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2012-171 Contract - Mountain View Paving
Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: Mountain View Paving ASHLAND CONTACT: Paul Meyer 20 East Main Street Ashland, Oregon 97520 ADDRESS: PO Box 508, Talent, OR 97540 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-535-3840, Cell 541-210-3735 DATE AGREEMENT PREPARED: August 1, 2012 FAX: 541-535-3865 BEGINNING DATE: August 1, 2012 COMPLETION DATE: August 17, 2012 COMPENSATION: $3,935.00 per proposal attached as Exhibit C. GOODS AND SERVICES TO BE PROVIDED: Garfield Park Asphalt— Per proposal attached as Exhibit C. ADDITIONAL TERMS: NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 2796.220, 27913.225, 279B.230, 279B.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $19,494 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses,judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Contractor(including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 9. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels Contract for Goods and Services Less than$25,000, Revised 06/3012012, Page 1 of 5 sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Contractor to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Contractor may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. . Time is of the essence for Contractor's performance of each and every obligation and duty under this contract. City by written notice to Contractor of default or breach, may at any time terminate the whole or any part of this contract if Contractor fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d)are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. 10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any requirement of ORS 279A.110 or the administrative rules implementing the Statute. 12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. . 14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 16. Insurance. Contractor shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers'compensation coverage for all their subject workers J. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contract. C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s)without 30 days'written notice from the Contractor or its insurers to Contract for Goods and Services Less than$25,000, Revised 06130/2012, Page 2 of 5 .i the City. ' e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City(and/or any other or department of the State of Oregon)and the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United c States Constitution, or otherwise, from any claim or from the jurisdiction. 18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. -THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS-AND CONDITIONS. 19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In- the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further liability to Contractor. 20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by refere ce. Contra City of Ashla Signature Department Head Print Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with 0 O el the signed contract. Purchase Order No. Contract for Goods and Services Less than$25,000, Revised 06/30/2012, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS f has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: j `C�a` (1) 1 carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. (3) Telephone listing is used for the business separate from the personal residence listing. � P-t (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. Contractor (Date) Contract for Goods and Services Less than$25,000, Revised 06/30/2012, Page 4 of 5 2/14/2010 01:10 541-535-3865 MOUNTAIN_VIEW PAVING,INC. #5012 P.001 /001 f,-j,,f i t!+#t i,,<e:,,'[:13 ur.;,;;+,x�,y,t,t,�,xi�!,E,!f�$+aI,r(�aI f F 2 x`'}{X t.t i,I a f ci.i.r'�x 2,i I$c�r 17I�<+tl`d a t,d a x,i i g t;}6 i�;t:7N��F7}},>>i f t i',i£es.�7!s$i 1`{ag''.�t<7 3'"}j fS3 f oe 4.l(,5•r,,t,�3 Y.t�r+£+:r:3 i>:'•p.«�•3,F's1.t;i:'r y#�I;.tt iF r's x 7t R'd f1#<,!:'�#EsS f9'{I t r t?IsI?sp a>ee�E}7 F7 i f"•"?�7i Sf r R'�f)xrt(r,l�e}?xd r.(i•�'a�••.#}' •"at:A�.r.,.iaJ#i•y t.t.:,:i"i'.2 r;r;+t,t'2t�FCetz#JffY t(�'ij�t•E y I j I�S<<3,it+a t t t t�o•rY 4 j�rx,}f e w a�At'ad t,�t j{�\qRi l T Z�Y��t fa\"g a�;<=�1 1#i\++ac";f�11 t�"`,�a,`k f��Y 2R�2x)i t�#C.