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HomeMy WebLinkAbout2021-090 PO 20220065- Pump Pipe & Tank Services LLC Purchase Order Fir41, Fiscal Year 2022 Page: 1 of: 1 B City of Ashland T _Ego ,nff- g V ��=: ATTN: Accounts Payable20 E. MPurchase Ashla da�OR 97520 Order# 20220065 T Phone: 541/552-2010 0 Email: payable@ashland.or.us V H C/O Facilities Maintenance Div E PUMP PIPE &TANK SERVICES, LLC I 90 North Mountain Ave N PO BOX 146 P Ashland, OR 97520 TALENT, OR 97540 Phone: 541/488-5358 R T Fax: 541/552-2304 t=,t=A-�=it=7==lo[E;— — — 541 535-6542 David Arnold�._=1- 07/27/2021_ 468 __ FOB ASHLAND_ OR Cit Accounts Pa able MSS tt - �-}:1=1E a] I I7pi}=��E�[v __— _—__E _—_�(�I``.�L—����-��{ — �-'Iv---.E-� _3 Ei=�6'el.�l �_� I �I ' — !_-C_ r{�`� t=l�_ t T=�.'�E� Fuel System Maintenance 1 Fuel system maintenance and repairs 1.0 $10,000.00 $10,000.00 Goods and Services Agreement(Less than $25,000) Completion date: June 30, 2022 Project Account: ***************GL SUMMARY*************** 088400-602400 $10 000.00 By: Date: 07/29/2021 Authorized Signature $10,000.00 'FORM #3 CITY OF .,��. •� ASHLAND 1 REQUISITION Date of request: 7/15/2021 Required date for delivery: Vendor Name Puma.Pipe&Tank Services.LLC Address,City,State,Zip PO Box 146.Talent,OR 97540 Contact Name&Telephone Number Ryan McHenry 541-535-6542 ryarna pumppipetank.com Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ' ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid 0 Form#13,Written findings and 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 ❑ Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: • 0 State of Oregon ❑ Direct Award _(Attach copy of council communication) Contract# ❑ Verbal/Written quote(s)or proposal(s) ❑ Request for Qualifications(Public Works) ❑ State of Washington Date approved by Council: Contract# (Attach copy of council communication) 0 Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than f$100,000 El Written quote or proposal attached Intergovernmental Agreement ® (3)Written quotes and solicitation attached 0 Form#4,Personal Services>$5K&<$75K Agency PERSONAL SERVICES ❑ Special Procurement 0 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 ❑ Direct appointment not to exceed$35,000 ❑ Written quote or proposal attached City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals/written solicitation Date approved by Council: ❑ Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services>$5K&<$75K Valid until: (Date) approval required.(Attach copy of council communication) Description of SERVICES Total Cost Fuel system management and repairs for FY22 $ 10,000.00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost O Per attached quote/proposal TOTAL COST Project Number _ _ Account Number 088400-602400 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,I certify that the City's public contracting requirements have been satisfied. Employee: Department Head: aqt.allip:" 9101 or!reater than$5,000) Department Manager/Supervisor: City Administrator: 0 (Equal to or greaterOn12_17L)11 9/2021 Funds appropriated for current fiscal year: YES /NO _ _ I/ u y Finar cl a Dire or-(Equa o or greater thin$5,000) Date -- Comments: Form#3-Requisition GOODS AND SERVICES AGREEMENT (LESS THAN$25,000) PROVIDER: Pump,Pipe&Tank Services, LLC • CITY OFPROVIDER'S AS H LAN D CONTACT: Ryan McHenry 20 East Main Street Ashland,Oregon 97520 ADDRESS: PO Box 146 Telephone: 541/488-5587 Talent, OR 97540 Fax: 541/488-6006 PHONE: 541-535-6542 • This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Pump, Pipe & Tank Services, LLC (a domestic/foreign business'corporation)("hereinafter"Provider"),for fuel system services. 