The URL can be used to link to this page

Home My WebLink About2005-178 Contract - Tobiasson CITY OF ASHLAND CONTRACT FOR PUBLIC WORKS CONSTRUCTION Contract made this cfl /q- day of June, 2005, between the City of Ashland, ("City") and Tobiasson Excavation, Inc., "(Contractor"). City and Contractor agree: 1. Contract Documents: This contract is made as a result of an Advertisement for Bid issued by City for the Bear Creek Trunk Sewer, Phase 5, Project Number 2003-05. Contractor was awarded the bid as the lowest responsible bidder. In the event of any inconsistencies in the tenns of this contract, the contract documents defined in the Advertisement for Bid and Contractor's bid, this contract shall take precedence over the contract documents, which shall take precedence over the bid. 2. Scope: Contractor shall begin and complete the project described in the contract documents within the time prescribed in the contract documents. The following exceptions, alterations, or modifications to the contract documents are incorporated into this contract: 3. Price & Pa vment: City shall pay Contractor amounts earned under the contract. All payments will be made at the times and in the manner provided in the contract documents. 4. Perfonnance and Payment Bonds: Contractor shall, within five days after execution of the contract and prior to doing any work under the contract, furnish bonds to the City of Ashland in a fonn and with a surety satisfactory to City in the penal sun1 of $224,433.23 conditioned upon the faithful payment and perfonnance of this contract upon the part of the Contractor as required by ORS 279C.380. 5. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents hannless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death,) or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the perfonnance of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perfonn work or services attendant to this contract.) Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and approximately caused by the negligence of City. 6. Insurance: Contractor shall, at its own expense, at all times during the terrn of this agreement, maintain in force a comprehensive general liability policy including coverage for contractual liability for obligations assumed under this Contract, blanket contractual liability, products and completed operations, owner's and contractor's protective insurance and comprehensive automobile liability including owned and non-owned automobiles. The liability under each policy shall be a minimum of $500,000 per occurrence (combined single li:mit for bodily injury and property damage claims) or $500,000 per occurrence for bodily injury and $100,000 per occurrence for property damage. Liability coverage shall be provided on an C:\DOCUME-1\tuneberl\LOCALS-1\Temp\GWViewer\03-05 Bear Creek Sewer 5 Tobiasson Contract 06 05.doc "occurrence" not "claims" basis. The City of Ashland, its officers, employees and agents shall be named as additional insureds. Contractor shall submit certificates of insurance acceptable to the City with the signed contract prior to the commencement of any work under this agree:ment. These certificates shall contain provision that coverages afforded under the policies can not be canceled and restrictive modifications cannot be made until at least 30 days prior written notice has been given to City. 7. Default: A default shall occur under any of the following circumstances: 7.1 If the Contractor fails to begin the work under contract within the time specified, or fails to perfonn the work with sufficient workers or equipment or with sufficient materials to insure the prompt completion of the project, or shall neglect or refuse to remove materials or perfonn anew such work as shall be rejected as defective or unsuitable, or shall discontinue the prosecution of the work. 1.2 If the Contractor shall become insolvent or declared bankrupt, or commit any act of bankruptcy or insolvency, or allow any final judgment to stand against the Contractor unsatisfied for a period of forty-eight (48) hours, or shall make an assignment for the benefit of creditors. 