�Ri�,1 6t e x a1q�aa.f a b s r it r 3 r£e 'b�r r t S�`Ratt�. 'N.7F � t t S R S �Elt t 1•a13T(. f i:<✓'d` t F � p C d' �f tt r �7 b < t 7 < � 1 i x tr e 6 x+ttt 'tr ft9 §x t �k0r a yrr.�+Id_ Ia ti � sS Ex� et Rt`{a•at`Sxi bz tt Yx. 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FI d •Il ja $ t) i�f i3r t.�f F +tx'I}�,'rSS Z$iE{ (srit i)r . 12ttiR'fY�E 7 E x�� C 7Y 4 2 e =i�St a� �,� l�tt,iypL� �i e S $➢f;t �:2`' {I +x'i..,F}P t,41JU�,Efi3 t f&g",Yt x.r;{y?f..x 1r1„a a#tkt�a• .r�+.2}:1 1}0.? ra-3:'a Ra,i e rt. da.L`�P nt`,; #&Iist.?1t'i 3 11.32`{',3`SI.(,r3'. 1 ',t f!�i v��#d .��!{�<t°t "�g>6 2 R.��C xI ax.t{S tY`}.;i�''rf£.`}`` ,�t`!\v x \Vt.'1•„��}"$�a,y �.i:i:.aua..., i.tit r Yl\S. �Vc hereby Submit specifications and estimates for: ASPHALT PAVING 1.CLEAN APPROXIMATELY 2250 SQ.FT.FORNEW 2”OVERLAY 2.REMOVE APPROXIMATELY 50 SQ.FT,OF ASPHALT FOR DRAINAGE 3.APPLY CSS—I BONDING OIL TO ABOVE SURFACES 4_PAVE ABOVE SURFACE AT 2"COMPACTED CLASS C ASPHALT WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of- THREE THOUSAND NINE HUNDRED THIRTY FIVE AND 00/100 ml�a 3,935.00 ) Payment to be made as follows: TOTAL DUE UPON COMPLETION OF PROJECT AN matetal is guarantaw to be as apecltled.All work to be completed in a pmtessfonel manner according to etandwo!practices.Any Aheraaon or deviation from above specifications i Mrng Addaional work and e)dra tl le will b00000 en®ma charge wen std abw the estimete.It eud base and/or bass Is prepated by otri guarantee Is limited b wakavriship.AD alteemams are contingent upon satkas,eeddents. irwlement wea�r,or odgr delays beyond our control. AUT012Sd Employees of oontrswor are covered by state ineuraroe laws.Terms:payment in lull on 3'gv9hua 4 comDleson of Project,unleas of hM antnpemants are made in wntlng-A 1.5%per month finance ' charge will be added on all Past due aeearmts(an anmral per roads rate of to%).it litigation is Noce:This Ptopavl may U9 Ireatuteci ar#sing acay re out of this Proposal,ft pre ailing Parw shall be entitled 10 reasenabla atemey.leas and cm=rncyncd.CCBM 58820, wifidrawn by us'rf cwt accepted within Gaya. ACCEPTANCE OF PROPOSAL—The above prices,specifications and conditions ate satisfactory and are hereby accepted..You are auihodZed Signawrc to do the work as specified. Payment will be made as outlined above. Daze dAcrc signature pmrcc: ac®RO® CERTIFICATE OF LIABILITY INSURANCE ogrI'MMmomvY) ,0/26/201, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Beecher Carlson Insurance Agency, LLC CONTACT NAME: EUG Sue Noakes 59 East 11th Avenue PHONE INC.No.Exti 541-284-3096 ac No: 541-284-3196 FAX Eugene, OR 97401 EWAIL ADDRESS: SUe.noake$ beechercadson.com INSURERS AFFORDING COVERAGE NAICA www.beechercarlson.com INSURERA: Liberty Northwest Ins Co 41939 INSURED INSURERB: Salf 52412 Mountain View Paving, Inc. 2560 E Main Street INSURER C: Ashland OR 97520 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 11497570 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR rypE OF INSURANCE B POUCY EFF POLICY EXP LTR POLICY NUMBER MM/DD MMIDD/YY1'Y LIMITS A GENERALLIABI-W ,/ C10154211 9/2512011 9/2512012 EACH�OCCURRENCE $ 1,000,000 COMMERCIALGENERALLIABILITY PREMISES Earl aloe $ 100.000 CLAIMS-MADE aOCCUR MEDE Any one person) $ 5,000 PERSONALSADVINJURY S 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PR0. LOC $ A AUTOMOBILE LIABILITY 010154211 9/25/2011 9125/2012 COMBINED ISINGLE LIMIT $ 1000000 ANY AUTO BODILY INJURY(Per pan.) $ ALL OVMED SCHEDULED AUTOS AUTOS BODILY INJURY(Per acciciart) $ HIRED ALTOS NONO WNED RPOaPE eP DAMAGE $ F $ $ A 1/ UMBRELLA LIAR 1/ OCCUR 010154211 9/25/2011 912512012 EACH OCCURRENCE $ 100000O EXCESS LIAR Cl-AIMS-MADE AGGREGATE $ 11000,000 DED RETENTION$10,000 $ B WORKERS COMPENSATION 4955476 10/1/2011 10/112012 WCSTATU- C&- AND EMPLOYERS'LIABILITY YIN ORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ 1,00000 OFFICER/MEMBER IXCLUOEOi N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY OMIT $ ,020000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if mom space is required) Certificate holder included as additional insured as respects general liability on a primary and