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HomeMy WebLinkAbout2021-004 PO 20220012- Knife River Materials µ } Purchase Order ,� CITY RECO E Fiscal Year 2022 Page: 1 of: 1 iTgf§7-2-7 1 1:141111. 7270-17!_011 BCity of Ashland _ - ATTN: Accounts Payable L Purchase 2022001 2 L 20 E. Main Ashland, OR 97520 Order# -r Phone: 541/552-2010 O Email: payable@ashland.or.us V H C/O Street Division EKNIFE RIVER MATERIALS I 90 North Mountain Ave PO BOX 1145 p Ashland, OR 97520 0 MEDFORD, OR 97501 Phone: 541/488-5313 R T Fax: 541/552-2304 —" �`-- 541)779-6304 Chuck Schweizer __--- __II 06/29/2021 774 FOB ASHLAND OR/NET30 Ci Accounts Pa able dl.Fi=ldna llt1511 15'-tsi�a= Asphalt Milling &Grinding • 1 Asphalt overlay milling and dig out grinding 1.0 $40,000.00 $40,000.00 Goods and Services Agreement(Greater than$25,000) Completion date: June 30, 2021 Amendment No. 1 Completion date: June 30, 2022 Project Account: Project Account: GL SUMMARY*************** 081200-602400 $15,000.00 081200-704100 $25,000.00 By: / Date: - u orized Signature P, tcj >> t - - •40 000.00 3. 1 FORM #31/ ;-----* :CITY OF A request lar a I to chase Met / P. 7--- ASHLAND REQUISITION oateotrequest: y ill 12,4 Required date for delivery: Vendor Name LTM,incorporated _ ,{ Address,City,State,Zip PO Box 1145 Medford,OR 97501 Contact Name&Telephone Number Jon Barton 541-770-2960 Email address - SOURCING METHOD • k ❑ Exempt from Competitive Bidding 0 Emeraencv ❑ Reason for exemption: 0 Invitation to Bid 0 Form#13,Written findings end Authorization ❑ AMC 2.50 Date approved by Council: 0 Written quote or proposal attached • Written quote or proposal attached (Attach copy of council communication) (If council approval required,attach copy of CC) • Small Procurement S Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council:_ ❑'•Stale of Oregon U Direct Award (Attach copy of council communication) Contract# ❑ Verbal/Written bld(s)or proposal(s) 0 Request for.Qualifications(Public Works) 0 State of Washington Date approved by Council: - Contract# (Attach copy of council coinmunicaton) 0 Other government agency contract Intermediate Procurement E Sole Source Agency i GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement O (3)Written bids&solicitation attached 0 'Form#4,Personal Services$5K to$751( Agency PERSONAL SERVICES 0 Special Procurement ❑ Annual cost to City does not exceed$25,000, Greater than$5,000 and less than$75.000 0 Form#9,Request for Approval Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment AP ID Written quote or proposal attached CflyAdministralor.AMC 2.50:070(4) -0 (3)Written proposals&solicitation attached Date approved by Council: 0 Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services$5K to$75K Valid until: (Date) approval required.(Attach copy of council communication) Description of SERVICES Total Cost Asphalt overlay milling and dig out grinding. .. " 6" Q "0 '" 4" , '��w�$��'� �� � a ��', �, x sE ay4 i r� [f g�5 0� -� X`fit h 4 b E 'j'�3.c., -ll b�`�, s$�40,000;t � � t �M ,a�� r�iii; *�.7 Item# Quantity Unit Description of MATERIALS Unit price Total Cost 1 ID Per attached quotelproposal ' TOTAL;COST y, +a � ,tv5s��y.,.i^aZ�S ? - -- - - 15)vorl l$� ,, A4Ira'5N 081200 602400 �'� � ;i� r,1a ,y; j;. Project Number Account Number � , 4 mJ4 itk,1 081200 704100.. v a,tf I 0170 • Account Number • Account Number • _ ___ 'Expenditure must be charged to the appropriate account numbers forthe 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,Icertify that the City's public contracting requirements have been satisfied Employee:& L iI II` Department Head: =,_lr.__�� -' 201--1 NTT.KcsiitNtt on"..'•t I.'.am Hanks Department ManagerlSupervisor: City Admin tor: A DN.mi;cn Adam Hanks,o=cigar to rr fl�pnd u— ailm,, (Egadtial!at W lan:.m,u auks sr�s. Funds appropriated for current fiscal year 1C-8-1"NO v� 9 L< Dare 2021.04.2813:113707'00' Deputy Finan Dir ctor.-(Equall�greater than 35,000) Date Comments: Form#3-Requisition GOODS&SERVICES AGREEMENT(GREATER THAN$25,000) PROVIDER: LTM,INCORPORATED dba KNIFE RIVER MATERIALS CITY OF ASHLAND PROVIDER'S CONTACT: Jon Barton • 20 East Main Street Ashland,Oregon 97520 ADDRESS: P.O.BOX 1145 Telephone: 541/488-5587 Medford,Oregon 97501 Fax: 541/488-6006 PHONE: 541-770-2960 • This Goods and Services Agreement (hereinafter "Agreement") isentered into by and between the City of Ashland,an Oregoh municipal corporation(hereinafter"City")and LTM,Incorporated dba Knife River Materials, a domestic business corporation(hereinafter"Provider"),for asphalt overlay milling and dig out grinding. 