HomeMy WebLinkAbout2012-274 Contract - Terrasurvey
Contract for PERSONAL SERVICES less than $35,000
CITY OF CONSULTANT: Terrasurvey Inc.
-ASHLAND CONTACT: Richard Alspach P.L.S.
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 274 Fourth St.
Telephone: 541/488-6002 Ashland OR 97520
Fax: 541/488-5311
TELEPHONE: 541-482-6474
DATE AGREEMENT PREPARED: 9/06/12 FAX: 541-552-0292
BEGINNING DATE: 9/06/12 COMPLETION DATE: 3/31/2013
COMPENSATION: NTE $4,100.00
SERVICES TO BE PROVIDED: Reference Exhibit C Proposal
ADDITIONAL TERMS: None
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 $19,494 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
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 arising out of or incident to the performance of this contract by Consultant (including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant 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.
10. Termination:
a. Mutual Consent. This contract may be terminated at an time b mutual consent of both parties.
Contract for Personal Services, Revised 06/30/2012, Page 1 of 5
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 Consultant, 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
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.
i. 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.
ii. 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.
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, 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 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. 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
b. Professional 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 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 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.
e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
Contract for Personal Services, Revised 06/30/2012, Page 2 of 5
4,ntent 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. 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 reslfect 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 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. 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 b reference.
onsultan City of Ashland
c~ sZ c. , r~
BY ` By
Signature Department ad
oO &g
Print Name Print Name
V ~13]e 0r to
las (rz
Title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No.
Contract for Personal Services, 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
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
(1) 1 carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
V (5) Labor or services are performed for two or more different persons within a period of one
year.
4- (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.
O
21
Contractor (Date)
Contract for Personal Services, Revised 06130/2012, Page 4 of 5
EXH I BIT C
TERRASURVEY, INC. TELEPHONE: (541) 4526474
PROFESSIONAL LAND SURVEYORS FACSIMILE: (14p552-0292
274 FOURTH STREET ASHLAND, OREGON 97520 ELFcT.RONIC: tcrt in@bisp.nct
ASHLAND, OREGON 97520
PROPOSAL
DATE: 9-06-12
CLIENT: CITY OF ASHLAND
JOB SITE ADDRESS: AIRPORTTREE SURVEY
MAP NO:
TAX LOT:
ORDERED BY: BILL TO:
Public Works Department Same
City of Ashland
20 East Main St,
Ashland, Oregon 97520
SCOPE OF WORK:
We propose to complete a detailed tree survey of the area within the Ashland Municipal
Airport runway approach zone (south). We will be looking for trees which encroach into the
20:1 approach slope that begins at the end of the runway. We will build upon previous work
completed by this office in February of 2007; focusing on the area south and east of Dead
Indian Memorial Road. We will check the top elevations of the trees which were not
intruding into the clear zone during the last survey.
PROPOSAL: We propose to do the above described work at the rates agreed to under our
City of Ashland surveying contract (see Page 2). We estimate the total cost to be less than
$4,100.00.
Page 1 of 2
THIS 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 $ 65/HR
PROFESSIONAL ° $ 80/HR
FIELD(TWO MAN CREW) $ 1201HR
THERE ARE NO UNDERSTANDINGS OR AGREEMENTS EXCEPT AS HEREIN EXPRESSLY
STATED.
BILLS ARE RENDERED UPON COMPLETION OF THE WORK DESCRIBED ABOVE. AND ARE
DUE AND PAYABLE UPON RECEIPT. AN INTEREST CHARGE OF 1.5% PER MONTH (18%
PER YEAR) WILL BE CHARGED FOR OVERDUE FEES. IF IT BECOMES NECESSARY TO FILE
SUIT IN THE COURTS TO COLLECTFEES DUE, REASONABLE LEGAL COSTS, INCLUDING
ATTORNEY FEES, SHALL BE PAID BY THE SIGNING RESPONSIBLE PARTY.
UNLESS OTHERWISE STATED IN THE ABOVE SCOPE OF WORK, ALL FIELD NOTES AND
ELECTRONIC FILL'S GENERATED BY THIS SURVEY ARE TO REMAIN THE SOLE PROPERTY
OF TERRASURVEY, INC.
WORK DESCRIBED TO BE PERFORMED IN THIS AGREEMENT WILL NOT BE UNDERTAKEN
UNTIL THIS WORK AGREEMENT IS SIGNED BY THE REQUESTING RESPONSIBLE PARTY.
THIS ESTIMATE SHALL EXPIRE 30 DAYS FROM THE ABOVE DATE.
TERRASURVEY, INC. DATE
i
SIGNATURE OF RESPONSIBLE PARTY DATE
Page 2 of 2
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ACC)MY CERTIFICATE OF LIABILITY INSURANCE 1011612012
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: N 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 close not confer rights to the
certificate holder In lieu of such andorsement(s).
PRODUCER Plane:(ae0) 5983700 Fax (aso) 59°-3700 COrIf MICHAEL J. HALLS COMPANY
MICHAEL J. HALL 8 COMPANY PHONE Az
HALL 8 COMPANY EH (360) 698-3700 (380) 698.1703
EMNL
19660 10TH AVENUE N.E.