non contribtutory basis per the attached CG8579 endorsement. Waiver of Subrogation applies to General Liability per written contract. This form is subject to policy terms,conditions,and exclusions. CERTIFICATE HOLDER CANCELLATION Re:Patches SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 N. Mountain ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORIZED REPRESENTATIVE (FUG)Sue Noakes ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 1149]5]0 (MG) Sue Noskes 10/26/2011 11:33:59 AM Page L of 10 COMMERCIAL GENERAL LIABILITY CG 85 79 05 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY MASTER PAK PLUS® FOR CONSTRUCTION (OREGON) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE BLANKET ADDITIONAL INSURED(OWNERS, LESSEES OR CONTRACTORS) 2 FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT 3 NON-OWNED WATERCRAFT q SUPPLEMENTARY PAYMENTS (BAIL BONDS) q PERSONAL AND ADVERTISING INJURY-ELECTRONIC PUBLICATION EXTENSION 5 AGGREGATE LIMITS(PER LOCATION) 5 AGGREGATE LIMITS (PER PROJECT) 5 VOLUNTARY PROPERTY DAMAGE COVERAGE 6 OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE 6 . NEWLY FORMED OR ACQUIRED ORGANIZATIONS 7 DUTIES IN THE EVENT OF OCCURRENCE,OFFENSE, CLAIM OR SUIT 7 BODILY INJURY(MENTAL ANGUISH) g WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS 8 MEDICAL PAYMENTS 8 BROAD NAMED INSURED 8 BROADENED MOBILE EQUIPMENT 8 INCIDENTAL MALPRACTICE LIABILITY, 8 NON-OWNED AIRCRAFT 9 PROPERTY DAMAGE-ELEVATORS 9 CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 9 CMT NO.: 11997510 (BUG) Sue NoakeB 10/26/2011 11:33:59 M page 2 of 10 1. BLANKET ADDITIONAL INSURED(Owners, Lessees Or Contractors) (Includes a Primary/Non-Contributory provision) Section II-Who Is An Insured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy in a written contract or written agreement. The written contract or written agreement must be currently in effect or becoming effective during the term of this policy and executed prior to the "bodily injury;"'property damage"or"personal and advertising injury." A person's or organization's status as an additional insured under this endorsement ends when your operations for that " additional insured are completed. The insurance provided the additional insured is limited as follows: A. The person or organization is only an additional insured with respect to liability caused by your negligence and: 1. Arising out of real property, as described in a written contract or written agreement, that you own, rent, lease or occupy; or 2. Caused by your ongoing operations performed for the additional insured. The insurance provided the additional insured in 1.A.2. above does not apply to: a. Coverage A-Bodily Injury and Property Damage Liability, Coverage B-Personal and Advertising Injury Liability or defense coverage under the Supplementary Payments arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,Feld orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities. b. "Bodily injury"or"property damage"occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)that was performed by or on behalf of the additional insured(s)at the site where the covered operations have been completed; or (2) That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. B. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of Insurance as stated in the Declarations of this policy and defined in Section III - Limits Of Insurance of this policy,whichever are less.These limits are inclusive of and not in addition to the limits of insurance available under this policy. C. The insurance provided the additional insured does not apply to the liability resulting from the negligence of the additional insured. CG 85 79 06 05 Includes copyrighted material of ISO Properties, Inc.,with its permission. Page 2 of 9 C T NO.: 11497570 (MG) Sue Noakes 10/26/2011 11:33:59 AM Page 3 of 10 D. As respects the coverage provided to the additional insured under this endorsement, Section IV-Conditions is amended as follows: 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim, or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an"occurrence"or an offense,that may result in a claim or"suit" under this insurance to us; b. Tender the defense and indemnity of any claim or"suit"to all insurers whom also have insurance available to the additional insured; and C. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. 2. The following is added to Condition 3. Legal Action Against Us: We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or"suit"from the additional insured. 3. The following is added to Paragraph a., Primary Insurance of Condition 4. Other Insurance: If the additional insured's policy has an Other Insurance provision making its policy excess, and a Named Insured has agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. 4. The following is added to Paragraph b., Excess Insurance of Condition 4. Other Insurance: Except as provided in Paragraph 4.a. Primary Insurance as amended above,any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis. In the event an additional insured has other coverage available for an"occurrence"by virtue of also being an additional insured on other policies,this insurance is excess over those other policies. 2. FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT If Damage To Premises Rented To You under Coverage A is not otherwise excluded from this policy, the following applies: A. The last paragraph of 2. Exclusions of Section 1-Coverage A is replaced by the following: If Damage To Premises Rented To You is not otherwise excluded, Exclusions c.through n.do not apply to damage by fire, lightning, "explosion"or sprinkler leakage to premises while rented to you or temporarily occupied.by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III -Limits Of Insurance. B. Paragraph 6. of Section III-Limits Of Insurance is replaced by the following: 6. Subject to 5. above,the higher of$300,000 or the Damage To Premises Rented To You Limit shown in the Summary of Limits and Charges section of this policy is the most we will pay under Coverage A for damages because of"property damage"to premises rented to you or temporarily occupied by you with the permission of the owner arising out of any one fire, lightning, "explosion"or sprinkler leakage incident. CG 85 79 05 06 Includes copyrighted material of ISO Properties, Inc.,with its permission. Page 3 of 9 CERT NO.: 11997570 (EUG) Sue Noakes 10/26/2011 11:33:59 AN Page 4 of 10 C. Paragraph b.(1)(b) of Condition 4.Other Insurance(Section IV—Conditions) is replaced by the following: (1) That is Fire, Lightning, Explosion or Sprinkler Leakage insurance for premises rented to you or temporarily occupied by you with the permission of the owner; D. Paragraph 9.a. of the definition of"insured contract'in Section V-Definitions is replaced by the following: 9. "Insured contract'means: a. A contract for the lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damages by fire, lightning, "explosion"or sprinkler leakage to premises while rented to you or temporarily occupied by you with the permission of the owner is not an"insured contract; E. The following definition is added to Section V-Definitions: "Explosion"means a sudden release of expanding pressure accompanied by a noise, a bursting forth of material and evidence of the scattering of debris to locations further than would have resulted by gravity alone. "Explosion"does not include any of the following:. 1. Artificially generated electrical current including electrical arcing that disturbs electrical devices, appliances or wires; 2. Rupture or bursting of water pipes; 3. Explosion of steam boilers, steam pipes, steam engines or steam turbines owned or leased by you, or operated under your control; or 4. Rupture or bursting caused by centrifugal force. 3. NON-OWNED WATERCRAFT Subparagraph g.