1.3 From any other cause whatsoever, shall not carryon the work in an acceptable manner. 8. Remedies: In addition to the rights and remedies to which the City may be entitled by law for the enforcement of its rights under this contract, City shall have full power and authority, without violating this contract, to take prosecution of the work from the Contractor, and appropriate or use any or all of the materials and equipment on the ground that may be suitable and acceptable and may cause a contract for the completion of this contract according to its tenns and provisions, or use such methods as required for the completion of the contract, in any acceptable manner. All costs and charges incurred by the City together with the costs of completing the work under the contract, shall be deducted from any money due or which shall become due the Contractor. In case the expense so incurred by the City shall be less than the sum which would have been payable under the contract if it had been completed by th~ Contractor, then the Contractor shall be entitled to received the difference less any darnages for delay to which the City may be entitled. In case such expense shall exceed the sum which would have been payable under the contract, the Contractor and the surety shall be liable and agree to and shall pay the City the amount of the excess with damages for delay of perfonnance, if any. 9. Prevailing Wage Rates: The Contractor shall pay a fee equal to one-tenth of one percent (0.1 percent) of price of this Contract. The fee shall be paid on or before the first progress payment or 60 days from the date work first begins on the Contract, whichever comes first. The fee is payable to the Bureau of Labor & Industries and shall be mailed or otherwise delivered to the Bureau at the following address: Bureau of Labor & Industries Wage & Hour Division Prevailing Wage Unit 800 N.E. Oregon Street #32 Portland OR 97232 C:\DOCUME-1\tuneberl\LOCALS-1\Temp\GWViewer\03-05 Bear Creek Sewer 5 Tobiasson Contract 06 05,doc 10. Living Wage Rates: If the amount of this contract is $15,964 or more, and Contractor is not paying prevailing wage for the work, Contractor must comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or Jmore of the work under this contract. Contractor must post the attached notice predominantly in areas where it will be seen by all employees. The Contractor shall fully comply with the provisions of ORS 279C.800 through 279C.870 pertaining to prevailing wage rates. 11. Assignment and Subcontracts: Contractor shall not assign this contract without the written consent of City. Any attempted assignment without written consent of City shall be void. Contractor 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 City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. Contractor may not substitute any subcontractors from the submitted list of First- Tier Subcontractor Disclosure Form without written consent of the City, or by following the procedures ofORS 279C.585 and OAR 137-049-0360. By: CITY OF ASHLAND , \ } \.. ' "...J).... Signature ........." ~~ ~ 0 ~ '- (k