HomeMy WebLinkAbout2012-145 Contract - Covey Pardee - Plaza Design Contract for PERSONAL SERVICES less than $35,000
C I T Y OF CONSULTANT: Covey Pardee Landscape Architects
ASHLAND CONTACT: Greg Covey
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 295 East Main Street, Ashland OR 97520
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-552-1015
DATE AGREEMENT PREPARED: 5/30/2012 FAX:
BEGINNING DATE: 611/2012 COMPLETION DATE: 7/29/2012
COMPENSATION: Not To Exceed: $12,000 plus $1,910 for topographic survey work
SERVICES TO BE PROVIDED: See Exhibit C
ADDITIONAL TERMS: The consultant must be licensed in accordance with ORS 279C and shall assume full
responsibilities for the following:
• Personnel, Materials and Equipment: The consultant shall provide qualified and competent personnel
and shall furnish all supplies, equipment, tools and incidentals required to accomplish the work. All
materials and supplies shall be of good quality and suitable for the assigned work.
• Business License Required: The consultant must have a current City of Ashland business license prior
to conducting any work for the City.
• Professional Responsibilities: The consultant shall perform the work using the standards of care, skill
and diligence normally provided by a professional in the performance of such series in respect to
similar work and shall comply with all applicable codes and standards.
FINDINGS:
Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and
determines that: (1)the services to be acquired are personal services; (2)the City does not have adequate personnel nor
resources to perform the services; (3) the statement of work represents the department's plan for utilization of such
personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient
to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints
provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein
is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings/Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service 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.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service 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.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $18,890 or more, Consultant 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 service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
Contract for Personal Services, Revised 06/30/2011, Page 1 of 7
it will be seen by all employees.
9. Indemnification:Consultant 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 adilri out of. onsultent's negligent acts, errors, or omissions in connection with the
performance of this'coh1qract'by Consultant(intruding but not limited to, Consultant's employees, agents, and
others desi nated by Consultant to perform work or services attendant to this contract). Consultant shall not
be held res onsible or any losses, expenses, claims, subrogations, actions,costs,judgments,or other
damages, irectly, solely, and proximately caused by the negligence of City.
10. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. CC '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 Consultant,or at such later dale 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
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 Consultant to provide the
services required by this contract is for any reason denied, revoked,suspended,or not renewed.
d. For Default or Breach.
1. Either City or Consultant 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.
if. Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or In any extension thereof.
Ill. 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, Consultant shall Immediately cease all activities under
this contract,unless expressly directed otherwise by City In the notice of termination.Further,upon termination,
Consultant 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 Consultant for work performed prior to
the termination date if such work was performed In accordance with the Contract.
11. Independent Contractor Status: Consultant Is an Independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers'compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant shall not assign this contractor 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. Consultant 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.
13. Default. The Consultant shall be In default of this agreement If Consultant: commits any material breach or default
of any covenant warranty,certification,or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license,certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant 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.
14. Insurance. Consultant 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. Consultant hereby certifies that it
does not have employees and does not intend to use employees on this project and the City,in reliance on this
Contract for Personal Services, Revised 06130/2011,Page 2 of 7
certification, does not require Consultant to obtain works' compensation coverage for its work on this project.
b. Professional Liabilitv 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 claim, incident or occurrence. This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
C. 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.
d. Automobile Liabilitv insurance. Not applicable
e. 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 Consultant or its insurer(s)to
the City.
f. Additional Insured/Certificates of Insurance. With the exception of professional liability and worker's
compensation, Consultant 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 Consultant's
services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As
evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance
certificates prior to commencing work under this contract. 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 Consultant shall be
financially responsible for all pertinent deductibles, self-insured retentions and/or self-insurance.
15. 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 Consultant 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 Stale 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 filed in Jackson County, Oregon. Consultant, 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.
16. 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.
CONSULTANT, 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.
17. 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. Consultant
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 Consultant,with no further
liability to Consultant.
Certification. Consultant shall sign the certification attached hereto as Exhibit A and herein incorporated by reference.
