HomeMy WebLinkAbout2007-146 Contract - Kokopelli River Guides
Contract for GOODS AND SERVICES Less than $25,000
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONTRACTOR: Kokopelli River Guides
CONTACT: Matt Dopp (Home: 1655 Parker Street)
ADDRESS: 2475 Siskiyou Blvd, Ashland, OR 97520
TELEPHONE: 541-201-7694
FAX: 541-201-1984
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise 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 any 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 worker-like 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 provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Goods shall be paid for within 30 days of an invoice after delivery of goods
conforming to the standards and specifications. 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, unless a separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 279B.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $16,936 or more, Contractor is required to 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 is also required to post the notice attached
hereto as Exhibit B 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 (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 proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. 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.
c. 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 ma be established b Cit under an of the followin
Contract for Goods and Services Less than $25,000, Revised by Legal 03/26/2007, Page 1 of 6
conditions:
i. 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;
ii. 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
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. 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 the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. 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.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obliaation/Liabilitv of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of 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 a, b, c or d of this section, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the 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.
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.
11. Non-discrimination Certificate: In accordance with ORS 279A.11 0, Contractor has provided the City with a signed
Non-discrimination Certificate.
12. Asbestos Abatement License: If required under ORS 468A. 710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the 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.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Comoensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1.000.000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
c. Automobile Liabilitv 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.
d. Notice of cancellation or chance. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
Contract for Goods and Services Less than $25,000, Revised by Legal 03/26/2007, Page 2 of 6
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The certificate will specify all of the parties who are Additional Insureds. Insuring companies
or entities are subject to the City's acceptance. If requested, 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.
17. 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.
18. 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.
19. Nonappropriations Clause. 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.
20. Prior Approval Required Provision. Approval by the City of Ashland Councilor the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
CITY OF ASHLAND:
BY
TITLE
DATE
DATE
DLj /1-) ) 0 t
CO
By:
D FINDINGS DETERMINED BY:
, )L
City Department Date: I' /" ,
ACCOUNT # ;2/1 1;Z {') '3 t:2: b- C 6: c; ;:2.:z
(For City purposes only)
c~C:jC9
FederallD#
CY3 ~- \ .~_.~ ) L\ loCI
*Completed W9 form must be submitted with contract
PURCHASE ORDER #
Contract for Goods and Services Less than $25,000, Revised by Legal 03/26/2007, Page 3 of 6
. r
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 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, (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:
/
If
.
~
/
VI
(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.
UP'
Contract for Goods and Services Less than $25,000, Revised by Legal 03/26/2007, Page 4 of 6
Form W-9
(Rev. January 2003)
Departmenl 01 the Treasury
Inlemal Revlnle Service
~ Name Ko
III
Q.
l5
.11I
~f5
~i
'C .s
~di!
1
III
$
III
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
, UJ h; ~Lt,' (1
.'
L ,(
_ L
o Corporation 0 Partnership ~her ~ _.n!:-;-_~_~:__ 0 ~=d~m backup
Requester's name and address (optionaQ
))0
Enter your TIN in the appropriate box. For individuals. this is your social seclXity number (SSN).
However, for a resident alien, sole proprietor. or disregarded entity. see the Part I instructions on
page 3. For other entities. it is your employer identification 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.
~
or
Certification
Under penalties of perjury. 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 Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends. or (e) 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
withholding 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 generally. payments other than interest and dividends. you are not required to sign the Certification. but you must
provide your correct TIN. (See the instructions on pa .)
Sign
Here
Signature of
u.s. person ~
<"J:."",;'
Date ~
(':..,
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-Q only if you are a U.S. person
(including a resident alien). to provide your correct TIN to the
person requesting it (the requester) and. when applicable. to:
1. 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 requester's 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).
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." 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.
Cat. No. 10231X
Form W-9 (Rev. 1-2003)
Contract for Goods and Services Less than $25,000, Revised by Legal 03/26/2007, Page 5 of 6
CITY OF ASHLAND, OREGON
EXHIBIT B
City of Ashland
LIVING
ALL employers described
below must comply with City
of Ashland laws regulating
payment of a living wage
r.'
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 $16,936 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
lfIIIper hour effective June 30, 2006
(Increases annually every June 30 by the
Consumer Price Index)
portion of business of their
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 $16,936.
~ 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,
401K and IRS eligible
.cafeteria plans (including
childcare) benefits to the
amount of wages received by
the employee.
~ Note: "Employee" does not
include temporary or part-time
employees hired for less than
1040 hours in any twelve-
month period. For more
details on applicability of this
policy, please see Ashland
Municipal Code Section
3.12.020.
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.
CITY OF
ASHLAND
Contract for Goods and Services Less than $25,000, Revised by Legal 03/26/2007, Page 6 of 6
..
