of Oregon
❑ Direct Award Date approved by Council: Contract#
❑ Verbal/Written quote(s)or proposal(s) ❑ State of Washington
Intermediate Procurement ❑ Sole Source Contract#
GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) ❑ Other government agency contract
$5.000 to$100.000 ❑ Written quote or proposal attached Agency
❑ (3)Written quotes attached ❑ Special Procurement Contract#
PERSONAL SERVICES ❑ Form#9,Request for Approval Intergovernmental Agreement
$5.000 to$75.000 ❑ Written quote or proposal attached ❑ Agency
❑ Less than$35,000,by direct appointment Date approved by Council: Date original contract approved by Council:
❑ 3 Written proposals attached Valid until: Date (Dale)
Description of SERVICES Total Cost
Attorney Services thru June 30,2012-$20,000.00 y
Attorney Services July 1,2012 -June 30,2013-$100,000.00 20,000 00
Approved by City Council May 15,2012 $r
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
❑ Per attached quotelproposal $ 5-
Project Number---------- Account Number 710.01.03.00.604100
Account Number -- -- -- ------
Account Number 710.01.03.00.604100
---
'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:
ITDirector Date Support-Yes/No
By signing this requisition form,I certify that the City's public contracting requirements have eon satisfifid. /
Employee Signature: Department Head Signature:
(Equal t r greater than$5,000)
Additional signatures(if applicable):
Funds appropriated for current fiscal year: ta / NO
Finance Direc(or-(Equalto orgresterthan$5,000) Date
Comments:
Form#3-Requisition -