HomeMy WebLinkAbout2007-093 Contract - Weathers Crushing
CITY OF ASHLAND
CONTRACT FOR PUBLIC WORKS CONSTRUCTION
Contract made this ~ ill day of H~ ' ,,?&) 7 ' between the
City of Ashland, ("CitY")~d W.pcJ.lo..("i (' .(~~ k-IC "(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 2007 Asphalt Crushing Project. Contractor was awarded the bid as the lowest
responsible bidder. In the event of any inconsistencies in the terms 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. This contract and
attached exhibits constitute the entire agreement between the parties. No waiver, consent, or
modification or change of terms of this contract shall bind either party unless in writing and signed by
both parties. Such waiver, consent, modification or change, ifmade, shall be effective only in the
specific instance and for the specific purpose given. There are no understandings, agreements, or
representations, oral or written, not specified herein regarding this contract. Contractor, by signature
of its authorized representative, hereby acknowledges that he/she has read this contract, understands it,
and agrees to be bound by its terms and conditions.
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 & Payment: 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. Performance 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 form
and with a surety satisfactory to City in the penal sum ofN/A (RFQ under $50.000) conditioned upon
the faithful payment and performance 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 harmless 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 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.
6. Insurance: Contractor shall, at its own expense, at all times during the term of this
agreement, maintain in force:
6.1 General Liability. 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 limit for bodily injury and property
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Weathers Asphalt Crushing Contract 5 07.doc
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.
6.2 Worker's Compensation. Worker's compensation insurance in compliance with ORS
656.017, which requires subject employers to provide Oregon workers' compensation coverage for all
their subject workers.
6.3 Automobile Liability. Automobile liability insurance with a combined single limit, or
the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for
each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-
owned vehicles, as applicable.
The City of Ashland, its officers, employees and agents shall be named as additional insureds on each
required insurance policy. 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 coverage 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.
Insuring companies or entities are subject to the City's acceptance. Ifrequested, complete copies of
insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be
financially responsible for all pertinent deductibles, self-insured retentions andlor self-insurance.
7. Compliance with Law:
7.1. This contract will be governed by and construed in accordance with laws of the State of
Oregon. Contractor shall promptly observe and comply with all present and future laws, orders,
regulations, rules and ordinances of federal, state, City and city governments with respect to the
services including, but not limited to, provisions of ORS 279C.505, 279C.515, 279C.520 and
279C.530.
7.2. Pursuant to ORS 279C.520(2) any person employed by Contractor who performs work
under this contract shall be paid at least time and a half pay for all overtime in excess of 40 hours in
anyone week, except for persons who are excluded or exempt from overtime pay under ORS 653.010
to 653.261 or under 29 U.S.C. Sections 201 to 209.
7.3. Contractor is a "subject employer" as defined in ORS 656.005 and shall comply with ORS
656.017. Prior to commencing any work, Contractor shall certify to City that Contractor has workers'
compensation coverage required by ORS Chapter 656. If Contractor is a carrier insured employer,
Contractor shall provide City with a certificate of insurance. If Contractor is a self-insured employer,
Contractor shall provide City with a certification from the Oregon Department of Insurance and
Finance as evidence of Contractor's status.
7.4. Any claim, action, suit or proceeding (collectively, "the claim") between the City (andlor
any other or department of the State of Oregon) and the Contractor that arises from or relates to this
contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson
County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall
be brought and conducted solely and exclusively within the United States District Court for the District
of Oregon filed in Jackson County, Oregon. Contractor, by signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this
section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh
Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction.
8. Default: A default shall occur under any of the following circumstances:
8.1 If the Contractor fails to begin the work under contract within the time specified, or fails
to perform 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 perform anew such
work as shall be rejected as defective or unsuitable, or shall discontinue the prosecution of the work.
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8.2 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.
8.3 From any other cause whatsoever, shall not carry on the work in an acceptable
manner.
