HomeMy WebLinkAbout2006-100 Contract - FD Thomas
C IT Y OF CONTRACTOR: F. D. Thomas Inc.
ASHLAND CONTACT: Dan Thomas / Ray Kinney
20 East Main Street ADDRESS: PO Box 4663, Medford, OR 97501
Ashland, Oregon 97520
Telephone: (541) 488-6002 TELEPHONE: (541) 664-3010
FAX: (541) 488-5311
FAX: (541) 664-1105
DATE AGREEMENT PREPARED: June 15,2006
BEGINNING DATE: June 16,2006 COMPLETION DATE: July 15, 2006
COMPENSATION: $11,285.00 - Per proposal dated 05-09-2006
SERVICES TO BE PROVIDED: Work to be performed on the WTP - Operations BuildinCl. Contractor to repair Dryvit siding
surface, pressure wash clean, caulk gutters, spot-prime as needed, then one coat of Elastomeric paint on the body and one
coat of Acrylic Semi-gloss on all trim. Protect all basins and water surfaces.
ADDITIONAL TERMS:
Contract for WORK less than $25,000
CITY AND Contractor AGREE:
1. All Costs by Contractor: Contractor shall, at its own risk and expense, perform the work described above and, unless othorwise
specified, furnish all labor, equipment and materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that all personnel assigned to the work
required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and workerlike manner and, if
required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also
maintain a current City business license.
3. Completion Date: Contractor shall start performing the work under this contract by the date indicated above and completo the work by
the completion date indicated above.
4. Compensation: City shall pay Contractor for work performed, including costs and expenses, the sum specified above. Once work
commences, invoices shall be prepared and submitted by the tenth of the month for work completed in the prior month. Payments shall be
made within 30 days of the date of the invoice. Should the contract be prematurely terminated payments will be made for work completed
and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to
$25,000.00 and City shall not be obligated to pay any sum in excess of $25.000.00 unless a separate written contract is en1ered into by
City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City.
6. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520, and 279C.530 are made part of this contract.
7. Livinq Waqe Requirements: 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 chaptel', to all
employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract.
Contractor must post the attached notice predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all
losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (in8luding injury
resulting in death,) or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance
of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform
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.
9. Termination: This contract may be terminated by City by giving ten days written notice to Contractor and may be terminated by
Contractor should City fail substantially to perform its obligations through no fault of Contractor.
10. Independent Contractor Status: Contractor is an independent contractor and not an employee of the City. Contractor shall have the
complete responsibility for the performance of this contract. Contractor shall provide workers' compensation coverage as rE,quired in ORS
Ch 656 for all persons employed to perform work pursuant to this contract and prior to commencing any work, Contractor shall provide City
with adequate proof of workers' compensation coverage. Contractor is a subject employer that will comply with GRS 656.01?
11. Insurance: Contractor shall, at its own expense, at all times during the term 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 in81uding owned
and non-owned automobiles. The liability under each policy shall be a minimum of $500,000 per occurrence (combined single limit 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 "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 agreement. These certificates shall contain provision that coverages afforded under the policies
cannot be canceled and restrictive modifications cannot be made until at least 30 days prior written notice has been given to City. Each
certificate of insurance shall provide proof of required insurance for the duration of the contract period.
12. Assiqnment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work without th'3 written
consent of City. Any attempted assignment or subcontract 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:, I ,"
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TITLE ) i('JfJ{Vl l (~/tt ~~J~
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FederallD #
CITY OF ASHLAND:
BY x:1t,/ ~ef<
FINANCE DIRE ~;R
OR
BY
DATE
CITY ADMINISTRATOR
~/~/~~
DATE
CONTENT REVIEW Il;J(~ ) l\'$1'-=\~ ~
CITY DEPARTMENT HEAD
DATE lo - ~,G- 'tJ <0
CCB Name r~ I) r / It> !l1v ~ '1 /1 e,
CCB # '7(~1~{32551
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City of Ashland - Business License # # / c' ;7 ~ (
ACCOUNT #
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PURCHASE ORDER #
(for City purposes only)
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* Insurance Certificates and a completed IRS W-9 form must be submitted with signed contract.