SC::C:\o--- Printed Name By: LM~ Lee Tuneber Finance Director Its: By: Leg' 1 REVIE By: S TO CONTENT: ( t -:J-l- 0 j'- Date: Coding: (For City use only) C:\DOCUME-1\tuneberl\LOCALS-1\Temp\GWViewer\03-0S Bear Creek Sewer S Tobiasson Contract 06 OS.doc JUL 25 2005 3:15PM CHIC 5032876100 p.2 .. Premium $5,611 . PERFORMANCE BOND The undexsigned Tobiasson Excavation Inc... as principal, further referred to in this bo}~ as, Contractor, and Contractors Bonding and Insurance Company -' as surety, further refer.red to in this bond as SuretY, are jointly and severally bound Wlto City of , Ashland, as ob]igcx; further referred to in this bond as City, in the sum of Two hundrc~d twentJ(- {our thousand four hundred thirty-five dollars and twentv-tmee cents.. Dollars ($224,433.23). Contt:actor and City have entered into a written contract dated June 21st, 2005 --' for the following project: Bear Creek Trunk Sewer. Phase V.. Project No. 2003-05. This contract is ' further refeJTed to in this bond as the Contract and is incorporated into this bond by thi:) rcfcre:r.tce. The conditions of this bond are: 1. If Contractor f3ithfuUy perfoxms the Contzact in accordance with the pl8ns, specifications and conditions of the oontxact withiD the: time p~scribed by the Con~ 45 required by ORS 279C. 3~ through 279C.38.5:t then, this obligation is null and void; otherwise it shall remain in full force and effect. 2.' If Contractor is declared by City to be in default under the Con1ract, the Surety. shall promptly remedy the defauJt,. perfonn all of Con1ractor' s obl~gatiOl1lS under the tontract in accordance with its terms and conditions and pay to City 11U damages that are due under the Contract. 3. This bond 'is subject to claims under ORS 279(;.380 through 279C.390. 4_ Ibis obligationjow.tIy and 5evera1ly. binds Contractor ~d S~y and their respective heirs;, exeCtitor~ administrators, successors. 5. Surety waives notice of mQdification of1he Contract or extension Qfthe Conttact 1ime. 6. Nonpayment of the bond premium shall not invalidate this bond. JUL 25 2005 3:15PM CHIC 5032876100 p.3 . 7. The bond number and the name, address, and telephone number of the "'gent authorized to receive notices concerning this bond are as follows. BOnd Number: PE1224 Bond Agent: Western States Ins'urance , 400. W Hersey Ashland.OR 97520 ~ Address: TelephOne: 541-482-2725 SIGNED this 25th day of July 2005. WITNESS: (Coworate Seal) CONTRACTOR: By: Title: Legal Address: Tobiasson Excavation Inc. 3055 Highway 66 Ashland OR 97520 Attest~ C~Jate Secretary WJTNESS: SURE1l(: Contractors Bonding and Insurance Company . By: ill-Y'\NI) 61 '\ V\ Ltt . TItle: Joanna Burnett, Attorney in Fact Lcga1Address~ 1213 Valley St.~, Seattle WA 98109 ,,,'\"\'\\ \\ \ 1\ i, ......... . f',;~-r.;.n !; .,-. ~ : " : -:."tC~~~~~) 3" ~ ~-- ~ c \, ~ .I... __:~~ o,,~/ ".-:~ 1)';;;"'- , -:...., ~. "tJ ! C) ~. ....cu.. . 0.. .,r.-\\_ . :~;: .,r ~ is- ~ ~~, ~'t~~-= " '., .... ~'- I, ."~,.,,,,\~~oa.._ . "1 ~ jJT-"~.....'" .'. .-a.h\\\"" . Attest: Corpomte Secretary ....i _.~.., . JUL 25 2005 3:15PM CHIC 5032876100 p.4 " PAYMENT BOND The undersigned Tobiasson Excavation Inc. ~ as principal, further referred to in tbis bond as ContoK:tor, and Contrac.tors Bondin~ and Insurance Company --' as surety, further ~fened to in this bond as Surety, are jointly and severally bound unto GJity of Ashlai1d, as obligee, further rerened to in this bond as City, in the sum of Two hundred ~_ four thousand fo\Q' hmdred thirtv..five dollars and twcntv-three cents. Dol1aJ:s ($224,433~). Contractor and City have entered into a written cont.ract dated June 21st 2005 ~ fQf the following project: &Dr Creek: Trunk Sewer. PhMe V. Project No. 2.003-05. This ~ct is further referred to in this boild as the Contract Jw.d is incorporated inea this bond by tlrls reference. The conditions of 1Ws bond are; 1. If Contractor faith:fu.Uy performs the Contract witbin the time prescribed by tbe . Con1ract, and promptly makes paYment to all claimants, as defined in ORS 279C.600 through 279(;.6207 then this obligation is null and void; otherwise it shall remain in full force and effect. . 