POULSBO WA 98370 INSURER(S) AFFORDING COVERAGE NAIC a
MURERA : Lloyd's Of London
MLMD
Terrasurvey, Inc
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274 4Th St w URI
Ashland, OR 97620-2044
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NAMERE
IN9URERF
COVERAGES CERTIFICATE NUMBER: 171165 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.
LMR TYPE OF INSURANCE AODL SUBR POLICY NUMBER MNKYEFF I`oJcYENP LIMITS
Ing
GENERAL tMS EACH OCCURRENCE s
COMMERCIAL GENERAL LIABILITY MENISES IEF ysvary $
CLAIMS-MADE OCCUR MED. EXP VM ane Person) f
PERSONAL E ADV INJURY f
GENERAL AGGREGATE f
GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS - COMP/OP AGO f
POLICY PRO-
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AUTO BODILY INJURY (Per Prawn) f
WNED SCHEDULED
AUTOS BODILYIWURV (Par ecd0ane) f
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AUTOS sedeual
f
UM ell UAS OCCUR EACH OCCURRENCE f
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A Pmflusi LlaNUly Claim Mane Fonn 11389953211012 02/08/12 02/08/13 $1,000,000 Per Claim
(1,000,000 Aggregate
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Reach ACORD 101, Addidorul Remorse achedua, N more apace I. required)
Project: Misc. Surveying Services
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97520.1814 ALTIGgi En REPRESEMATNE 9/ p
Attention: Bradley Barber, City Surveyor / /J-~-~-
John Becker
ACORD 25 (2010106) ®1988.2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
q' ® DATEIMWDONYYY)
olz
v CERTIFICATE OF LIABILITY INSURANCE lo/ls/z012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE O INSURANCE CONTRACT ALTER BEETWEEN COVERAGE THISSUING AFFORDED BELO NSURR(S), AUTHORIZED
IWC THIS DOES NOT AFFIRMATIVELY DOES NOT CONSTITUTE
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 NAMECT Julie Asher
Ashland Insurance Inc PHONE (541)482-0831 F (s4Llnee-sesL an. 585 A Street Suite 1 EuoL ,Jasher@ashlaadinsurance.com
P. O. BOX 880 INSURERS AFf-0R01NO COVERAGE NAICO
Ashland OR 97520 INSURER A'Assurance Company America 9305
INSURED WSURERe:NOrth Pacific Ins. Co. 3892
TERRASURVEY, INC INSURFnc:
274 4TH STREET INSURER O:
INSURER E
ASHLAND OR 97520-2044 INSURER F:
COVERAGES CERTIFICATE NUMBER:012101503797 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.
iLYN TYPEDFOJSURANCE a POLICY NUMBER MIW00 E~ MM/DO IXP UNns
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES eammenre S 1,000,000
A CLAMSMADEFXI OCCUR I X AS043357319 /10/2012 /10/2013 MED EXP(AMa pmean 5 10,000
PERSONAL 6 ADV INJURY 5 1,000,000
GENERAL AGGREGATE S 2,000,000
GERL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG S 2,000,000
X POLICY PRO- LOC 5 'rCT -1
RUTOMOBILEtoroS LVABILT' SINGLE tT 5 1 000 000 COMBIN B AUTBODILY INJURY (Per Pinson) S
0SICHHEEDDULED X 11151749 0/30/2011 0/30/2012 BODILY INJURY(ParemBmt) S
NON-0N0JE0 PPROP~DAMAG S
H07ED AAUTOS
Unhwod mokdol combined 5 11000,000
UMBRELLALIAB OCCUR EACH OCCURRENCE S
EXCESS LUAB CLAIMS-MADE tEAGH S
DED RETENTIONS 5
WORKERS COMPENSATION OTW
AND EMPLOYERS LIABILITY
ANY FROPRIETORIPARTNERIEXECUriVE Y N 1 A NT S
OFFICERMOASER IX(Mandatory in NH)EMPLOYE S
deaobe under LICY LIMIT S
DESCRIPTION OF OPERA110N3 M. OFSCFUP11ON OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Ronarks Saheduk, it main spore Is mqubod) IP-b
The City of Ashland, OR and its elected officials, officers and employees as Addi n any
insurance policies required herein but only with respect to Consultants Service this
contract.
OCT 1 7 2012
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CERTIFICATE HOLDER CANCELLATION a
(541) 488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ashland
20 E. Main St.
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
Julie Asher
ACORD 26 (2010105) 069W2010 ACORD CORPORATION. All rights reserved.