Revised 4-27-05
CITY OF ASHLAND, OREGON
City of Ashland
LIVING
ALL employers described
below must comply with City
of Ashland laws regulating
payment of a living wage.
-..
._~
Employees must be paid a
living wage:
For all hours worked under a
service contract between their
employer and the City of
Ashland if the contract
exceeds $15,964 or more.
~ For all hours worked in a
month if the employee
spends 50% or more of the
employee's time in that month
working on a project or
portion of business of their
~per'hOIl" effective J...n1eSI, 'lIt4
(lncreasesannllally everyJlIl1le 30 by the
Consumer Pricelnde)(.)
employer, if the employer has
ten or more employees, and
has received financial
assistance for the project or
business from the City of
Ashland in excess of
$15,964.
~ If their employer is the City of
Ashland including the Parks
and Recreation Department.
~ In calculating the living wage,
employers may add the value
of health care, retirement,
401 K and IRS eligible
cafeteria plans (including
childcare) benefits to the
amount of wages received by
the employee.
~ Note: "EmploYHe" does not
include tempora.ry or part-
time employees hired for less
than 1040 hours in any
twelve-month pl3riod. For
more details on applicability
of this policy, please see
Ashland Municipal Code
Section 3.12.02~0.
For additional information:
Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator,
City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us.
Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all
employees.
<:ITY Of
ASHLAND
COA TlNG & SPECIAL TV CONTRACTOR
May 9,2006
City of Ashland
Public Works/Facility Maintenance
90 North, Mountain Avenue
Ashland, OR 97520
Attn: Dale Peters
Re: Water Treatment Plant
Exterior repairs and repainting proposals
We propose to provide all materials, labor and equipment necessary to complete the work as described,
for the total sums listed below:
",J''''.t.f~_rationa'8ut_:, ,{.'U~..OO deduct for use of your lift: $445.00
Repair Dryvit siding surface, pressure wash clean, caulk gutters, spot-prime as needed, then one
coat of Elastomeric paint on the body and one coat of Acrylic Semi-gloss on all trim. Filter basins
shall be protected with tarps to prevent influence of our activities.
2. New Chemical Building: $ 8,725.00 deduct for use of your lift: $:~OO.OO
Repair Dryvit siding surface, pressure wash clean, spot-prime as needed, then one coat of
Elastomeric paint on the body and one coat of Acrylic Semi-gloss on all trim.
3. Shop Building: $ 2,025.00 - no lift required -
Pressure wash surfaces, caulk as needed, spot prime as needed. One coat of Elastomeric paint
on the bqdy and one coat of Acrylic Semi-gloss on all trim.
4. Old Chemical Building: $ 4,915.00 deduct for use of your lift: $300.00
Repair Dryvit siding surface and CMU cracks, pressure wash clean, spot-prime as needed, then
one coat of Elastomeric paint on the body and one coat of Acrylic Semi-gloss on all trim. Screen
tarps are to be used to protect Creek.
5. Chlorine Building: $ 6,295.00 deduct for use of your lift: $300.00
Pressure wash surfaces, caulk as needed, spot prime as needed. One coat of Elastomeric paint
on the body and one coat of Acrylic Semi-gloss on all trim. Screen tarps are to be used to protect
Creek.
6. Powerhouse Roof clean: $ 2,825.00 deduct for use of your lift: $300.00
Pressure wash entire roof surface to remove moss from the composite shingles. No painting.
mailing: PO Box 4663. Medford, OR 97501 . shipping: 217 Bateman Dr. . Central Point, OR 97502
Phone 541-664-3010 . 1-800-554-3010 . Fax 541-664-1105 . fdtmedford@fdthornascom
COATING 8t SPECIALTY CONTRACTOR
Ashland Water Plant painting proposal, page 2
. NOTES:
1. The deduct for the possible use of you lift shall be credited to the proposed price for that building,
and only if the lift is capable of performing the tasks that we assumed need to be~ performed. We
have figured to use a 60' articulating-knuckle boom, or a 65' straight boom w/fin~ler-jib.
2. We need to have 5 day's notice to schedule the equipment and personnel for this work.
3. Owner is to provide ample 115V, 20-amp electrical service and bathroom facilitie~s.
4. Excluded from this proposal are Overtime costs and premium costs associated with night,
weekend or holiday shifts. We expect to complete the work during normal weekday hours.
