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HomeMy WebLinkAbout2015-193 Contract - SOS Plumbing Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: SOS Plumbing ASHLAND CONTACT: Kathy Kinney, Service Manager 20 East Main Street Ashland, Oregon 97520 ADDRESS: 206 S. Pacific Hwy, Talent, OR 97540 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541 535 5063 DATE AGREEMENT PREPARED: 17 Jun 2015 FAX: BEGINNING DATE: 1 Jul 2015 COMPLETION DATE: 30 Jun 2016 COMPENSATION: Not to exceed $3500.00 GOODS AND SERVICES TO BE PROVIDED: Repairs, maintenance and service to plumbing systems in City buildings for FY 15/16. Per fee schedule attached as Exhibit C. 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 prima 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 06/02/2015, 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 Damag( Contract for Goods and Services Less than $25,000, Revised 06/02/2015, 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 the certification attached hereto as Exhibit A and herein incorporated by reference. Contractor: City of Ashland By By Signature Department Head r ! r J 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. l Contract for Goods and Services Less than $25,000, Revised 06/02/2015, 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. (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 4 of 5 CITY OF ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGI: per hour effective June 30, 2015 (Increases annually every June 30 by the ILI 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 Y 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. ➢ If their employer is the City of 1040 hours in any twelve- y 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 employee's 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, For additional information: 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 06/02/2015, Page 5 of 5 SOS 206 So. Pacific fivvy. Talent OR 97540 535-5063 jolenO 488-2680 (Ashland) 779-3472 (Medford) Fox: 535-3964 CC8 #079604 S.O.S. Plumbing provides 24-hour service, 7 days a week at the following rates. Regular Service Rates: Plumbing/Drain Cleaning/Drain Jetting Regular Time - $120/hr • Monday - Friday: 8:00 a.m - 5:00 p.m. Overtime - $180/hr • Monday - Friday: 5:00 p.m. - 8:00 p.m. • Saturday: 8:00 a.m. - 5:00p.m. Double Time - $240/hr • Monday - Friday: 8:00 p.m. - 8:00 a.m. • Saturday after 5:00 p.m. • All Sunday calls Specialty Services: • Drain Camera - $195 Per Hour • Cleaning drains through roof vent or pulling toilet - $50 additional charge • Grease Trap Cleaning - $200 without maintenance agreement New Construction/Remodel/Excavation: As per bid From: Medford Office #2 Fax: To 54 1 552 23 04@rcfax.con Fax: +15415522304 Page 2 of 2 07/16/2015 4:22 PM l ® DATE (MM/DDNYYY) ACORN CERTIFICATE OF LIABILITY INSURANCE 7/16/2015 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. 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). CONTACT Thomas Wilson PRODUCER NAME: AIC No Extl' (541) 857-0679 FAX (541) 857-9883 Ashland Insurance Inc PHONE A/C No : _ 801 O'Hare Park-way, Ste 101 E-MAIL DRESS: twilson@ashlandinsurance.cam ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Medford OR 97504 INSURER A :SAIF Corporation INSURED INSURER B : SOS Plumbing and Drain Service, Inc. INSURER C 206 S Pacific Hwy. INSURER D: INSURER E: Talent OR 97540 NSURERF COVERAGES CERTIFICATE NUMBER:CL1571605630 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 POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DDNYYY MMlDDlYYYY COMMERCIAL GENERAL LIABILITY FJ',CH OCCURRENCE _ $ DAMAGE TO RENTED $ CLAIMS-MADE E OCCUR PREMISES a occurrence MED EXP (Any one person) $ PERSONAL 3 ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE _ POLICY E] PRO- LOC PRODUCTS - COMPIOP AGG $ OTHER. COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY Ea accident) ANY AUI O BODILY INJURY (Per person) I $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ u AUTOS L AUTOS - AUTOS NONLOWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS er accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIM SMADE AGGREGATE $ _ 4DED RETENTIONS WORKERS COMPENSATION PER STATUTE EROTr+ AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E_L EACH ACCIDENT $ 500,000 E. EXCLUDED' 7 N/A OFFICatorory in n NH) NH) A (Mandatory 754526 10/1/2014 10/1/2015 I EL. DISEASE- EA EMPLOYE $ S00,000 Lyes,describeunder EL DISEASE -POLICYLIMIT $ 500 000 DESCRIPTION OF OPERATIONS below i DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 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 AUTHORIZED REPRESENTATIVE IMarcene Forney/MARC ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INSO?S oni Anil ■~an Wilson BBNW (1/7) 06/17/2015 09:27:30 AM -0700 %MA4C"1?E> 1 ~„y DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/17/2015 TTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LOW. 