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Home My WebLink About2007-114 Contract - Asphalt Maintenance Assoc. CITY OF ASHLAND CONTRACT FOR PUBLIC WORKS CONSTRUCTION Contract made this 2e'f'- day of -1 wve- , 2007, between the City of Ashland, ("City") and Asphalt Maintenance Associates, 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 2007 Street Slurry Seal 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, 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 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 of $56,911.20 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 Street Slurry Seal AMA Contract Doc 6 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 insuranc .th 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 and/or 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 (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 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.IIfthe 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. G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Street Slurry Seal AMA Contract Doc 6 07.doc 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 carryon 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 ofthe 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 ofthe 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 Street Slurry Seal AMA Contract Doc 6 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 (10.4) 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 10.4 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 10.4 .of this section, Contractor shall immediately ceased all activities under this contract, unless expressly directed otherwise by City in notice oftermination. 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 coinply with the provisions of ORS 279C.800 through 279C.870 pertaining to prevailing wage rates. 13. Living Wage Rates: Ifthe 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. G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Street Slurry Seal AMA Contract Doc 6 07.doc 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 ofthe 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 ofthe 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 ATTACHED 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 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. 16. Prior Approval Required: Approval of the City of Ashland Councilor Public Contracting Officer is required before any work may begin under this contract. CONTRACTOR By: 3~M/~ Signature Efj)~n~~al{!~ Its: 7~eM7J&J7 ----.... CITY OF ASHLAND By'. ///{ J' /7 /? /l.J'< -;:;;1 J1--~'" ~-~ Lee Tuneberg . Finance Director v? /2 7~i 7 REVIEWED AS TO CONTENT: By: 4~ L ' Date: 21JIfAt IT] Department Head Coding: 6l--v OJ ? {; g 6 for City use only) G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Street Slurry Seal AMA Contract Doc 6 07.doc 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. ~ (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. (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 liability insurance relating to the labor or services to be provided. ~k:>./e Contractor b ~ rJ )-(){),1 Date G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Street Slurry Seal AMA Contract Doc 6 07.doc BeecherCarlosn/JBLK 6/20/2007 9:18:55 AM PAGE 001/007 Fax Server JB~K RISK SERVICES, LLC FAX TRANSMITTAL NAL4678FOD95BEE Date: 6/20/2007 9: 18:08 AM To: Company: Phone: Fax: Dawn Lamb City of Ashland Num of Pages: (including cover) From: Phone: Fax: Email Address: 7 541-488-6006 Nadya Alami (541 )284-3091 (541 )284-3191 nadya.alami@jblk.com Please find attached a Certificate of Insurance issued for Asphalt Maintenance Associates Inc. Thank you, Nadya 59 East 11th Ave Eugene, OR 97401 (541 )485-6633 Main (541 )485-3946 Fax CA Ucense #OF09618 OR Ucense #816307 WA Ucense #252204 dba JBL&K Insurance Agency ...a Beecher Carlson Company . . BeecherCarlosn/JBLK 6/20/2007 9:18:55 AM PAGE 002/007 Fax Server A CORD_ CERTIFICA TE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 6/19/2007 PRODUCER (541) 485-6633 FAX: (541) 485-3946 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JBL&K Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 59 E 11th Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 70206 Euaene OR 97401 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Indian Harbor Insurance Asphalt Maintenance Assoc Inc INSURER B. Safe co Insurance 2080 Prairie Rd INSURER C INSURER D Eugene OR 97402 INSURER E 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 DDCUVlENT 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 CONDITlONS OF SUCH POliCIES. 