5. Final Payment shall be invoiced net 30 days and without retention.
6. Any contract written for this work shall include this entire proposal as a whole within the contract
or as a referenced attachment.
7. We are expecting to complete all of the above-listed work, or any selected portions thereof, in no
more than two mobilizations. If requested, we will need to charge additional mob charges for work
desired but not scheduled consecutively.
We appreciate the opportunity to provide this quote. Please call with any questions.
Sincerely,
Dan Brewington
F.D. Thomas, Inc.
mailing: PO Box 4663. Medford, OR 97501 . shipping 217 Bateman Dr . Central Point, OR 97502
Phone 541-664-3010 . 1-800-554-3010. Fax 541-664-1105. fdtmedford@fdthomas.Gom
ACORDTM . CERTIFICATE OF LIABILITY INSURANCE I DATE (lllllD1lIYY)
06/13/2006
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATl'ER OF INFORMATION
Woodruff-Sawyer Oregon, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1001 SW 5th Avenue, Suite 500 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Portland, OR 97204 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(503) 416-7180 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Zurich American Insurance Company
F.D. Thomas, Inc. INSURER B: American Zurich Insurance Company
POBox 4663
Medford, OR 97501 INSURER C:
INlU IRF'R D:
I INSURER E:
__u --- _...~-~ - -. "-"'- .~. u
COVERAGES
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 CERTIFIICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS J~D CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Ir<<t: TYPE OF INSURANCE POUCY NUMBER POUCY EfFE(:1lVE POUCY EXPIRAnoN UMI18
GENERAL UABIUTY CP03739102 12/31/2005 12/31/2006 EACH OCCURRENCE, $ 1.000.000
f---
A eX 3MERCIAL GENERAL UABlUTY FIRE DAMAGE (My elllll Inl $ 300.000
ClAIMS MADE 00 OCCUR MED EXP (My 0081ll1l'SOl'l1 $ 10;000
- Stop Gap - $1,000,000 1.000.000
X. PERSONAL & ADV I~UURY $
GENERAL AGGREGI~TE $ 2 000 000
- 2 000 000
~'L AGGRErYiE UMIT APnS PER: PRODUCTS - COMPIOP AGG $
POliCY X ~~g: LOC
B ~OBILE UABIUTY CP03739102 12/31/2005 12/31/2006 COMBINED SINGLE UMIT $ 1,000,000
x.. ANY AUTO (Ea accident)
- ALL OWNED AUTOS BOOIL Y INJURY
$
SCHEDULED AUTOS (Pw penon)
X HIRED AUTOS BODILY INJURY
- $
X NON-QWNED AUTOS (Pw accident)
PROPERTY DAMACJ.E $
(Pw accidenl)
I RGE UABlUTY AUTO ONLY - EA Al:CIDENT $
I ANY AUTO ~ EA ACC $
I OTHER THAN
AUTO ONLY: AGG $
EXCESS UABlUTY EACH OCCURRENI::E $
:J OCCUR 0 ClAIMS MADE AGGREGATE $
$
=i DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSAnoN AND I T~9T~.N-..1 IO~-
I EMPLOYERS' UABIUTY E.L EACH ACCIDENT $
E.L DISEASE - EA EMPLOYEE $
E.L DISEASE - POUCY UMIT $
OTHER S
S
S
DESCRIPTION OF OPERAnoN8ILOCAnoNSIVEHIClES/EXCLUSlONS ADDED BY ENDORBEMENTISPECIAL PROVISIONS
I All Operations
I Operations of the Named Insured subject to policy terms and conditions.
I
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,
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CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION 10 Day Notice for Non-Payment ofPrcmiwn
! SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION
, City of AsWand DATE THEREOF, THE ISSUING INSURER WILL ENDEAV(IR TO MAIL ~ DAYS WRITTEN
i
I Service Center NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE I.EFT, BUT FAILURE TO DO so SHALl
i 90 N. Mountain Ave. IMPOSE NO OBUGAnoN OR UABIUTY OF ANY KIND UPON THE INSURER, 118 AGENTS OR
I AsWand, OR 97520 REPRESENTATIVES.
