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2015-137 Contract - Bertocchi Builders
Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: Bertocchi Builders, Inc. ASHLAND CONTACT: Mark Bertocchi 20 East Main Street Ashland, Oregon 97520 ADDRESS: 1860 Gabriel Way, Medford, OR 97501 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-944-7137 DATE AGREEMENT PREPARED: 04/23/2015 FAX: BEGINNING DATE: May 11, 2015 COMPLETION DATE: June 12, 2015 COMPENSATION: $13,268.00 GOODS AND SERVICES TO BE PROVIDED: Enclose open bay, install 12x14 electrically operated overhead door and one (1) 3' metal man door, install insulation on 3 sides, per proposal dated 04/07/2015 attached as Exhibit C. Location: "B" Street Yard ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services 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 the said primary 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. 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 27913.220, 27913.225, 27913.230, 27913.235, 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 $20,142.20 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 art, effective upon deliver of Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 1 of 5 .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 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 b. 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. 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 e, Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 2 of 5 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 insurer(s) to 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 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 he certification attached hereto as Exhibit A and herein incorporated by reference: Contra9 City of Ashland Y Y _ Si rvatu'r Department Head 11A'L X~ Z Print Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. shla Ity Attorney Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 3 of 5 Date- ° VZ5~ 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. A0 (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. Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 4 of 5 CITY OF ASHLAND Memo DATE: May 19, 2015 TO: David Lohman, City Attorney FROM: Dale Peters, Facility Maintenance RE: B Street Yard Building Enclosure 1. The job review was conducted verbally with each of the contractors. Questions and answers were provided to make sure all aspects of the job were understood. 2. Multiple contractors were contacted however there were only two willing to participate in the quote process. 3. The bid from Green Meadows Building Co was somewhat open ended in his bidding approach and was treated as a "Not To Exceed" the amount quoted. PERSONNEL DEPARTMENT Tel: 541-552-2110 20 East Main Street Fax: 541-488-5311 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.or.us nr CITY OF ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGE per hour effective June 30, 2014 (Increases annually every June 30 by the Consumer Price Index) portion of business of their 401 K and IRS eligible employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. ➢ For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: "Employee" does not employer and the City of $20,142.20. include temporary or part-time Ashland if the contract employees hired for less than exceeds $20,142.20 or more. y If their employer is the City of 1040 hours in any twelve- Ashland including the Parks month period. For more ➢ For all hours worked in a and Recreation Department. details on applicability of this month if the employee spends policy, please see Ashland 5m or more of the ➢ In calculating the living wage, Municipal Code Section employee's time in that month employers may add the value 3.12.020. working on a project or of health care, retirement, additional For Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 5 of 5 EXHIBIT C CITY OF ASHLAND WORKERS' COMPENSATION INSURANCE CERTIFICATION Unless an exemption under ORS Chapter 656 applies, Contractor must maintain Workers' Compensation insurance coverage for the duration of this Agreement and ensure that any subcontractor also meets the requirements of ORS Chapter 656. If the Contractor or any of its subcontractors fail to meet the requirements of ORS Chapter 656 or if any worker as a result of this Agreement claim Workers' Compensation coverage, Contractor agrees to indemnify and hold harmless the City for any penalties; costs, including defense costs; and financial obligations for injury to the worker(s) the State deems are covered workers under its law and rules regulating Workers' Compensation benefits. By placing the initials of Contractor's authorized representative in the applicable blank below and the signature of Contractor's authorized representative on page no. 2, Contractor certifies that Workers' Compensation coverage will be maintained for the term of the Agreement or that Contractor is exempt from the requirement to obtain Workers' Compensation insurance. CERTIFICATION OF COVERAGE: Contractor will maintain Workers' Compensation insurance coverage for the term of the contract and will