1. PROVIDER'S OBLIGATIONS 1.1 Provide asphalt overlay milling and dig out grinding as set forth in the"SUPPORTING DOCUMENTS" attaehed hereto and,by this reference,incorporated herein. Provider expressly acknowledges that time • is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The goods and services defined and described in the"SUPPORTING DOCUMENTS"shall hereinafter be collectively referred to as"Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance • of all Work received hereunder,a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability,and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an"occurrence" and not a"Claims made" form,and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; . • Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional-named insured except to the extent that-two or more such policies are intended to "layer" coverage and,taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage o Provider shall supply an endorsement naming the City,its officers,employees and agents as additional insureds by the Effective Date of this Agreement; and e Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 6: Agreement between the City of Ashland and LTM,Incorporated.dba Knife River Materials _ � I 1.3 All subject employers working under this Agreement are either employers that will comply with ORS 656.017 or employers that are exempt under ORS 656.126. As evidence of the insurance required by this Agreement,the Provider shall furnish anacceptable insurance certificate prior to commencing any Work under this Agreement. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex,marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this • • Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of • federal and state civil rights and rehabilitation statutes,rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise • certified under ORS 200.055,in awarding subcontracts as required by ORS 279A,110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of$0.80(eighty cents)per square yard for overlay grinding and$4.50' 2 (four dollars and fifty cents)per square yard for dig out grinding plus$800.00(eight hundred dollars) per mobilization as provided herein as full compensation for the Work as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$40,000.00 (forty thousand dollars)without the express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation - of compensation or reimbursement. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole. discretion. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave,and retirement. • 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations,and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. Page 2 of 6: Agreement between the City of Ashland and LTM,Incorporated.dba Knife River Materials 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, • in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue,and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred,as appropriate,so as to effectuate this choice of venue. 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims, suits, actions,losses, damages, liabilities, costs, and expenses of • any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees,contractors,or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God,strikes,lockouts,accidents,or other events beyond the control of the other or the other's officers,employees or agents. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions,but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable,preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the Goods.Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains.liable for latent defects,fraud, and warranties. 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this • Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor,material and manufacture.Provider shall transfer all warranties to the City. 4. SUPPORTING DOCUMENTS The following documents are,by this reference,expressly incorporated in this Agreement,and are collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:" • The City's written Invitation To Bid dated March 11,2021. • The Provider's complete written Proposal dated March 17,2021. - 5. REMEDIES 0 5.1 In the event Provider is in default of this Agreement, City may, at its option,pursue any or all of the remedies available to it under this Agreement and at law or in equity,including,but not limited to: 5.1.1 Termination of this Agreement; Page 3 of 6: Agreement between the City of Ashland and LTM,Incorporated.dba Knife River Materials • } 