I LOAN #: AUTHORIZEDREPRESE~ATIVE ~-I
ACORD 25-8 (7/97) ID #:
Q ~~CORD CORPORATION 1988
IMPORTANT
I
J
If thA r.Artifi~tA hnlcfAr i~ an ADDITIONAl INSLJRFD, the policy(ies) must be endorsed. A st
on ....:- . . cfnA~ nnt '. to the . L ~- r in lieu of such endorsemenUsl.
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 oartificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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ACORD 25-8 (7/97)
I ACORD.. CERTIFICATE OF LIABILITY INSURANCE \ OATE(IIIIIDDIYY)
; 06/13/2006
! PRODUCER THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
I Woodruff-Sawyer Oregon, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
11001 SW 5th Avenue, Suite 1208 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY TIHE POLICIES BELOW.
, Portland, OR 97204
! (503)416-7180 INSURERS AFFORDING COVERAGE
!INSURED INSURER A:. SAIF Corporation
IF.D. Thomas, Inc. INSURER B:
POBox 4663
,Medford, OR 97501 INSURER C:
I INSURER D:
I I INSURER E:
COVERAGES
I 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 ~lND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Ilf'I~ TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POUCY EXPIRA110N UMlT8
~NERAL UASIUTY EACH OCCURRENCI:, S
COMMERCIAL GENERAl UASllITY FIRE DAMAGE (My ene lire) S
I ClAIMS MADE D OCCUR MED EXP (My cne Ilt'-) S
I - PERSONAL & AOV INJURY S
I - GENERAl AGGREW,TE S
~'L AGGREn LIMIT nS PER: PRODUCTS - COMP/OP AGG S
POLICY ~g: LOC
~OMOBlLE UASIUTY COMBINED SINGLE LIMIT S
AN'( AUTO (Ea 1Cdden1)
-
- ALl OWNED AUTOS BODILY INJURY
S
SCHEDULED AUTOS (Per penon)
-
I-- HIRED AUTOS BODILY INJURY
S
NON..QWNED AUTOS (Per accldent)
I--
PROPERTY DAMAGE S
(Per accldent)
, =rOE UAmUTY AUTO ONLY - EA AC:CIDENT S
AN'( AUTO OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCESS UASIUTY EACH OCCURRENc::e S
~ OCCUR D ClAIMS MADE AGGREGATE S
I s
I ==l DEDUCTIBLE S
RETENTION S S
I , WORKERS COMPENSAnON AND X I ~~T~Jltq I JO~-
iA ' EMPLOYERS' UASIUTY 812175 10/1/2005 10/1/2006 s 500,000
E.L EACH ACCIDENT
I E.L DISEASE - EA EMPlOYEE S 500,000
E.L DISEASE - POLICY LIMIT S 500.000
I OTHER S
S
i S
I DESCRlPTlON OF OPERA11ON8IL0CA11ON8IVEHICLESlEXCLUSlONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
I All Oponti...
Operations of the Named Insured subject to policy tenDS and conditions.
:
CERTIFICATE HOLDER I I ADDITIONAL INSURED' INSURER LETTER: CANCELLATION 10 Day Notice for Non-Payment of Premium
I SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CMCELLED BEFORE THE EXPlRAnoN
I City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVCiR TO MAIL ~ DAYS WRITTEN
I Service Center
I NOncE TO THE CERTIFICATE HOLDER NAMED TO THE I.EFT, BUT FAILURE TO DO so SHALL
90 N. Mountain Ave. IMPOSE NO OBUGATION OR UA8IUTY OF ANY KIND IJIPON THE INSURER, lT8 AOENTS OR
Ashland, OR 97520 REPRESENTATlVES.
I LOAN #: AUTHORIZED REPRESENTATNE ~.(
ACORD 25-8 (7/97) 10 #:
lit ~~CORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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 cortificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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ACORD 25-5 (7/97)
File:37 [OR] [PUBLIC] [OWNER]
Recording Requested by and Return
F. D. Thomas, Inc.
217 Bateman Drive
Central Point, OR 97502
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to: I
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City of Ashland
Customer:
P.O. #:
Project:
Rec ID:
Job #:
Cert No.:
City of Ashland
1TXOSOKQH
06-01110
0000 0000 0000 0000 0575
NOTICE OF RIGHT TO LIEN FOR FURNISHING LABOR,
MATERIALS OR EQUIPMENT
AND REQUEST FOR COPY OF PUBLIC BOND
TO THE OWNER OR REPUTED OWNER
City of Ashland
New Chern Building
90N. Mountain Ave.