1. PROVIDER'S OBLIGATIONS 1.1 Provide fuel system management and repairs for FY22 as set forth in the "SUPPORTING DOCUMENTS" attached 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 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'sliall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability,and products/completed operations coverage; and • Automobile Liability. • Workers' Compensation 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 inatired except to the extent that two or more such policies are intended. to "payer" 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 Page 1 of 6: Goods and Services Agreement between the City of Ashland and Pump,Pipe Bc Tank Services,LLC • Provider shall supply an endorsement naming the City, its officers,employees and agents as additional instu'eds by the Effective Date of,this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. 1.3 Provider shall, at its own expense, maintain Worker's Compensation insurance in compliance with ORS 656.017,which requires subject employers to provide Workers' compensation coverage for all of its subject workers. 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 Iti 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. 1.6 Living Wage Requirements: If the amount of this Agreement is $22,002.43 or more, Provider is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in that chapter, to_ all employees performing Work under this Agreement and to any Subcontractor who performs 50%or more of the Work under this Agreement. Provider is also required to post the notice attached hereto as "Exhibit A" predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider 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 the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. p2. CITY'S OBLIGATIONS - �`' '� 2.1 City shall pay Provider the sum sit _ . _ • = " . = - - 'refer to Proposal) as prov-ide4-heroin as full—eempeascMtion 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$10,000.00,ten thousand dollars without 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. Page 2 of 6: Goods and Services Agreement between the City of Ashland and Pump,Pipe&Tank Services,LLC T- 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, Whetherwrittenor oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 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. ' I 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.0.13 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 defecta within a reasonable time, the City may reject the Goods and cancel this Page 3 of 6: Goods and Services Agreement between the City of Ashland and Pump,Pipe&Tank Services,LLC • 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 Provider's hourly rate sheet. • The Provider's firm price bid(s)for each individual project. 5. REMEDIES 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 orcin equity, including, but not limited to: 5.1.1 Termination of this Agreement; 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, 2022, 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: Page 4 of 6: Goods and Services Agreement between the City of Ashland and Pump,Pipe&Tank Services,LLC City of Ashland • Facilities Maintenance Department Attn: David Arnold 20 E. Main Street Ashland, Oregoti 97520. Phone: (541)552-2292 • With a copy to: City of Ashland—Legal Department 20 E.Main Street • Ashland, OR 97520 Phone: (541)488-5350 If to Provider: Pump,Pipe&Tank Services,LLC Attn:Ryan McHenry 541-535-6542 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: (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 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 enforde 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 Agreement and to seek damages and any other relief available under this Agreement, at law, or in equity. Page 5 of 6: Goods and Services Agreement between the City of Ashland and Pump,Pipe&Tank Services,LLC IN WITNESS 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 OF ASHLAND: Pump,Pipe&Tai k Services,LLC (PROVIDER): By: �-- By; re Signature Star vLy Ryan McHenry Printed Name Printed Name pUoy—kl, poets pi _ Owner Title Title • �I t1 i 2021 7/2/2021 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. • • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Pump,Pipe&Tank Services,LLC ' u p Pipe & Tank Se ices, LC CCB#197390, CA#569114: $ _.... PO Box 146 Talent, OR 97540 >.a E-mail:servicerequest@pumppipetnnk.com go CM Phone:541-535-6542 or Toll Free:1-844-450-2503 Fax:541-535-5557 June 18,2021 ATTN: David Arnold Facility Maintenance Representative 90 N.Mountain Ashland,OR 97520 David.Arnold@ashland.or.us/PH:541-552-2292 FUEL PUMP MAINTENANCE: CITY OF ASHLAND SERVICE CENTER FUEL ISLAND 90 N.MOUNTAIN,ASHLAND,OR 97520 la. Annual Inspections in accordance with the DEO/EPA requirements; Annual Line Tightness Testing-$275.00 Annual Leak Detector Testing-$85.00 Annual Overfill Equipment Testing-$50.00 Annual Release detection/Tank Monitor Equipment Testing-$50.00 lb. Yes,we do use quality parts and labor practices. 1g. Hazardous Material and Disposal Fees Vary:Used Filter Disposal Set price$3.80 per filter.Our Misc./Job/Supplies,Safety supplies/Haz. Disposal etc./Per job fee$25.00 Please see rate sheet below for Items c,d,e,f CUSTOMER RATES PPT RATES Labor hourly rate $85.00 Travel hourly rate $85.00 Overtime $127.50 Overtime Travel $127.50 Weekend Rate $170.00 Weekend Travel $0.00 Holiday Rate $255.00 Holiday Travel $0.00 Mileage $0.00 © No Mileage or Travel in the Medford/Ashland area. C:\Users\addie\Desktop\City of Ashland 2021 B1D.doc 2 • Pump Pipe&Tank Services, LLC is willing to enter into a contract to provide these services from July 1,2021 to June 30,2022 and provide Insurance Certificates for General Liability,Automobile and Workers Compensation, including the City of Ashland as additional insured. Pump Pipe&Tank Services, LLC is Licensed with the below Departments to do all required work: Oregon CCB:197390 Department of Environmental Quality: Decommissioning License:10442 Installation/Retrofit License:10441 Tank Tightness Testing License:11264 UST Service Provider License:10606 Thanky.u, Ryan McHenry Service Manager—Owner rvan@pumppipetank.com/PH:541-535-6542 C:\Users\addie\Desktop\City of Ashland 2021 BID.doc 3 900621 BBsi June 20,2021 PUMP PIPE&TANK SERVICES LLC 5446 S PACIFIC HWY PHOENIX,OR 97535-6608 Re: Barrett Business Services, Inc.("BBSI") Letter of Self-Insurance for Workers'Compensation Coverage As the named addressee of this Letter, your company's required workers' compensation coverage is provided through BBSI's state approved Self-Insured Workers' Compensation Plan by way of your co-employment contract with BBSI. Additional information is as follows: State: Oregon Workers'Compensation Limits: Employer Liability Limits: Self Insurance Certification #: 1068 Statutory $5,000,000.00 Each Accident $5,000,000.00 Disease Coverage Limit by Client $5,000,000.00 Disease; Each Employee Other Comments(place an"X"if applicable): I X I Named"Letter Holder": City of Ashland 20 E Main St Ashland, OR 97520 Other: Contract effective 5/1/2012, renewed through 4/30/2022.Subject to 30 days'notice of cancellation. Additionally, BBSI's self-insured program is further supported by an excess workers'compensation insurance policy with ACE American Insurance Co.. Copy of certificate is available upon request. For additional information,please contact your local BBSI office at: MEDFORD (541)772-5469 3512 Excel Drive Suite 107 Very truly yours, Medford,OR 97504 Gary Kramer President and Chief Executive Officer doc:LOS1-2 �� PUMPP-1 OP ID: KV1 ACORN" DATE(MMIDD/YYYY) L.—...----- 07/12/2021 OF LIABILITY INSURANCE 07/12/2021 • 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. 