804 Contractor commits any material breach or default of any covenant, warranty,
certification, or obligation it owes under the Contract;
8.5 Contractor loses its QRF status pursuant to the QRF Rules or loses any license,
certificate or certification that it required to perform the Services or to qualify as a QRF;
8.6 Contractor attempts to assign rights in, or delegate duties under the Contract.
9. 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 terms 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 the Contractor, then the Contractor shall be entitled to received the difference
less any damages 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 performance, if
any.
10. Termination:
10.1 Mutual consent. This contract may be terminated at any time by mutual consent of
both parties.
10.2 City's Convenience. This contract may be terminated at any time by City upon 30
days' notice in writing and delivered by certified mail or in person.
10.3 For Cause. City may terminate or modify this contract, in whole or in part, effective
upon delivery of written notice to Contractor, or at such later date as may be established by City under
any of the following conditions:
a. If City funding from federal, state, county, or other sources is not obtained and
continued at levels sufficient to allow for the purchase of the indicated quantity of services;
b. If federal or state regulations or guidelines are modified, changed or interpreted
in such a way that the services are no longer allowable or appropriate for purchase under
this contract or are no longer eligible for the funding proposed for payments authorized by
this contract; or
c. If any license or certificate required by law or regulation to be held by Contractor
to provide the services required by this contract for any reason denied, revoked, suspended,
or not renewed.
lOA For Default or Breach.
a. Either City or Contractor may terminate this contract in the event of a breach of
the contract by the other. Prior to such termination the party seeking termination shall give
to the other party written notice of the breach and intent to terminate. If the party
committing the breach has not entirely cured the breach within 15 days of the date of the
notice, or within such other period as the party giving notice may authorize or require, then
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Weathers Asphalt Crushing Contract 5 07.doc
the contract may be terminated at any time thereafter by a written notice of termination by
the party giving notice.
b. Time is of the essence for Contractor's performance of each and every obligation
and duty under this contract. City by written notice to Contractor of default or breach, may
at any time terminate the whole or any part of this contract if Contractor fails to provide
services called for by this contract within the time specified herein or in any extension
thereof.
c. The rights and remedies of City provided in this subsection (1004) are not
exclusive and are in addition to any other rights and remedies provided by law or under this
contract.
10.5 Obligation/Liability of Parties: Termination or modification of this contract
pursuant to subsections 10.1, 10.2, 10.3 and lOA above shall be without prejudice to any obligations or
liabilities or either party already accrued prior to such termination or modification. However, upon
receiving a notice of termination (regardless whether such notice is given pursuant to subsections 10.1,
10.2, 10.3 and 1004 of this section, Contractor shall immediately ceased all activities under this
contract, unless expressly directed otherwise by City in notice of termination. Further, upon
termination, Contractor shall deliver to City all contract documents, information, works-in-progress
and other property that are or would be deliverables had the contract been completed. City shall pay
Contractor for work performed prior to the termination date if such work was performed in accordance
with the Contract.
11. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget.
Contractor understands and agrees that City's payment of amounts under this contract attributable to
work performed after the last day of the current fiscal year is contingent on City appropriations, or
other expenditure authority sufficient to allow City in the exercise of its reasonable administrative
discretion, to continue to make payments under this contract. In the event City has insufficient
appropriations, limitations or other expenditure authority, City may terminate this contract without
penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further
liability to Contractor.
12. 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
The Contractor shall fully comply with the provisions of ORS 279C.800 through 279C.870 pertaining
to prevailing wage rates.
13. 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 more of the work under this
contract. Contractor must post the attached Living Wage notice predominantly in areas where it will be
seen by all employees.
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14. 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.
15. Governing Law: Jurisdiction: Venue: This contract shall be governed and construed in
accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws,
rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City
(and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to
this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson
County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall
be brought and conducted solely and exclusively within the United States District Court for the District
of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this
section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh
Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction.
16. MERGER CLAUSE: THIS CONTRACT AND ATIACHED EXHIBITS CONSTITUTE
THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT,
MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER
PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER,
CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE
SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO
UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITIEN, NOT
SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF
ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS
READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS
AND CONDITIONS.