Kokopelli River Guides
2476 Siskiyou Blvd.
Ashland, OR 87620
(541) 201-7884
fax: 641-201-1884
InfoCIkokopelllrlvergu....com
www.kokooelliriverauides.com
2007 Summer AdultlYouth Raftina and Kavaklna ProoosaI
fri&.$80 per person + 3% RiverlLake Use Fee for both rafting trips and kayaking lessons
All of our rafting guides and kayak instructors are highly trained professionals. They are all
required to have a minimum of Advanced First Aid and CPR as well as certification in SWiflwater
Rescue. .'
Our auides and instructors:
Matt Dopp- owner of KokopeIIi River Guides. Guide and instructor for 14 years. Certified as an
ACA kayak instructor. Class 5 rafter and kayaker.
Leslie Dopp- owner of Kokopelli River Guides. Guide and instructor for 13 years. Competent
Class 4+ raft guide as well as competent Class 3+ whitewater kayaker.
Larry Zitzelberger- raft guide for 5 years. This will be Larry's 3rd summer working for Kokopelli.
Class 5 raft guide.
CJ Svela- raft guide for 6 years. This will be CJ's 2nd summer summer working for Kokopelli.
Class 5 raft guide. CJ is a Paramedic.
Greg Cross- raft guide for 3 years. This will be Greg's ~ summer summer working for Kokopelli.
Greg grew up learning to rr:NI rafts with his family in Ashland.
Jon Dallas- raft guide 5 years. Jon is an accomplished Class 4 whitewater kayaker. He is an
EMT.
All of the necessary equipment to be used is pwned by Kokopelli River Guides and is maintained
and kept in proper working condition throughout the season.
Raftina Eauioment
. 13' Hyside rafts
. Coast Guard approved life jacket for each participant
. Throw bag on every boat
. First aid kit and repair kit on every trip
. Safety talk given before every trip
Kavakina Eauioment (kids classes)
. Hardshell whil:ewater kayaks wI paddles
· COast Guard approVed life jacket for each participant and helmet
. First aid kit for eVery class
Kavakina Eauioment (Adult classes)
. Recreational, touring and Sit-on- Top kayaks wI paddles
. Coast Guard approved life jacket for each participant
. First aid kit for every class
Evergreen Insurance Managers Inc
PO Box 6597
DATE (MIIIIlDIYYI
5/23/2007
TIFICATE D OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
COMPANIES AFFORDING COVERAGE
Beaverton, OR 97007
INSURED
Kokopelli River Center and Kokopelli River Guides, Kokopelli
1655 Parker Street
COMPANY
A Certain Underwriters a LIoyds
COMPANY
B
COMPANY
C
Ashland, OR 97520
THIS IS TOCERTlFYTHATTHE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOlWlTHSTANDINGANYREQUIREMENT, TERMORCONDmON OF ANY CONTRACT OR OTHER DOCUMENTIMTH RESPECTTOIMiICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THE TERMS,
EXCLUSIONS AND CONDmONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co
LTR
TYPE OF INSURANCE
POUCY NUMBER
POUCY I!FFECTIVE POUCY EXPIRATION L.MTS
DATE (MMIDDIYY) DATE (MMIDDII'Y)
4/25/2007 4/25/2008 GENERAL AGGREGATE $ $2,000,000
PRODUCT8-COMPIOP AGG $ $1,000,000
PERSONAL & ADV INJURY $ $1,000,000
EACH OCCURRENCE $ $1,000,000
FIRE DAMAGE CM'/ one fl'-I $ $100,000
MED EXP (Any .... _) $
A
GENERAL UABlUTY
X COMMERCIAL GENERAL UA8IUTY
CLAIMS MADE ~ OCCUR
OWNER'S & CONT PROT
RBL002073
AUTOMOBILE UABIUTY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE UMIT $
BODILY INJURY
(Per pefIOn)
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
GARAGEUABlUTY
ANY AUTO
AUTO ONLY. EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
EXCESSUABIUTY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
~ COMPENSATION AND
EMPLOYERS' UABIUTY
THE PROPRIETOR!
PARTNERSIEXECUTIVE
OFFICERS ARE:
INCl.
EXCL
STATUTORY UMITS
EACH ACCIDENT $
DISEASE - pOLICY LIMIT $
DISEASE - EACH EMPLOYEE $
Operations: Guided whitewater rafting and rentals of raftslkayaks including guest lodging and meals.
Rental of snow skis, snowboards and ski tuninglbindings.
Certificate holder as added as Additional Insured
City of Ashland
Ashland Parks and Recreation
340 South Pioneer St.
Ashland, OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POUCES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSU"O COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOIl! NO OBUGATlON OR UABlUTY
OF ANY KIND UPON THE COMPANY, ITS AOENTS OR REPRESENTATIVES.