Contract for Personal Services, Revised 06/3012011, Page 3 of 7
Consultant: Citg9f Ashland //''
By By
//gy� G�� i nature D partment Head
RP - T-: C/"V RAJ& KAN,3&tQ
Print Name Print Name
PAING/PA-L (,Iiz'ia.
Title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No. l
R E 0 FORM
�-
Signature
Date
Contract for Personal Services, Revised 06/30/2011, Page 4 of 7
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 a
manner consistent with that degree of care and skill ordinarily exercised by members of the same
profession currently practicing under similar conditions, 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
V/ purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
year.
(6) 1 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.
l0_
— UY Contracto (Date)
Contract for Personal Services, Revised 06/30/2011, Page 5 of 7
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295 East Main,No.g,Ashland.OR 97520 i 5415521015;greg covey Ilc 7 coveyparde.com LANOSfePE nau;.T:.as
Exhibit C
June 7, 2012
Ann Seltzer
City of Ashland, Management Analyst
20 East Main Street
Ashland, OR 97520
Re: Landscape Design Services for the Plaza in Downtown Ashland
Scope of Work
Dear Ann,
Below please find our Scope of Work and fees for the Plaza project based on our proposal and discussions
during the first two meetings with City of Ashland staff. The Project Area for the Scope of Work is defined
by the yellow boundary line shown on Exhibit E,the Ashland Plaza aerial photograph, in the City's Request
for Proposals.
SCOPE OF WORK
Covey Pardee's Basic Services include the following tasks and deliverables:
1. Programming&Coordination:
a. City Staff Meeting #1: Meet with City staff to discuss design program, work scope, and
project schedule.
Completed: May 30, 2012
b. Coordinate preparation of site topographic survey by TerraSurvey, Inc. Survey to be
completed as a part of this scope of work.
c. City Staff Meeting #2: Meet with full City Staff Team to review project objectives, design
program, and schedule.
Completed:June 4, 2012
d. Conduct site assessment of existing conditions within the project area.
e. Review previous conceptual designs of the project site, related studies provided by City
staff, and historical photographs.
2. Preliminary Conceptual Design and Public Outreach:
a. Prepare Site Assessment Exhibits including diagrams, public open space design criteria, and
historical and current site photographs.
b. Based on site assessment, prepare up to three Preliminary Concept Plan Alternatives
defining hardscape and landscape improvements including walkways, seating, walls, rails,
bollards, and planting areas. The alternatives may explore possible relocation of existing
elements such as the utility cabinet and information kiosk.
c. City Staff Meeting#3: Meet with full City Staff Team to review Site Assessment Exhibits and
Preliminary Concept Plan Alternatives.
Scheduled:June 18, 2012
Landscape Design Services for Ashland Plaza
Scope of Work
June 7, 2012
d. Based on City staff review and comments, refine Site Assessment Exhibits and Preliminary
Concept Plan Alternatives for public presentation.
e. Public Outreach Meeting #1: Present Site Assessment Exhibits and Preliminary Concept
Plan Alternatives to the general public and stakeholders for comment and input. The
meeting will be an interactive workshop format in two sessions, one during lunchtime and
one in the early evening.
Scheduled:June 21, 2012
3. Final Conceptual Design and Cost Estimate:
a. City Staff Meeting#4: Meet with full City Staff Team to review input from Public Meeting
#1, and to select a preferred alternative for refinement.
Scheduled:June 25, 2012
b. Prepare one final Concept Plan indicating hardscape and landscape improvements including
walkways, seating, walls, rails, bollards, and planting areas. The final Concept Plan will
include preliminary layout and grade information for pedestrian hardscape and landscape
areas,and proposed planting concepts.
c. Prepare a Preliminary Opinion of Probable Construction Cost for the final Concept Plan.
d. Public Outreach Meeting #2: Present the final Concept Plan to the general public and
stakeholders for comment and input. The meeting will be a presentation format in two
sessions,one during lunchtime and one in the early evening.
Scheduled:July 9,2012
e. City Staff Meeting #5: Meet with City staff to review input from Public Meeting #2, and
discuss refinements to the final Concept Plan, if necessary.
To be scheduled
f. Provide all exhibits, plans and project information to City staff for distribution to City
Council.
