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HomeMy WebLinkAbout2020-098 PO 20210144-S&S Sheetmetal Inc ' 1 �l we. Purchase Order Fiscal Year 2021 Page: 1 of: 1 r=1,1 . a lfb� € %14, 0:41N74.4, a •=s--_ l City of Ashland _ 'Fa-1M L ATTN: Accounts Payable L 20 E. Main Purchase 20210144 Ashland, OR 97520 Order* 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 ANTELOPE ROAD p Ashland, OR 97520 WHITE CITY, OR 97503 Phone: 541/488-5358 R T Fax: 541/552-2304 7- 3e 2.-Ae a [-�ii®'la l �� �—a.�.�+. :��Eit t @ate-'..i Fc3a= _— David Arnold 1€ e 1 _ — Yt ;i;i ri,1s=° �-a 10/09/2020_ 390 ��� FOB ASHLAND OR City Accounts Payable _ i�fl►l L• rEn1El—�. _.. _'3+ '= 41i i=74 ,riti:; '... ,3ii-T_ Motor and sensor replaced 1 Replacement of motor and sensor at Fire Station 1 1.0 $4,029.31 $4,029.31 Goods &Services Agreement Completion date: 06/30/2021 Project Account: *************** GL SUMMARY*************** 082400-602400 $4,029.31 Q By: 4 Date: /f70490 Authorized Signature 4 029.31 FORM #3 CITY OF NI ASHLAND A request Thr a Purchase O)�c1P. 0 ,, 04 ( D /,�'`� REQUISITION Date of request: 9/29/2020 Required date for delivery: Vendor Name S&S Sheetmetal,Inc. • Address,City,State,Zip 912 Antelope Road,White City.OR 97503 Contact Name&Telephone Number Christie Salazar 541-210-2946 christie.salazar@sandsheating.com Email address SOURCING METHOD ❑ Exempt from Competitive Bidding 0 Emergency O Reason for exemption: 0 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 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# ❑ Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 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 O (3)Written quotes and solicitation attached 0 Form#4,Personal Services>$5K&<$75K Agency PERSONAL SERVICES 0 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 O Direct appointment not to exceed$35,000 0 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 • Replacement of motor and sensor at Fire Station 1 $.4,029:31_ Item# Quantity Unit Description of MATERIALS Unit Price Total Cost O Per attached quotelproposal TOTAL 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 . rove all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,I certify th•, if My s public contracting requirements have been satisfied.4----7 I Employee: -/ Department Head: ��irr. .l to or gre• erthan0(420 dift 0) Department ManagerlSupervisor: . City dminist or: (Equal to or greater than 25,000) Funds appropriated for current fiscal year: yEs1 NO ---' i,i Deputy Finance Director-(Equal to or greater than$5,000) D. e Comments: • • Form#3-Requisition . i I GOODS &SERVICES AGREEMENT j PROVIDER: S&S Sheetmetal,Inc. ' C.I T Y or PROVIDER'S ASHLAND D CONTACT: Christie Salazar 20 East Main Street j Ashland,Oregon 97520 ADDRESS: 912 Antelope Road Telephone: 541/488-5587 White City, OR 97503 Fax: 541/488-6006 • PHONE: 541-210-2946 • This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation(hereinafter "City")ty ) and S&S Sheetmetal, Inc., a domestic business corporation("hereinafter"Provider"),for replacement of motor and sensor. 1. PROVIDER'S OBLIGATIONS 1.1 Provide replacement of motor and sensor at Fire Station 1 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly I acknowledges that time is of the essence of any completion date set forth in the SUPPORTING i DOCUMENTS,and that no waiver or extension of such deadline may be authorized except in the same I 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 fmal 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; i • 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 primary y as p ary 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 namingtheCity,ty,its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and I • Be evidenced by a certificate or certificates of such insurance approved by the City. j Page 1 of 5: Agreement between the City of Ashland and S&S Sheetmetal,Inc. • 1.3 All subject employers working under this Agreement are either employers that will comply with ORS 656.017 or employers that are exempt under ORS 656.126. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055,in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider for its Work at the hourly rates and charges as set forth in Exhibit"X",entitled "Quotation"which is attached hereto and incorporated herein by this reference,as full compensation for Provider's performance of all Work under this Agreement. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed • the sum of$4,029.31 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. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave,and retirement. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations,and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 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. 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 September 23,2020 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, 2021, 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,Inc. Attn: Christie Salazar 912 Antelope Road White City, OR 97503 541-210-2946 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: S&S Sheetmetal,Inc. (PROVIDER): By: . By: Ce �u Signature ��-- Twp, CkWiSlic So 144 4 v Printed Name Printed Name • ert-M mxt bar-,s Vatc.[6L— r` tt Mb1 ng9-c4' Title Title d�r/?o 61/2.1/2_02 0 ate Date is to be submitted with this signed Agreement) Purchase Order No. D �l 7.416 Page 5 of 5: Agreement between the City of Ashland and S&S Sheetmetal,Inc. >SE IN .. . Qtra O� Fac Quote Number:215154S SHEATING & Quote Date:Sep 23,2020 AIR-GOND Page: 1 T SHEETMETAL, INC. FsT. 1990 CITY OF ASHLAND Our Mission 20 E.MAIN ST. We are committed to raise the bar and make our team the ASHLAND,OR 97520 standard others are judge by in commitment of unsurpassed service,craftsmanship,loyalty,and integrity to our customers and team. _ I .� 3 a c;;7r x - .. any r r .y �T+¢". j ,<x 3 Customer ID `g Good Thru 4PaymenfTerms r :Sales Rep , ; { C002 10/23/20 Upon Completion M003 x " 4 Dtscrtp#ion t �t ...,r,.:�__.�n� � _�,��._�.._�s .� .., _ ,..._ �_ _�._ --._.___.. �__... ___nR - -Ma a_',*Amount ..-..y:b RE:FIRE STATION 1 We are pleased to provide you with the following quotes: Quote#1 To replace a faulty exhaust fan motor,labor and materials. 2,809.00 Total of$2,809.00 Quote#2 To replace carbon monoxide sensor and a E3 Point No.2 remote mounted sensor,labor and materials. Total$1,220.31 1,220.31 QUOTED BY:Juan Partida,Service Technician ACCEPTED BY: j 1 "In the event customer fails to pay the invoice amount when due,interest shall accrue on the unp Subtotal 4,029.31 balance from the due date of the invoice at the rate of 2%per month(24%per annum). If S&c Sales Tax Sheetmetal,Inc.is required to seek collection of the amount due by legal process,customer shall responsible to pay S&S Sheetmetal,Inc.in additionto the invoice amount the interest,all attorneTOTALS f ` { A4029r31` ! and cost incurred by S&S Sheetmetal Inc. ,.S„` rii rc YL, t „} ^µ .;y rt, I 912 Antelope Rd.,White City,OR 97503 AccoRD CERTIFICATE OF LIABILITY INSURANCE DA 9/20/2020 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(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 CONTACT Anchor Insurance and Surety, Inc PHONE Carol Beitiri FAX 1201 SW 12th Ave.Ste.500 • faro.No.Ext):503-224-2500 (Arc,No):503-224-9830 Portland OR 97205 ADDRESS: certlflcates@anchorias.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:SAIF Corporation 36196 INSURED S&SSHEE-01 INSURER B: S&S Sheetmetal Inc. 912 Antelope Road INSURER C: White City OR 97503 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:921561122 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 EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _$ DAMAGE TO RENTED CLAIMS-MADE OCCUR • PREMISES(Ea occurrence) $ MED EXP(Any one person) $ _ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ _ OTHER: AUTOMOBILE LIABILITY COMBINEDISINGLELIMIT $ 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 _ $ DED RETENTION$ $ A WORKERS COMPENSATION 811929 .10/1/2020 10/1/2021 X STATUTE OTH- ER OR AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) EL.DISEASE-EA EMPLOYEE $1,000,000 Eyes,describe under 1111 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) City of Ashland HVAC 90 N.Mountain Ave.,Ashland,OR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland - ACCORDANCE WITH THE POLICY PROVISIONS. 90 N.Mountain Ave. Ashland OR 97520 AUTHORIZED REPRESENTATIVE USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • www.saif.com ■ sauWork. Life. Oregon. Carrier no: 20001 Endorsement no: WC000313 SAIF policy: 811929 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, 2020 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned September 17, 2020 at Salem, Oregon Kerry Barnett President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol_PC1_E4306 A �® CERTIFICATE OF LIABILITY INSURANCE �'1 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 CONTACT FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER HOME OFFICE:P.O.BOX 328 (A1C No, Ex!):888-333-4949_ _ FAX,No):507-446-4664 OWATONNA,MN 55060 ADDRESS:CLI ENTCONTACTCENTEReFEDI NS.COM i 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: COVERAGES CERTIFICATE