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 Brown & Brown Northwest NAMEACT Susan Wilson 3256 Hillcrest Park Drive PHONE FAX Medford, OR 97504 E-MANo Ext : 541-494-2658 A/c No): 541-494-2758 ADDRESS: swilson bbnw.com INSURERS AFFORDING COVERAGE NAIC# www.bbnw.com INSURERA: American Hallmark Insurance Company of Texas 43494 INSURED INSURER B SOS Plumbing & Drain Service Inc. INSURERC: 206 South Pacific Highway Talent OR 97540 INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 25128938 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFF POLICY EXP I sum INSR LTR TYPE OF INSURANCE WVD POLICY NUMBER MMIDDIYYYY MM/DD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY 44CL44337609 3/11/2015 3/11/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAINIS-NIADE 121 OCCUR PREMISES EaCCCLInence $ 100,000 MEDEXPAnyone person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000.000 POLICY ✓ PRO F LOG PRODUCTS -COh3Pi0PAGG $ 2,000,000 OTHER. A AUTOMOBILE uaeluTV 44CL44337609 3/11/2015 3/11 /2016 cromI'BiDeDtswGLE ulsT $ 1,000,000 ✓ I BODILY INJURY (Pe, person) $ ANY AUTO ALL OWN ED SCHEDULED BO DI LY IN JU RY(Per accOenf) $ AUTOS i AUTOS - - - - - - NON-OWNED PROPERTY DAMAGE- $ Per acmdent HIRED AUTOS ' AUTOS $ A ✓ UMBRELLA LIAB ✓ OCCUR 44CU44337709 3/11/2015 3/11/2016 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED ✓ RETENTION $10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNFR/EXECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) EL DISEASE - EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) General Liability coverage includes Blanket Additional Insured coverage including Primary/Non-contributory, Per Project Aggregate and Waiver of Subrogation when required by written contract per attached endorsement MP97670408. Subject to policy terms, limits, conditions and exclusions. 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 Attn: Dale Peters ACCORDANCE WITH THE POLICY PROVISIONS. 90 N Mountain Avenue Ashland OR 97520 AUTHORIZED REPRESENTATIVE Susan Wilson © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Js128e16 1 io~~i 1 13-15 cL/Unse/AITTO sus-' wilso,' 1 9:2s:2B A&i ~rl'DT'' I P1q, L of 'I Susan Wilson BBNW (2/7) 06/17/2015 09:28:32 AM -0700 ARTISANS ADVANTAGE ENHANCED COVERAGE ENDORSEMENT THIS ENDORSEMENT CHANCES THE POLICY. PLEASE READ IT CAREFULLY. This endorser7ient modifies insurance provided under the following: BUILDING AND (PERSONAL PROPERTY COVERAGE FORM CAUSES OF LOSS - SPECIAL FORM COMMERCIAL PROPERTY CONDITIONS COMMERCIAL GENERAL. LIABILITY COVERAGE FORM When this endorsernen~t is attached to the policy, insurance under the, Building and Personal Property Coverage Form, the Causes of Loss Special Form, the. Commercial Property Conditions and the Commercial General Liability Coverage Form is enhanced io provide the coverages describer) In this endorso ent. All other conditions of the policy continue to apply. Thris coverage is subject to the provisions applicable to the Building and Personal Property Coverage Form, Causes of Loss- Special Form, the Commercial Property Conditions and the General Liability Coverage Form, SCHEDULE Coverage Enhancement s Limlts_of Insurance Each Locatio.n, Pro ,tr,t„K,gkygLgq. Extt nsions Newly Acquired or Constructed Property Buildings $250,000. at Each Building Business Personal Property $100,000, at Each Building Personal Effects and Property of Others $ '10,000. at Replacement Cost Valuable Papers and 1=tecords (Other than Electronic Data) $ 25,000. Property Ofif-Premises (including), Laptops and Other Electronic Equiprmient) $ 10,000. Outdoor Property ((Named Perils) $ 1,000. per tree/shrub, max. liim'rt $15,000. INGn-Owned Detached Trailers $ 10„000. Accounts. Receivable $ 25,000. Property in Transit (t.ncluding Laptops and Other Electronic Equipment), $ 10,000. Prgpgq r Additional Co eMgg§ Electronic Data $ 15,000, Arson Reward $ 5,000, Water Back Up and Sump Overflow $ 25,000. Business Incorne Including Extra Expense $ 25,000. Inventory or Appraisal Cost $ 5„000. [honey and Securities Inside $ 10,000. Outside $ 5,000. Ordinance or Law Coverage Coverage A Included within Building Liniiit. Coverages LEA and C Combined 25% of Bldg, Limit, $15.0,000, maximum Outdoor Signs $ 5,000- Recharging of Fire Extinguishers $ 5,000. Inland Marine Coverages Installation Coverage $ 10,000. Contractors Equipment Coverages: Small Tools $ 2,500_ (Maximum Ilmil per item $500) Employee Small Tools $ 1,000. (Maximum limit per item $250) Leased and Rented Equa pment $ 0,000. Rental Reimbursement $ 1,000. !Generat lliabiility Additional Coverages Blanket Additional Insured (including Primary (Non-Contributing Coverage) Included in Each Occurrence Limit Mobile Equipment Broadened Coverage Included iin Each Occurrence Limit Aggregate Limit Pei, Project Included iin Each Occurrence Limit BianketWaiver Included iin Each OCCIurrenoe Limit MP 97 67 04 06 Iricluclr5, copyrighted n rMeri,,till of ISO Propertir Iris. .Ind Page 1 of 18 Air oriiCir) A,,soci;atioii of drt au ~7re S~n'vi~r;c>, Irio., used with iri6r perrtliti~5.io,r zsIlS9,e 11U5) 19-15 C,L/U'B/AUTO I SUSBG Wilson. I 6/17/ 015 9:as:z, PPS (PDT; I Page of 7 Susan Wilson BBNW (3/7) 06/17/2015 09:29:39 AM -0700 C. The following is added to A.2. Property Not Covered of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM: r. Property while stored or operated underground in connection with any mining operatoons, d. The following is added to Paragraph 2.• of B. Exclusions of the CAUSES OF LOSS - SPECIAL FORM., n_ We will not pay for loss or damage caused by puncluire., blowout and road damage to tires and tubes mounted on vehicles. However, we do pay for puncture, blowout or road damage caused by a specified peril. a.: We will not pay for loss caused by hijimrdity, dampness, dryness or changes in or ex1reirres of temperature. p_ We will not pay for loss caused by the weight of a load which, under the operating conditions at the time of a loss., exceeds the registered lifting capacity of any equipment or machine. ql.. We will not pay for loss due to theft or mysterious disappearance from any vehticle or attached container. We will pay for (loss due to bur•gBary when there are signs of forcible entry to a locked vehicle or container. e. E.7. Valuation of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM is deleted and replaced by the folliowiing: 7. Valuation We will determine the value of covered property in the event of loss or damage as. flows: a. At actual cash value at the time of the loss (with a deduction for depreciation) except as provided in paragraphs b. and c. foelowing. b. Pair or Set. The value of a lost or damaged article which is part of a pair or set is based on a reasonable proportion of the value of the entire pair or set. The loss is not considered a total loss of the pair or set. c. Loss to (Parts. The value of a. Bost or damaged part of an itern that consists, of several parts when it is complete is based on the value of only the lost or darnaged part or the cast to repair or replace it. 2. Rental Reimbursement In the event of lions by a covered peril to covered contractors" equipment that you own, we will reirrlburse you for your expense to rent similar egpuipment while your equipment is iinoperablle. The most we will reimburse you for rental reimbursement expenses is $1,000, We will continue to reimburse you for the rental of equipment after the expiration date of this coverage provided the loss occurred before the expiratlion date. We will not reanburse you1: a_ If you can continue or resume your operations with similar equipment that is available to you at no additional expense to you, or b. For the rentall expense of any equipment unless you make every reasonable effort to repair, replace or rebuild the inoperable equipment after the covered loss occurs. 3. With respect to thus Additional Coverage, Contractors Equipment Coverage, Section D. Deductible of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM is deleted) and replaced by the lol'lowing: D. Deductible We will not pay for loss or damage in any one occurrence untlll the amount of loss or damage exceeds $500, We will then pay the amount of loss or damage in excess of $500 up to the applicable limit of insurance. We will not reimburse YOU for the rental of equipment until after 72 faolurs have passed since the covered property was rendered inoperable. After 72 hours have passed, we will only reiimburse you for the rental expense that you actually incur. The deductible of $50-0 does not appliy to rental reimbursement expenses, Generall Liability Additional Coverages 1_ _ Thee following Additional Coverages are added to the. COtudItNJItERCIIAL GENERAL LIABILITY COVERAGE FORM. A. Blanket Additional Insured Coverage I. 