(2)of Paragraph 2., Exclusions of Section I -Coverage A is replaced by the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; 4. SUPPLEMENTARY PAYMENTS In the Supplementary Payments-Coverages A and B provision: The limit for the cost of bail bonds in Paragraph 1.b. is changed from $250 to$1000. CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc.,with its permission. Page 4 of 9 C T NO.: 11497570 (EUG) Sue Noakes 10/36/2011 11:33:59 M Page 5 of 10 5. PERSONAL AND ADVERTISING INJURY-ELECTRONIC PUBLICATION EXTENSION Paragraphs 14.b., d. and e. of Section V-Definitions are replaced by the following: b. Malicious prosecution or abuse of process; d. Oral,written, televised,videotaped or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral,written,televised, videotaped or electronic publication of material that violates a person's right of privacy; The following is added to Paragraph 14. "Personal and Advertising Injury"of Section V-Definitions: h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is: (1) Not done intentionally by or at the direction of: (a) An insured; or (b) Any"executive officer"director, stockholder,partner or member of the insured; and (2) Not directly or indirectly related to the employment, prospective employment or termination of employment of any person or persons by any insured. Subparagraphs b. and c. of 2., Exclusions of Section I-Coverage B-Personal And Advertising Injury Liability are replaced by the following: b. Material Published With Knowledge Of Falsity "Personal and advertising injury"arising out of oral,written,televised,videotaped or electronic publication of material, if done by or at the direction of the insured with knowledge of its falsity; C. Material Published Prior To Policy Period "Personal and advertising injury"arising out of oral,written,televised, videotaped or electronic publication of material whose first publication took place before the beginning of the policy period; 6. AGGREGATE LIMITS OF INSURANCE (PER LOCATION) . The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your"locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. "Location"means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway,waterway or right-of-way of a railroad. 7. AGGREGATE LIMITS OF INSURANCE(PER PROJECT) The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your projects away from premises owned by or rented to you. CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc.,with its permission. Page 5 of 9 CENT NO.: 11497570 (EOG) Sue Noakes 10126/3011 11:33:59 M Page 6 of 10 8. VOLUNTARY PROPERTY DAMAGE COVERAGE At your request,we will pay for"loss"to property of others caused by your business operations. The most we will pay for this coverage is$500 each"occurrence" The"loss"must occur during the policy period. The occurrence"must take place in the"coverage territory". "Loss"means unintended damage or destruction. "Loss"does not mean disappearance, abstraction or theft. This coverage does not apply to: 1. Damage arising out of the use of any"auto'; 2. Property you own, occupy, rent or lease from others; or 3. Property on your premises for sale, service, repair or storage. None of the other policy exclusions apply to this coverage. If the policy to which this endorsement is attached is written with a property damage liability deductible,the deductible shall apply to Voluntary Property Damage. The limit of coverage stated above shall not be reduced by the amount of this deductible. 9. OFF PREMISES CARE,CUSTODY OR CONTROL COVERAGE A. We will pay those sums that you become legally obligated to pay as damages because of"property damage"to personal property of others while in your or your"employees'care, custody or control or real property of others over which you or your"employees'are exercising physical control if the"property damage"arises out of your business operations. This Coverage is subject to sections B., C., D. and E. below. B. Exclusions This insurance shall not apply to: 1. 'Property damage"of property at premises owned, rented, leased, operated or used by you; 2. 'Property damage"of property while in transit; 3. The cost of repairing or replacing: (a) Any of your work defectively or incorrectly done by you or by others on your behalf; or (b) Any product manufactured, sold or supplied by you, unless the"property damage"is caused directly by you after delivery of the product or completion of the work and resulting from a subsequent undertaking; or 4. 