16. Prior Approval ReQuired: Approval of the City of Ashland Council or Public Contracting
Officer is required before any work may begin under this contract.
CON~710R . J! . ~
By: /lvb4<4i. II- !J~
S{gnature
OAR UJ IrV 0/ WIft A--17I.?~/
Printed Name
Its: --f(~I~
CITY OF ASHLAND
By: ~.:I- L-,_
Lee Tuneberg" U
Finance Director
By:
Legal Department Date:
REVIEWED AS TO CONTENT:
BY:l~~'t" \~~~r-
Date:
Department Head ~ r- jo r- Q'I
Coding: 206. Off. I :;. DO _ fJ;Q7/af')
(For City use only)
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Weathers Asphalt Crushing Contract 5 07.doc
REVIEWED AS TO FORM:
CITY OF
ASHLAND
REQUEST FOR QUOTATIONS
Asphalt located at the Glenview Street asphalt pit. Finished product should be crushed
to a diameter of 1 inch or smaller. Water will be supplied by the City of Ashland Street
Department.
Please indicate your quotation for each of the following items as indicated below.
Item Descri tion
Unit
Unit Price
Amount
No.1 As halt Crushin
PLEASE RETURN QUOTE BY: 9:00 AM Friday. May 25. 2007
Date:
~ ilj~
S gnature
~ARlv tAl 0. tU6.4'TL~e&Address:
nn Name
Pt<b~ {Oe.~ T
lIue
By:
C::D70 1?~1C W~~
~/o/(R,4^- po I'A/r; d< ~
Q7c;oZ-
(;Jf:;+-~5 C~('vG :fA/C-..
(.;()/11pany
Phone: S-4/ -~Gq--43bO
Street Division
20 E. Main Street
Ashland. Oregon 97520
www.ashland.or.us
G:\pub-wr1<s\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Asphalt Crushing RFQ for Street Dept 5 07.doc
Tel: 541/488-5313
Fax: 541-/552-2329
TTY: SOOn35-2900
r.,
Form W-9
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
(Rev. January 2003)
Department of the Treasury
lrCemaI RIlW!nlJe Senrice
N Name
~ &.
~orporation 0 Partnership 0 Other. ...m_m____.___ 0 ~:;:n~~~m backup
Requester's name and address (optionaQ
(JfL.
o/7YO t---
I Social security INmber
I I + I + I
Enter your TIN in the appropriate box. For individuals. this is your social security m.mber (SSN).
However. for a resident alien, sole proprietor, or disregarded entity. see the Part I instructions on
page 3. For other entitles. it is your employer identiflC8tion number (EIN). If you do not have a number.
see How to get a TIN on page 3.
Note: If the account is in more than one name. see the chart on page 4 for guidelines on whose number
to enter.
Certification
Under penalties of pe!jwy. I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me). and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding. or (b) I have not been notified by the Intemal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends. or (c) the IRS has
notified me that I am no longer subject to backup withholding. and
3. I am a U.S. person [InCluding a U.S. resident alien).
Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withhoiding because you have failed to report all interest and dividends on your tax return. For real estate transactions. item 2 does not apply.
For mortgage Interest paid. acquisition or abandonment of secured property. cancellation of debt. contributions to an individual retirement
arrangement (IRA). and generany. payments other than interest and dividends. you are not required to sign the Certification. but you must
provide your correct TIN. (See the i tructions on pag .)
Sign
Here Oate ~
Purpose of Form
A person who is required to file an information return with
the IRS. must obtain your correct taxpayer identification
number (TIN) to report. for example. income paid to you. real
estate transactions. mortgage interest you paid. acquisition
or abandonment of secured property. cancellation of debt. or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
Qncluding a resident alien). to provide your correct TIN to the
person requesting it (the requester) and. when applicable. to:
,. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued).
2. Certify that you are not subject to backup withholding.
or
3. Claim exemption from backup withholding if you are a
U.S. exempt payee.