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) wwhorn you are required to add as an Additional insured' on this policy under: a. A written contract Qr agreeirent-, and b. Where a cert ficate of insurance showing that person or organization as an additional insured has been issued; and Page 14 of 18 Iri€ u e,, c. pyrighted mart ri ti oP 1130 Prcporties, Inc and MP 97 67 04 08 American ~sso~i3r.i~r cr insurance 4c,rvxx a Inc I used with 1r)6 r perrniss.io,7 zslaesae 1GS 7 1 14 -is aL/uMB/AuTo susar wiIsvn I E/i'//aoi5 9:25:23 M, PDT; 1 Page 3 of v Susan Wiison BBNW (4/7) 06/17/2015 09:31:03 AM -0700 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. 1 'he 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 orrisslons of the Named insured or anyone directly or indirectly employed by the Narned Insured or fcr 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 [nsurance applicable to the Additionall Insured are those specified in the written contract or agreement but not more than the Limiits of Insurance specified in the Declarations for this pollcy. 'I fie L units 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 rather exclusions applicable to Section It, Coverages A., B. and C. of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, the insurance provided to the. Additional Insured does not apply lo: 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 o surveyor's rendering or failure to render any professional services for you, for the Additional Insurer) 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) Ali 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 untended 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 IVY- 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 oil behallf of the Additional Insured, and ally 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. Mobille Equipment Broadened Coverage V.12.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-Ipropel'led vehicles of less than 1,000 pounds gross vehicle weight which are not intended for use on a highway C. Aggregate Limit Per Project 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. MP 97 67 04 08 liieaudee,, cc pxrighrod rriaierr;tii or 11,33C0 Propomies, Ific, aold Wage 15 of 18 Ainerilearv A+ ,-or,%ation of InGQJ(01 me 4ervrcr:.t9, Into , used W01 fhPiu perrrri P,ioo ~slzssse ioszv is-ls cLiusai~u_o slsae wilsor 9:~s:a, Nli :EVr'r I Pagz 4 of 7 Susan Wilson. BBNW (5/7) 06/17/2015 09:32:26 AM -0700 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 m.. COMMERCIAL GENERAL LIABILITY' CONDITIONS) is amended by the addition of the follow) ng: We waive any right of recovery we, rna.y have against any person or organization to whonn you by written contract or agreerrrnent have waived your own right or recovery for loss caused by that person or organization because of payments we r7nake for iinjury or damage arising out of your ongoing operations or "your work" dome under a. contract with that person or Organization and included in the "products-completed operations hazard." Additional Conditions A.. Insurance Under Two or More Coverages The following is added to paragraph C. Insurance under Two or More Coverages of the COMMERCIAL PROPERTY CONDITIONS: if <a Coverage Form is attached to this policy that provides a limit for any coverage provided by this endorsement; the lirnit shown in the SCHEDULE and the coverage provided by this endors.ernn:eni are deleted and replaced by the hniiit and coverage provided by the Coverage Form. B. Limits of Insurance Regardless of the nurtnber of buildings at a (location covered by this endorsernent, the most we will pay underthis Coverage Enhancement endorsement in any one occurrence is the applicable Limits of Insurance shown in the SCHEDULE on. page t of this a W-nd'orsernent. C_ Deductibles -I lie Deductible described in section D. of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM applies to each of the Coverage Enhancernents except as shown below: We will not pay for loss or clamage in any one Occurrence until the amount of loss or damage exceeds $500. We will then (pa'y'the amount of loss or damage in excess of $500 upto'the applicable Lirritof Insurance for the following enhancemernt$: 1. Personal Effects and (property of Others 2. Valuable Papers and Records (01~her than Electroniic Data) 3. Accounts Receivable 4. Property Off-Premises (Including Laptops and Other- Electronic Equipment) 5. Outdoor Property (Tamed Perils) 6. Money and Securities 7. Water Back-Up and Sump Overflow S. Electronic Data 9. property in T'ranslt (including Laptops and Other Electronic Egcripnnent) No deductible provisions apply to the following enhancements: 1. Arson Reward 2. Recharging of Fire Extinguishers 3. nventory or Appraisal Cost 4. Rental Reimbursement D. Additional Definitions The following Additional (Definitions apply to this endorsement only: 1. "'Banking Premises" means the interior of that portion of any building occupied by a banking institution or s,imila.r safe depository. 