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HomeMy WebLinkAbout2021-121 PO 20220116- Barry Dale ___ Lx31/41 •, r%4 1 I ,Z)7,,i y% . 1,r,i,z--$7,-,T .-','ZJ Q ..L.: _,),!:_,Iff,—..,.., 1 , ,,,,_____ .---__ ,/ -- , • \ ,,,c•,,ct 0 R Ecas.,0 \\.........._ Purchase Order Fiscal Year 2022 Page: 1 of: 1 MIME:gal_@ -:•PP.-'RIOICKL-.------------- t.,71- --A-Sifiir-~-Oa taisq g 1 it,W, I* -:=7. B Ashland Parks Commission ,I ATTN: Accounts Payable L 20 E. Main _ Purchase L 202201 16 Ashland, OR 97520 Order# T Phone: 541/552-2010 . 0 Email: payable@ashland.or.us V S H C/O Recreation Division (Grove E BARRY DALE 1 1195 East Main Street N 4318 AVENUE E p Ashland, OR 97520 WHITE CITY, OR 97503 Phone: 541/488-5340 0 R T Fax: 541/488-5314 , 0 wzi433-- Pliili-0---tro ---——-,•.„&-------------- oik i Eir-7i MI [el Na..-i-- -, _4'_-_71-:-.1a=:--&----- -_-_I-Uk-4. -atrZ,i;---- ---mi.3t,i,,...1-*---- -=---------- -- Lonny Flora .ffEE&WICEda atendo-Mah .--- --EfeEit-z5m.,_7;72--.---7Nik. ";:r1" f_--- --.---7''-- 7_,F1_-;-=-7;-;Z;.:g;-e .i-17.f-t-':ja-777: :; 08/31/2021 6355 FOB ASHLAND OR/NET30 Parks Accounts Payable Refinish The Grove Gym Floor 1 Sand, seal and refinish The Grove gym floor 1.0 $7,600.0000 $7,600.00 Goods and Services Agreement(Less than $25,000) Completion date: September 10, 2021 Project Account: $7,600.00 ***************GL SUMMARY*************** I 121200-704001 $7,600.00 I .-*-i-------;1---,,___Z-1-11—„,-----.-...,-- -------------- -,:--t--- ---- --.7,-;--_, -... -1 1_,--/....--(4 i By:, telesr ./ Date: Au rize ignature -:-__.1K -M-_-_iii---.!--,---,------ ___ $7,600.00 . • FORM #3 ' �—, C11TIY tIDF orfi y LA 4�=,'.%j11.•f:F,i toy a a'�I.11�;dlei`ia; REQUISITION ,. 7 �. /( (7Date of request: 07/15/2021. Required date for delivery: 08123/2021 Vendor Name Barry Dale Contracting Address,City,State,Zip 4318 Avenue E,White City,OR 97503 Contact Name&Telephone Number Barry Dale 541-890-0974. Email address bkdale64@gmail.com SOURCING METHOD ❑ Exempt from Competitive Bidding 0 Invitation to Bid 0 Emergency ❑ Reason for exemption: Date approved by Council: ❑ Form#13,Written findings and Authorization ❑ AMC 2.50 _(Attach copy of council communication) .❑ Written quote or proposal attached ❑ Written quote or proposal attached (If council approval required,attach copy of CC) ❑ Small Procurement 0 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# • ❑ VerballWritten bid(s)or proposals) ❑ .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 0 Sole Source Agency 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 [■J (3)Written bids&solicitation attached , ❑ Form#4,Personal Services$51(to$75K Agency 'PERSONAL SERVICES Date approved by Council: ❑ Annual cost to City does not exceed$25,000,. Greater than$5,000 and less than$75,000 Valid until: _ (Date) Agreement approved by Legal and:approved/signed by ❑ Less than$35,000,by direct appointment 0 Special Procurement City Administrator.AMC 2.50.070(4) • (3)Written proposals&.solicitation attached ❑ Form#9;Request for Approval ❑ Annual cost to City exceeds$25,000,Council ▪ Form#4,Personal Services$5K to$75K ❑ Written quote or proposal attached approval required.(Attachcopy of council communication) Dateapproved by Council:_ Valid until: . (Date) Description of SERVICES Total Cost Sanding,sealing,and refinish of The Grove gym floor 7:600` Item# Quantity Unit Description of MATERIALS , Unit Price Total Cost O Per attached quote/proposal TOTAL'COST Project Number • Account Number 1 2 1 2 0 0.7 0 4 0 0 1 7 ' 00 • • Account Number - Account Number • *Expenditure must be charged to the appropriate account numbers for the financials toaccurately reflect the actual expenditures. 17'Director in collaboration with department to approve all hardware and software purchases: 1T Director Date Support-Yes/No By signing this requisition form,t ce ' that the City's public contracting requirements have been saiistiie . ., Employee:__ Department Head: (Equal to or greater than$5,000) Department,Manager/Supervisor: City Manager: (Equal to or greater than$2„$,907 Funds appropriated for current fiscal year: , YES / NO ✓��. JI 9/ J/ Fina a Director-(Equal to or greater than$5,000) Date Comments: - Form#3-Requisition ASHLAND PARKS & RECREATION COMMISSION 340 S PIONEER STREET • ASHLAND,OREGON 97520 COMMISSIONERS: S ff� Michael A.Black,AICP • Mike Gardiner % ,' y Director Rick Landt • Julian Bell z,. Leslie Eldridge ass$rrEcO" Jim Lewis 541.488.5340 AshlandParksandRec.org parksinfo@ashland.or.us STAFF MEMORANDUM TO: City of Ashland Legal Department Michael Black, Ashland Parks and Recreation Director FROM: Lonny Flora, Recreation Manager DATE: 7/15/2021 SUBJECT: The Grove Gym Floor Refinishing Bids Ashland Parks and Recreation Staff has investigated potential providers and received quotes for refinishing The Grove gym floor. Staff has selected Barry Dale Contracting to complete the project with the low bid of$7,600. Other bids came from Phenom Flooring for$8,000 and Magnum Construction and Flooring for $12,600. GOODS AND SERVICES AGREEMENT(LESS THAN$25,000) PROVIDER: Barry Dale Contracting CITY OF PROVIDER'S CONTACT: Barry Dale ASH LAN 20 East Main Street ADDRESS: 4318 Avenue E,White City,OR 97503 Ashland, Oregon 97520 Telephone: 541/488-5587 PHONE; 541-890-0974 Fax: 541/488-6006 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter"City") and Barry Dale Contracting, (a domestic/foreign business corporation) ("hereinafter"Provider"),for refinish of existing maple flooring in The Grove Gym. 1. PROVIDER'S OBLIGATIONS 1.1 Provide sanding down existing floor finish, one coat sealant, and three coats of floor finish 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 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 • • Provider shall supply an endorsement naming the City,its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and Page I of 5: Goods and Services Agreement between the City of Ashland and Barry Dale Contracting • t ® 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 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. 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. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of$7,600 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$7,600 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. Page 2 of 5: Goods and Services Agreement between the City of Ashland and Barry Dale Contracting -- r 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 completeunderstanding 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. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 2798.220,279B.230 and 27913.235, 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. Page 3 of 5: Goods and Services Agreement between the City of Ashland and Barry Dale Contracting I 1 I f is 1 4. SUPPORTING DOCUMENTS i t 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are t collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:" 1 6 Ashland Parks and Recreation Request for Proposal Memorandum date July 15,2021. o The Provider's complete written quote dated June 8,2021. 6 i 4.2 This Agreement and the. SUPPORTING DOCUMENTS shall be construed to be mutually i complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved, the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In. the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. I 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 a. 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; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled s 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 G any remedy or remedies singly, collectively,successively or in any order whatsoever. , L 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 ii immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION r 6.1 Term jr This Agreement shall be effective from the date of execution on behalf of the City as set forth below 9 (the"Effective Date"),and shall continue in full force and effect until September 10,2021,unless sooner I terminated as provided in Subsection 6.2. I 6:2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. i 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. 11 Such termination is in addition to and not in lieu of any other remedy at law or equity. a 7. NOTICEvj Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in I 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 n address set forth below: n q I Page 4 of 5: Goods and Services Agreement between the City of Ashland and Barry Date Contracting 1 i 1 i • Y If to the City: Ashland Parks and Recreation Cotnmision Attn: Lonny Flora i 1195 E. Main Street Ashland, Oregon 97520 Phone: (541)552-2250 I , i 1 With a copy to: • City of Ashland—Legal Department 20 E. Main Street y Ashland, OR 97520 Phone: (541)488-5350 If to Provider: + Barry Dale Contracting 4318 Avenue E White City,OR 97503 3 541-890-0974 t y 8. WAIVER OF BREACH 1 One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, is or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether 4 or not of the same nature. 3 v 9. PROVIDER'S COMPLIANCE WITH TAX LAWS ' 9.1 Provider represents and warrants to the City that: 1 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: ., - # (1) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 3.18; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and i (iii) Any rules,regulations,charter provisions, or ordinances that implement or enforce any ofli the foregoing tax laws or provisions. f 9.1.2 Provider,for a period of no fewer than six(6) calendar years preceding the Effective Date of this ti Agreement, has faithfully complied with: (1) 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 r g Provider; and (iii) Any rules,regulations, charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 1 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any r political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, 1 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 5: Goods and Services Agreement between the City of Ashland and Barry Dale Contracting S 6 F .I 1 ' IN WITNESSWHEREOF 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: Barry D. Contracting I" I ER): By: Z .*-r By. ' Signature S'_nature 11 (t/a A . Meal, rci .JQl Printed Name Printed Name 4 wn-er Title Title Date - Date (W-9 is to be submitted with this signed Agreement), • Purchase Order No. (/to • Page 6 of 5: Goods and Services Agreement between the City of Ashland and harry pale Contracting ACO I CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 8/1.0/2021 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(ies)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 lieu of such endorsement(s). PRODUCER CONTACT NAME: INSURANCE MARKETPLACE PHONE FAX (NC.No.Ext): (AIC.No): PO BOX 278 E-MAIL ADDRESS: MEDFORD,OR 975010019 - INSURER(S)AFFORDING COVERAGE NAIC S (541)779-0177 INSURER A: Contractors Bonding and Insurance Company 37206 INSURED INSURER B: BARRY KEITH DALE INSURER C: BARRY KEITH DALE DBA: INSURER D: 4318 AVE E INSURER E: WHITE CITY,OR 97593 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 TYPE OF INSURANCE ADDL NSD SUBR WVD POLICY NUMBER (MM/DDIYYYY) (MMIIO POLICY YY) LIMITS A X COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR D11PJ69502/13/2021 2/13/2022. DAMAGE TO RENTED PREMISES(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 5,000 Y PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY jECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached.If more space Is required) CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER FORM CBGL0051 ATTACHED. Products and completed operations coverage is included according to the terms of the policy and subject to applicable policy exclusions. CERTIFICATE HOLDER CANCELLATION ASHLAND PARKS&REC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1195 E MAIN ST ASHLAND,OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE . Name of Person or Organization: ASHLAND PARKS & REC 1195 E MAIN ST ASHLAND, -OR 97520 ,(If no entry appears above, information required to complete this endorsement will be shown in the Decla- rations or Supplemental Schedule as applicable to this endorsement.) A. 'Section II —Who Is An Insured is amended to include as an additional insured the person(s) or or- ganization(s) shown in the Schedule. Such person or organization is an additional_insured only with respect to liability for"bodily injury", "property damage" or"personal and advertising injury"caused by your negligence in the performance of your ongoing operations performed for that additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage", or"personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, in- cluding but not limited to: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings,opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection,architectural or engineering activities. 2. "Bodily injury"or"property damage"occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or b. That portion of"your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. . 3. "Bodily injury"or"property damage"occurring or commencing before: a. Execution of the written contract or agreement that such person or organization be added as an additional insured on your policy. CBGL 00 51 06 06 Contains Copyrighted Material of Page 1 of 1 ISO Properties, Inc.,with permission ' '''''''' ,„„,, a „.„„‘„„„,,,,,„:„,„„„„,„„,,,„a„„,,„,,,,, ,„,,,,„,t,„,„,„,,,,,,,,,;,,,,,e,,,,,, � ��3 owepiTsii�� , ,. xr `s«s�r s e- a �43�a8,AuenueE zd ''*,,', ff s'a'c a 'z a t'aa.. ..,...„,,,„0„.„,„,,.,,,„„„.., ,,,,,,,,, , „,„„„„:„:„,,,,,,„,-- :„, ..,,,,,,,,,,„,,,„„:„.„.,,,. ,,,:,.„,,,,,:,,:„,„,,:,„„,,,„,„„„,„,,.,,,,,,„,,,u,,„,,..„,„„,,„„,,,„.,„,:,,„,„ „. §ice d 7fi egi White Cltyr. f)f 97$O3 A e sa'�° ..�a,l"� - s :Phoney' Y_lr'Q �_.O9 h ,7 gx a 9.''fi �. .�'� .. JOB QUOTE • Name: Ashland Parks and Red Ref: Lonny Flora The Grove Address: 1195 E. Main Main._. , OR. 97520zi : AshandCity/state/ Date: June 8,2021 • QUANITY DESCRIPTION UNIT AMOUNT PRICE iki‘likifilL...,1;ii,it 2000>S ' Refinxsb e ist�ng w5IIPIIIImaple flooring In gym! 'G k , /� k . � � Fmish w/one coat Boana classic seal and three'coats o im f , ,I 5 Bona Traffic HD commerce l floor finish logy vbC� i�iF $ 7,600x00\&,fr 30. \ `k\ dap FIIIMIIIIIIIIIIIII' \ \ �\�\ vii \\a �”F. 6 'megE. .. tl�' .kE _\ Yom. `� � �` e<��- .,� t „m 1 ire- -Ar.L. r, 0 ., '4 I'.4 1m, f,' '' {� a .ted 4 4' '"fit` '. °= fir"' 111".- .. ,:., ,,-, t,,,,a ', v v CONSTRUCTION AND FL.CRI:NG INC. Ryan Morse 863 S. Haskell St. Central Point,OR 97502 magnumco541@gmail.com 541-261-0643 Licensed, Bonded and Insured CCB#173857 Lonny Flora . The Grove Recreation Center 1195 E. Main St. Ashland, OR 97520 541—324—1473 lonny.flora@ashland.or.us Estimate (7-5-21) Sand down the existing maple flooring in the Gym Buff and Finish with 3 coats of Satin Bona Traffic Finish *Need a 30 amp 220 plug installed prior to refinishing for the sander Total Estimate: $ 12,600 J 7/15/2021 Mails Lonny Flora-Outlook Floor sanding Bid Scott Koivunen <scott.koivunen@gmail.com> Tue 6/29/2021 3:39 PM To: Lonny Flora <lonny.flora@ashland.or.us> [EXTERNAL SENDER] Lonny... Please accept this as my bid for your Ashland Parks and Rec floor. Full sanding (to bare wood)of aerobic room floor using Bona water base DTS seal and Bona Supersport HD finish. 2 coats of seal and two coats of finish. The floor is approximately 2000 sq ft. My price is$8,000. My availability is not open until this Fall. Thank you for the opportunity to bid this project. Scott Koivunen PHENOM FLOORING Mobile - 503-784-8998 phenomflooring.com https://outlook.office365.com/mail/id/AAQkAGFiZmUONGMwLWQyZmQtNDM3ZC1 hNGQ3LTZhYzQwODNiZTA2MwAQAK%2BuRr9p4oFHh33%2888... 1/1 • Kariann Olson From: Lonny Flora Sent Wednesday,August 25,2021 1:41 PM To: Kariann Olson Cc: Rachel Dials Subject: Re:Barry Dale PO Attachments: Magnum Gym Refinish.doc;Phenom Flooring Bid.pdf;thegrove quote updated.doc I will work on the auto insurance and have him send the exemption form ASAP. I had contacted the various contractors by phone using info from other school gyms and dance floors in the area. Once I had contacted them they scheduled a time to visit and provide a quote. Lonny Flora, CPRP Recreation Manager,Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Kariann Olson<kari.olson@ashland.or.us> • Sent:Wednesday,August 25, 2021 1:26 PM To: Lonny Flora <lonny.flora@ashland.or.us> Cc: Kariann Olson<kari.olson@ashland.or.us> Subject: RE: Barry Dale PO • Can you forward the written quotes to me. • Also, please forward the docs referenced as supporting documents in the contract. (copy of rfp and written quote submitted by successful contractor) These docs referenced in the contract always need to accompany the contract. • I don't see Auto insurance or Workers'Comp. If he is doing the work himself and doesn't have employees, he can fill out the attached exemption form. Thank you. Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olson@ashland.or.us Visit the City's web site at: www.ashland.or.us 1 r r. This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for • disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora <lonny.flora@ashland.or.us> Sent:Wednesday,August 25, 2021 12:44 PM To: Kariann Olson<kari.olson@ashland.or.us> Subject: Re: Barry Dale PO Ok I got the signed copies back finally for this P0. Hopefully everything is in order and please let me know if you need anything else. Thanks! Lonny Flora, CPRP Recreation Manager, Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473, TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Kariann Olson<kari.olson@ashland.or.us> Sent: Friday,August 20,.20219:50 AM To: Lonny Flora <Ionny.flora@ashland.or.us> Subject: RE: Barry Dale PO Okay. . .I will keep a look out for it. . .thank you. Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 ' kari.olsonOashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora<lonnv.flora@ashland.or.us> Sent: Friday,August 20, 2021 9:44 AM To: Kariann Olson<kari.olson@ashland.or.us> Subject: Re: Barry Dale PO Ok. I was told Michael had signed off on it. It is for the Grove Gym floor refinishing. I'll check to see when and how forms were sent. 2 Lonny FlOra, CPRP Recreation Manager, Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY- 800-735-2900 FAX- 541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Kariann Olson<kari.olson@ashland.or.us> Sent: Friday,August 20, 2021 9:40 AM To: Lonny Flora<lonny.flora@ashland.or.us> Subject: RE: Barry Dale PO Hello Lonny, Happy Friday I have not seen anything for Barry Dale. . .??? Please advise. Thank you. Kariann Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olsonOashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora<lonny.flora@ashland.or.us> Sent: Friday,August 20, 2021 9:35 AM To: Kariann Olson<kari.olson@ashland.or.us> Subject: Barry Dale PO Hi Kari, I hope you are doing well. I just wanted to check and see if you had received everything you need for Barry Dale PO for gym floor refinishing? I know you are busy. Lonny Flora, CPRP Recreation Manager,Ashland Parks and Recreation 3 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City,of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. • 4 Kariann Olson From: Lonny Flora Sent Tuesday,August 31,2021 11:55 AM To: Kariann Olson Subject: Barry Dale Auto Insurance c Attachments: Farmers ID card 188878875.pdf Here is info for—Barry Dale's auto insurance Lonny Flora, CPRP Recreation Manager,Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and'retention. If you have received this message in error please contact me at (541) 552-2250. From: Barry Dale<bkdale64@gmail.com> Sent:Tuesday,August 31,2021 11:53 AM To: Lonny Flora<lonny.flora@ashland.or.us> Subject: [EXTERNAL SENDER] 1 — CERTIFICATION OF EXEMPTION FROM " {'WORKERS' COMPENSATION INSURANCE REQUIREMENTS . Contractor is ex:empt:from.the requirement to obtain workers.compensation insurance pursuant to ORS Chapter 656 for the following season: Contractor is to initial the appropriate box as follows: xn.. (aik- . SOLE PROPRIETOR L'' iittals); " • Contractor`is a sole proprietor,and • Coitractor:has no-employees,and - • ■ Contractor will not hire employees or subcontractors to perform this.contract. CORPORATION—FOR PROFITr - (Initials) '■ -Contractors business;is:incorporated;and , • All employees of the corporation:are officers and directors and haven substantial ownershipinterest*in the corporation,.and. • All work will be performed.by the officers and directors;;Contractor willnot hire other employees or subcontractors to perform this'contract. . CORPORATION-NONPROFIT- (Initials) • 'Contractor's business is incorporated:as ;a:nonprofit'corporation,and • Contractor has no employees;"all"work� .is performed by volunteers,and Contractor will not hire employees or•subcontr• ctors to perform this,contract. . PARTNERSHIP (Initials) • Contractoris a partnership,anal . 1 Contractor has no employees,and . • All,work will be;performed by the partners,Contractor will not hire employees or subcontractors:to'perform;this • contract,and , '■ Contractor is not.engaged`in work performed in direct connection with the,construction,alteration,repair, .improvement,moving or demolition of:an improvement to real property or appurtenances thereto,:**":.' LIMITED LIABILITY COMPANY (Initials) • Contractor is a limited:liability iconipany,and. - ■ Contractor has no"employees,and ■ All work will be performed by the members;Contractor will not hireemployees.or subcontractors to perform this contract,and: • If Contractor has,more than one member,Cgntractor isnot engaged in-work;performed in direct connection with the • construction,alteration,repai 'improvement,movirig°or demolition of an improvement`to realpiopertyor, appurtenances thereto:** ,: 40P . (Signa re of Authorize• .ig r r) (Date) • (Authorized S ner's Titl *NOTE: Under OAR436-50-050 aahareholder has a"substantial ownership"interest if theshareholder owns 10%of the corporation,or if less than 10%is owned,the shareholder has ownership that is at least equal to or greater than.the average percentage of ownership of all shareholders. **NOTE: Under certain circumstances partnerships and limited liability companies can claiman exemption even when performing, construction work. The requirements forthis"exemption.are complicated. Consult with City Attorney's Office before an exemption request is accepted from a contractor who Will perform construction work. Certificate of Liability Insurance FARMERt' State of Oregon INSURANCE Named Insured(s): Barry K Dale Policy Number:188878875 Cheryl Dale, Effective:7/12/2021 Vehicle: 2019 Toyota Rav4 4D 4Wd Xle Expiration: 1/12/2022 VIN: JTMP1 RFV1 KD518004 KEEP WITH VEHICLE Registered Owner(s):Toyota Lease Trust NAIC Number:21636 Your Agent:Megan McPherson 1112 Progress Dr#103 Medford,OR 97504 Agent Phone:(541)776-0673 Underwriting Company: • Farmers Insurance Company of Oregon 6600 SW Hampton Street Tigard,OR 97223 Phone:1-888-327-6335 KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES. Contact Farmers Claim Department or Roadside Assistance 24 hours a day at (800)435-7764 Para Espanol,(lame al(877)732-5266 Report a claim at www.farmers.com,via the Farmers®Mobile App or Contact your Farmers Agent At the scene of an accident: 1.Obtain the following: --Name,address,and phone number of each driver,passenger,and witness.Obtain a driver's license number for each driver. --License plate number,insurance company,and policy number of each involved vehicle. --Photos of vehicle damage and accident scene. 2.Report the accident to the proper authorities. 3.Do not admit fault.An investigation may later reveal you were not responsible for the accident. i 25-9017 8-19 • Certificate of Liability Insurance '' FA R M E R S State of Oregon w INSURANCE Named Insured(s): Barry K Dale Policy Number:188878875 Cheryl Dale Effective:7/12/2021 Expiration:1/12/2022 Vehicle: 2005 Gmc Truck Sierra 2500 Cr Pu 4X4 VIN: 1 GTHK232X5F856769 KEEP WITH VEHICLE Registered Owner(s): Barry K Dale NAIC Number:21636 Your Agent:Megan McPherson 1112 Progress Dr#103 Medford,OR 97504 Agent Phone:(541)776-0673 Underwriting Company: Farmers Insurance Company of Oregon 6600 SW Hampton Street Tigard,OR 97223 Phone:1-888-327-6335 KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES. Contact Farmers Claim Department or Roadside Assistance 24 hours a day at (800)435-7764 Para Espanol,(lame al(877)732-5266 Report a claim at www.farmers.com,via the Farmers®Mobile App or Contact your Farmers Agent At the scene of an accident: 1.Obtain the following: --Name,address,and phone number of each driver,passenger,and witness.Obtain a driver's license number for each driver. --License plate number,insurance company,and policy number of each involved vehicle. --Photos of vehicle damage and accident scene. 2.Report the accident to the proper authorities. 3.Do not admit fault.An investigation may later reveal you were not responsible for the accident. 25-9017 8-19 • • J , • Kariann Olson From: Lonny Flora Sent: Tuesday,August 31,2021 12:00 PM To: Kariann Olson Subject: Re:Barry Dale Auto Insurance Yes,exemption form should be coming shortly. I guess he had e-mailed these earlier but never came through to me. He is doing the work by himself. Lonny Flora, CPRP Recreation Manager, Ashland Parks and Recreation 1195 E:Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX- 541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Kariann Olson<kari.olson@ashland.or.us> Sent:Tuesday,August 31,2021 11:58 AM To: Lonny Flora<lonny.flora@ashland.or.us> Cc: Kariann Olson<kari.olson@ashland.or.us> Subject: RE: Barry Dale Auto Insurance What about Workers' Comp? Is he doing the work himself without any employees? If yes, he can fill out that exemption form. If he has employees and no Workers'Comp,that is a problem. Thank you. Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olson@ashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland,and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora <lonny.flora@ashland.or.us> Sent:Tuesday,August 31,2021 11:55 AM To: Kariann Olson<kari.olson@ashland.or.us> Subject: Barry Dale Auto Insurance 1 Here is info for Barry Dale's auto insurance • • Lonny Flora, CPRP Recreation Manager,Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX- 541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Barry Dale<bkdale64@gmail.com> Sent:Tuesday,August 31,2021 11:53 AM - To: Lonny Flora <Ionny.flora@ashland.or.us> Subject: [EXTERNAL SENDER] • 2 Kariann Olson From: Kariann Olson Sent: Wednesday,August 25,2021 1:27 PM To: Lonny Flora Cc: Kariann Olson Subject: RE:Barry Dale PO - Attachments: Certification of EXEMPTION from WORKERS COMP.docx • Can you forward the written quotes to me. • Also, please forward the docs referenced as supporting documents in the contract. (copy of rfp and written quote submitted by successful contractor) These docs referenced in the contract always need to accompany the contract. • I don't see Auto insurance or Workers'Comp. If he is doing the work himself and doesn't have employees, he can fill out theattached exemption form. Thank you. Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olson@ashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora<Ionny.flora@ashland.or.us> Sent:Wednesday,August 25,2021 12:44 PM To: Kariann Olson<kari.olson@ashland.or.us> Subject: Re: Barry Dale PO Ok I got the signed copies back finally for this PO. Hopefully everything is in order and please let me know if you need anything else. Thanks! Lonny Flora, CPRP Recreation Manager, Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. 1 From: Kariann Olson<kari.olson@ashland.or.us> Sent: Friday,August 20, 2021 9:50 AM To: Lonny Flora<lonny.flora@ashland.or.us> Subject: RE: Barry Dale PO Okay. . .I will keep a lookout for it. . .thank you. Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olson@ashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora<lonnv.flora@ashland.or.us> Sent: Friday,August 20, 2021 9:44 AM To: Kariann Olson<kari.olsont ashland.or.us> Subject: Re: Barry Dale PO Ok. I was told Michael had signed off on it. It is for the Grove Gym floor refinishing. I'll check to see when and how forms were sent. Lonny Flora, CPRP Recreation Manager, Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473, TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Kariann Olson<kari.olson@ashland.or.us> Sent: Friday,August 20, 2021 9:40 AM To: Lonny Flora <lonnv.flora@ashland.or.us> Subject: RE: Barry Dale PO Hello Lonny, Happy Friday I have not seen anything for Barry Dale. . .??? Please advise. Thank you. .2 Kariann' Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olsonOashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland,and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora<Ionnv.floraPashland.or.us> Sent: Friday,August 20, 2021 9:35 AM • To: Kariann Olson<kari.olson@ashland.or.us> Subject: Barry Dale PO Hi Kari, I hope you are doing well. I just wanted to check and see if you had received everything you need for Barry Dale PO for gym floor refinishing? I know you are busy. Lonny Flora, CPRP Recreation Manager,Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY- 800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. 3 Kariann Olson From: Lonny Flora Sent: Tuesday,August 31,2021 2:51 PM To: Kariann Olson Subject: Re:Barry Dale Auto Insurance Attachments: B_Dale_WorkerCompWaiver.pdf Here is the waiver. Thanks. Lonny Flora, CPRP Recreation Manager, Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Kariann Olson<kari.olson@ashland.or.us> Sent:Tuesday,August 31, 2021 11:58 AM To: Lonny Flora<lonny.flora@ashland.or.us> Cc: Kariann Olson<kari.olson@ashland.or.us> Subject: RE: Barry Dale Auto Insurance What about Workers' Comp? Is he doing the work himself without any employees? If yes, he can fill out that exemption form. If he has employees and no Workers'Comp,that is a problem. Thank you. Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olson@ashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From: Lonny Flora<lonny.flora@ashland.or.us> Sent:Tuesday,August 31,2021 11:55 AM To: Kariann Olson<kari.olson@ashland.or.us> Subject: Barry Dale Auto Insurance 1 Here is info for Barry Dale's auto insurance • Lonny Flora, CPRP Recreation Manager, Ashland Parks and Recreation 1195 E. Main St., Ashland , Oregon 97520 Desk: 541-552-2250 Cell: 541-324-1473,TTY-800-735-2900 FAX-541-488-5314 This email transmission is official business of the City of Ashland and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error please contact me at (541) 552-2250. From: Barry Dale<bkdale64@gmail.com> Sent:Tuesday,August 31,2021 11:53 AM To: Lonny Flora<lonny.fiora@ashland.or.us> Subject: [EXTERNAL SENDER] 2