Loading...
HomeMy WebLinkAbout2015-284 Lease Extension - Auto-Chlor System Contract for GOODS AND SERVICES Less than $25,000 I. S "t CONTRACTOR: Auto-Chlor System CONTACT: Josh Holte, Branch Manager ~ $ rEC nc.i ~.:.r 340 S. Pioneer Street ADDRESS: 541 Business Park Dr. #G, Medford, OR 97504 Ashland, Oregon 97520 Telephone: 541/488-5340 TELEPHONE: 541 / 772-7203 CELL: 541-210-3822 Fax: 5411488-5314 DATE AGREEMENT PREPARED: 9122115 FAX: 541 / 734-7752 BEGINNING DATE: 10/1/15 COMPLETION DATE: June 30, 2017 COMPENSATION: $4,90 GOODS AND SERVICES TO BE PROVIDED: Leased dishwasher for Oak Knoll Golf Course bhouse. The $205 monthly lease payment includes associated costs for maintenance and materials. Price i garanteed through June 30, 2017. 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, 279B.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $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 an time b City upon 30 days' notice in writing Contract for Goods and Services Less than $25,000, Revised 0810212015, Page 1 of 5 and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City Linder 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. Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 2 of 5 C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $$1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its 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 r, By By i na ure Department Head Print Name Print Name 'Vrlc&x~N ON W e/1, ~ _L= ~ 4`f ~"SAP ED AS TO FO M Title Date!. "Ashland sst. ity Attom y W-9 One copy of a W-9 is to be submitted with I -V 29 the signed contract. Purchase Order No. i)at Contract for Goods and Services Less than $25,000, Revised 06/02/2015, Page 3 of 5 EXHIBIT 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. Contr for (Date) Contract for Goods and Services Less than $$25,000, Revised 06/0212015, Page 4 of 5 0=!~i M= EXHIBIT B City Ashland LIVING, WAG f per hour effective June 30, 2015 (Increases annually every June 30 by the Consumer Price Index) portion of business of their 401K 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 For all hours worked under a assistance for the project or the employee, ➢ 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. ➢ 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 h if the employee spends policy, please see Ashland employee's mor more more of time in the that month ➢ In calculating the living wage, Municipal Code Section employers may add the value 3,12.020, working on a project or of health care, retirement, Call the Ashland City Administrator's office at 541-458-6002 or write to the City Administrator, City Hail, 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. C I T Y OF -ASHLAND Contract for Goods and Services Less than $25,000, Revised 06102/2015, Page 5 of 5 Oftr- hk Dishwashing Machine Agreement sYs~~e~l AGREEMENT, made this date between Auto Chlor Systcm of OREGON, INC and DBA OAK KNOLL GOLF COURSE at 40 S PIONEER ASHLAND OR 97520 hereinafter called "Customer." 1. Auto-Chlor System agrees to furnish an automatic dishwashing machine, Model ADS ET-AF, Serial No, and all Detergent, Rinse Aid and Sanitizing compounds necessary for washing dishes. Any excess Detergent and Sanitizing compounds used will be charged to Customer at current prices and Customer further agrees to return all empty chemical containers or pay for them at current prices. Customer agrees to pay a fixed amount of $205.00 at the beginning of each four (4) week period. Customer further agrees to pay an additional amount of 7.9 cents per cycle for all cycles washed in excess ofi4404-during the four (4) SC7O week period (determined by counter attached to machine). Customer agrees to pay applicable sales taxes. This agreement shall last for 65 four-week periods (5 years). At tttc end of the total term, this agreement automatically renews itself for another period of 52 weeks on each annual anniversary unless either party gives the other party at least 2 four-week periods (56 days) notice in writing of its election not to renew the agreement, /A2Q-5-I,goo j o v 7 q 2. Auto-Chlor System reserves the right to adjust prices if necessary. However, if Auto-Chlor System adjusts prices, the Customer may terminate this agreement by giving Auto-Chlor System 2 four-week periods (56 days) notice in writing to that effect, so long as that notice is given within twenty-eight (28) days after the price increase takes effect. If customer becomes delinquent in payment, Auto-Chlor System may, at its option, elect to interrupt the operation of the automatic dishwashing machine without notice, and/or, may elect to terminate this agreement by giving the customer seven days written notice of its election to do so. Upon such election, Customer shall owe Auto- Chlor System all back payments plus liquidated damages of the fixed amount and for the term set forth in paragraph 1 above. Upon Auto-Chlor System's election to terminate this agreement for non-payment, the Customer agrees voluntarily to surrender possession of the automatic dishwashing machine to Auto-Chlor System, and Auto-Chlor System shall have the right to remove the automatic dishwashing machine from the Customer's promises. Auto-Chlor System's election to terminate should not be construed as a waiver of any other rights Auto-Chlor System may have under this Agreement, 3. Auto-Chlor System will deliver the machine to Customer's place of business and will advise as to installation of the unit but Customer must arrange for necessary plumbing connections, sheet metal work, electrical work and racks at his own expense. Auto-Chlor System will thoroughly service the machine at regular intervals and supply all parts necessary for proper maintenance. Emergency service will be furnished free of charge, 4. The automatic dishwashing machine shall remain the property of Auto-Chlor System and Customer shall not transfer or encumber the machine, deliberately deface or damage the machine, assign this agreement, remove, alter or deface any numbers or description of the machine, or remove the machine from the location specified above or permit anyone other than its regular employees in the regular course of its business to use the machine. 5, Auto-Chlor System shall not be held liable for any damages by reason of failure of equipment to operate or faulty operation of equipment, nor be responsible for any direct consequential damage or losses resulting from the use or operation of furnished equipment. 6, in the event that it becomes necessary for Auto-Chlor System to employ attorney(s) to enforce collection of the sums due hereunder, or to enforce any of the agreements heroin contained or to remove the dishwashing machine, Customer agrees to pay the reasonable attorney's fees, costs and expenses incurred by Auto-Chlor System in connection therewith. Should any part of this agreement be doomed unenforceable by a Court, the remainder of this Agreement remains in full force and effect. 7. Should Customer disconnect or remove automatic dishwashing machine or otherwise attempt to unilaterally terminate this agreement, except as set forth above, then Customer shall remain responsible for the payment of the fixed amount set forth above for the entire term of this Agreement. 8, Customer agrees to provide Auto-Chlor System with the name and address of the owner of the property upon which Customer's business is located and inform Auto- Chlor System of any change of ownership of the property so that Auto-Chlor System can give written notice to the landlord of Auto-Chlor System's ownership of the automatic dishwashing machine. 9. Auto-Chtor System may impose an energy surcharge on each invoice to offset petroleum or utility based increases in its cost of goods, vendor or transport energy surcharges, and/or fuel cost increases. Energy surcharges may be adjusted periodically depending on market conditions. OAK KN L GOLF COURSE Auto-Chlor System of OREGON, INC Customer's Trade Name by (signature) by (signature) (541)772-7203 Print Name & Title Local Sales & Service Phone Number Customer's Phone Numb Customer's Building Owner's ame Customer's See' Security Number Customer's Buildin vmcr's Address Typ olc Prop., Partnership, or Corp. Customer's Building Owner's Phone Number aparan For consideration received, the undersigned ('Guarantor') hereby guarantees to Lessor timely payment and full performance by Lessee of all obligations of Lcsscc under the above )case including expenses of collection thereof, including attorney's fees and court costs and also of all expenses including attorney's fees and court costs incurred in enforcing this guaranty. Guarantor further authorizes Lessor to investigate Guarantor's credit capacity and history. Lessor and Lcsscc may by subsequent agreement add, delete, increase, decrease, or otherwise alter any of their rights and obligations as to each other without notice to or consent from guarantor and without in any way affecting the liability of Guarantor hereunder, not shall Guarantor's liability be affected by Lessee's assignment of the ]case or sublease of any Equipment. Notice of acceptance of this guaranty as well as al I demands, presentments, notices of protest and notices of every kind or nature including those of any action or nonaetion on the part of Lessee, Lessor or any other party arc hereby waived upon any default of Lessee. Lessor may, at its option proceed directly and at once, without notice against Guarantor to collect and recover the full amount hereby guaranteed or any portion thereof, without proceeding against Lessee or any other person or exercising of any other remedy available to Lessor whatsoever. Guarantor thereby waives the pleading of any statute of limitations as a defense to Guarantor's obligations hereunder to the full extent pcnrritted by law. The invalidity or uncnforceability, of the above lease as to Lcsscc for whatever reason shall not affect the enforceability of this guaranty. If more than one guarantor, obligation of each shall bejoint and several, If the equipment is not returned at the end of the term of the lease, or if the equipment is not returned after Lessee has defaulted in any manner specified in the lease, and has failed to cure such default after a reasonable period of time, the undersigned personally guarantees the fair market value of said equipment at the commencement of the lease which is $4,800.00 , to be decreased 0.5% for each month paid under the lease. Dated as of the date of the lease GUARANTOR (Individual) SIGNATURE WITNESS GUARANTOR (Individual) PRINT ADS ET-AF-PRICEGROUP 00-2015 (OAUTO-CHLOR SYSTEM, LLC - DO NOT REPRODUCE Oak Knoll Golf Course 340 s. Pioneer Ashland OR. 97520 ATTN:Susan 9/9/15 This is an official quote for Oak Knoll Golf Course, for the lease of our dishwasher. The lease is for 5 years, the price of 205/500/,079 will be guaranteed for 2 years as of the date agreement is signed through June 30`h 2017. Thanks Josh Holte 541 Business Park Dr., Suite G, Medford, OR 97504 - (541) 772-7203 - Fax (541) 734-7752 m m D L ~ m m OoD N C < C n C) zm0 G C) CEO 0) mO z ~0-< o c 0) 0 m z o m Dim o p ~ D 2 U) v p Q w -n -n 0 a z -n (n 3 z -n 2~ -n D r c, o to z o ;U G) z A p m ~D o zZ z o z m® z m C:~ rn ~ cJl 0 d O Q)m 4w m z rn rn G) 0 v Z` 1 n m n _ro o C~ C , O m 09 . o C (n a (n C m r z D rn n w m o AC" CERTIFICATE F LIABILITY I SU ANC DATEIMMfDD,YYYYI 1 18/2712015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: Woodruff-Sawyer & Co. PHONE 415-391-2141 FAX 415 989-9923 50 California Street, Floor 12 (AtC,No.II h9J:...___ MAIL - San Francisco CA 94111 EA DRESS: INSURER (S AFFORDING COVERAGE NAtC INSURER A:Continental Casualty Company 20443 INSURED AUTOSYS-01 INSURER 13:01d Republic Insurance Company 24.14_7__, Auto-Chlor System INSURER C 450 Ferguson Drive - - Mountain View CA 94043-5214 NSURERD; NSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1394552575 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 TYPE OF INSURANCE T POLICY EFF POLICY EXP LIMITS LTR INSD VND POLICY NU h1BER h1MlDDNYYYY MM1D011'Y(Y B X COMMERCIAL GENERAL LIABILITY Y MVVZY304998 71112015 71112016 EACH OCCURRENCE $1,000,000 DA"AGE TO _ _ CLAIMS-MADE EXIOCCUR PREMISES (FaEoccu r nco $100,000 MED EXP (Any one person) _ $5,00_0 _ _ PERSONAL & ADV INJURY- 31,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 PRODUCTS - CO!APlOPAGG $2,000,000 X POLICY F-] JET LOC. OTHER: B AUTOMOBILE LIABIUTY MWTB304999 7!1!2015 71112016 Ea ardent I I $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) S UTS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per acadent I S J A X UMBRELLA LIAR X OCCUR L4030901205 71112015 711/2016 EACH OCCURRENCE $25,000,000 EXCESS LfAB CLAAIS-MADE AGGREGATE $25,000,000 DED RETENTIONS S B WORKERS COMPENSATION MWC30499700 711/2015 71112016 X PER OTH- AND EMPLOYERS' LIABILITY _ STATUTE ER _ YIN A14Y PROPRIETOP/PARTNER/EXECUTIVE ❑ NIA EL EACH ACCIDENT $1,000,000 OFFICERIMEMSER EXCLUDED? (l,fandalory in NH) E.L. DISEASE - EA EMPLOYE $1,000,000 It yes, descnba under DESCRIPTION OFOPERATICNS belay E.L. DISEASE- POLICY LIMIT 51,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is requlred) The City of Ashland is included as an Additional Insured as respects General Liability per attached form. 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, Parks and Recreation Commission ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Susan Dyssegard 340 S. Pioneer Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations AS REQUIRED BY WRITTEN CONTRACT f Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or personal and advertising injury" 11 damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts oromissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1, The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III - Limits Of Insurance: whichever Is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of Insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 Zimbra dyssegs@ashland.or.us Revised quote. From :Joshua Holte <holte@autochlor.com> Thu, Oct 01, 2015 07:07 AM Subject o Revised quote. !1 attachment To v'susan.dyssegard@ashland.or.us' <susan.dyssegard@ashland.or.us> Cc v Joshua Holte <holte@autochlor.com> Susan, For 3 mo, July 1St 2015- September 30th 2015 we have billed you 3 times at $189.00 plus a environmental service charge of $6.95, to total $585.00 For 10 mo, October 1St through June 30th 2016 we will bill 10 times at $205.00 plus a environmental service charge of $6.95. to total $2119.50 For 13 mo, July 1St through June 30th 2017 we will bill $205.00 plus a environmental service charge of $6.96. 2755.35 The grand total for 2 years will be $5459.85. Susan I forgot to include the environmental charge in the or looked at your old invoices. It is a charge that all customers fluctuations in petroleum prices. We do this to keep the co! you can imagine there are a lot of hidden costs that the cup don't include in our machine costs. I do apologize for the oversight. If you have any questions please let me know. Thank You Josh oak knoll past due invoicesopdf 51 KB Page 1 / 1 ASHLAND PARK COMMISSION 20 E MAIN ST. DATE PO NUMBER ASHLAND, OR 97520 10/6/2015 00502 (541) 488-5300 VENDOR: 003274 SHIP TO: AUTO-CHLOR SYSTEM OF OREGON 541 BUSINESS PARK DRIVE SUITE G MEDFORD, OR 97501 FOB Point: Ashland, Oregon Req. N:m Terms: net Del, t.: Req. Del. Date: Contact: Susan Dvsseqard Special Inst: Confirmirll? No Quantity Unit Description Unit Price Ext. Price 3.00 4Wks Continued lease on existing dishwasher 195.00 585.00 at Oak Knoll Golf Course Monthly charge plus environmental service charge of $6.95, (3 each 4-week payments - Julv 2015 to Sept 2015) 10.00 4Wks Monthly charge plus environmental 211.95 2,119.50 service charge of $6.95 (10 each 4-week payments - Oct 2015 to June 2016) 13.00 4Wks Monthly charge plus environmental 211.95 2,755.35 service charge of $6.95 (13 each 4-week pavments - Julv 2016 to June 2017) Contract for Goods and Services Beginning date: 10/01/2015 Completion date: June 30, 2017 1 SUBTOTAL 5,459.85 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 5,459.85 Account Number Project Number Amount Account Number Project Number Amount E 211.12.04.00.60221 5,459.85 Authori d Signature VENDOR COPY roRl3 CITY OF A t~of~t.lr~st fora i='I-~~~chfltle oI°dr.t. ASHLAND REQUISITION Date of request: 9/28/15 Required date for delivery: 1019115 Vendor Name Auto-Chlor System, Attn: Josh Holte, Branch Manager Address, City, State, Zip Contact Name & Telephone Number 541 Business Park Drive #G, Medford, OR 97504 Tel: 541-772-7203 Cell: .541- -3822 Fax Number Fax: 541-734-7752 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 q quote or proposal attached A, El Small Procurement Cooperative Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon _ ® Direct Award Date approved by Council Contract # ❑ VerbalMritten quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract# V 1 GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Olhergovernmentagencycontract' $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 r $$5,000 to $75.000 ❑ Agency ❑ Form #9, Request for Approval - ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council/ ❑ (3) Written proposalsAvritten solicitation Date approved by Council: (Date) a ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description. of SERVICES Total Cost Continued lease on existing dishwasher for Oak Knoll Clubhouse. kcludes lease payment and costs for general maintenance, monthly service and products associated with the machine. Price is guaranteed through June 30, 2017. Item # Quantity Unit Description of MATERIALS Unit Price Total Cost ® Per attached quotelproposal TOTAL COST Project Number _ - Account Number-211 - _12-_04- 00 -_602210 Account Number Account Number 'Expenditure must be charged to the appropriate account numbers forthe financials to accurately reflect the actual expenditures. lT Directorin collaboration with department to approve all hardware and software purchases: _ By signing this requisition form,1 certify that the City's public contracting requirements have been satisfied IT Director Date Support -Yes/ No Em la ee: 4 p Y ~'l 'Department ent 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. NO Fin eDI'Mctor (Equal to orgreateirlhan$5,000) Date Comments: Form #3 - Requisition