1\,,,,, I~;: ~~~} TYPE OF INSURANCE POLICY NUM BER P8H~~~~~g8~~ "%~'fJ (~X~~~I~N LIMITS ~NERAL LIABILITY EACH DeCl RRENCE $ 1 000 000 ~ ~~rI'.ERCIAL GENERAL LIABILITY ~~:ro:1HTE~~J~~...,ce) $ 100,000 A - CLAIMS MADE ~ OCCUR ESGOO22307 2/26/2007 2/26/2008 MED EXP IAnv one oe"""" S 5,000 X Wash~ngton stop Gap DER"n"A . ^~ ''^ "D' $ 1 000 000 X Emp10yee Benefits GENERAL AGGREGATE $ 2,000,000 ~'L AGGREC ATE LIMIT APPLIES PER: PROOIJCTS - COMPIOP AGe; $ 2,000,000 X POLICY I I ~c?T r I LOC Employee llenefi t~ 1.,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 r--- (Ea dcctdent) $ f--- ANY AUTO B ALL O_ED AUTOS 01CH3672271 2/26/2007 2/26/2008 BODILY INJURY f--- (P@r p@r!>on) $ ~ SCHEDULED AUTOS ~ HIRED AUTOS BODIL Y INJURY $ ~ NON-Ov..NED AUTOS (Per acc>lent) ~ PROPERTl' DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG S EXCESSfUMBRELLA LIABILITY EACH OCCURRENCE $ o OCCUR D CLAIMS MADE AGGREGATE $ $ ~ DEDlJCTIBLE $ <>=<=NTI"" 0 WORKERS COMPENSATION AND I T~?T~J\Ys I IOJ~- EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE If yes, describe under SPECIAL PROVISIONS below E L DISEASE POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONSfLOCATlONS/VEHICLE5IEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS The City of Ashland, its officers, emp10yees & agents are included as additional insured as respects general liability where requ~red by written contract. This form is subject to policy terms, condi tions, and exclusions, Re: 2007 Slurry Seal Project CERTIFICATE HOLDER CANCELLA TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Ci ty of Ashland EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 East Main Street 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT Ashland f OR 97520 - FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPREseNT A TIVE ~((~/ Ron CEamer/NADYAL ACORD 26 (2001/08) INS026 (0108) 08a @ACORDCORPORATION 1988 Page1of2 BeecherCarlosn/JBLK 6/20/2007 9:18:55 AM PAGE 003/007 Fax Server COMMERCIAL GENERAL LIABILITY CG 20 33 07 D4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU Thfs endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A 5e<;:tlon II - Who Is An Insured is amended 10 include as an additional insured any person or or- ganization lor whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organizatlon is an additional insured only with re- spect to liability for "bodily injury", Rproperty dam- age" or "personal and advert.lsing II1jury" caused, in whole or in part, by: 1. Your ads or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations tor that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render. any professional architectural, engineering or sur- veying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury. or "property damage" occurring after: it. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repa~rs) to be performed by or 00 behalf of the additional insured{s) at the Iocatlon of the covered operations has been completed; or b. That portion of "your workR out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractQf" Of subcontractor engaged in performing operations for a principa I as a part of the sam e project. CG 20 33 07 04 Copyright, ISO Properties, Inc., 2004 BeecherCarlosn/JBLK 6/20/2007 9:18:55 AM PAGE 004/007 Fax Server POLlCY NUMBER: ESG0022307 COMMERCIAL GENERAL LIABILITY CG 20 3710 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU Location And Descriptio n of Completed Operations: Additional Premium: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) Section II - Who Is An Insured is amended to include as an Insured the perscln ()r organization shown in the Schedule, but only with respect to liability arising out of .your work" at the loceti<ln designated and descrjbed in the schedule of this endorsement performed for that insured and included in the "products-completed operations hazard". CG 20 37 10 01 Copyright, ISO Properties. Inc., 2000 BeecherCarlosn/JBLK 6/20/2007 9:18:55 AM PAGE 005/007 Fax Server IMPORT ANT If the certificate holder is an ADDITIONAL INSURED, the policY(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu oi 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 certiiicate does not conier rights to the certificate holder in lieu oi 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. ACORD 26 (2001108) INS026 (0108) 08a Page 2 of 2 BeecherCarlosn/JBLK 6/20/2007 9:18:55 AM PAGE 006/007 Fax Server ACORD... CERTIFICA TE OF LIABILITY INSURANCE DATE (MMIDDIYYYYJ 6/19/2007 PRODUCER (541) 485-6633 FAX: (541)485-3946 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JBL&K Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 59 E 11th Ave Al TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 70206 Eugene OR 97401 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. SAIF Corporation Asphalt Maintenance Assoc Inc INSURER S. 2080 Prairie Rd INSURER C INSURER D Eugene OR 97402 INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT\MTHSTANDING ANY REQUIREMENT, TERM OR CONDITlON 