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 817-640-5035 Rigor Jim Beam,CIC Monroe&Monroe Insurance PHONEC817-640-5035 I FAlcnx 817-640-0131 Agency, Ltd. (N ,No,Ext): ( ,Noi: 2921 Galleria Dr., Suite 102 E-MAIL • Arlington,TX 76011 ADDR S: Jim Beam,CIC INSURERISI AFFORDING COVERAGE NAIC# INSURERA:Mid-Continent Casualty Co. 23418 INSURED TNSLJRER a:The Hanover Insurance Group 22292 Pump Pipe&Tank Services LLC Robert McHenry dba Pump Pipe& INSURER C: Tank Services Petroleum Pump Supply INSURER D; PO Box 146 INSURER E: Talent,OR 97540 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP ITR TYPE OF INSURANCE @tgn wvn POLICYNUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR x X 04GL1050340 11/15/2020 11/15/2021 PREMISES(Ea occurrencel $ 100,000 X Pollution Liab MED EXP(Any one person) 5 -0 X Professional LiabPERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY X PRO- LOC PRODUCTS-COMP/OP AGG $ 3,000,000— JECT OTHER: $ B AUTOMOBILE LIABILITY (Ea accident )SINGLE LIMIT $ 1,000,000 X ANY AUTO x x AWDA75436205 10/15/2020 10/15/2021 BODILYINJURY(Perperson) $ OWNED SCHEDULED AUTOSIONLY AUTOS BODILY INJURY(Per accident) $ i X AUT OS ONLY X NOONLYY (PeeraccIdenRAMAG E $ S A _ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE 04X$217191 11/15/2020 11/15/2021 AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N PER ER ANY YIPROPRIETOR/PARTNER/EXECUTIVE ROPRIE ORS�/PXRTNEED�CUTIVE N/A • EL.EACH ACCIDENT $ (MandatoryInNH) E.L.DISEASE-EA EMPLOYEE 5 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Equipment Floater 04CIM16823 11/15/2020 11/15/2021 Owned Equ 22,125 . DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) The General Liability and Commercial Auto policies include a blanket additional insured and waiver of subrogation endorsement which provides additional insured and waiver of subrogation status to the City of Ashland, Oregon,its officers,agents and employees only when there is a written "insured contract"as defined by the ***SEE NOTES*** • CERTIFICATE HOLDER CANCELLATION CITASHI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. Facility Maintenance Dept. 90 North Mountain Ave, AUTHORIZED REPRESENTATIVE Ashland,OR 97520 7e,,,..._ ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy No.04GL1050340 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 SCHEDULE Name of Person or Organization: Any person or organization for whom the named insured has agreed by written"insured contract"to designate as an additional insured subject to all provisions and limitations of this policy. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability caused, in whole or in part, by your performance of ongoing operations for that insured. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by written "insured contract",the insurance afforded to such additional.insured will not be broader than that which you are required by the written "insured contract"to provide for such additional insured. ML 10 81 (0413) Page 1 of 1 NOTEPAD: HOLDER CODE CITASHI PUMPP-1 PAGE 2 INSURED'S NAME Pump Pipe&Tank Services LLC OP ID: KV1 Date 07/12/2021 policy, between the named insured and the certificate holder which requires such status. The General Liability policy contains a special endorsement with "primary and noncontributory" wording. BBB! 900621 June 20;2021 PUMP PIPE&TANK SERVICES LLC 5446 S PACIFIC HWY PHOENIX, OR 97535-6608 Re: Barrett Business Services, Inc.("BBSI") Letter of Self-Insurance for Workers'Compensation Coverage As the named addressee of this Letter, your company's required workers' compensation coverage is provided through BBS1's state approved Self-Insured Workers'Compensation Plan by way of your co-employment contract with BBSI. Additional information is as follows: State: Oregon Workers'Compensation Limits: Employer Liability Limits: Self Insurance Certification#: 1068 Statutory $5,000,000.00 Each Accident • $5,000,000.00 Disease Coverage Limit by Client $5,000,000.00 Disease; Each Employee Other Comments(place an"X"if applicable): X Named"Letter Holder": City of Ashland 20 E Main St Ashland, OR 97520 n Other: Contract effective 5/1/2012, renewed through 4/30/2022.Subject to 30 days'notice of cancellation. Additionally, BBSI's.self-insured program is further supported by an excess workers'compensation insurance policy with ACE American Insurance Co.. Copy of certificate is available upon request. For additional information,please contact your local BBSI office at: MEDFORD (541)772-5469 3512 Excel Drive Suite 107 Very truly yours, Medford,OR 97504 Gary Kramer President and Chief Executive Officer doc:Los!-2 FORM#2 CITY OF • ASHLAND • INVITATION TO BID INTERMEDIATE PROCUREMENT Release date: June 14,2021 Requested by: David Arnold,Facility Maintenance Representative Tel: 541-552-2292 Fax: 541-552-2304 David.Arnold a,ashland.or.us Bids are due prior to: 2:00 PM,Monday,21 June 2021 Project name: Fuel Pump Maintenance Location: Service Center Fuel Island,90 N.Mountain,Ashland,OR 97520 Bids may be faxed,emailed or hand delivered.Contractors shall submit kid on their company letterhead. Informal email bids and/or late bids will not be accepted.Terms or discounts which are conditioned upon payment.Within a certain time will not be considered for purposes of comparison of bids.The successful contractor will be required to enter into a contract with the City for the services and provide insurance certificates in their own name for General Liability,Automobile and Workers'Compensation.Subcontracting will not be permitted. SCOPE OF SERVICES The Facility Maintenance Department is requesting proposals for Fuel System services for fuel tanks and pumps • • and firm prices for these services to be suaranteed from July 1,2021 to June 30,2022.This contract may be extended for an additional year for a maximum term of two years. Inspections as required and in accordance with the Oregon EPA UST State and Federal Requirements Repairs on an as needed basis with same day response time as requested by City of Ashland staff. Suggest Preventive Maintenance to prevent future maintenance issues. ' Please provide an official proposal on.vour company letterhead,including the following information: 1. Firm prices for the following items: a. Annual Inspections in accordance with EPA Requirements b. Use of Quality Parts and Labor Practices c. Hourly Rate for Service Calls during normal business hours d. Hourly Rate for Service Calls during after normal business hours e. Hourly Rates for Travel f. Milage Charge Per Mile g. Hazardous Material Disposal Fees 2. Written confirmation that you are willing to enter into a contract to provide these services from July 1,2021 to June 30,2022 and provide insurance certificates for general liability,automobile and Workers'Compensation,including the City of Ashland as the additional insured. Due date and time for submitting quotes is 2:00 PM;Monday 21 June 2021:Late quotes will not be considered. If you have any questions and/or need additional information,please contact David Arnold at 541-552-2292. Thank you. Method of Award:ORS 279B4O70 Intermediate Procurements.(4)!fa contract is awarded,the contracting agency shall award the contract to the offeror whose quote or proposal will best serve the interests ofdre cotittacting agency,taking into account price as well as considerations including,but not limited to,experience,expertise,product functionality,suitability for a particular pm pose and contractor responsibility under ORS 279B.110. Form#2—Intermediate Procurement,Invitation to Bid,Trade Services,Page 1 of 3,6/18/2021 3 &d Process FUE Company Contact Infrmation 14-Jun Action 15-Jun Action 16-Jun Emailed Called for Valid Carson Invitation No Response N/A N/A Point of 541 773 7311 to Bid Contact Carr Team Emailed Pump Pipe &Tank Invitation Received N/A N/A N/A 541 535 6542 to Bid Asked Addie Clarifying Question Hays Oil N/A N/A N/A N/A N/A 541 772 2053 Emailed ITB to Emailed Called for Valid Bradie N SME Solutions Invitation Undeliverable Point of Request N/A 866 205 7777 to Bid Contact Email Forward to Appropriate Quotes Department Arnie (Retired) Management FY22 Letter of Letter of Action 17-Jun Action Results Acceptance Condolences Emailed Avery M/ Requested Forward to N/A N/A No Response as N/A Unable to Send of Deadline No Point of Contact Point of Contact N/A N/A N/A Received Bid Sent 22 Jun N/A 21 Jun Left Voicemail N/A with Steven Steven Not in There N/A N/A Returned Call Field (Owner) N/A N/A N/A No Response as N/A Sent 22 Jun of Deadline Its .