'Property damage"of property caused by or arising out of the"products-completed operations hazard". C. Limits Of Insurance-The most we will pay for"property damage" under this Section 9. is $25,000 for each "occurrence". The most we will pay for the sum of all damages covered under this Section 9. because of "property damage"is an annual aggregate limit of$25,000. The Limits Of Insurance provided under this Section 9. are inclusive of and not in addition to any other limits provided in the policy or endorsements attached to it. . D. Deductible-We will not pay for"property damage" in any one occurrence"until the amount of"property damage"exceeds$250. If the policy to which this endorsement is attached contains a 'property damage" deductible, that deductible shall apply if it is greater than $250. E. In the event of"property damage"covered by this endorsement, you shall, if requested by us, replace the property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or overhead charges. CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc.,with its permission. Page 6 of 9 CERT NO.: 11497570 (EGG) Sue Noakes 10/26/2011 11:33:59 M Page 7 of 10 10. NEWLY FORMED OR ACQUIRED ORGANIZATIONS A. Paragraph 4. of Section II-Who Is An Insured is deleted and replaced by the following: 4. Any business entity acquired by you or incorporated or organized by you under the laws of any individual state of the United States of America over which you maintain majority ownership interest exceeding fifty percent. Such acquired or newly formed organization will qualify as a Named Insured if there is no similar insurance available to that entity. However: a. Coverage under this provision applies only until the expiration of the policy period in which the entity was acquired or incorporated or organized by.you. b. Coverage A does not apply to"bodily injury" or"property damage"that occurred before the entity was acquired or incorporated or organized by you. C. Coverage B does not apply to"personal and advertising injury'arising out of an offense committed before the entity was acquired or incorporated or organized by you. d. Records and descriptions of operations must be maintained by the first Named Insured. B. This Section 10. does not apply to newly formed or acquired organizations if coverage is excluded either by provisions of the Coverage Part or by other endorsement(s)attached to it. 11. DUTIES IN THE EVENT OF OCCURRENCE,OFFENSE, CLAIM OR SUIT A. The requirements in Section IV-Conditions, Paragraph 2.a.,that you must see to it that we are notified of an "occurrence"applies only when the"occurrence"is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. A member or manager, if you are a limited liability company; 4. An executive officer or designee, if you are a corporation; 5. A trustee, if you are a trust; or 6. A designee, if you are any other type of organization. B. The requirements in Section IV-Conditions Paragraph 2.1b. that you must see to it that we receive written notice of a claim or"suit"will not be considered breached unless the breach occurs after such claim or"suit"is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. A member or manager if you are a limited liability company; 4. An executive officer or designee, if you are a corporation; 5. A trustee, if you are a trust; or 6. A designee, if you are any other type of organization. Knowledge of an "occurrence,"claim or"suit" by the agent, servant or"employee"of any insured shall not in itself constitute knowledge of the insured unless an officer or designee shall have received notice from its agent, servant or "employee". 12. BODILY INJURY Paragraph 3. of the definition of"bodily injury" in the Section V-Definitions is replaced by the following: 3. "Bodily injury"means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc.,with its permission. Page 7 of 9 CFAT NO.: 11497570 (EWI Sue Noekee 10/26/3011 11:33:59 AM Page a of 10 13. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization for whom you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the agreement. 14. MEDICAL PAYMENTS If Coverage C Medical Payments is not otherwise excluded,the Medical Expense Limit provided by this policy shall be the greater of: A. $10,000; or B. The amount shown in the Declarations. 1s. BROAD NAMED INSURED Paragraph 2.a.(1)(d)of Section II -Who Is An Insured is replaced by the following: (d) Arising out of his or her providing or failing to provide professional health care services. However, this exclusion does not apply to nurses, emergency medical technicians or paramedics who are employed by you to provide medical or paramedical services to your employees. 