HomeMy WebLinkAbout2015-017 Contract - Jon Lange PHD
Contract for GOODS AND SERVICES Small Procurement Less than $5,000
C I T Y OF INDEPENDENT CONTRACT~R1: Q~j
ASHLAND CONTACT: C~ I-
20 East Main Street ADDRESS: r4,5 Ashland, Oregon 97520 2 44AJ. Sl&J c2gve /,o
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 77oO-4 M FAX:
BEGINNING DATE: -2t- 15 COMPLETION DATE:
COMPENSATION: , V o-*
GOODS AND SERVICES TO BE PROVIDED:
In the event of conflicts or discrepancies among Contract Documents, this standard form of the City of Ashland Contract will be primary and
take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and
interpreted in a manner that will not conflict with this standard form City of Ashland Contract.
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. Ownership of Production: All documents, materials or items produced by Contractor pursuant to this contract shall be the property of City.
4. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 279B.235, ORS Chapter 244 and ORS 670.600 are made part of this contract.
5. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from those losses, expenses,
or other damages resulting from injury to any person or damage to property arising out of or incident to the negligent performance of this contract
by Contractor its employees, or agents. Contractor shall not be held responsible for any losses, expenses, or other damages, directly, solely, and
proximately caused by the negligence of City.
6. Termination: City's Convenience. This contract may be terminated at any time by the City.
7. 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.
8. 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.
9. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license.
10. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work.
11. 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.
12. 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.
13. Insurance. Contractor shall at its own expense provide the following insurance:
a. 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. Worker's compensation insurance is required if work is performed by employees,
subcontractors, or volunteers.
BY INITIALING THIS SENTENCE, CONTRACTOR CERTIFIES UNDER PEN OF LAW THAT THE WORK REQUIRED BY THIS
CONTRACT SHALL BE PERFORMED SOLELY BY THE UNDERSIGNED:
b. General Liability insurance with a combined single limit, or the equivalent, of of less than $1,000,000 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 $1,000,000 for each accident for Bodily
Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable.
14. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon
15. 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.
Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference.
Contractor: City of Ashland:
By ate. E By
Signatu a artm nt Head
4/9 l J& l t ti l ' S
Pri t Name Print Name
Title Date
W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order NO.
Revised 10-28-14 Page 1 of 2
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.
(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.
Contract r (Date)
Revised 10-28-14 Page 2 of 2
+ INVOICE
John Karns, Fire Chief
Ashland Fire & Rescue
455 Siskiyou Blvd.
Ashland, OR 97520
As contracted: $150/hour
Date Activity Hours Per Hour
5/2/2014 MtgJK 1.00 $150.00 $150.00
5/9/2014 Reading/Outline 0.33 $50.00
5/12/2014 Phone 0.25 $37.50
5/14/2014 Preparation/Phone 1.00 $150.00
6/19/2014 Mtg JK 0.50 $75.00
23 Jun Preparation/E-mail 0.10 $15.00
6/24/2014 E-mail 0.50 $75.00
8/4/2014 E-mail 0.20 $30.00
8/5/2014 E-mail 0.12 $18.00
8/8/2014 Preparation/E-mail 0.33 ~l ~O T < < 71)0 $50.00
8-Oct Preparation/E-mail 0.50 $75.00
10/9/2014 Mtg JK 1.00 d ,L $150.00
10/9/2014 Seek SOU representative 0.20 $30.00
Total ! $905.50
Date Activity Hours Per hour
10/19/2014 Finalize Agenda/E-mail 0.50 $150.00 $75.00
20-Oct Agenda, Power Point, E-mail 1.16 $174.00
10/23/2014 Prep 0.15 $22.50
Meeting Ashley and Terry 0.25 $37.50
Phone X 0.10 $15.00
Check Facility 0.15 $22.50
25-Oct Facilitate Meeting 6.00 $900
14-Nov Phone JK 0.20 $30.00
12/4/2014 First Draft of Second Agenda/E-mail 1.33 $199.50
1/2/2015 Prep (Edit letter) 0.25 $
i
Jon Lange, Ph.D.
2345 Blue Sky Lane
Ashland, OR 97520
Thank you.
lange a(~.sou.edu
541 778-4072
Tax I.D.: 198-36-0728
PAID. Thank you
Please remit to the address above.