2. "Business Income''' nneans the a. Net income (Net Profit or Loss before lncome taxes) that would have been earned had no loss occurred; and b. Continuing norrmal' Operating expenses incurred, including payroll. For manufacturing risks, Net Income includes the net sales vdlue of production, Page 16 of 18 Iridu es copyrighted materiall or 113-0 Propeaiet, Int. and PAP 97 67 04 Oft Aineriioaro AssoeiaYior'i or l bsu,rai7r,e 4etvrt(. Iri , used with 1h~iir perEtli. 5ita~7 ZS1::B939 1 1 0537 1 14-15 CL/UiB/All'1'0 I SISar Wilso,- I -/17i~ols 9: ;b ass (VDT? I P.Q1 5 of 7 Susan Wilson BBNW (6/7) 06/17/2015 09:33:33 AM -0700 3 "Client" means an individual, oompany or organization with whom you have a written contract or work order for your serviices for a described premises and have billed for your services. 4. "Employee" as used in Money and Securities coverage means: a. "Employee" means: (1) Any narturall person (a) While in your service or for 30 days after termination of service; (b) Who your compensate directly by salary, wages or contimissions; and (c) Who you have the right to direct and contrail while performing services for you, (2) Any naturall person who is furnished temporarily to you: (a) To substitute for a permanent ""employee" as defined in Paragraph (1) above, who is on heave, or (b) To meet seasonal or short-term work load conditions; while that person is subject to your direction and control and performing services for you, exclluding, however, any such person wr,hile• having care and custody of property outside the "premlises", (3) Any natural person who is leased) to you under a written agreement between you and a. labor leasing firm, to perform duties related to the conduct of your business, but does not mean a temporary er nployee as defined in Paragraph (2) above,- (4) Any natural person who is your director or trustee whole that person is handling "money" or "securities." (5) Any natural person who is a former "employee," director, partner, rrtember (an owner of a limited liability company represented by its membership interest, who also may serve as a manager), manager (a person serving in a directorial capacity for a. limited I'ba.bilily company), representative or trustee retained as a. consultant while performing services for you; or (6) Any natural person who is a guest .student or intern pursuing studies or duties, excluding, however, any such person while; having care and custody of "money" or "'securities" outside the "premises." b, "Employee'" does not mean: (1) Any agent, broker, factor, cowmission merchant, consignee, independent contractor or representative of the same general character; or (2) Any manager (a person serving in a directorial capacity for a limited liability company)" director or trustee except while performing acts coming within the scope of the usUai duties of an "emlpioyee."" r. "Extra Expense"' means necessary expenses you incur during the "period of reconstruction" lhat you would not have incurred if there had been no. direct physical loss or damage to property caused by or resulting from a Covered Cause of Loss_ Coverage pertains to expenses (other than the expense to repair or replace property) which are Incurred to (1) Avoid or Minimize the "suspension"' of 'ousiness acid to continue "operations" at the described prerm,ses or at replac;errent prer'nises or temporary locations, Including relocation expenses and costs to equip and operate the replacement location or temporary location. (2) (Minimize the ""suspension"" of business it you cannot continue "operations." 6. "Finished stock." means stock you have manufactured. (Finished stock also includes whiskey and alcoholic products being aged. 7. "Loss" as used in the Accounts Receivable Extension means accidental loss or damage. 8. "Messenger" rneans you, any of your partners or any employee while having care and custody of the property outside the "premises." 9. "Money"' means: a. Currency, coins and bank notes whether or not in current use; and b. Travelers checks, register checks and money orders held for sale to the public. 10. "'Occurrence" as used in the Money and Securities coverage means an act or series of related acts, involving one or more persons: or an act or event, or a series of related acts or, events not Involving any person. 