Note: If a requester gives you a form other than Form W-9
to request your TIN. you must use the requesters form if it is
substantially similar to this Form W.9.
Foreign person. If you are a foreign person. use the
appropriate Form W-8 (see Pub. 515, Withholding of Tax on
Nonresident Aliens and Foreign Entities).
or
Nonresident alien who becomes a resident alien.
Generally. only a nonresident alien individual may use the
terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However. most tax treaties contain a
provision known as a "saving clause. H Exceptions specified
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipient
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an
exception contained in the saving clause of a tax treaty to
claim an exemption from U.S. tax on certain types of income.
you must attach a statement that specifies the following five
items:
1. The treaty country. Generally. this must be the same
treaty under which you claimed exemption from tax as a
nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that
contains the saving clause and its exceptions.
4. The type and amount of income that qualifies for the
exemption from tax.
5. SuffICient facts to justify the exemption from tax under
the terms of the treaty article.
Cal. No. 10231 X
Form W-9 (Rev. 1-2003)
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Page 20 of 20
CERTIFICATIONS OF REPRESENTATION
Contractor, under penalty of perjury, certifies that:
(a) The number shown on this form is its correct taxpayer ID (or is waiting for the number to be issued
to it; and
(b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding
or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup
withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that
it is no longer subject to backup withholding. Contractor further represents and warrants to City that
(a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed
and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its
terms, and
(c) The work under the Contract shall be performed in accordance with the highest professional
standards, and
(d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor
also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it
is a corporation authorized to act on behalf of the entity designated above and authorized to do
business in Oregon or is an independent contractor as defined in the contract documents, and has
checked four or more of the following criteria:
V (1) I carry out the labor or services at a location separate from my residence or is in a specific
portion of my residence, set aside as the location of the business.
1(2) Commercial advertising or business cards or a trade association membership are purchased
for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
[/' (4) Labor or services are performed only pursuant to written contracts.
V (5) Labor or services are performed for two or more different persons within a period of one
year.
(6) I assume financial responsibility for defective workmanship or for service not provided as
evidenced by the ownership of performance bonds, warranties, errors and omission insurance or
liai~:;/~ors~ce;::;d~c 7
~actor . Date
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Weathers Asphalt Crushing Contract 5 07.doc
Ma~ 29 07 12:57p
Darwin & Penn~ ~eathers
541-884-7555
p. 1
Certificate of Insurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED.
This is to Certify that
~ Libe~
\P' Northweste
WEATHERS CRUSHING, INC.
6070 ROCK WAY
CENTRAL POINT OR 97502-1666
11.111111.1.1.1.111111.1.111.11.1111.1111.11..111.11I11.11,111
Man-her orUhcny NU!:~I Group
PO Box 4555
Portland. OR 97208-4555
503.239.5800
is, at the date of the certificate, in$ou,ad by the Company under the policylies) listed below. The insurance afforded by the II.ted pOlicyllesl
is subject to all their terms, exclusions, and conditions and is not altered by any requirement, term or condition of any contract or other
document with lespoet to which this certificate maybe issued.