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. l I R"" '''''.... A'M<:: IN;: t,~~~ TYPE OF INSURANCE POLICY NUM BER P8kt~~~~6&WF "%~'fJ r~'l.,~C~I~N LIMITS GENERAL lIABILITY EACH OCCURRENCE $ - ~~~~~~J?E~~J';;~ncel - ==rMERCIAL GENERAL LIABILITY $ - CLAIMS M~DE D OCCUR MED EX? IAnv one De"",,nl $ - PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ - n'l AGGREGATE L1MI1 APPLIES PER: PR()[)IIr.TS. I $ POLICY I l ~8T r l LOC AUTOMOBILE LIABILITY COM81NED SINGLE LIMIT f-- (Ea aCCident) $ ANY AUTO f-- ALL OWNED AUTOS BODILY INJURY f-- (Per person) $ f-- SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY $ NON.OiNNEO AUT OS (Pel' accident) - PROPERTY DAMAGE $ (Pel" accident) GARAGE LIABilITY AUTO ONLY. EA ACCIDENT $ ~ ANY AUTO OTHER THAN "A ArY. $ AUTO ONLy AGG ~ EXCESs/UMBRelLA LIABILITY EACH OCCURRENCE $ :=J OCCUR D CLAIMS MADE AGGREGATE $ ==1 DEDUCTIBLE S $ $ A WORKERS COMPENSATION AND I. v..c STATU.; 1 OTH. X TORY LIMITS ER EMPLOYERS' LIABILITY ~,OOO,OOO ANY PROPRIETOR/PARTNERJEXECUTIVE E L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? 440262 10/1/2006 10/1/2007 E.L. DISEASE. EA EMPLOYEE, 1 000,000 If ye~, describe under 1,000,000 SPECIAL PROVISIONS below EL DISEASE. POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONSlLOCATIONS/VEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City of Ashland, its officers, employees & agents Re: 2007 Slurry Seal Project CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE Ci ty of Ashland EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil 20 East Main Street 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEn, BUT Ashland, OR 97520 - FAILURE TO DO so SHAll IMPOSE NO OBLIGATION OR lIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHOR~EDREPRESENTATWE ~k~/ Ron CLamer/NADYAL ACORD 26 (2001108) INS026 (0108) 08a @ ACORD CORPORA nON 1988 Page 1 at 2 BeecherCarlosn/JBLK 6/20/2007 9:18:55 AM PAGE 007/007 Fax Server IMPORT ANT If the certificate holder is an ADDITIONAL INSURED, the policY(les) 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 certificate 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. ACORD 25 (2001/08) INS025 (0108) 08a Page 2 of 2 0;-) n~ (r ri) [F,f 0 iJJ m- Il" Lie lrl r' c: 1./ --' -.l Uu JUl 2 :_- Z~~I? By CITY OF ASHLAND NOTICE OF TRANSMITTAL TO: KARl OLSON PURCHASING DATE: PROJECT: JOB NO.: SUBJECT: JUNE 27, 2007 2007 STREET SLURRY SEAL PROJECT N/A REQUISITION THE FOLLOWING ITEMS ARE BEING SENT TO YOU: Please find attached one original contract with Asphalt Maintenance Associates Inc. to slurry seal various streets with Ashland. Along with the requisition are the certificate of insurance and the certificate of representation. Please issue a PO for this project at your earliest opportunity. t- UNDER SEPARATE COVER ENCLOSED REMARKS: COPIES TO: Department OfP~b c ~rks By: Dawn Lamb \ Title: PW Mana em t ssistant PUBLIC WORKS 20 E. Main Street Ashland, Oregon 97520 www.ashland.or.us G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2007\2007 Street Slurry Seal AMA Req NOT 6 07.doc Tel: 541-488-5587 Fax: 541-488-6006 TTY: 800-735-2900 r~' CITY RECORDER'S COpy Page 1 / 1 rA' CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 ~ ~~--MI~ 7/4/2007. . 07636 , VENDOR: 004331 ASPHALT MAINTENANCE ASSOCIATES 2080 PRAIRIE ROAD EUGENE, OR 97402 SHIP TO: City of Ashland-Warehouse (541) 488-5354 90 N MOUNTAIN ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: Speciallnst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No 2007 Street Slurry Proiect - Slurry sealinQ of various streets within Ashland 56,911.20 Contract for Public Works Construction Date of aQreement: June 28, 2007 Insurance required/On file BILL TO: Account Payable 20 EAST MAIN ST 541-552-2028 ASHLAND, OR 97520 SUBTOTAL TAX FREIGHT TOTAL 6 11 .20 0.00 0.00 56,911.20 E 260.08.12.00.60240 E 260.08.12.00.70410 ~~-~? Auth ed Sig ature VENDOR COPY CITY OF ASHLAND REQUISITION No. PW - FY 2007 Department Street Department Vendor ASPHALT MAINTENANCE ASSOCIATES INC. 2080 PRAIRIE ROAD EUGENE OR 97402 Account No. 260.08.12.00.602400 260.08.12.00.704100 Date June 27, 2007 Requested Delivery Date Deliver To Via 75% (0 Note: Please IIlow IppI'OltimateIy two(2) weeks for delivory on items not 25% ~ CIried in stored, and IppI'OximateIy two (2) monlhs on printingjobs.) ASAP JOHN PETERSON Item No. Quantity Unit Description Use ofPurcbasin Office Unit Price Total Price PO No. Contract with Asphalt Maintenance Associates Inc. for the sluny sealing of various streets within Ashland. S 56,911.20 TOTAL $ 56,911.20 Job No. 1 . " ' . 00 .:~.YBS,,:;;.: " o iN/A' ",.",; Unit No. I honby catiIY Ibat the Ibove items .... nocasory for the operation ~~---- ~ / Heod or Authorized Penon Issued By Date Received By ~.l' G:Pubwrks\eng\deptadmin\engIneer\pr0ject\207 Street Slln)' Seal AMA Requls~ion 6 07.xls