ASHLAND, OR 97520
TO ORIGINAL OR REPUTED CONTRACTOR
TO LENDER, SURE TY OR BONDING CO.
1. The fallowinq is a general descriptiun of
the labor,service,equipmellt or materials
furnished or to be furnished by the undersigned:
See Exhibit C
o Estimated Price: $##########
3. The name of the person who furnished
that labor, service, equipment or
materials is:
F. D. Thomas, Inc.
217 Baternan Drive
Central Point, OR 97502
4. The name ot the person who contractRd for
purchase of that labor, service, equi~@ent
or material is:
City of Ashland
New Chern Building
90N. Mountain Ave.
ASHLAND, OR 97520
5. The description of the jobsite is:
City of Ashland
90 N. Mountain Ave
ASHLAND, OR 97520
County of JACKSON
REQUEST FOR COPY OF PAYMENT BOND AND NAME OF SURETY COMPANY
TO CONTRACTING BODY: City of Ashland New Chern Building or State Comptroller
The undersigned claimant hereby declares that he has supplied labor or materials as
described above, that payment has not yet been made therefore, and that he hereby
requests that the contracting body furnish a certified copy of the Payment Bond, if
any, to the claimant, at the address listed above, and the current address of the
contracting public entity.
NOTICE TO PUBLIC ENTITY OR AGENCY
THIS IS NOT A _Lr~". THIS IS NOT A REFLECTION ON THE INTEGRITY OF ANY CONTRACTOR OR
srJ''3C(i~TRACTOR. i.i'& UNDERSIGNED HAS ENTERED Ir.frC A C\"'~~~~cr 'I'O '::C:RFC~.: ~Gr: "'0 ~_1p~ISE
MATERIALS FOR THE ABOVE-DESCRIBED PUBLIC PROJECT, AND WILL LOOK TO YOU AND YOUR
SURETIES FOR PAYMENT IF THE PERSON ORDERING SUCH MATERIALS AND LABOR FAILS TO PAY FOR
THEM.
I declare that I am
read the foregoi
knowledge. I d
Executed at C
I have
my own
correct.
PROOF OF SERVICE BY MAIL AFFIDAVIT
I declare that I served a copy of the above document, and any related documRnts, by
certified or registered mail, postage prepaid, or other certified delivery, addressed
to the above named parties, at the addresses listed above, on Ob/20/2006. I declare
under penalty of perjury that the foregoing is true and correct. Executed at Central
Point, Oregon on 06/20/2006.
Prepared
Shawndra
IMPORTANT INFORMATION FOR YOUR PROTECTION
Under Oregon's laws, those who work on your property or provide labor, equipn~nt,
services, or materials and are not paid have a right to enforce their claim for payment
against your property. This claim is known as a Construction Lien.
If your contractor fails to pay subcontractors, material
suppliers, service providers or laborers or neglects to
payments, the people who are owed money can look to
even if you have paid your contractor in full.
suppliers, rental
make other legally
your property for
equipment
required
payment,
The law states that all people hired by a contractor to provide you with materials,
equipment, labor, or services must give you a notice of right to a lien to let you know
what they have provided.
WAYS TO PROTECT YOURSELF ARE:
--RECOGNIZE that this notice of a right to a lien may result in a lien against your
property unless all those supplying a notice of the right to lien have been paid.
--LEARN more about the lien laws and the meaning of this notice by contacting the
builders board, an attorney or the firm sending you this notice.
--WHEN PAYING your contractor for materials, labor, equipment or services you may make
checks payable jointly to the contractor and the firm furnishing materials, equipment,
labor or services for which you have received such a notice of the right to a lien.
--OR use one of the methods suggested in the INFORMATION NOTICE TO OWNERS. If you have
not received such a notice, contact the builders board.
--GET EVIDENCE that all firms from whom you have received a notice of the right to a
lien have been paid or have waived the right to claim a lien against property.
--CONSULT an attorney, a professional escrow company, or your mortgage lender.
File:38 [OR] [PUBLIC] [OWNER]
Recording Requested by and Return
F. D. Thomas, Inc.
217 Bateman Drive
Central Point, OR 97502
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to: I
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city of Ashland
Customer:
P.O. #:
Project:
Rec ID:
Job #:
Cert No.:
City of Ashland
1TXOSVKW9
06-01109
0000 0000 0000 0000 0585
NOTICE OF RIGHT TO LIEN FOR FURNISHING LABOR,
MATERIALS OR EQUIPMENT
AND REQUEST FOR COPY OF PUBLIC BOND
TO THE OWNER OR REPUTED OW,ER
City of Ashland
New Chern Building
90N. Mountain Ave.
ASHLAND, OR 97520
TO ORIGINAL OR REPUTED CONTRACTOR
TO LENDER, SURETY OR BONDING CO.
1. The following is a general description of
the labor, service, equipment or materials
furnished or to be furnished by the undersigned:
See Exhibit C
~ Estimated Price: $##########
3. The name of the person who furnished
that labor, service, equipment or
materials is:
F. D. Thomas, Inc.
217 Bateman Drive
Central Point, OR 97502
4. The name nf the person who contracted for
purchase of that labor, service, equipment
or material is:
City of Ashland
New Chern Building
90N. Mountain Ave.
ASHLAND, OR 97520
5. The description of the jobsite is:
City of Ashland
Paint Ops Building
90 N. Mountain Ave
ASHLAND, OR 97520
County of JACKSON
REQUEST FOR COPY OF PAYMENT BOND AND NAME OF SURETY COMPANY
TO CONTRACTING BODY: City of Ashland New Chern Building or State Comptroller
The undersigned claimant hereby declares that he has supplied labor or materials as
described above, that payment has not yet been made therefore, and that he hereby
requests that the contracting body furnish a certified copy of the Payment Bone, it
any, to the claimant, at the address listed above, and the current address of the
contracting public entity.
NOTICE TO PUBLIC ENTITY OR AGENCY
THIS IS NOT A LIEN. THIS IS NOT A REFLECTION ON THE INTEGRITY OF ANY CONTRACTOR OR
SUBCONTRACTOR. THE UNDERSIGNED HAS ENTERED INTO A CONTRACT TO PERFORM LABOR OR FURNISH
MATERIALS FOR THE ABOVE-DESCRIBED PUBLIC PROJECT, AND WILL LOOK TO YOU AND YOUR
SURETIES FOR PAYMENT IF THE PERSON ORDERING SUCH MATERIALS AND LABOR FAILS TO PAY FOR
THEM.
I declare that I am
read the fore~oing
knowledge. I dec r
Exe,:uted at Ce
Prepared by:
Chuck MC[lon
I have
my own
correct.
Fax: (541) 664-1105
PROOF OF SERVICE BY MAIL AFFIDAVIT
I declare that I served a copy of the above document, and any related document,o, by
certified or registered mail, postage prepaid, or other certified delivery, addressed
to the above named parties, at the addresses listed above, on 06/20/2006. I declare
under penalty of perjury that the foregoing is true and correct. Executed at Central
Point, Oregon on 06/20/2006.
Prepared by: ~~
Shawndra Strusz, Contract Admin~or
IMPORTANT INFORMATION FOR YOUR PROTECTION
Under Oregon's laws, those who work on your property or provide labor, equipnlent,
services, or materials and are not paid have a right to enforce their claim for pai~ent
against your property. This claim is known as a Construction Lien.
If your contractor fails to pay subcontractors, material
suppliers, service providers or laborers or neglects to
payments, the people who are owed money can look to
even if you have paid your contractor in full.
suppliers, rental
make other legally
your property for
equipment
req1.lired
payment,
The law states that all people hired by a contractor to provide you with materials,
equipment, labor, or services must give you a notice of right to a lien to let you know
what they have provided.
WAYS TO PROTECT YOURSELF ARE:
--RECOGNIZE that this notice of a right to a lien may result in a lien against your
property unless all those supplying a notice of the right to lien have been paid.