INS025 (201005).01 The ACORD name and logo are registered marks of ACORD
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PRECISION PORTFOLIO POLICY ZURICH
SUPPLEMENTAL DECLARATIONS
PRECISION AMERICA
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ADDITIONAL INSURED - DESIGNATED PERSON OR
LIABILITY ORGANIZATION
NAVE OF ADDITIONAL IRSUREDS PERSONS ) OR ORGANIZATION(S)
CG2026 0704 NAVE 1 CITY OF ASHLAND
NAVE 2
ADDRESS 1 20 E. VAIN STREET
ADDRESS 2
CITY ASHLAND STATE OR ZIP 97520
COMMERCIAL GENERAL LIABILITY O C T 1 7 2012
ms900 Ea 3-00 AGENT'S COPY 04/04/2012
3. 4. 2 co - of Asm
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POLICY NUMBER: CONNA RC1AL GENERAL LIABILITY
CG 32 61 10 05
THISENDoRSEMENTCHANGESINEPOLICY. PLEASE READ ITCARBILLY
OREGON ADDITIONAL INSURED - OWNERS,
LESSEES OR CONTRACTORS - SCHEDULED PERSON
OR ORGANIZATION
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHB13ULE
Name of Additional Insured Personts) Or Organizationtsk
Location(s) Of Covered Operatiorm
Information required to complete this Schedule, if not shown above, will be shown in the OeclaratIons.
A Section 6- Who Is An Insured is amended to Include B. With respect to the insurance afforded to these
as an additional Insured the person(s) or organization(s) additional Insureds, the following additional exclusion
shown in the Schedule, but only with respect to applies:
liability for "bodily Injury', " roperty damage` or This insurance does not apply to "bodily injury" or
"personal and advertising Injuryy" caused by your ,prop damage" occurring after.
ongoing operations for the additlonal Insured(s) at
the location(s) designated above and only to the extent 1 AO work, including materials, parts or equipment
that such "bodily injury", 'property damage" or furnished in connection with such work, on the
"personal and advertising injury" is caused by your project (other than service, maintenance or
negligence or the negligence of those performing ad~onat inse a performed
tthe location or a of the behalf of the
operations on your behalf. covered
operations has 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 organlzation other
than another contractor or subcontractor
engaged in performing operations for a principal
as a part of the same projet RECEIVED
Ill; f' 1-7 2012
CG 32 61 10 05 Copyright, 150 Properties, Inc., 2005 Page 1 of 1
City of Ashland
Page 1 /I
CITY OF CITY RECORD DATE PO NUMBER
ASHLAND
20 E MAIN ST. 11/8/2012 11285
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 003354 SHIP TO: Ashland Public Works
TERRASURVEY INC (541) 488-5587
274 FOURTH STREET 51 WINBURN WAY
ASHLAND, OR 97520 ASHLAND, OR 97520
FOB Point: Req. No.:'
Terms: Net Dept.:
Req. Del. Date: ' Contact: Scott Fleury
Special Inst: Confirming? No
Quantity Unit Description Unit Price Ext. Price
Airport Approach Tree Survey and 4,100.00
Toppinq Plan
Contract for Personal Services
Beqinninq date: 09/06/2012
Completion date: 03/31/2013
r.
SUBTOTAL 4100.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 4,100.00
ASHLAND, OR 97520
Account Number Project Number Amount Account Number Project Number Amount
E 280.08.00.00.60232 E 201218.999 2,500.00
E 280.08.00.00.60235 E 201218.999 800.00
E 280.08.00.00.60240 E 201218.999 800.00
2 -
Autho ed signature VENDOR COPY
FORM'#3 CITY iAOF T
raqu~;S$ nr iaf0? rdar ASl iLL 11~J
REQUISITION Date of request: 10/16i2012
Required date for delivery: SAP
Vendor Name Terrag ryey Inc
Address, City, State, Zip 274 Fourth St. Ashland OR 97520.
Contact Name & Telephone Number Richard Aslpach P.L.S. 5471482-6474
Fax Number 5641-552-0292
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 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) ❑ Stale of Oregon
M Direct Award Date approved by Council: Contract #
❑ VerbalNWritten quote(s) or proposal(s) ❑ Stale of Washington
Intermediate Procurement ❑ Sole Source Contract #
GOODS & SERVICES ❑ Applicable Form (45,6, 7 or 8) ❑ Other government agency contract
$5,000 to $100,000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes attached ❑ Form #4, Personal Services $5K to $75K Contract #
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5.000 to $75.000 ❑ Form #9, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3) Written proposals attached Date approved by Council: (Date)
❑ Form #4, Personal Services $51K to $75K Valid until: Date
Description of SERVICES Total Cost
C oPPr~s G PLAT t
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTALY OUST,,
® Per attached quotelproposal $
Project Number Account Number28O- D& oo - oo - (pozZ'ZD ~ZSOo
i
a6o
Account Number ?9?°$-O°----00 Account Number ??p-ce,-O°po-6oZ3s3 ~goo.6c'
'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 g s req isition form, I certify that the City's public contracting requirements have been satisfied.
Employee Signatu t Department Head Signature: Cc~ fl b ~23/s }
(Equal to orgreatert an$5,000)
Additional signature -(if-applica
Funds appropriated for current fiscal year: YES / NO
Finance Director- (Equal to orgreaterthan $5,000) Date
Comments:
Form #3 - Requisition