16. BROADENED MOBILE EQUIPMENT Paragraph 12.f.(1) of Section V-Definitions is replaced by the following: (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning provided that vehicles have a Gross Vehicle Weight of 1,000 pounds or greater; 17. INCIDENTAL MALPRACTICE LIABILITY Paragraph 3. of Section V-Definitions is replaced by the following: 3. 'Bodily injury" means bodily injury, sickness, disease or"incidental medical malpractice"sustained by a person, including mental anguish or death resulting from any of these at any time. The following is added to Section V-Definitions: 23. "Incidental medical malpractice'means injury arising out of the negligent rendering or failure to render medical or paramedical services to persons by any physician, dentist, nurse, emergency medical technician or paramedic who is employed by you to provide such services to your employees, provided you are not engaged in the business or occupation of providing any services referred to in this definition. 18. NON-OWNED AIRCRAFT The following is added to Subparagraph g. of 2., Exclusions of Section I -Coverage A Bodily Injury And Property Damage Liability: (6) An aircraft with a paid crew,that is hired, chartered or loaned but is not owned by any insured. CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 8 of 9 CEAT NO.: 11497570 (EUG) Eue Noekee 10/26/3011 11:33:59 AM Page 9 0£ 10 19. PROPERTY DAMAGE -ELEVATORS The following is added to Subparagraph j. of 2., Exclusions of Section I -Coverage A Bodily Injury And Property Damage Liability: Paragraphs (3) and (4)of this exclusion do not apply to damages that result from the use of elevators. All other terms and conditions of your policy remain unchanged. I I I I I I I I CG 85 79 05 05 Includes copyrighted material of ISO Properties, Inc.,with its permission. Page 9 of 9 CERT NO.: 11497570 (EUG) Sue Noakae 10/26/2011 11:33:59 AM Page 10 OP 10 CITY RECORDER Page 1 / 1 Ashland Park Commission DATE - PO NUMBER 20 E MAIN ST. 8/15/2012 1 00133 ASHLAND, OR 97520 (541)488-5300 VENDOR: 000559 SHIP TO: MOUNTAIN VIEW PAVING, INC. 2560 EAST MAIN STREET ASHLAND, OR 97520 FOB Point: _ Req.No.: Terms: net - Dept.: Req.Del.Date: Contact: Bruce Dickens Special Inst: Confirming? NO Quantity, Unit Description Unit Price Ext.Price Asphalt Overlay-Garfield Park 3,935.00 Contract for Goods&Services Beqinninq date: Auqust 1, 2012 Completion date: Auqust 17, 2012 Insurance required/On file SUBTOTAL 3.935.00 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 3,935.00 Account Number Project Number Amount Account Number - Project Number Amount E 411.12.00.00.70420 3,935.00 yi VENDOR COPY Authorized Sianature FORM #3 CITY 0,11' ASHLAND REQUISITION Date of request: ( jz- Required date for delivery: ( Z_ Vendor Name m©C(iYt 1 PU L Address,City, State,Zip Contact Name&Teleghone Number 5y)_ ��_ �g rAO� L ' Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergent; ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form 413,Written findings and Authorization ❑ 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) ❑ State 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 EJ Less than$35,000,by direct appointment Dale approved by Council: Date original contract approved by Council: ❑ 3 Written proposals attached Valid until: (Date) (Dale) Description of SERVICES Total Cost. 6)a ao f)Q FT thi--�-Spha l r '9V(2/zl&J SGz� 05l� Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL- .COST' ❑ Per attached quotelproposal $ Project Number______-___ Account Number___-__-__-__- Account Number -__-__-_ ______ Account Number___-__-__- - `Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,/1 certify that the City's public contracting requirements have been satisfied. Employee Signature: f 6��/t/J Department Head Signature: (Equal to or greater than$5,000) Additional signatures(if applicable): Funds appropriated for current fiscal year. YES / NO Finance Director-(Equal to orgrearerman$5,000) Date Comments: DL�T O 7hye� IfCI ��Ilfl�� oA) C t-I rN OL PW ✓ ag)( Iy< 1, L5 l,(,t UW&) `iZ) G I a Fnrm 83-Rem iisitinn