2. If Contractor is decJaxed by City to be in default under the Con~ the SuretJr shall pro.mptly remedy the default., per.form all of Contractor s obligations tmder the~ COntract in accordance with its tenns and conditions and pay to City aU damages that are due under the Contract. 3. This bond is ~ject to claims under ORS 279C.600 through 279C.620. 4. This Qbligationjointly and severally binds Con1ractor and Surety and their respective heirs~ executors, adnUnistrato:r~ successors. s. Surety waives notice of modification of the Contract or extension of the COntra4~ time. 6. Nonpayment of the bond p.remium shall not invalidate this bond. JUL 25 2005 3:15PM CHIC 5032876100 p.5 ... 7. The bond number and the naro.~ address, and telephone number of the agent authorized to receive notices concerning this bond are as follows. Bond Number: PE1224 Western States Insurance Bond Agent: Addres~: Telephone: 400 W Hersey Ashland OR 97520 541-482-2725 SIGNED this 25th 2005. day of July WITNESS: (Corporate Seal) WI1NESS: """...,\\), _.......' rIll\J~ )1, .=' ~~ iUP,~I" - ~E CI) Q. 0 "~~ : ..... ! ~ .......:: iJ) ~ fiE ~ ~ z:.... ~.l ;.');', "$ G) " ~ (i) i -; ",.,. );;:~'..i'..." 0 i it ~ II -' ~ ......::: _ CS'..- , ~ 0 1"1, I.,~ 11& ~ ~ _~ :: , " ~ '1'1 ""h' p.....~tl" g-: .', .(.JA}"""~ ....... I, """'00 1J ....... JI"~~,,\\\,,,," ' . . :';'" '"J.._".# CONTRACTOR: Tobiasson Excavation Inc. By: Title: Legal Address~ 3055 Highway. 66 Ashland OR 97520 Attest: Cotporate Secretary SURETY: Contractors Bonding and, ,Insuranc,e Company . By; ~1'\Q.\.~lh\.Ctf. _ Title: Joanna Burnet t, At torney in Fact Legal Address: 1213 Valley St. Seattle WA 98109 Atte~ Corporate Secretary LIMITED POWER OF ATTORNEY - READ CAREFULLY C0NTR:.\CTORS BONDING AND INSURANCE COMPANY IS RESPONSIBLE ONLY FOR THE BOND DESCRIBED AND UP TO THE AMOUNT SET FORTH IN THIS LIMITED POWER OF ATTORNEY. ANY ERASURE WILL VOID THIS POWER OF A TORNEY. IF YOU HAVE ANY QUESTIONS ABOUT OR WANT TO VERIFY THIS POWER OF ATTORNEY CALL CONTRACTORS BONDING AND INSURANCE COMPANY TOLL FREE AT 1 (800)765-2242 Attorney No.: PO 127 Power Number: 051946 7/25/2006 Date Approved: 7/25/2005 $224.433.23 Bond No. : PEl224 Penal Sum: $ Limited Power of Attomev Exoires: Approved by : --./' ~ Name of Principal: TOBIAS SON EXCA V AnON INC. Name of Obligee: CITY OF ASHLAND Descriptions(s): BEAR CREEK TRUNK SEWER, PHASE V PROJECT NO. 0305 ~.on ~rkin ~ nm ame) Location (if aoolicable): ASHLAND OREGON KNOW ALL MEN BY THESE PRESENTS that CONTRACTORS BONDING AND INSURANCE COMPANY, a corporation duly organized and existing under the laws of the State of Washington and having its principal office in Seattle, King County, Washington does by these presents make, constitute and appoint JOANNA BURNETT OF ASHLAND, OR its true and lawful Attorney-in-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver the bond(s) and/or other documents incidental thereto described above; and to bind the Company thereby as fully and to the same extent as if each such bond, or other documents incidental thereto was signed by the President, sealed with the corporate seal of