--LEARN more about the lien laws and the meaning of this notice by contacting the
builders board, an attorney or the firm sending you this notice.
--WHEN PAYING your contractor for materials, labor, equipment or services you may make
checks payable jointly to the contractor and the firm furnishing materials, equipnent,
labor or services for which you have received such a notice of the right to a lien.
--OR use one of the methods suggested in the INFORMATION NOTICE TO OWNERS. If you have
not received such a notice, contact the builders board.
--GET EVIDENCE that all firms from whom you have received a notice of the right too a
lien have been paid or have waived the right to claim a lien against property.
--CONSULT an attorney, a professional escrow company, or your mortgage lender.
r.,
C I TV 1""\....:, 1"'" ,...
I , r!t:lA..hiDER'S COpy
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
Page 1 / 1
6/20/2006
E'1-:~~~1
VENDOR: 004329
F D THOMAS
PO BOX 4663
MEDFORD, OR 97501
SHIP TO: Ashland Building Maintenance
(541) 488-5358
90 N MOUNTAIN AVENUE
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date: 6/16/2006
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Dale Peters
Confinning? No
BLANKET PURCHASE ORDER
Contractor to repair Dryvit sidinQ
surface, pressure wash clean, caulk
Qutters, spot-prime as needed, then one
coat of Elastomeric paint on the body
and one coat of Arylic Semi-Qloss on
all trim. Protect all basins and water
surfaces.
11,285.00
Location: WTP Operations BuildinQ
Contract for Wark
Date of AQreement: June 15, 2006
BeQinninQ Date: June 16, 2006
Completion Date: July 15, 2006
Insurance required/On file
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
11 285.00
0.00
0.00
11,285.00
~ ~dSign:~~C
VENDOR COPY
;.r.
n
CITY OF
ASl-l LAN D
REQUISITION FORM
THIS REQUEST IS A:
D Change Order(existing PO #
Date of ReqUi3st: 112.:t~ ~ I
Required Date of Delivery/Service: I A~A1' I
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
F:. O. ...,- ~rY\. A So
-.:po ~ q(.~~
t'Y\ s.n~RD O~ ~"fso \
S~\ - c.<.,.- 30\ <:>
$'+1- ~C.l.f-I\QS
R..q'f K'NN~1 .G'-t1-'4Lf-l~~G
SOLICITATION PROCESS
Small Procurement. D Sole Source D Invitation to Bid
D Less than $5,000 D Written findings attached (Copies on file)
D Quotes (Optional) D Quote or Prooosal attached
Cooperative Procurement D Request for Proposal
D State of ORIWA contract (Copies on file)
Intermediate Procurement D Other govemment agency contract D Special I Exempt
D (3) Written Quotes D Copy of contract attached D Written findings attached
(Copies attached) D Quote or Proposal attached
D Contract # D EmerQencv
D Written findings attached
D Quote or Prooosal attached
Description of SERVICES
Or<=-~\\61'\:1C '1;\4,- K~i>R' R. ~'JV't: Sd:>\N(.;" SlA"+,~)
itE5t'u~E- \..J...'>:=,Stf G~~-i2'cR.. Sv.12 t':::xt.E I C!..t"'ll.\. \ KJ sfOt rl2.~1'7\6 /O;s
NIS~O,6D, A y.y'} o-,..,e:,. cc.~l ~L~STC:Ynce"c- c:::r-r-.. loody ~^"O
Ac.~'j\'c Sc...-'-n'\' ,,1~ ~ trz.. ......... tko,c-<:.:r r<.\ LL "B i'=)S'~S ~ 17
o Per attached PROPOSAL \,t.:> ~ T ~ Q.. '5 U. (l...p ~~ .
Item #
Quantity
Unit
Description of MATERIALS
Unit Price,
Total Cost
Project Number _ _ _ _ _ _ - _ _ _
h (, (;
1(1t[
o Per attached QUOTE
Account Number~~ -~ t<=t -~ . ~ ~$3
. Items and services must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately
By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can be provided upon request. "
Employee Signa';;;;': ~ SupervisorlDept. Head Signature: U~.R<<Xt'H'
G: Finance\ProcedureIAP\Formsl8_Requisition form revised.doc
Updated on: 5/17/2006