NUMBER:245 REVISION NUMBER:4 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 ADOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD IMM/DDIYYYY) (MM/DDIYYTY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEU $1,000,0D0 CLAIMS-MADE n OCCUR PREM SI ES fEo neam,nrel $100,000 MED EXP(Any one person) EXCLUDED A Y N 9910853 04/24/2020 04/24/2021 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREAgE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 RX POLICY I IJECT n LOC PRODUCTS-COMPIOP AGO $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 1Ea accident) X ANY AUTO BODILY INJURY(Per person) A —OWNED AUTOS ONLY SArm CHEDULED Y N 9910853 04/24/2020 04/24/2021 BODILY INJURY(Por accident) — HIRED AUTOS ONLY AUTOS NED PROPERTY DAMAGE — AUTOS ONLY IPer e[ddent) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS UAB CLAIMS-MADE N N 9910854 04/24/2020 04/24/2021 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION PER STATUTE ER OT AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE L E.L.EACH ACCIDENT OFFICER/MEMBER EXCWDED? - N I A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE II yea,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarts Schedule,may be attached If more space Is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. CERTIFICATE HOLDER CANCELLATION 343-547-6 245 4 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 90 N MOUNTAIN AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ASHLAND,OR 97520-2014 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1(/e. _ 0 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2018103) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the.following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for"bodily injury" and "property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto"with your permission. However,this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto"you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a covered "auto"owned by him or her or a member of his or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured, or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To "loss"which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented "auto"or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA-F-127(03-03) Policy Number: 9910853 Transaction Effective Date:07-21-2020 COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in,a contract 1. "Bodily or agreement that such person or organization be injury", "property damage" or added as an additional insured on your policy. "personal and advertising injury" arising out Such person or organization is an additional of the rendering of, or the failure to render, insured only with respect to liability for "bodily any professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury"caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, onyour opinions, reports, surveys, field orders, 2. The acts or omissions of those acting change orders or drawings and behalf; specifications; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims additional insured: against any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring, and employment, training or monitoring of others 2. Will not be broader than that which you are by that insured, if the "occurrence" which required by the contract or agreement to caused the "bodily injury" or "property provide for such additional insured. damage", or the offense which caused the A person's or organization's status as an "personal and advertising injury", involved the additional insured under this endorsement ends rendering of or the failure to render any when your operations for that additional insured professional architectural, engineering or are completed. surveying services. © Insurance Services.Office, Inc., 2018 Page 1 of 2 CG 20 33 12 19 Policy Number: 9910853 Transaction Effective Date:07-21-2020 2. "Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring after: additional insureds, the following is added to a. All work, including materials, parts or Section III -Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed;or 2. Available under the applicable limits of b. That portion of "your work" out of which insurance; the injury or damage arises has been put to its intended use by any person or whichever is less. organization other than another contractor This endorsement shall not increase the or subcontractor engaged in performing applicable limits of insurance. operations for a principal as a part of the same project. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9910853 Transaction Effective Date:07-21-2020