the Company and duly attested by its SecretaIy; hereby ratifYing and confirming all that the said Attorney-In-Fact may do in the premises. Said appointment is made under and by the authority of the following resolutions adopted by the Board of Directors of CONTRAcrORS BONDING AND INSURANCE COMPANY on September 10,200 1. RESOLVED that the Chief Executive Officer, President, Chief Financial Officer, SecretaIy or any Vice President of the Company is authorized to appoint Attomeys-In-Fact for and on behalf of the Company with the power and authority to sign on behalf of the Company those surety bonds or undertaki:t~ of suretyship which may from time to time be approved by the Chief Executive Officer, President, Chief Financial Officer, 5ecretaIy or any Vice President of the ~~ompany; provided, however, that no Attomey-In-Fact snall be authorized to execute and deliver any bond or undertaking that shall obligate the Comrany for any portion of the penal smn thereof in excess of$ I 5,000,000, and provided, finther, that no Attomey-In-Fact shall have the authority to issue a bId or proposa bond for any project where, if the contract is awarded, any bond or undertaking would be required with a penal ~1Iill m excess of$15,000,000. An Attorney-In-Fact may also be authorized by Power of Attorney to excecute any consent or other document incidental to said bond or undertaking, provided such document does not obligate the Company is excess of the limit set fortli above. In no event shall any Attorney-In-Fact have any authority to sign any document or othetWise bind the Company in any way in connection with a claim on a surety bond or undertaking. RESOLVED FURTHER that each Power of Attomey must set forth the specific description of the surety bond or undertaking to which it applies, the name of the principal, the name of the obligee, the penal sum, the fund number (except for a bid bond where there is no number), the idennfYing number of the Attomey-In-Fact, and the identifYing number of the Power of Attomey. The Attorney-In-Fact shall not be authorized to obligate Company for surety bond or undertaking specified in the Power of Attorney (mcluding any consents or other documents incidental to the surety bond or undetaking) for more than the penal smn specified in the Power of Attorney. RESOLVED FURTHER that the Chief Executive Officer, President, Chief Financial Officer, SecretaIy or any Vice President of the Company is authorized to establish a specific expiration date for the Power of Attomey and to modifY that date rrom time to time as the Chief Executive Officer, President, Chief Financial Officer, SecretaIy or any Vice President of the Company deems necessal)' in his/her sole discretion; the applicable expiration date is to be clearly set forth in any written Power of Attorney. RESOLVED FURTHER that all previous resolutions by the Board of Directors authorizing the Chief Executive Officer, President, Chief Financial Officer, SecretaIy or any Vice President of the Company to appoint Attomeys-In-Fact for and on behalf of the Company remain in full force and effect; and that if a Power of Attorney baSed on this resolution is attached to a bond (for example, a bid bond), and a Power of Attorney based on another Board of Directors resolution is attached to another bond (for example, a perfonnance and payment bond), it shall not affect the validity of either Power of Attomey or Bond RESOLVED FURTHER that this Limited Power of Attorney containing this and the foregoing resolutions and the signatures of the President, SecretaIy, and NotaIy Public, and the corporate and NotaIy seals