TYPE OF POLICY EXPIRATION POLICY NUMBER LIMITS OF LIABILITY
DATE
COVERAGE AFFORDED UNDER W.C. LAW COVERAGE AFFORDED UNDER W.C. LAW
OF FOLLOWING STATES: OF THE fOLLOWING STATES:
IXI WORKERS'
COMPENSATION 10/01/2007 WC4-1NC-005581 OR
EMPLOYERS LIABILITY LIMITS EMPLOYER LIABILITY LIMITS
Each Iccitlenl S 500.000 Elch leciden. S
Diseose - policy 1I..lt S 500.000 DI.e..e - policy IImll S
Disease - e8ch employee S 500.000 Disease - ..ch emplayee S
MARITIME COVERAGE-fOLLOWING STATES LIMIT Of L1AB.-MARITIME COVERAGE
GENERAL LIABILITY Generol Aggregate $
0 Producls Camp/OPS Aggrego" $
Commercl.1 Generol
Li.bili.y IOccurencel PersoRl' " Advertising Injury $
0 Owner's and Elch Occurence $
[oDlrecler's PrDtectiYe fire llom.ge (Any one IIre~ $
0 Medic"' Expense (Any ane pe..onl S
AUTOMOBILE LIABILITY
0 Any Au'o CSL S
0 All uwned Aul.. Bodily In I ury (Per Persunl $
0 Scheduled Autos Bodily Inlury (Per Accident. $
0 Hired Altos Properly ll".."ge $
0 No.-own.~ Autos
0 G.r.ge li"hililY
0
OTHER
LOCATIONCSI Of OPERATIONS & JOB /I (IF APPLICABLE) DESCRIPTION OF OPERATIONS
PLEASE FAX ASAP TO: 541-488-6006
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING
CANCELLATION: COMPANY WILL ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT
FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, OR
REPREC::ENTATIVES.
MAILED TO: ,
CITY OF ASHLAND ~ /tMA&
ATTN: DAWN LAMB, ADM ASSISTANT v ,,""""""-
, ,
20 E MAIN ST AUTHORIZED REPRESENTATIVE
ASHLAND OR 97520-1850
11.1..111I1.1.1.,,1.1111111..11I111.,1.1,11.111.1111.111I1.1,1
EFS pol
9/1512006
MEDFORD
DATE ISSUED
OFFICE
Ma~ 29 O? 12:5?p
Darwin & P@nn~ Weathers
541-664-?555
p.2
ACORD... CERTIFICA TE OF LIABILITY INSURANCE DATE (MMlDDIYYYY)
8/31/2006
PRODUCER (541)772-1111 FAX: (541)772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Securi. ty :tnsura9C8 Aqency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
707 Murphy Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford. OR 97504 INSURERS AFFORDING COVERAGE NAIe #
INSURED INSURER A:. Oregon Automobi.~e :tns Co 23922
Weathers Crushing :tnc. INSURER B:
6070 Rook Way INSURER C
INSURER [)
Central. Poi.nt OR 97502 INSURER E:
THE POUCIES OF INSURANCE LISTED BELOW HAVE 8EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NaTWIll-tSTANDING ANY
REQUIREMENT, TERM OR CONDI110N 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 HE~,~~"IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDI110NS OF SUCH POUCIES.
INSR ADD'L TYPE or INSURANCE I'OUCY NUMBER "8.t-~<<i~=g&Wf PODALIflIIif...l:b~N LIMIT.
~NERAL LIABILITY 5 .1,000,000
~ pl\lERClAL GE3IIERAL LIABILITY DAMAGE TO REm'ED 5 100,000
A I-- CLAIMS MADE [Jl] OCCUR C1 7112459 9/.1/2006 9/1/2007 5 5 000
& AOV INJURY $ 1,000,000
r--- 2,000,000
I-- $
n'L AGGREGATE LIMIT nS PER; ~""'" ,~ - $ 2,000,000
,nPRO-
POLICY JECT LOC
~CMOBlLE UABILITY COMBINED SINGLE UMIT $ 1,000,000
~ /W'fALlTO (Ea eccidont)
A ALL U\lYNt:u AU I 00 C1. 71124:1l1 9/1/2006 9/1/2007 BODlL Y INJURY
r--- (Per person) $
r--- SCHEDULED AUTOS
I-- HIRED AUTOS BODILY INJURY $
NON-O~EC AUTOS (Per occodonl)
I--
I-- PROPERTY DAMAGE $
(Per lICCldonlj
GARAGE LIABILITY ALlTO ONLY - eA ACCIDENT $
R ANY ALlTO OTHER THAN "A ArY' $
ALlTO ONLY: AGG $
EXCESSAJMBRELLA LIABILITY $ 1,000,000
~ OCCUR D CLAIMS MADE AGGREGATE $
$
A R DBJUCTIBLE C17112459 9/1/2006 9/1/2007 $
RIiT"NTIO'" S S
WORKERS COMPl!NSA TICN AND I 'oIICSTATU- OJ~
EliPLOYERS' LJ.o.BIUTY
ANY PROPRlETORlPARTNERlEXECUTIVE E.L. EACH ACCIDENT $
OFFlCERh.lEtvEER EXCLUDED? E.L. DISEASE, EA
~I:-C=V='NS be""" E.L, DISEASE - POUCY UMIT $
OTHER . ,.