2007-07-0915:55
I(olr:opelll River Center 541-201-1984 :>:> 5414885320
P 1/1
KAHUT III WALKf.R INS
716 E JACKSON
MEDFORD, OR 97504
-
nriv~'
,........t:I'I6M~
Commercial Auto
Insurance Coverage Summary
This is your Renewal
Declarations Page
Policy number: 02194222-8
Underwnlten by
Progressive Northwestern Ins Co
.lu~e ~6, 2007
Policy Penod Jun 26,2007 - 0<>( 26, 2007
Page I of 2
drivein Su r;uue. com
Onlin. S'fYice
Ma~e payments, check billing activity, print
policy docum@nts, or check lhe stalu; of <)
claim.
Named insured
MA TT DOPP
DBA KOKOPElLl KAYAK
1655 PARKER ST
ASHlAND, OR 97520
541-179-6444
KAHUl .. WAlKER INS
Contact your agent for personalized service.
800-444-4487
For cllstomer service If YOlll agent IS
unavailClble or to report a claim.
~ ~
Your (0", rage beg^" on J""' 26. 2007 a I 11 01 ,. m. 'his policy 'pr.s on December 16.~ 1,01 ""
ThiS coverage summary replaces your prior one, Your insurance policy an any po I, ements contain a full explanation of
your coverage, The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto,
unless the policy contract allows the ~la(king of limits. The policy contract IS form 5912 (03/05) The contract is modified by forms
Z435 (12/06), Z228 (07/05), l5520R (10/05), 28520R (10/05), 48520R (10/05), 4B810R. (09/05) and 4792A (01/03)
The named insured organization type IS a corporation
Outline of coverage
De>Crlp\lOl'l
. ... .. ....
llmll\
D~duC1ible
Premium
liability To Others
.. Bodily Ini~~andPropertx Damage liability..
Uninsured Motorist Bodily Injury
~~msuredMotonst ~rop~lty DarT1a~e .
PersonallnjulY Prot~ct!on
ComprehenSive
See Schedule Of Covered Autos
. " '" .
Collision
See Schedule Of CoverlCd Autos
..1, " "
Total 6 month p~li~yprelT1l~m
[,)krnllnl if ni'llrl in fill!
$1,358
$1,000,000 combinedsln.gle limit.
$1,000,000 combined Single limit
'" .,.. . . .... ..
. ,Rejected
$15,000 each peMn .
120
$0
49
87
Limit of liability less deductible
, , . ..
380
limit of liability less deductible
"
$1,994
.93
2007-06-1214:48
lCokopelll River Center 541-201-1984:>:> 5414885320
P2/2
ICAHUT & WALIU:R INS
716 E JAC~ON
MEDFORD, OR 97504
-
rlriVA.
III.....lIII...,I'*~
1I11OSfl7
Commercial Auto
Insurance Coverage Summary
This is your Renewal
Declarations Page
Policy number: 02194222.7
UnderWIIlIen by:
l109fe~slv~ NOllhw~Jl~III Ins Co
De<.etnlJltl lR. 1001,1
rollcy Pl!1I0~: Dee 26. 2006 - Jun 26. 200 I
Page , 01 2
driveinsurance.com
Online Service
Milke payments. chcck billlflQ activity. PIli'l(
policy documcnt" or check lhe ~talli; of J
c1.'I/'Tl
Named in>ured
MATT DOPP
DBA KOKOPElLlI<AYJl.K
lfiSC; PARKrR ST
ASIUAND. OK 9/520
11.1" 1..,1.1.1.. .1.11I.... .1.1..11.11.." 1.1..1.1..1.1.1,"11
54'-779.6444
lAHUl & WALkER INS
Contact YOllr aqenllol personalized sel'Vlce,
Your coverage began on D!!l(~rnber 25, 200b at 12 :01 i), m, ~
This wveldgc $ummalY replaces your prior Ol]t'. YUill insurance poll polity t'ndol'.rrnents contain a t:.lll e~plilnation of
your coverage, The poli(y limits shown for an aulo may nul be com with the limits for \hl' ~i:lITll! lOvelage on another i1uto,
unlr~~. the policy contract allows the stackinSl of limits. The poli . ntract IS form 6912 (03/05). 1 he contract I> modilird by fOlllls
lnH (U7/05), 16520R (10/05), 28520R (lo/OS),48520R (1O/0S). 48810R (09/05) and 4792A (01/03)
The named insurt!d organlLi.llilin type is a corporation,
Outline of coverage
~.e'~riplion .' ."",.".".""" 00..".".."
Llabilily To Olhers
. .~o~ily.ln!~ryand ProP(!ll,xo.al~~~,~I.a~I.lity.
Uninsured Motorist Bodily InjulY
................. I
l)nin~ul~d ,~?toris.t p'~op~rt.y. o.arni;lgp..
P.el~onallnju'Y p'r~\~~li~~n.,..".,
Comprehensive
See S(hedule Of Covered Auto~
..",,,........,,............ ,
Collision
See Schedule Of Covered Aulo~
.............. ... ...................
Total 6 month policy premiqm
. , . . . . . . . , .. . .. . . . . . . . . . " . . . . . . . . . . . . . . . . . . .
r)i~(~~n~ jf paid In tvll.."." "''''''
Total 6 month policy premium if paid in full
luml~
Dedul\lble
Pl~mlllm
~1,(l52
, ,$,1 ~O,OO.~O.O, c.ol~.bl~,e~slngle limit
$1.00~~~~~ ~~~,b~~e~ single, limit
.. .. .....~~r:ct~d
Jl :.'O.O~ .e~c~ person .....,,,
14/
$0
..."
37
8/
limit at Iiabilily b~ deductible
. ...... ................
7.61
I imil or lidOility less dedlJ('tlhlr
$',579
-70
S 1,509
Rated drivers
. . . . . , . . , . . . . , . , . .. ...,...,.. . . . ,
1. MATT DOPP
...."...............
2, LESlIF DOPP
FOlln 6489 OR (05;1l2)
o
(otllillUl'lI
2007-06-1214:48
kokopelll River Center 541-201-1984 ;);) 541488 5320
P 1/2
salF'CORPORATION
400 High Street SE, Salem, OR 97312-1000 (503)373-8000 1-800-285-8525
Carrier No:
Policy No:
20001
957174 AR
Endorsement No:
WC890416
Agency:
KOKOPELLI KAYAK & WHITEWATER LLC
1655 PARKER ST
ASHLAND. OR 97520
HART INSURANCE (GRANTS PASS)
PO BOX 1240
GRANTS PASS. OR 97528
Policy Information Page Endorsement
Item 4 is changed to show this interim adjustment of premium:
Item 4. The premium for this policy will be determined by our Manuals of Rules. Classifications.
Rates and Rating Plans. The premium and rates and the experience rating modification
factor. if any, may change on your anniversary rating date of 10-01-2007. All
information required below is subject to verification and change by audit.
Class
Description. .....__
..
Estimated
Policy Period
Pa roll
Rate Per
$100 of
Pa roll
Estimated
Pr~_~ium .
Period: 10/01/2006 -12131/2006
Kokopelli Kayak & Whitewater Lie
2697 05 Guides-Noc-Dr
8017 41 Sporting Goods.Retall
881003 Office Clerical
Tota' Payroll
Manual Premium
Merit Rating
Non-experience Rated Credit
Estimated Premium
$4,096
$3,403
$0
$7.499
6.95
2.02
0.28
$284.67
$68.74
$0.00
x
x
$353.41
0.9000
0.8900
$283.08
Period: 01/01/2007 - 08/30/2007
Kokopelli Kayak & Whitewater lie
2697 05 Guides-Noc-Dr
801741 Sporting Goods-Retail
881003 Office Clerical
Total Payroll
Manual Premium
Merit Rating
Non.el(perience Rated Credit
Estimated Premium
$12.154
$10,097
$1
$22,252
6.95
2.02
0.28
$844.70
$203.96
$0.00
x
x
$1,048.66
0.9000
0.8900
$839.98
Page 1
CITY RECORDER'S COpy
Ashland Park Commission
Page 1 / 1
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
DATE
6/13/2007
PO NUMBER
00009
VENDOR: 001469
KOKOPELLI RIVER GUIDES
1655 PARKER STREET
ASHLAND, OR 97520
SHIP TO:
FOB Point:
Terms: Net 30 days
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: Park and Recreation
Contact: Kari Olson
Confirming? No
Quantity Unit Description Unit Price Ext. Price
Certified Guided RaftinQ & KayakinQ 12,500.00
Trips
2007 Parks Summer Session
RaftinQ:
20 Persons/5 Trips $8,240.00
KayakinQ
Youth- 8 Persons/4 Trips $2,636.80
Adults - 8 Persons/2 Trips $1,318.40
Plus 3% River/Lake UsaQe Fee
Not to exceed $tZ,500.00
Contract for Goods & Services
BeQinninQ date: June 27,2007
Completion date: AUQust 3, 2007
Insurance required/On File
SUBTOTAL 12 500.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 12,500.00
Account Number Project Number Amount Account Number Project Number Amount
E 211.12.03.02.60692 12 500.00
~ .' /
flY:; / e,. L/ /",.{
Authorize . natcfre
VENDOR COPY