appearing hereon, are generated, stored and transmitted electronically, and therefore appear in printed foml only at recipient's fax machine. This fax printed Limited Power of Attomey document and the signatures and seals appearing hereon therefore are, and shall be deemed orginals in all respects. RESOLVED FURTHER that the Company acknowledges the applicability of the Electronic Signatures in Global and National Commerce Act to this Limited Power of Attomey and that the signatures of the President, SecretaIy and NotaIy Public and the corporate and NotaIy seals appearing on any Limited Power of Attorney containing this and the foregoing resolutions as well as the Limited Power of Attomey itself and its transmission may be, or may be by facsimile or other means of electronic or electro-mechaniCaJ. transmission or reproduction; and any such Limited Power of Attomey shall be deemed an original in all respects. IN WITNESS WHEREOF CONTRAcrORS BONDING AND INSURANCE COMPANY has caused these presents to be signed by Don Six;kf~ad~botporate seal to be hereto affix::(9/9f2 2. :/"i-s,"-;"PO'R"':"'J',,\ ;- ~ ." .Q" -f~'. 'P " CONTRAcrORS BONDING AND INSURANCE COMPANY {~( CSEAL\~\ B : \~ ..... ..... ,OJ y S' kin, Pre '..1 I, '. 1979.' ~ Don IT . ....sIuent ',."',.........:<:;,~.: '1,\;, J"H J N (j \ .---- \\0",,'",........- ST ATE OF WASHINGTON - COUNTY OF KING On 9/9/2002, personally appeared DON SIRKIN to me known to be the representative of the corporation that executed the foregoing Limited Power of Attorney and acknowledged said Limited Power of Attorney to be free and voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that he is authorized to execute the said Limited Power of Attorney. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year first above written. ~"\"""'I, f:'dt!.", J. &:"" fl}?""~~+, = Ir +O...~ ~ ~~Fo";';'~ l~g '; ...~~~..,o ff 1"Ji; 0; ~$';~.# 'tlh.n~",""'~ (WdfJt4d' ~-r:r Notary Public in and for the State of Washington, residing at Seattle The undersigned acting under authority of the Board of Directors of CONTRACTORS BONDING AND INSURANCE COMPANY, hereby certifies, as or in lieu of Certificate of the Secretary of CONTRACTORS BONDING AND INSURANCE COMPANY, that the above and foregoing is a full, true and correct copy of the Onginal Power of Attorney issued by said Company, and does hereby further certify that the said Power of Attorney is still in force and effect. GIVEN under my hand. at Portland. OR this 2~ day of JUL 2005 ~ R. Kirk Eland, Secretary Al (052004) ACORD... CERTIFICATE OF LIABILITY INSURANCE 01F' ID C~ DATE (MM/DDIYYYY) TOB:IA-l 08/0a/05 P~ODUCE.R. THIS CERTIFICA.TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Western State.s - Ashla.nd HOLDER. 1"I-:lJ$ CERTIFICATE DOES NOT AMEND. EXTEND OR 400 West Hersey ALTER THE COVERAGE AFFORDED BY TlfiE POLICIES BELOW. Ashland OR 97520 Phone: 541-482-2725 piax:541-488-00S6 INSURERS AFFORDING COVERAGE NAIC# INSUR,~D INSURER A: American States Insura.nc:e. 24740 INSURI:R B: CBIC Contraotors Tobiasson Excavation Ine INSURER c: 3055 Hwy 66 INSURER D~ Ashland OR 97520 IN$UR~R E.: COVERAGES THE. POL.ICIES OF INSUAANCE LISTED BELOW HAVE BEEN IS$UEDTOTHE INSURED NAM~D ABOV~ ~ORTH~ POLICY PERIOD INDICATED. NOTWITHSTAUDING ANY REQUIR~MI:;NT, TERM OR. CONDITION OF ANY CONTAACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS C~RTIFICATI:; MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFfORDED BY THE POLlCI~S DESCRI8~ HEREIN ~ SUBJECT TO All THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLlC!ES. AGGR.EGATE. LIMITS SHOWN MAY HAVE BEEN REDUCEo f3y PAJD CLAIMS. NSR~ POLICY NUMBER