'. " . ..
: >',!
"
DE$CRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlEXCLUSlONS ADDeD BY ENDORSEMENTISPECIAL PROVISIONS
Re: ~haJ. ~ crushi.ng_ Ve~.t.:f.t.catJ.on of .t.nsurance. Sub:)ec~ to po1.t.cy t.ezma, cond:l. taons and excl.us1ons.
CERTIFICATE HOl. DER CANCELLAnON
SHOULD ANY OF THE ABOVE DESCRIBI!D POUClES BE CANCeLLED BEFORE THe
Ci ty of Ash~and EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDCAVOR TO MAIL
Dawn Lamb 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT
a:i.ak Illl&nagen.nt Dept. FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
20 East: Main INSURER, ITS AGENTS OR REPRESENTATIVES.
Ash1.and, OR 97520 AUTHORIZED REPRESENTATIYE
ACORD 26 {2001108)
INS026 (0108).08 AMS
@.... Wollllrs Kl.- =inancial Service6
o ACORD CORPORATION 1888
Poge1 "'2
Page 1 / 1
~A'
ASHLANf}JTY RECORDE~
20 E MAIN ST. 6/12/2007
ASHLAND, OR 97520
(541) 488-5300
PO NUMBER
07595
VENDOR: 006544
WEATHERS CRUSHING INC
6070 ROCK WAY
CENTRAL POINT. OR 97502
SHIP TO: Ashland Public Works
(541) 488-5587
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
Quantity Unit DescriDtion Unit Price Ext. Price
CrushinQ 3462 cubic yards of asphalt at 29.705.00
the Granite Street pit
Contract for Public Works Construction
Date of aQreement: May 30. 2007
Start date: June 10. 2007
Completion date: June 30, 2007
Insurance required/On File
I
SUBTOTAL 29 705.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 29,705.00
ASHLAND, OR 97520
Account.Number Project Number Amount Account Number Project Number Amount
E 260.08.12.00.60240( 22278.75
E 260.08.12.00.70410( 7.426.25
/ ~V2oV
~~- /
. Auth . ed Signature
'7
VENDOR COpy
REQUISITION
Department Street Department
Vendor WEATHERS CRUSHING INe.
6070 ROCK WAY
CENTRAL POINT OR 97502
Account No. 260.08.12.00.602400
260.08.12.00.704100
CITY OF
ASHLAND
No. PW - FY 2007
Date June I, 2007
Requested Delivery Date
Deliver To
Via
ASAP
JOHN PETERSON
750/0 (* Note: Please allow approximately two(2) weeks for delivery on items not
25% generally caried in stored. and approximately two (2) monlhs on printingjobs.l
. .
Item No. Quantity Unit DesCriptiOD Use o(Purchasine Office OnlY
Unit Price Total Price PO No.
Crushing 3462 cubic yards of asphalt at the Granite
Street pit. S 29,705.00
TOTAL S 29,705.00
for Kari:
BID IRFP / EXEMPT: RFQ
Contract Start Date: June 10, 2007
Contract Completion Date: June 30, 2007
Insurance on file: I YES I NO
Project No: N/A
.
Job No.
Unit No.
J hereby certify that the above items are necessary for the operation
.~-~-- ~
I t Head or Authorized Person
Issued By
Received By
Date
~~,
G:Pubwrks\engldeptadmin\engineer\project\2007 AsphaR Crushing Weathers RequisRion 507.xls