Page 1 /1
CITY OF Gil, i I'
ASHLAND DATE PO NUMBER
P ~ 20 E MAIN ST. 10/31/2014 12582
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 001670 SHIP To: Ashland Fire Department
LANGE, PHD, JONATHAN 1 (541) 482-2770
320 HEMLOCK LANE 455 SISKIYOU BLVD
ASHLAND, OR 97520 ASHLAND, OR 97520
FOB Point: Ashland, Oreqon Req. No.:
Terms: Net Dept.:
Req. Del. Date: Contact: Kimberley Summers
Special Inst: Confirming? No
Quantity Unit Description Unit Price Ext. Price
THIS IS A REVISED PURCHASE ORDER
Strateqic Planninq Meetinq Facilitator 905.50
Services provided 05/02/14 to
10/09/2014 per attached invoice
Processed change order 01/26/2015 3,100.00
Contract processed 01/20/2015 for
complete project - Not to exceed $4,000
per PROPOSAL. provided in January, 2015
Contract for Goods and Services - Small
Procurement Less than $5,000
Beqinninq date: 01/21/2015 (Actual
beginninq date in Mav, 2014)
Completion date: 06/30/2015
SUBTOTAL 4,005.50
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 4,005.50
ASHLAND, OR 97520
Account Number Project Number Amount Account Number Project Number Amount
E 110.07.12.00.60410 4,005.50
VENDOR
Authorize Signature COPY
FORM #10'Lr~~'~` • F
CONTRACT AMENDMENT APPROVAL REQUEST FORM S H LAN
Request for a Change Order
Name of Supplier / Contractor 1 Consultant: Jon Lange PHD Total amount' of this
contract amendment:
Purchase Order Number: 12582
Title I Description: Strategic Planning Meeting Facilitator Serviced Provided 101912014 to 61112015 $2,500.00
Per attached contract amendment
Contract Amendment
Original contract amount $ 905.50 100 % of original contract
Total amount of previous contract amendmen % of original contract
Amount of this contract amendment 2500.00 % of original contract
TOTAL AMOUNT OF CONTRAC $ -3405:50 % of original contract
In accordance with OAR 137-047-0800: 1) The amendment is +n escoae of procurement as described in the solicitation documents, Sole Source notice or approval of Special
Procurement 2) The amendment is necessary to comply with a change in law that affects performance of the contract 3) The amendment results from renegotiation of the terms and
conditions, including the contract price, of a contract and the amendment is advantageous to the City of Ashland, subject to all of the following conditions: a) goods and services
to be
provided under the amended contract are the same as the goods and services to be provided under the unamended contract; b) The City determines that, with all things considered,
the
amended contract is at least as favorable to the City as the unamended contract; c) The amended contract does not have a total term greater than allowed in the solicitation document,
contract or approval of a Special Procurement An amendment is not within the scope of the procurement if the City determines that if it had described the changes to be made by
the
amendment in the procurement documents, it would likely have increased competition or affected award of contract
Contract amendment is within the scope of procurement YES NO' (If "NO", requires Council approval I Attach copy of CC.)
Sourcing Method:
SMALL PROCUREMENT - Less than $5,000 INVITATION TO BID or COOPERATIVE PROCUREMENT, QRF or
❑ "YES", the total amount of contract and cumulative REQUEST FOR PROPOSAL EXEMPTION PURSUANT TO AMC 2.50
amendments :5 $6,000. ❑ "YES", the total amountof cumulative amendments ❑ "YES", the total amount of original contract and
❑ If "NO", amount exceeding authority requires s 25% of original contract amount or $250,000 cumulative amendments s $100K for Goods & Services, 5
Council approval. Attach copy of Council whichever is less. $75K for Personal Services, < $50K for Attomey Fees.
Communication. ❑ If "NO", amount exceeding authority requires ❑ If "NO", amount exceeding authority requires Council
❑ Exempt- Reason: Council approval. Attach copy of Council approval. Attach copy of Council Communication.
PERSONAL SERVICES Communication. ❑ Exempt- Reason:
❑ "YES", Direct appointments $35,000 ❑ Exempt-Reason:
❑ If "NO", requires approval.
INTERMEDIATE PROCUREMENT SOLE SOURCE EMERGENCY PROCUREMENT
Goods & Services. $5,000 to $100,000 ❑ "YES", the total amount of cumulative amendments ❑ Written Findings: Document the nature of the
Personal Services - $5.000 to $75.000 5 25% of original contract amount or $250,000 emergency, including necessity and circumstances
❑ "YES", the total amount of cumulative whichever is less. requiring the contract amendment
amendments :9 25% of original contract amount ❑ If ❑ If "NO", amount exceeding authority requires ❑ Obtain direction and written approval from City
"NO", amount exceeding authority requires Council Council approval. Attach copy of Council Administrator
approval. Attach copy of Council Communication. Communication. ❑ If applicable, attach copy of Council Communication
❑ Exempt- Reason: ❑ Exempt-Reason: ❑ Exempt- Reason:
SPECIAL PROCUREMENT INTERGOVERNMENTAL AGREEMENT
❑ "YES", the total amount of original contract and cumulative amendments are ❑ "YES', the original contract was approved by City Council.
within the amount and terms initially approved by Council as a Special Provide date approved by City Council: (Date)
Procurement. If "NO", Council approval is required. Attach copy of Council Communication.
❑ If "NO", amount exceeding authority requires Council approval. ❑ Contract amendment approved and signed by C'dy Administrator.
Attach co of Council Communication.
Project Number Account Number 110.07.12.00.604100 Account
`Expenditure must be charged to the app W riate account numbers for the financials to reflect the actual expenditures accurate) . Attach extra pages if needed.
Employee Signature: 1r=L ' 1.~~ Department Head Signature:
(T 1 mount of c tract z $5,000)
City Administrator:
(Equal to or greater than $25,000 or 10%)
Funds appropriated for current fiscal year YES / NO
Finance Director (Equal to orgreaterthan $5,000) Date
Comments:
Form #10 - Contract Amendment Approval Request Form, Request for a Change Order, Page 1 of 1,1/812015