PO"=-~1, P~kt~Y(~~~h~N LTR TYPE OF INSURANCE DATE M"MroDNY;- LIMITS G=NI;RAL. LIABILITY EACH OCCURRENCE $ 500000 I--- A X COMME.RCIAL GEN5:RAL. LIABILITY 01CG3342492 04/15/05 04/15/06 PR~~'ES (E~:~~~(!) $200000 I CLAIMS MADE ~ OCCliR MED EXP (Any one ~et2(1)) $ 10000 PERSONAL & ADV INJURY $ 500000 - GENERAL AGGRI:GATE S 1000000 - GEN'L AGGREGATE LIMIT APPLIES PE~ PRODUCTS - COMP/OP AGG $1000000 I nPRO- n POLICY JECT LOG AUTOMOBILE LIAelL.ITY COMBINED SINGLE LIMIT - $750000 A ANY AUTO 01CG3342492 04/15/05 04/15/06 (81 ou:cident) f--- I--- All OWNED AUTOS BODI L Y INJURY $ ~ SCHEDULED AUTOS (Per person) HIRED AUTOS BODIL. Y INJURY I--- $ NON-OWNED AUTOS (Per 6ICCI"ent) - I--- - PROPERTY DAW.G~ S (Per ..ccident) GARAG~ LIABILITY AUTO ONLY - EA ,o,CCIDENT $ q ^"Y AUTO . OTHER THAN EA ACC $ AUTO ONLY; AGG $ f.XCESSI\JMBRELlA lIABILITY EACH OCCURRENCE $ ~ OCCUR 0 CLAIMS MADe AGGREGATE $ S ==j DEDUCTIBLE $ RETENTION $ $ WOR.KERS CQMPENSATION AND I TORY LIMITS I IUTI-!- ER EMPlOYER,S' LIABILITY E.L. EACH ACCIDE:NT $ ANY P.ROPR!ETOR,tPARTN~R!EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE ' ~ E:MPLOYEE S ~~~J~r~~~~~1~~s below E.L. DISEASE - POLICY LIMIT S O"!ifE:R A Equipment Floate:r OlCG3342492 04/15/05 04/15/06 bond 15000 B license Bond 808448 06/30/04 06/30/05 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSE.ME.NT I SPE.CIAL PROVISJONS THE CITY OF ASHLAND IS ADDITONAL INSUR~~ WITH RESPECTS TO THE OPERATIONS OF ~OBIASSON EXCAVATION. CERTIFICATE HOLPER City of Ashlo!lnd Fax 488-6006 Publi~ Works Dept 20 Eaat Main .Ashland OR 97520 CANCELLATION CITYO 0 6 SHOULD ANY OF THE ABOVE. DESCR,IBED POLICIES ~E CANCEllED BEFORE THE EXPIRATION DATE TH~REOF, THE I$$UING INSURER WILL ENDEAVOR. TO MAIL DAYS WR.ITTE:N NoncE TO THE CERTIfiCATE HOLDER. NAMED TO TH~ lEF'T, Bur FAI~URE TO DO 50 SHALL IMPOSE NO OBUGATION OR LIABILITY OF AN REPRE$ENTAnVES. AUTHOR~~.REPRES Cin ' Clo!l @ ACORD CORPORATION 1988 ACORD 25 (2001/08) III 'd I lZvL'ON ~d6S:l 900Z '8 '2nV r~' CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 ~o ?~r~ Page1/1 [.w:'r~t**i!fi<$ftf(h!ffj'f;j~iSM'1Ki.?Mtt .;:~<t{~~]l1:'J!:Wl:~?J.:J::;U-JY1Pt;;rx%~%;~:;4f:::::; 06220 VENDOR: 002814 TOBIASSON EXCAVATION INC 3055 HIGHWAY 66 ASHLAND, OR 97520 SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: 8/8/2005 Speciallnst: Req. No.: Dept.: PUBLIC WORKS Contact: Jim Olson Confirming? No BILL TO: Account Payable 20 EAST MAIN ST 541-552-2028 ASHLAND, OR 97520 SUBTOTAL TAX IFREIGHT TOTAL 224 433.23 0.00 0.00 224,433.23 ~~.~ . ~{,~r A orized Slgna(ure VENDOR COpy CITY OF ASHLANJD REQUISITION No. PW - FY 2006 Department Public Works Vendor Tobiasson Excavation 3055 Highway 66 Ashland OR 97520 Account No. 675.08.39.00.704200 Date August 8, 2005 Requested Delivery Date ASAP Deliver To Jim Olson Via (* Note Please allow approximately two(2) weeks for delivery on items not generally caried in stored, and approximately two (2) months on printing jobs) I I Item No. Quantity Unit Description Use of Purchasing Office Only Unit Price Total Price PO No. Construction Services for the Bear Creek Trunk Sewer Line Construction Phase 5 $ 224,433.23 TOTAL $ - $224,433.23 for Kari: BID /RFPIEXEMPT: BID Contract Start Date: August 8, 2005 Contract Completion Date: October 5,2005 Insurance on file: I YES L NO Project No: 200iC).31(20 ~41 ~~ tJ~,~ ;2-0 ~ I Job No. Unit No. I hereby certify that the above items are necessary for the operation of this department and are budgeted ~ Department Head or Authorized Person Issued By Date Received By ~A~' w. G:Pubwrks\eng\deptadmin\engineer\project\o3-QS Tobiasson Bear Creek S Requisition 8 OS.xls