11. "Operations" as used in the Business Income including Extra Expense coverage means your business activities occurring at the address shown iln the Declaration that you occupy for your business, 12. "'Period of restoration as used in the Business Income including Extra Expense coverage means the period of time that: a. Pegins with the date of direct physical loss or damrage cauised by or resulting from any Covered (Cause of Loss at IVIP 97 67 04 08 Include,88, cc p} rtrjhted mareri tii of 1130 Properties, Iftc. Auld Page 17 of 18 Arrreriican Associfition of dnsw,)I)PC SONIcr? IrLC_, usod with tneor perrn t-.5.ior7 zsi e9~e ioszt 14 -ZS CLiu;•ae/Au•io I Susan Wilson I ~/i't/zms 9:25:;3 tit tPDT) l P q, ~ of Susan Wilson BBNW (7/7) 06/17/2015 09:34:56 AM -0700 the described prerriises; and b. Ends on the date when the property at the described premises should be repaired: rebuts or replaced with reasonable speed and similar quality. "Period of Restoration" does not include any increased period required due, to the enforcement of any ordinance of taw that: (1) Regulates the construction., use or repair, or requires the tearing down of any property; or (2) Requires any insured or others to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, Orin any way respond to, or assess file effects of "pollutants." 13. "Pollutants" means any solid, liquid, gaseouis or therni:al irritant or contaraainant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled,, reconditioned or reclaimed. 14. "'Premises" as used in the Money and Securities coverage means the interior of that portion of any building you occupy in conducting your business. 15. "'Premises" as used in the Accounts Receivable Extensions means that intNr-iorof the building at the address shown in the Declarathons that you occupy for your business. 16. "Securities" i negotiable and non-negotiable instruments or contracts representing either "money" or other property and include: a. Tokens, ticlkets, revenue and other stannps whether or not in current use; and b. Evidences of debt Issued in connection with credlit or charge cards, wNch are not of your oven issue but does not include "money." 17. "Small Tools" rneans any tooli wh'lch can be rm,oved easily by one person without mechanical assistance andl'or can be hand held for the. purpose of doing labor. 18. ""Suspension"' as used in the Business Vlncome including Extra Expense coverage means the showdown or cessation of your business activities. 19. "Temporary storage location" means a location where property that is to become a permanent part of a completed project is stored while waiting: to be delivered to the job site-.. a. "I "hat you do not ovin, lease or operate; and b. /here work, is in progress, or wili begin in 30 days. 20. "Theft"' as used In the Money and Securilfies coverage means the unlawful taking of "money" or "securities" to. the deprivation of the Insured. All Other Conditions of this Policy apply Page 18 of 18 Iriclucies copyrighted mare ritll of ISO Prcperrie8. Inc_ aoid MP 97 67 04 08 Amoriican A5soci34loi' of drtsuuafw,, 4cKVit~z irir_, used With their perrni; 3.ion asize9,e 1 1 G5ri 1 14-1S CL/1J',+7A/au:0 l suear wilsor_ C/17/ G15 s. s:z~ Ajl7 iPDT; I Page 7 of r Page 1 / 1 . C I T Y OF ASHLAND DATE PO NUMBER 20 E MAIN S 7 7/7/2015 12956 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 001052 SHIP TO: Ashland Building Maintenance S.O.S. PLUMBING, INC (541) 488-5358 206 S PACIFIC HWY 90 N MOUNTAIN AVENUE TALENT, OR 97540 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 Repairs, maintenance and service to 3,500.00 plumbinq systems in City buildinqs - FY 16, Not to exceed $3,500.00. Contract for Goods and Services Beqinninq date: JuIV 1, 2015 Completion date: June 30, 2016 SUBTOTAL 3,500.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 3,500.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 410.08.24.00.60240 3,560.00 Authorized S' nature VENDOR COPY FORM #3 CITY OF ASHLAND REQUISITION Date of request: 16 JUN 2015 Required date for delivery: Vendor Name S()S PI I IAARIN(; Address, City, State, Zip 206 s PACIFIC HWY Contact Name & Telephone Number Fax Number TALENT OR 97540 541 535 5063 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 a 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 # 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 j p w t rzs; W t a . n IP%J ~ c -6- .n X499:00 rev Item # Quantity Unit Description of MATERIALS Unit Price Total Cost r-~ (o TOTAL COST F-1 Per attached quote/proposal u ~ 30 ~l $ Project Number _ 000000.000 Account Number 410.08.24.00.602400 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 !ate Support -Yes/ No By signing this requisition fo 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 year YES / NO Finance Director- (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition