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HomeMy WebLinkAbout2020-084 PO 20200349- S&S Sheetmetal, Inc. Purchase Order prA V/1111 C g y.a :CORDERFiscal Year 2020 Page: 1 of: 1 +dal 0 411 WEI,E.re- B City of Ashland ATTN: Accounts Payable Purchase Ashlanda�OR.97520 Order# 20200349 T Phone: 541%552-2010 0 Email: payable@ashland.or.us • V H C/O Facilities Maintenance Div E S &S SHEETMETAL, INC I 90 North Mountain Ave N 912 ANTELOP ROAD p Ashland, OR 97520 O WHITE CITY, OR 97503 Phone: 541/488-5358 TT Fax: 541/552-2304 = _€[.[_] t ale] -61 B.1 -,el]p[ [e' las mow. _ David Arnold rrs..� _.�[@=j�=l�r.�r.�►csr �3' 61 L`L Y AF= -.o-.r.aw 2f := -1E IN W eie— -��,�... .. �i. � _- 02/27/2020 390 FOB ASHLAND OR City Accounts Payable i e5;;=3 ___ 3�.,1.:.a=i�:;f�9 - E5i[;1' a_eMilatrESkt - - - Replace WWTP PTAC Unit 1 Replacement of existing WWTP PTAC unit with failed 1 $2,305.0000 $2,305.00 compressor. Goods&Services Agreement Completion date: June 30, 2020 Project Account: ***************GL SUMMARY*************** 082400-602400 $2,305.00 • • By:6� Date: , • Authorized Signature $2 305.00 — — FORM #3 �� � � � CITY OF A MCI 11 or a r» 'i'<Cn a ? t, ,fit ri' ASHLAND 41 REQUISITION �� azD O cF D te.of request: 2/14/20 Required date for delivery:q ry • Vendor Name ) S&S Sheetmetal,Inc. Address,City,State,Zip 912 Antelope Road,White City,OR 97503 Contact Name&Telephone Number Mike Shipley I Christie Salazar 541-210-2946 Email address 'SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: 0 Invitation to Bid ❑ Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: _ - - ❑ 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: ❑ State of Oregon ® Direct Award _(Attach copy of council communication) Contract# ❑ Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works). 0. State of Washington Date approved by Council: - Contract# (Attach copy;oficouncil communication) ❑ Other government agency contract Intermediate Procurement D 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 ❑ (3)Written quotes and solicitation attached ❑ Form#4,Personal Services>$5K&<$75K Agency PERSONAL SERVICES ❑ Special Procurement ❑ Annual cost to City does not exceed$25,000. Greater than$5,000 and Cess than$75,000 ❑ Form#9,Request for Approval Agreement approved;by Legal and approved/signed by O 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: 0 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 • f .. Replacement of existing WWTP PTAC unit with failed compressor $2,305:00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost • Per attached quotelproposal TOT%AL'COST Project Number _ _ Account Number 082400-602400 *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 req ;ion form,I certify that the. ' 's public contracting requirements have been satisfied. Employee: � � I Department Head: /to/A)Zv (Equal to or greater than$5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater than$25,000) Funds appropriated for current fiscal year: YES / NO Deputy Finance Director-(Equal to or greater than$5,000) Date • Comments: Form#3-Requisition • r, David. Al nod gAcklait6( 6V US . GOODS & SERVICES AGREEMENT PROVIDER: S&S Sheetmetal, Inc. CITY OF PROVIDER'S AS H LAN D CONTACT: Dave McIntyre 20 East Main Street Ashland,Oregon 97520 ADDRESS: 912 Antelope Road Telephone: 541/488-5587 White City, OR 97503 Fax: 541/488-6006 PHONE: 541-826-6661 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and S&S Sheetmetal, a domestic business corporation("hereinafter"Provider"), for replacing PTAC unit. 1. PROVIDER'S OBLIGATIONS 1.1 Provide replacement of existing WWTP PTAC unit with failed compressor 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 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 • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 5: Agreement between the City of Ashland and S&S Sheetmetal,Inc. • 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 $21,507.75 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. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of$2,305.00 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$2,305.00 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. 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. Page 2 of 5: Agreement between the City of Ashland and S&S Sheetmetal,Inc. 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. 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 complete written Quotation dated 2/5/2020 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 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 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, 2020, unless sooner terminated as provided in Subsection 6.2. Page 3 of 5: Agreement between the City of Ashland and S&S Sheetmetal,Inc. 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—Facilities Maintenance Department Attn: David Arnold 90 North Mountain Avenue Ashland, Oregon 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: S&S Sheetmetal Attn:Dave McIntyre 912 Antelope Road White City, OR 97503 541-826-6661 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. Page 4 of 5: Agreement between the City of Ashland and S&S Sheetmetal,Inc. 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 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 Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. 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: I!(PROVIDER): Y: By:/ /�c B r Signature Signa rey� Printed Name Printed Name P141 2EGTe�___ Seied)Lc /1/ fie Title Title 20 ceir,g zv Z — 1 I- 2-4?2.47 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. ,1--" I"' ; ` --1617� Page 5 of 5: Agreement between the City of Ashland and S&S Sheetmetal,Inc. • QQco,\SE fNF'ro QUOTATION \. F�� Cl HEATING & Quote Number: 693 7-- 7A1 kg kr° m S AIR-COND Quote Date 02/05/2020 FS SHEETMETAL, INC. T. 1gg Quoted To: _ Our Mission CITY OF ASHLAND-MAIN ST. We are committed to raise the bar and make our team the standard NA others are judge by in commitment of unsurpassed service, ASHLAND 97520 craftmanship,loyalty,and Customer ID C002 _ _ Description Amount L Ashland Water Treatment Plant We propose to replace existing PTAC unit that has a failed compressor. Provide and install a new Amana PTAC into existing wall sleeve. Includes proper disposal of existing unit. TOTAL PRICE: $2305.00 QUOTED BY: Dave McIntyre Title:Service Manager Email:dave.mcintyre@sandsheating.com APPROVED BY: "In the event customer fails to pay the invoice amount,when die,Interest shall accrue on Subtotal 0.00 the unpaid balance from the due date of the invoice at a rate of 2% per month (24% Sales Tax 0.00 annum).If S&S Sheetmetal, Inc is required to seek collection of the amount due by legal process, customer shall be responsible to pay 5 &5 Sheetmetal, Inc. IN addition to the TOTAL 0.00 invoice amount the interest,all attorney fees and cost incurred by 5&S Sheetmetal,Inc 912 Antelope Rd.,White City,OR 97503 • S&SSHEE-01 CBETTIN ACORU' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY) 2/13/2020 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 Carol Bettin NAME: Anchor Insurance&Surety,Inc. PHONE FAX 1201 SW 12th Ave.Suite 500 (AIC,No,Ext):(503)224-2500 I(Alc,No):(503)224-9830 Portland,OR 97205 • E-MAIL cbettin@anchorias.com • INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:SAIF Corporation 36196 INSURED - INSURER B: S&S Sheetmetal Inc. INSURER C: • 912 Antelope Road INSURER D: - White City,OR 97503 INSURER E: 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 SUBR -POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYY) IMMIDDIYYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ • MED EXP(Any one person) $ PERSONAL ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: • GENERAL AGGREGATE $ POLICY JECOT- • LOC PRODUCTS-COMP/OP AGG_ $ OTHER: � $ AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ • _ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY NON-OWNEDS NLY (Per accident)DAMAGE • $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ • DED RETENTION$ $ A WORKERS COMPENSATION x AND EMPLOYERS'LIABILITY STATUTE EERH ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N 811929 - 10/1/2019 10/1/2020 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 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) Goods&Services Agreement-Provide HVAC as needed for FY20 • • • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Ashland - THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. Fleet Services/Facilities Maintenance 90 North Mountain Avenue Ashland,OR 97520 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - • www.saif.com • if saih: . Carrier no: 20001 Endorsement no: WC000313 SAIF policy: 811.929 S&S Sheetmetal, Inc. •. Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule' Description: ALL OPERATIONS Contractor name: Persons and/or organizations with whom the insured-employer is required by written contract to waive subrogation rights. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. • Effective date: October 01, 2019 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned September 30, 2019 at Salem, Oregon Kerry Barnett President and Chief Executive Officer • _ I 400 High Street SE • Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol PC1 E4300/ ' ACOREP DATE(MM/DDIYYYY) `....--- CERTIFICATE OF LIABILITY INSURANCE 03/21/2019 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 lieu of such endorsement(s). PRODUCER CONAME CT CLIENT CONTACT CENTER — FEDERATED MUTUAL INSURANCE COMPANY PHONE HOME OFFICE:P.O.BOX 328 (A/C,No,Ext):888-333-4949 FAX C, No):507-446-4664 OWATONNA,MN 55060 AIL ADDRESS:CLIENTCONTACTCENTERta1FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 343-547-6 INSURER B: S&S SHEETMETAL INC INSURER C: 912 ANTELOPE RD WHITE CITY,OR 97503-1607 INSURER D: INSURER E: INSURER F: I COVERAGES CERTIFICATE NUMBER:245 REVISION NUMBER:0 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. TR TYPE OF INSURANCE ADDLSSUBR POUCY NUMBER (MM/DDIYYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL UABILITY - EACH OCCURRENCE $1,000,000 CLAIMS-MADE (X I OCCUR PREMISES(Ea RENTED $100,000$100,000 MED EXP(My one person) EXCLUDED A N N 9910853 04/24/2019 04/24/2020 PERSONAL&ADV INJURY $1,000,000 OEN'L AGGREGATE LIMIT ^LOC APPLIES PER: GENERAL AGGREGATE $2,000,000 I POLICY T n PRO- I RI PRODUCTS-COMP/OP ACG $2,000,000 X JEC OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 (Ea acdder d X ANY AUTO BODILY INJURY(Per person) A OWNED AUTOS ONLY _AUT SULED N N 9910853 04/24/2019 04/24/2020 BODILY INJURY(Per accident HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE _AUTOS ONLY (Per accident).. X UMBRELLA LIAB X OCCUR f ~—""^-Y-OCCURRENCE $2,000,000 A EXCESS LIAB CLAIMS-MADE N N 9910854 04/24/2019 ---''- � $2,000,000 DED I I RETENTION ( ""', WORKERS COMPENSATION ,... /' f AND EMPLOYERS'LIABILITY Y/N r ANY PROPRIETORIPARTNERIEXECUTIVE n /1,e (/2 /(Mand toryin ER EXCLUDED? nNIA / A'V L- it - i Mandatory in under / `/Y ySdescribeOF W Pet DESCRIPTION OF OPERATIONS below OL.- i V' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If rl A_�i/( J.-- ,,ti, .� ,fin- 13-2 -' ' hN-:;(" " b{ a-E,'' e''' 7 W• u I, , f� il CERTIFICATE HOLDER CANCELI' / 343-547-6 245 0 _ j. CITY OF ASHLAND SHOULD ANY OF THE Arsux..-_ _ 'RED 90 N MOUNTAIN AVE THE EXPIRATION DATE THEREOF, NOTIe E---. 'RED IN ASHLAND,OR 97520-2014 ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE II/441,a 6 geA, © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Kariann Olson From: Kariann Olson Sent: Tuesday, February 25, 2020 12:48 PM ' To: - David Arnold Cc: Kariann Olson Subject: S &S Sheetmetal - Insurance Certificate Attachments: Blanket additional insured sample.pdf; Sample certificate.pdf; Specific additional insured endorsement sample.pdf Hello David, The insurance certificate is missing some verbiage (refer to "Description of Operations. . . ." on example certificate) required by the City and the additional insured endorsement for general liability and ideally auto. Please review the attached examples and request another insurance certificate from S&S Sheetmetal. Thank you. Kariann Olson Purchasing Representative 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. 1