Scheduled:July 10, 2012
g. City Council Meeting 111: Present the final Concept Plan and Preliminary Opinion of
Probable Construction Cost to the City Council at their regularly scheduled study session.
Scheduled:July 16, 2012
Additional Services beyond Landscape Architect's Basic Services may be provided if confirmed in writing.
Additional services include, but are not limited to, additional presentations and project meetings requested
by the City, preparing site and landscape construction documents (which include layout, grading, irrigation,
and planting plans, construction details, and technical specifications), preparing plans for City planning
review and building permit applications, providing construction observation services, and determining
subsurface conditions and geotechnical requirements. Changes to the proposed scope of work, project
schedule, or total project area may result in additional services fees.
Excluded Services are not a part of Landscape Architect's Basic or Additional Services and are the
responsibility of others. Excluded services include, but are not limited to, the following: applications and
payments for permits, and project management during construction.
Covey Pardee Landscape Architects Page 2 of 3
Landscape Design Services for Ashland Plaza
Scope of Work
June 7, 2012
Fees and Payment
Total Fee for Basic Services $12,000
Topographic Survey` $1.910
Total $13,910
'See attached proposal from TerraSurvey, Inc.
Basic Services fees will be billed on a percentage of completion basis not to exceed the total indicated.
Billing will be once per month for Basic Services and approved Additional Services. Landscape Architect
shall bill on an hourly basis for Additional Services requested by the City and confirmed in writing. Our
billing rates are as follows:
Principal Landscape Architect $110/Hour
Project Manager $90/ Hour
Associate Landscape Architect $75/Hour
Thank you again for the opportunity to work with the City of Ashland on this exciting and important local
project. We are looking forward to beginning the design process.
Sincerely,
Greg Covey
Covey Pardee Landscape Architects
Covey Pardee Landscape Architects Page 3 of 3
(541)482-6474
■
; TERRASURVEY, M
27,4 FOLTIVI'l I STRIMPT AS I I LIND,W tZ00-N lr520
U120
ASFn-AND, 011MON 9
PROPOSAL
.DATE: 6/4/12
CLIENT: Covey-Pardee Landscape Architects
JOB SITE ADDRESS: Ashland Plaza
MAP NO:
TAX LOT:
ORDERED BY: BILL TO:
Greg Covey Sallie
Covey Pardee Landscape Architects
295 E Main Street, Ste. 8
Ashland, Oregon
SCOPE OF WORK:
Topographic Survey
Ely field survey determine the topographic features of the triangular portion of the plaza as defined by
die curb perimeter. Topographic features will include, hardscapes w/juaierial designation,top&toe
orcurbs, fountains,kiosk.Irces w/driplines,visible surface utilities(water valves,catch basins, etc.),
PDStS,street signs widesignation, light poles, irrigation valve boxes,catch basins&manholes
adjacent to curb.
Prepare a plot of the topographic features at a scale or I"=10' with a V contour interval and spot
elevations.
Topographic Survey;Option A
Include lop and toe of curbs&crosswalks opposite the triangular portion of plaza. Include
underground utilities markings for underground utility locations.
Additional Topography
Extend topographic survey to include the area adjacent to the bus stop shelter to the opposing curbs
of the plaza and along the curbs of Fast Main street north in the bike racks.
FIXED FEE:Topographic Survey, 51,080
Topographic Survey Option A; Additional $350
Additional Topography; Additional $480
Inge 1 of 2
i
'PHIS PROPOSAL AND ESTIMATE. IS FOR THE SCOPE OF WORK DESCRIBED ABOVE. ANY
REQUESTED ADDITIONAL WORK ABOVE AND BEYOND THE SCOPE OF WORK SO
DESCRIBED WILL BE BILLED AT THE FOLLOWING RATE:
OFFICE $ 80/14R
PROFESSIONAL $ 100AdR
FIELD(CREW) $ 160/14R
THERE ARE NO UNDERSTANDINGS OR AGREEMENTS EXCEPT AS HEREIN EXPRESSLY
STATED.
BILLS ARE RENDERED UPON COMPLETION OF THE WORK DE'SCRIBE'D ABOVE.AND ARE
DUE AND PAYABLE UPON RECEIPT- AN INTEREST CI LARGE OF 1.5%PER MONTH(19%
PER YEAR) WILL BE CHARGED FOR OVERDUE FEES. IF IT 131 COMES NECESSARY TO 171LL
SUIT IN THE COURTS TO COI.LIiCT'FLEES DUE.-REASONABLE LEGAL COSTS,INCLUDING
ATTORNEY FEES.SHALL BE PAID BY THE SIGNING RFSPONSIBLF PARTY.
UNLESS OT14FRWISE STATED IN THE ABOVE SCOPE OF WORK, ALL FIELD NOTES AND
ELECTRONIC FILES GENERATED BY THIS SURVEY ARE TO REMAIN THE SOLE hROPER'1'Y
OP TERRASURVEY,INC.
WORK DESCRIBED TO BE PERFORMED IN THIS AGREEMENT WILL NOT BE UNDERTAKEN
UNTIL THIS WORK AGREEMENT 1S SIGNED BY THE REQUESTING RE'S'PONSIBLE PARTY.
T111S ESTIMATE SHALL EXPIRE 10 DAYS FROM TFIE ABOVE DATE.
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CITY O F CITY RECORDER
�.
ASHLAND DATE - PO NUMBER
20 E MAIN ST. 6/29/2012 10935 .
ASHLAND, OR 97520
(541)488-5300 .
VENDOR: 016982 SHIP TO: City of Ashland
COVEY PARDEE (541)488-6002
295 EAST MAIN STREET STE 8 20 E MAIN STREET
ASHLAND, OR 97520 ASHLAND, OR 97520
FOB Point: Req.No.:
Terms: Net Dept.:
Req.Del.Date: Contact: Ann Seltzer
Special Inst: Confirming? NO
Quantity Unit -... " _ !.. . .:. Description - - Unit Price Ext.Price .-
Plaza Design 13,910.00.
Not to exceed $12,000
Topographic survey work$1,910
Contract for Personal Services
Beginning date: June 1, 2012
Completion date: July 29, 2012
SUBTOTAL 13 910.00
BILL TO:Account.Payable - TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 13,910.00
ASHLAND, OR 97520
`Account Number Project Number - Amount Account Number: - Project Number - -Amount
E 110.99.00.00.604100 E 000294.999 12 000.00
E 260.08.12.00.704200 E 000294.999 1,910.00
Authorize"gnature VENDOR COPY
FORM.#3 CITY OF
ASHLAND
REQUISITION Date of request:
Required dale for delivery:
Vendor Name r
Address,City,State,Zip
Contact Name&Telephone Number .SUr
Fax Number
r�y .�.�
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergency
❑ Reason for exemption: Invitation to Bid (Copies on file) ❑ Form#13,Written findings and Authorization
❑ AMC 2.50 late 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 Date approved by Council: Contract If
❑ 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 ❑ Wdtten quote or proposal attached Agency
(3)Written quotes attached ❑ Special Procurement Contract It
PERSONAL SERVICES ❑ Form#9,Request for Approval Intergovernmental Agreement
$5.000 to$75.000 ❑ Written quote or proposal attached ❑ Agency
Less Ilan$35,000,by direct appointment Date approved by Council: Date original contract approved by Council:
3 Written proposals attached Valid until: Date (Date)
Description of SERVICES Total Cost
Pldzet -� IDIOv-v
J ilq iV $ i3 /10
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
❑ Per attached quote/proposal $
ProjectNumberooax-` Account Numberild-0.0-11 --OLVIP0
Account Number___-__-__-__-______ AccountNumber (� -�}o-71I� QO> � �� blQ(�
'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditurEs. V l C/ 0
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support-Yes/No
y signing this requisition for ,I certify that the City's public contracting requirem is have been safisfi4d.
Employee Signature• 4 4 / thug Department Head Signature �� < <—
(Equal to or reater than$5,000)
Additional signatures(if applicable):
Funds appropriated for current fiscal year., dsi/ NO . —7w-2—v/ L
Finance Director-(Equal to or greaterthan$5,000) Date
Comments:
Form#3-Requisition