provide Certificate of Workers' Compensation Insurance before Project Beginning Date. CERTIFICATION OF EXEMPTION FROM COVERAGE: Contractor is exempt from the requirement to obtain workers compensation insurance under ORS Chapter 656 for the following reason (initial the appropriate box). SOLE PRIETOR Cr is a sole proprietor, and • Contractor has no employees, and • Contractor will not hire employees or subcontractors to perform this contract. CORPORATION - FOR PROFIT Contractor's business is incorporated; and • All employees of the corporation are officers and directors and have a substantial ownership interest* in the corporation, and • All work will be performed by the officers and directors; Contractor will not hire other employees or subcontractors to perform this contract. Simi: CORPORATION - NONPROFIT • Contractor's business is incorporated as a nonprofit corporation, and (Contractor has no employees; all work is performed by volunteers, and • Contractor will not hire employees or subcontractors to perform this contract. 0-0- PARTNERSHIP • Contractor is a partnership, and Contractor has no employees, and • All work will be performed by the partners; Contractor will not hire employees or subcontractors to perform this contract, and • Contractor is not engaged in work performed in direct connection with the construction, alteration, repair, improvement, moving or demolition of an improvement to real property or appurtenances thereto. * * Page 1 of 2 EXHIBIT C CITY OF ASHLAND WORKERS' COMPENSATION INSURANCE CERTIFICATION LIMITED LIABILITY COMPANY • Contractor is a limited liability company, and • Contractor has no employees, and • All work will be performed by the members; Contractor will not hire employees or subcontractors to perform this contract, and • If Contractor has more than one member, Contractor is not engaged in work performed in direct connection with the construction, alteration, repair, improvement, moving or demolition of an rovem o real pr erty or appurtenances thereto." (Signature,-e -Co-n--tractor's Authorized Representative) (Date) i t (Print Name - Contra or's Authorized Representative) (Title - Contractor's Authorized Representative) *NOTE: Under OAR 436-50-050 a shareholder has a "substantial ownership" interest if the shareholder owns 10% of the corporation, or if less than 10% is owned, the shareholder has ownership that is at least equal to or greater than the average percentage of ownership of all shareholders. **NOTE: Under certain circumstances partnerships and limited liability companies can claim an exemption even when performing construction work. The requirements for this exemption are complicated. Consult with City Attorney's Office before an exemption request is accepted from a contractor who will perform construction work. Page 2 of 2 A~°® VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE (MM/DD/YYYY) 05/05/2015 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. This form is used to report coverages provided to a single specific vehicle or equipment. Do not use this form to report liability coverage provided to multiple vehicles under a single policy. Use ACORD 25 for that purpose. PRODUCER CONTACT NAME: Jon Snowden PHONE StafeFarm Jon Snowden FAX ~ arc No Ext : (541) 482-2461 a/c No l: (541) 482-4957 420 Bridge St noDRESS: jon@jonsnowden.com Ashland, OR 97520 PRODUCER CUSTOMER ID INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A : State Farm Mutual Automobile Insurance Company 25178 Bertocchi, Mark INSURER B : DBA Bertocchi Builders INSURER C : 1860 Gabriel Way INSURER D: Medford, OR 97501 INSURER E : DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKE I MANUFACTURER MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER 2005 Chevy K2500 Pickup 1GCHK23235F847007 DESCRIPTION SERIAL NUMBER COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICY(IES) OF INSURANCE LISTED BELOW HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD(S) 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 POLICY(IES) DESCRIBED HEREIN IS/ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). INSR ADVL POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD/YYYY) DATE (MM/DD/YYYY) LIMITS X VEHICLE LIABILITY COMBINED SINGLE LIMIT $ Y 002 6612-F22-37N 12/22/2014 06/22/2015 BODILY INJURY (Per person) S 100,000 BODILY INJURY (Per accident) $ 300,000 PROPERTY DAMAGE $ 50,000 GENERAL LIABILITY EACH OCCURENCE $ OCCURRENCE GENERAL AGGREGATE $ CLAIMS MADE INSR Loss POLICY EFFECTIVE POLICY EXPIRATION LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYYYY) DATE (MM/DDIYYYY) LIMITS / DEDUCTIBLE X VEH COLLISION LOSS ❑ ACV ❑ AGREED AMT $ LIMIT Y 002 6612-F22-37N 12/22/2014 06122/2015 ❑ ❑ STATED AMT $ 1000 DED X VEH COMP VEH OTC L] ACV AGREED AMT $ LIMIT 002 6612-F22-37N 12122/2014 06/22/2015 ❑ ❑ STATED AMT $ 250 DIED PROPERTY ❑ ACV ❑ AGREED AMT BASIC BROAD $ LIMIT ❑ RC ❑ STATED AMT SPECIAL $ DIED REMARKS (INCLUDING SPECIAL CONDITIONS I OTHER COVERAGES) (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ADDITIONAL INTEREST CANCELLATION Select one of the following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The additional interest described below has been added to the policy(ies) listed herein by policy number(s). BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE A request has been submitted to add the additional interest described below to the policy(ies) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, listed herein b policy numbers), VEHICLE / EQUIPMENT INTEREST: LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST NAME AND ADDRESS OF ADDITIONAL INTEREST X ADDITIONAL INSURED LOSS PAYEE City of Ashland LENDER'S LOSS PAYEE 20 E Main St LOAN / LEASE NUMBER Ashland, OR 97520 AUTHORIZED REPRESENTATIVE © 1997-2010 ACORD CORPORATION. All rights reserved. ACORD 23 (2010/05) The ACORD name and logo are registered marks of ACORD 1004361 142987.2 01-28-2013 From:Hart Insurance Medford 541 772 3963 05/19/2015 14:36 #603 P.001/004 9BERTBU OP ID: KD CERTIFICATE OF LIABILITY INSURANCE 0611 D912 912 Y015 S THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R10NTS 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 pollcy(les) must be endorsed. It 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). C2NTACT PRODUCER Phone: 541-779-4232 N ME: Hart Insurance 1123 Royal AVe Fax: 641-772-3983 PHONE Ne . Medford, OR 97604 G-MAIL Hart Insurance / Medford IN9URfi 9 AFFORDING COYGRAAfi NAIC M INSURPRA: Developers Sur & Indemnity INSURED Bertocchl Builders Inc INSURER 0; 1860 Gabriel Way 1N9URGR C Medford, OR 97501 INSURER D : INSURER E INJIUBER F., COVERAGES CERTIFICATE NUMBER: 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. R TYPE OF INSURANCE ADOLBUOR POLICY NUMBER LIMITS GGNGRAL LIABILITY EACH OCCURRENCE • 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 61800011008.06 0311211016 03/11/2018 dt 100,00 CLAIMS-MADE a OCCUR MID EXP An one person) f 6100 PERSONAL & ADV INJURY S 1,000,0 GENERAL AGGREGATE $ 2,000,0 GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS • COMP/OP AGG $ 2,000,0 PRO- LOC 6 X POLICY F7 F7 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT scud ANY AUTO BODILY INJURY (Per person) S ALL OWNED SCHEDULED e00ILYINJURY (Peracaldent) i AUTOS NON-OWNED I PROPERTY DAMAGE 4 MIRED AUTOS AUTOS P dente UMBRELLA LAS OCCUR EACH OCCURRENCE EXCESS LIAO CLAIMS-MADE AGGREGATE S DED RETENTION S WORKERS COMPENSATION FR AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y - N / A E.L. EACH ACGDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) EX, DISEASE • EA EMPLOYEE 3 if yes deeu,De r E RIPTI N undeP E.L. DISEASE - POLICY LIMIT 5 T DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remaft Schedules M mom space Is required) oertiticate holder is listed as additional insured per attached torn ID0037 tax to 541-552-2304 CERTIFICATE HOLDER CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. attn: Dale Peters AUTHORIZED REPRESENTATIVE 20 E. Main Street Hart Insurance / Medford Ashland, OR 97520 ®1888-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD From:Hart Insurance Medford 541 772 3963 05 /19 /2015 14:36 #603 P.003/004 ID 00 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 - Who Is An Insured is amended to Include as an additional Insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing In a contract or agreement that such person or organization be added as an additional Insured on your policy. Such person or organization is an additional Insured only with respect to liability for "bodily Injury", "property damage" or "personal and advertising Injury" caused by and to the extent of your negligence in the performance of your ongoing operations for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional Insured are completed. B. With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply: This Insurance does not apply to: 1. "Bodily Injury', "property damage" or "personal and advertising Injury"arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, Inspection, architectural or engineering activities. Z "Bodily injury" or "property damage" occurring after: a. All work, Including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or b. 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 a part of the some project. 3. -Bodily Injury', "property damage- or "personal and advertising Injury" involving or related to or In connection with any additional Insured or any location covered by a scheduled or blanket additional Insured endorsement that Is a part of the policy. C. Primary and Non-contributory Insurance - We will consider this insurance to be primary and non- contributory to other Insurance issued directly to additional Insured person(s) or organization(s) to which this endorsement applies If each such additional Insured is a named insured In such other Insurance and a written contract between you and such person(s) or organization(s) specifically requires that we consider this Insurance to be primary and non-contributory.. 0. Waiver of Subrogation - We waive any right of recovery we may have against the additional insured person(s) or organization(s) to which this endorsement applies if each such additional Insured is a named Insured in such other Insurance and a written contract between you and such person(s) or organization(s) specifically requires that we waive subrogation of payments we make for Injury or damage arising out of "your work" done under a contract with such person(s) or organizatlon(s) to which this endorsement applies. ID 00 37 04 13 Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE DATE(M5/20M/DD/Y5 5/115 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(ies) 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 CNAME:ONTACT Amy Keown Redwoods Leavitt Insurance Agency PHONE (855)285-5609 AX No: (541)479-2669 209 Crater Lake Ave ADDRIESS: Y-keown@leavitt.com INSURERS AFFORDING COVERAGE NAIC # Medford OR 97504 INSURERA:Ohio Security Insurance Co 4082 INSURED INSURER B : Hannon Enterprises Inc, INSURERC: DBA: Overhead Door Co. of the Rogue Valley INSURER D : PO BOX 8193 INSURER E : Medford OR 97501 INSURER F: COVERAGES CERTIFICATE NUMBER:15/16 GL and Auto 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE Fx_]OCCUR X KS56556295 4/29/2015 /29/2016 MED EXP (Any one person) $ 10 , 000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG S 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 5 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED X AS56556295 4/29/2015 4/29/2016 AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PeOPERTYtDAMAGE $ HIRED AUTOS AUTOS Uninsuredmotoristcombined $ 1 000 000 X UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ 10,00 S056556295 4/29/2015 /29/2016 $ TORY OTH- WORKERS COMPENSATION WC STATU- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N / A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) This certificate is issued naming the holder as additional insured in regards to general liability and auto liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE S Johnson/STJOHN ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r7ninnFt nl The Arr1Rr) name nnrl Innn arc rcnicfcrcrl marlrc of Ar r1Rr) www.saif.com Oregon Workers' Compensation -4. NOAP saif Certificate of Insurance ,corporation Certificate holder: DALE PETERS CITY OF ASHLAND 20 E. MAIN STREET ASHLAND, OR 98520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by this policy is subject to all the terms, exclusions and conditions of such policy; this policy is subject to change or cancellation at any time. Insured Producer/contact Hannon Enterprises Inc Paynewest Insurance Inc PO Box 8193 Paynewest Ins of Medford Medford, Or 97501-0493 541.779.1321 Issued 05/18/2015 Limits of liability Policy 631720 Bodily Injury by Accident $1,000,000 each accident Period 02/01/2015 to 02/01/2016 Bodily Injury by Disease $1,000,000 each employee Body Injury by Disease $1,000,000 policy limit Description of operations/locations/special items Various/Ongoing Important This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. Authorized representative b John D. Gilkey Interim President and CEO 400 High Street SE Salem, OR 97312 P: 800.285.8525 F. 503.584.9812 Pol i cy_O L CA_Certificate Of I nsu ran ce 9SOINSU OP ID: JO (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 708/07/2014 THIS CERTIFICA`I E 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(ies) 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 Phone: 541-479-5521 NAME CT Hart Insurance PHONE P. O. Box 1240 Fax: 541-474-1890 A/c No Ext : 'C No): Grants Pass, OR 97528 E-MAIL Mark O'Hara ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: American Hallmark Ins Co of TX 43494 INSURED Southern Oregon Insulation LLC INSURER B: SAI F Corp 36196 1473 NE Jennifer Way INSURER C: Mutual of Enumclaw 14761 Grants Pass, OR 97526 INSURER D: Lexon Insurance Company INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 ADDL UBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 44CL440195 09/13/2014 09/13/2015 PREMISES Ea occTur $ 100,00 CLAIMS-MADE 1XI OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 X POLICY PREC~ O LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident $ C ANY AUTO BAP000106803 03/08/2014 03/08/2015 BODILY INJURY (Per person) $ ALL OWNED X AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON-OWNED PeOr a RTY DAMAGE $ AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION $ $ WORKERS COMPENSATION X TWO CRY OTH- AND EMPLOYERS' LIABILITY T RY LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y 979521 10/01/2014 10/01/2015 E.L. EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,0 D Bond 9809683 0911912011 09/19/2015 RGC 20,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Hoilder included as Additional Insured. CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Dale Peters 90 N. Mountain Street UTHORIZED REPRESENTATIVE Ashland, OR 97520 a t l ©1988-2010 ACO COR ORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are egistered marks of ACORD General Liability Additional Coverages The following Additional Coverages are added to the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. A. Blanket Additional Insured Coverage 1. SECTION II -WHO IS AN INSURED of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include as an insured any person or organization (referred to as Additional Insured) whom you are required to add as an Additional Insured on this policy under: a. A written contract or agreement; and b. Where a certificate of insurance showing that person or organization as an additional insured has been issued c. When the written contract or agreement and certificate of insurance are currently in effect or becoming in effect during the term of the policy and executed prior to the "bodily injury," "property damage," or "personal and advertising injury." 2. The insurance provided to the Additional Insured is limited as follows: a. The Additional Insured is only an additional insured for: (1) "Bodily injury," "property damage," or "personal and advertising injury" caused in whole or in part by negligent acts or omissions of the Named Insured or anyone directly or indirectly employed by the Named Insured or for whose acts a Named Insured may be liable. (2) Liability arising out of your ongoing operations for the Additional Insured by or for you. A person's or organization's status as an insured under this coverage ends when your operations for that insured are completed. b. The Limits of Insurance applicable to the Additional Insured are those specified in the written contract or agreement but not more than the Limits of Insurance specified in the Declarations for this policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations for the Named Insured. 3. In addition to the other exclusions applicable to Section I, Coverages A., B. and C. of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, the insurance provided to the Additional Insured does not apply to: a. "Property damage" to: (1) Property owned, used, occupied by, loaned or rented to the Additional Insured; (2) Property in the care, custody or control of the Additional Insured or over which the Additional Insured are for any purpose exercising physical control; or (3) "Your work" performed for the Additional Insured. b. "Bodily injury," "property damage," or "personal and advertising injury" arising out of an architect's, engineer's or surveyor's rendering or failure to render any professional services for you, for the Additional Insured or for others, including, but not limited to: (1) The preparing, approving or failure to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2) Supervisory, inspection or engineering services. c. "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) to be performed by or on behalf of the additional insured at the site of the 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 organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 4. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance, is amended to add the following subparagraph: d. Additional Insured's Other Insurance As Excess Insurance To the extent required by an "insured contract," this insurance is primary on behalf of the Additional Insured; and any other insurance maintained by the Additional Insured is excess and not contributory with this insurance. If the "insured contract" does not require this provision, then Paragraph a. above will apply. B. Mobile Equipment Broadened Coverage V.1 2.f.(1) of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM 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. Except the above provisions do not apply to self-propelled vehicles of less than 1,000 pounds gross vehicle weight which are not intended for use on a highway. C. Aggregate Limit Per Project MP 97 67 10 10 Includes copyrighted material of Insurance Services Office, Inc. and Page 1 of 2 American Association of Insurance Services, Inc., with their permission The General Aggregate Limit under SECTION III - LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separately to each of your projects away from premises owned by or rented to you. Page 22 of 25 Includes copyrighted material of Insurance Services Office, Inc. and MP 97 67 10 10 American Association of Insurance Services, Inc., with their permission D. Blanket Waiver Of Transfer Of Rights Of Recovery Against Others To Us The Transfer Of Rights Of Recovery Against Others To Us Condition (SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against any person or organization to whom you by written contract or written agreement have waived your own right or recovery for loss caused by that person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a written contract or written agreement with that person or organization and included in the "products-completed operations hazard." This provision does not apply unless the written contract or written agreement has been executed prior to the "occurrence" or offense giving rise to the "bodily injury" or "property damage." E. Voluntary Property Damage Coverage 1. We will, at your request, pay but not defend any claim for "property damage" to the property of others otherwise excluded under A.2.j.(4), (5) and (6) of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM provided that: a. Such "property damage" takes place while such property is in your care, custody or control, or is property of others over which you, for any purpose, are exercising or have exercised physical control; and b. Such "property damage" takes place away from any premises you own, rent or lease; and c. Such "property damage" takes place within the "coverage territory" and during the policy term; and d. Such "property damage" takes place only during your operations that are known to us, are scheduled on the policy and for which a premium has been charged. 2. The insurance under this additional coverage does not apply to "property damage" to property: a. Held by you for servicing, repair, storage or sale at premises owned by, rented or leased to you; b. While being transported by or caused by the ownership, maintenance, operation, use, "loading or unloading" of any "auto," watercraft or aircraft; or c. Owned or occupied by or rented to you. 3. Deductible This additional coverage will apply only to that amount of any loss in each "occurrence" that exceeds $500. The terms of the policy with respect to your duties in the event of "occurrence," claim or "suit" and the Company's right to investigate, negotiate and settle any claim or "suit" apply irrespective of the application of the deductible amount of $500. We may pay any part or all of the deductible amount of $500 to effect settlement of any claim or "suit." Upon notification of the action taken, you must promptly reimburse us for such part of the deductible amount as has been paid by us. 4. Limits of Liability The Limit of Liability for this additional coverage shall not exceed $2,500 for each "occurrence" and is the limit of the Company's liability for all damages on account of each claim or "suit" covered herein. The annual aggregate Limit of Liability is $2,500 and is, subject to the above provisions respecting each claim, the total limit of the Company's liability for all damages. 5. Settlement in the event of loss covered by this additional coverage, you shall, if requested by us, replace the property or furnish the labor and materials necessary for repairs thereto at actual cost to you, excluding prospective profit or overhead charges of any nature. Any property so paid for or replaced shall, at our option, become the property of the Company. Payment hereunder shall not constitute an admission of liability of you or, except as stated herein, of the Company. MP 97 67 10 10 Includes copyrighted material of Insurance Services Office, Inc. and Page 2 of 2 American Association of Insurance Services, Inc., with their permission From Bertocchi Builders Inc. Proposal Dated 4-7-2015 1860 Gabriel Way Medford Or 97501 541-944-7137 CCB # 181329 To: City of Ashland (Dale Peters) 90 N Mountain Ave Ashland Or 97520 Proposal regarding: B Street Yard building bay improvements In close last open bay in existing building, install framing, metal beams and steel studs to in close rear and front of building. Install automatic 12x14 430 series sectional door, install one metal 3.0 man door. Install metal siding. Install insulation to three sides. Clean up site remove debris from site Total Cost $13,628.00 Any additional electrical needs will be performed by City of Ashland election. Page 1 / 1 CITY OF wmax ASHLAND DATE PO NUMBER 20 E MAIN ST. 5/27/2015 12886 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 013674 SHIP To: Ashland Building Maintenance BERTOCCHI BUILDERS INC (541) 488-5358 1860 GABRIEL WAY 90 N MOUNTAIN AVENUE MEDFORD, OR 97501 ASHLAND, OR 97520 FOB Point: Ashland, Oreqon Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Dale Peters Special Inst: Confirming? No Quantity Unit Description Unit Price Ext. Price Enclose open bay - "B" Street Vard bldq 13,268.00 Install 12x14 electrically operated overhead door and 1- 3 foot metal man door. Install insulation on 3 sides. Contract for Goods and Services Beqinninq date: May 11, 2015 Completion date: June 12, 2015 SUBTOTAL 13 268.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 13,268.00 ASHLAND, OR 97520 Account Number Project Number. Amount Account Number Project Number Amount E 260.08.12.00.70420 13 268.00 Autho ' ed Signature VENDOR COPY FORM #3 frL1~<v ✓ y ~rQ.r ;~/ry CITY OF ASHLAND REQUISITION ~7..ez ~o,~r` re es` 20APR2015 Required ate for delivery: Vendor Name BERTOGGHi Ri ill DERC Inc Address, City, State, Zip 1860 GARRIFI WAY Contact Name & Telephone Number MFnFnRn OR 97501 Fax Number 541 944 7137 MARK BFRTOCCHI 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) ❑ 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 and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # ,JK 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/written solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost '6NCL.oSF- o .ay -~.Lr0c%K]LC. tZx/'1- El~c it:ea ID a ~ecrL ,q..~n / 3°MET19~-Mf~/`~~601L, ~'NST+9+'+- 13268.00 Jnu&rz'7 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal $ Project Number Account Number 260.08.12.00.704200 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, I certify that the City's public contracting requirements have been satisfied. Employee: Department Head: (Equal to or greater than $5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal yea . YES / NO Finance Director- (Equal to orgrear rthan $5,000) Date Comments: -7 ~2 Form #3 - Requisition