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5:1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly,collectively,successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits.If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30,.2021, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may,upon not less than thirty (30) days' prior written notice,terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement,with cause,by not less than fourteen(14)days'prior written notice if the cause is not cured within that fourteen(14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery,by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail,return receipt requested,postage prepaid,to the address set forth below: If to the City: City of Ashland—Street Division, Public Works Department Attn: Avram Biondo 20 E.Main Street Ashland,Oregon 97520 - Phone: (541)488-5313 • With a copy to: City of Ashland—Legal Department 20 E.Main Street Ashland,Oregon 97520 Phone: (541)488-5350 { If to Provider: Knife River Materials Attn: Jon Barton P.O.BOX 1145 Medford Oregon 97501 Page 4 of 6: Agreement between the City of Ashland and LTM,Incorporated.dba Knife River Materials \ J 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition; or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: r- (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317,and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider;and (iii) Any rules,regulations,charter provisions,or ordinances,that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider,for a period of no fewer than six(6)'calendar years preceding the Effective Date of this 1 Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317,and 318; (ii) Any-tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider;and (iii) Any rules,regulations,charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9,shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this s Agreement and to seek damages and any other relief available-under this Agreement,at law,or in equity. r •Page 5 of 6: Agreement between the City of Ashland and LTM,Incorporated.dba Knife River Materials y I IN WITNESS SS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. ' CITY(A ND:(°:litacni-=`,Iiat,tncE,Itynok; LTM,INCORPORATED,dba KNIFE RIVER shland,ou=Administration, MATERIA S(PROVIDER): . e hailadam.hanks@ashland.or.0 is,'r—USS By._ Dt 2029.0.0]12.0247.0700' Adam s;City Manager Pro Tem By: �Q� 5/3/21 Signature Date Joe Soares Printed Name General Manager • Title 4/21/2021 Date Purchase Order No. f (W-9 is to be submitted with this signed Agreement) . I • APPROVED AS TO FORM: ssistant City Attorney •424� / /s i Zc L/ Date • • • • Page 6 of 6: Agreement between the City of Ashland and LTM,Incorporated.dba Knife River Materials • • I ' 1 , Proposal LTM,INCORPORATED dba KriOregon License#56603 ' � a„ California License#567735 MATERIALS AN MDU RESOURCES COMPANY P.O.Box 1145 Telephone 770-2960 Medford,Oregon 97501 Fax 664-4567 EQUAL OPPORTUNITY EMPLOYER Date: 03117/21 PROPOSAL SUBMITTED TO: JOB NAME DESCRIPTION/LOCATION: City of Ashland Asphalt Grinding Rates Attn:Chuck Schweizer Various Locations ITEM DESCRIPTION QTY UNIT PRICE ESTIMATED TOTAL 1 Daily or Additional Street Mobilzation(s) TBD EA $800.00 TBD 2 1-2"Depth Asphalt Overlay Grinding 18,333:00 SY $0.80 $14,666.40 3 5"Digout Grinding 2,500.00 SY $4.50 $11,250.00 Availability is NOT Guaranteed.Schedule to be mutually agreed upon at least 3 weeks in advance. This is a Unit Price Proposal ` Addenda Acknowledged= none Job specific notes: TOTAL>>» TBD Includes:Cut&Load Only. Excludes:Offhaul trucks,handwork,cleaning,sweeping,areas Pricing Valid 3/17/2021 through 6/30/2022 Inaccessible by grinder,lowering of utilities,traffic control or flagging,water,light plants,layout,clean up and dump fees. Customer to provide adequate offhaul trucks&water to grinder, General Conditions 1 Bond fees are excluded. Please add 1%If required. All construction fees&permits excluded. 2 Excludes trucking,offhaul,sweeping&dump fees. 3 Exclusions:traffic control; trench patching;temporary or permanent pavement markings of any kind;adjustments of utilities; surveying;surveying or layout;pavement cleaning or sweeping. 4 Based on free and clear access,without hindrance by other operations. 5 Sanitary facilities to be provided by others. • 6 Temporary protection of valley gutters,concrete crosswalks,&concrete aprons by others. 7 Schedule to be mutually agreed upon.Advanced notice of at least two weeks is recommended. Submitted by: --- Jon Barton-Estimator/Project Manager Phone:541.618.2606 i / ® DATE(MMIDDIYYYY) f'►`� CERTIFICATE OF LIABILITY INSURANCE 12/2212020 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 have ADDITIONAL INSURED provisions or be endorsed. r 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 Ileu of such endorsement(s). • PRODUCER CONTACT Marsh USA Inc. NAME: 333 South 7th Street,Suite 1400 t .PHONE.Exti: (A/C.Not: Minneapolis,MN 55402-2400 E-MAIL Attn:MDU.CertRequest@marsh.com;Fax:(212)948-5382 • ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC S CN102299309-LTMM•GAWX-2122 LTMME INSURER A:Liberty Mutual Fire Ins Co 23035 INSUREDLTM,Incorporated INSURER B:NIA NIA dba Knife River Materials INSURER c:Liberty Insurance Corporation 42404 PO BOX 1145INSURER D: • Medford,OR 97501 INSURER E: _ INSURER F: COVERAGES • CERTIFICATE NUMBER: CHI-009317931-06 ' 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 LTR TYPE OF INSURANCE 1NSD WVD POLICY NUMBER (MMIDDIYYYYI (MMDDIYYYY) LIMITS . A X COMMERCIAL GENERAL LIABILITY Y TB2-641-005097-041 01/01/2021 01/0112022 EACH OCCURRENCE $ 2,000,000 DCLAIMS-MADE n OCCUR PREMISEGES(Ea O RENTED cccurrence) $ 1,000,000 MED EXP(Any one person) $ 10,000 ' • PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIESPE2: GENERAL AGGREGATE $ 4,000,000 PRO- PRODUCTS-COMP/OP AGG $- 4,000,000 POLICY JECT LOC OTHER: $ A AUTOMOBILELIABILITY Y AI2-641-005097-051 0110112021 01101/2022 MBaceldeINEDS ntlINGLELIMIT $ 2,000,000 {Fa X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ -- AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS' ONLY - (Per accident) $ $ UMBRELLA UAB _OCCUR EACH OCCURRENCE S EXCESS LIAB - CLAIMS-MADE AGGREGATE S DED RETENTION$ $ C WORKERS COMPENSATION WA7-64D-005097-021(Regulated) 01/01/2021 01/01/2022 x STATUTE ERH AND EMPLOYERS'LIABILITY C YIN WA7-64D-005097-011(AOS) 01/01/2021 01/01/2022 ANYPROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED? n NIA Includes"Stop-Gap"" es (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ ' DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Re:Asphalt Grinding for the City of Ashland. The City of Ashland and its officers,employees,and agents while acting within the scope of their duties as such is/are included as additional insured under general liability per the attached CG 2010 and CG 2037 endorsements end does not include professional liability coverage;Blanket Additional Insured for Automobile Liability is included per attached designated Insured Endorsement CA 2048.Primary and Non- Contributory applies for General Liability per CG 20 01 attached. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. ' AUTHORIZED REPRESENTATIVE • of Marsh USA Inc. Manashl Mukherjee LoLsno.c.s4 ..ji4Jutte-Ku:,4-u- ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) ' The ACORD name and logo are registered marks of ACORD c a POLICY NUMBER:Al2-641=005097-051 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by.this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s)or organization(s)who are"insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s)Or Organization(s): Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event-to exceed either the scope of coverage or the limits of insurance provided in - this policy. This policy will be primary and non-contributory to any like insurance . available to the person or organization noted above.-- J • Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Each person or organization shown in the Schedule is • an"insured"for Covered Autos Liability Coverage,but only to the extent that person or organization qualifies as an"insured"under the Who Is An Insured provision contained in Paragraph A.1.of Section Il - Covered Autos Liability Coverage in the Business Auto,and Motor Carrier Coverage Forms and Paragraph D.2.of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ©Insurance Services Office, Inc.,2011 J Page 1 of 1 Policy Number:AI2-641-005097-051 Issued By: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART , GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Other Person(s)! Email Address or mailing • Number Organization(s): address: Days Notice: • Per schedule on file with the Per schedule of certificate holders 90 Company on file with the Company ff t I_ • . E . A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. _ I B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 0511 ©2011, Liberty Mutual Group of Companies. All rights reserved. . Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER:TB2-641-005097-041 COMMERCIAL GENERAL LIABILITY CG 2010 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 PART A. Section II — Who Is An Insured is amended to 1. All, work, including materials, parts or include as an additional insured the person(s) or eqipment furnished in connection with such organization(s) shown in the Schedule, but only with work, on the project (other than service, respect to liability for "bodily injury,: "property maintenance or repairs) to be performed by or damage" or "personal and advertising injury' on behalf of the additional insured(s) at the caused,in whole or in part,by: location of the covered operations has been 1. Your acts:or omissions;or completed;or 2. The acts or omissions of those acting on your 2. That portion of "your work" out of which the behalf; injury or damage arises has been put to its in the performance of your ongoing operations for intended use by any person or organization the additional insured(s) at the location(s) other than another contractor or subcontractor designated above. engaged in performing operations for a principal as a part of the same project. However. C. With respect to the insurance afforded to these 1. The insurance afforded to such additional additional insureds, the following is added to insured' only applies to the extent permitted by Section III—Limits Of Insurance: law;and If coverage provided to the additional insured is 2. If coverage provided to the additional insured is required by a contract or agreement, the most we required by a contract or agreement, the will pay on behalfofthe additional insured is the insurance afforded to such additional insured will amount of insurance: not be broader than that which you are required 1. Required by the contract or agreement;or by the contract or agreement to provide for such additional insured. 2. Available under the applicable Limits of B. With respect to the insurance afforded to these Insurance shown in the Declarations; additional insureds, the following additional whichever is less. exclusions apply: This endorsement shall not increase the This insurance does not apply to "bodily injury" or applicable Limits of Insurance shown in the "property damage"occurring after: Declarations. SCHEDULE • J , r 1 CG 2010 0413 ©Insurance Services Office,Inc.,2012 Page 1 of 2 l I • SCHEDULE(continued) Name Of Additional Insured Person(s) Location(s)Of Covered Operations Or Organization(s): Any person or organization with whom you have agreed All locations as required by a written contractor in writing in a contract or agreement, prior to an agreement entered into prior to an"occurrence"or "occurrence"or"offense",that such person or offense. organization be added as an additional insured on your policy;and 2.Any other person or organization you are required to add as an additional insured under the contract or agreement described in item(1?above. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. I J J . .) CG 2010 0413 ©Insurance Services Office,Inc.,2012 Page 2 of 2 0 • POLICY NUMBER:TB2-641-005097-041 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEM ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS J This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART 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 is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we . "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the"products-completed operations hazard". 1. Required by the contract or agreement;or However 2. Available under the applicable Limits of 1. The insurance afforded to such additional Insurance shown in the Declarations; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the applicable 2. If coverage provided to the additional insured is Limits of Insurance shown in the Declarations. • 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. SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Any person or organization for whom you have agreed . All locations as required by a written contract or in writing in a contract or agreement, prior to an agreement entered into prior to an"occurrence"or "occurrence"or"offense",that such person or offense. organization be added as an additional insured on your policy;and 2.Any other person or organization you are required to add as an additional insured under the contract or agreement described in item(1)above. v Information required to complete this Schedule,if not shown above,will be shown in the Declarations. CG 20 37 0413 ©Insurance Services Office,Inc.,2012 Page 1 of 1 c I • 1I Policy Number TB2-641-005097-041 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD'PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE.PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL.GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY-UMBRELLA COVERAGE FORM A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule of this endorsement. We will send notice to the email or mailing address . listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. Schedule Name of Other Person(s)/ Email Address or mailing address: Number Days Notice: Organization(s): • Per Schedule on file with the Company Per Schedule on tile with the company 90 LIM 99 01 05 11 ©2011,Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 6 t 4 Policy No. TB2-641-005097-041 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) Youhave agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance:and CG 20 01 0413 ©Insurance Services Office,Inc.,2012 Page 1 of 1 J 4 NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this_policyfor any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule below.We will send notice to the email or mailing address listed below at least 10 days, or the,number of days listed below, If any, before cancellation becomes effective.In no event does the notice to the third party exceed the notice to the first named Insured. B. This advance notification ofa pending cancellation of.coverage Is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nornegate cancellation of the policy. • Schedule Name of Other Person(s)! Email Address or mailing address: Number Days Notice: Organization(s): Per Schedule on file with the Per Schedule on file with the 90 Company Company • • f • • • r ~ All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation 21814 For attachment to Policy No.WA7-64D-0OS097 011 Effective Date Premium$ Issued to Centennial Energy Holdings,Inc. Endorsement No. WC 9920 75 @ 2016 Liberty Mutual Insurance Page 1 of 1 Ed.12101/2016 • NOTICE OF CANCELLATION TO THIRD PARTIES A. If we Cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule below.We will send notice to the email or mailing address listed below at least 10 days,or the number of days listed below, If any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named Insured. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Schedule Name of Other Person(s)I Email Address or mailing address: Number Days Notice: Organization(s): Per schedule on file with the Per schedule on file with the 90 Company Company • All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation 21814 For attachment to Policy No.WA7-64D-005097-021 Effective Date Premium$ Issued to MDU Resources Group,Inc. Endorsement No. WC 99 20 75 02016 Liberty Mutual Insurance Page 1 of 1 Ed.12/0112016 w . • i FORM#1O CITY OF i- i CONTRACT AMENDMENT APPROVAL REQUEST FORMAsHLAND Request for a Change Order Name of Supplier 1 Contractor!Consultant: LTM dba Knife River Materials • TOfalamoutt of7ttiis' !fOontractlamendmerit ; Purchase Order Number: • rz Ft. $;datei(change)',only -.' Title 1 Description:Asphalt overlay Milling end dig out t 0 Per attached contract amendment } Contract Amendment Original contract amount $ 100 %of original contract ' Total amount of previous contract amendments %of original contract Amount of this contract amendment %of original contract I TOTAL AMOUNT OF CONTRACT $ %of original contract In accordance with OAR 137-047-0800:1)The amendment is within the scone of procurement as described in the solicitation documents,Sole Source notice or approval of Special Procurement 2)The amendment is necessary to comply with a change In law that affects performance of the contract 3)The amendment results from renegotiation of the terms and conditions,including the contractprice,of a contract and the amendment Is advantageous to the City of Ashland,subject to all of the following conditions:a)goods and services to be provided under 1h emended contract are the same as the goods and services to be provided under the unamended contract;b)The City determines that,with all things considered,the amended contract is at least as favorable to the City as the unamended contract;c)The amended contract does not have a total term greater than allowed in the solicitation document, contract or approval of a Special Procurement.An amendment Isnot within the scone of the procurement if the City determines thali(it had described the changes to be made by the i a amendment in the procurement documents,it would likely have Increased competition or affected award of contract Contract amendment is within the scope of procurement: YES NO (If"NO",requires Council approval I Attach copy of CC.) i 1� Sourcing Method: SMALL PROCUREMENT—Not exceeding$5,000 INVITATION TO BID or COOPERATIVE PROCUREMENT.QRF or 0*YES",the total amount of contract and cumulative REQUEST FOR PROPOSAL EXEMPTION PURSUANT TO AMC 2.50 amendments 5$6,000. ❑ 'YES',the total amount Of cumulative amendments 0°YES°,the total amount of orginal contract and O if'NO°,amount,exceeding.authori-ty requires 5 25%of original contract amount or$250,000 cumulative amendments$100K for Goods&Services,5 Council approval.Attach copy of Council whichever Is less. $75K for Personal Services,<$50KforAttomey Fees. Communication. ❑If NO amount exceeding authority requires 0 If1N0°,amount exceeding authority requires Council • ❑ Exempt—Reason: Council approval.Attach cony of Council approval.Attach copy of Council Communication. PERSONAL SERVICES(Direct Appointment) Communication. ❑ Exempt—Reason: ' 0 'YES',cumulative amendments 5$35,000. ❑ Exempt-Reason: • • ❑ If°N0',requires'council approval.(Attach Co)C • INTERMEDIATE PROCUREMENT SOLE SOURCE ••EMERGENCY PROCUREMENT - Goods&Services•>$5.000 and<$100,000 0 'YES',the total amount of cumulative amendments 0 Written Findings:Document the nature of the personal Services->$5,000 and<$75,000 5 25%of original contract amount or$250,000 emergency,including necessity and circumstances ❑ °YES°,the total amount of cumulative whichever is less. requiring the contract amendment amendments 5 25%of original contract amount 0 If'NO°,amount exceeding authority requires 0 Obtain direction and written approval from City ❑If"NO",amount exceeding authority requires Council approval.Attach copy of Council Administrator • Council approval.Mach copy of Council Communicafon. 0`If applicable,attach copy of Council Communication Communication. 0 Exempt—Reason: 1 Exempt—Reason: ❑ Exempt—Reason: •_ SPECIAL PROCUREMENT ' - • INTERGOVERNMENTAL AGREEMENT ❑'YES",the total amount of original contract and cumulative amendments are 0 Renewal of Intergovernmental Agreement:Terms modified in accordance with initial within the amount and terms initially approved by Council as a Special agreement OR costwili not be more than 25%greater than initial agreement.Renewal Procurement. approved by City Attorney and department head affected by renewal and approvedlsigned ❑ If°NO",amount exceeding authority requires Council approval. by City Administrator.AMC 2.28.045(B) Attach cony of Council Communication. • 0 If'NO',Council approval Is required.Attach copy of Council Communication Project.Number _ __ Account Number• - Account Nwnber • - • *Expenditure must be charged to the appropriiaat�e'acccoount(n�umbers for the financials to reflect the actual expenditures accurately. Attach extra pages if needed. •Employee Signature: CAA141 1 A Yasut4- l Uvo Department Head Signator .• Zoe ua r than$5,0000 0) ' City Manager: - (Equal to or greater than$25,000 or 10%) Funds appropriated for current fiscal year: YES /NO . Finance Director(Equal'fo or greater than$5,000) Date / Comments: . Form 00—Contract Amendment Approval Request Form,Request for a Change Order,Page 1 of 1,4!23!2020 AMENDMENT NO. 1 to GOODS AND SERVICES AGREEMENT between THE CITY OF ASHLAND, an Oregon municipal corporation, ("City") and LTM,INCORPORATED dba KNIFE RIVER MATERIALS, ("Contractor") • for ASPHALT OVERLAY MILLING AND DIG OUT GRINDING SERVICES RECITALS A. The City and Contractor previously entered into a Goods and Services Agreement effective May 4, 2021 (the "Agreement") in order for the Contractor to provide asphalt overlay milling and dig out grinding services to the City; and B. The City and Contractor wish to amend the Agreement to correct its term. AGREEMENT NOW THEREFORE,in consideration of the mutual benefits and obligations set forth herein,the parties agree as follows: 1. Amend the Completion Date as follows,with strikeout wording deleted and underscored wording added: 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"),and shall continue in full force and effect until June 30,2022 June 30,2021,unless sooner terminated as provided in Subsection 6.2. 2. This Amendment No. 1 is effective upon being signed by both parties. 3. Except as specifically modified by this Amendment No. 1,the terms and conditions of the Agreement remain in full force and effect. Page 1 of 2: Amendment No. 1 to Goods and Services Agreement .60 z IN WITNESS WHEREOF the parties have caused this Amendment No. 1 to be signed in their respective names by their duly authorized representatives as of the dates set forth below: CITY OF ASHLAND,OREGON LTM,INCORPORATED dba KNIFE RIVER MATERIALS(CONTRACTOR) BY: By U'4 Printed Name: _ FL£W,y Printed Name: Joe Soares Title: pleguc_, Wcyee-S DitlE[ bt..` Title: General Manager Date: 3(I! 41Zc2.) Date:5/12%2021 • • } Page 2 of 2: Amendment No. 1 to Goods and Services Agreement