HomeMy WebLinkAbout2007-147 Contract - Lange, Jon
Contract for PERSONAL SERVICES Less than $25,000
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONSULTANT: Jon Lange
CONTACT: Jon Lange
ADDRESS: 194 Logan Drive, Ashland, OR 97520
TELEPHONE: 541-552-6425
DATE AGREEMENT PREPARED: 7/2/07
BEGINNING DATE: 7/2/07
COMPENSATION: $150.00/Hour
FAX:
COMPLETION DATE: 8/31/07
SERVICES TO BE PROVIDED: Facilitate City of Ashland Goal Setting Session plus set up of system for
trackinq proqress over next 12 months.
ADDITIONAL TERMS: Contract total not to exceed $5000.00
FINDINGS:
Pursuant to AMC 2.52.040E and AMC 2.52.060, after reasonable inquiry and evaluation, the undersigned Department
Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have
adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for
utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and
capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and
financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the
compensation negotiated herein is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings I Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service 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.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified
above. Once work commences, invoices shall be prepared and submitted by the tenth of the month for work
completed in the prior month. Payments shall be made within 30 days of the date of the invoice. Should the contract
be prematurely terminated, payments will be made for work completed and accepted to date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $17,342 or more, Consultant 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 service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Consultant 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 Consultant (including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations,
actions, costs, judgments, or other damages, directly, solelv, and proximately caused by the negligence of Citv.
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 1 of 2
10. 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 Consultant, or at such later date as may be established by City under any of the following
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 Consultant 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 Consultant 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 Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant 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. Oblioation/Liability 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, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Consultant 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 Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant 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. Consultant 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.
13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant 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.
14. Insurance. Consultant shall at its own expense provide the following insurance:
a. 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
b. Professional Liability Not Applicable. This is to cover damages caused by error, omission or negligent
acts related to the professional services to be provided under this contract.
c. General Liability Not Applicable. It shall include contractual liability coverage for the indemnity provided
under this contract.
d. Automobile Liability Not Applicable.
e. Notice of cancellation or chanoe. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coveraoe(s) without 30 days' written notice from the Consultant or its insurer(s) to
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 2 of 6
the City.
f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Consultant's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Consultant 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 Consultant shall be financially responsible for all pertinent
deductibles, self-insured retentions and/or self-insurance.
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 Consultant 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. Consultant, 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. 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.
CONSULTANT, 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.
17. 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. Consultant
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 Consultant, with no further
liability to Consultant.
Certification. Consultant shall sign the certification attached hereto as Exhibit A and herein incorporated b reference.
CONSULTANT CITY OF ASHLAND:
BY
BY
R
TITLE
DATE
DATE
tJ7/o01
FederallD#
/9%-3~-072g
ACCOUNT #
*Completed W9 form must be submitted with contract
PURCHASE ORDER #
CJ'7G~6
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 3 of 6
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 10 (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:
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.
V' (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.
V (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.
conq5 4f
t)7~Z-/o 7
(Date)
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 4 of 6
Form W-9
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
Enter your TIN in the appropriate box. For individuals. this is your social security 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.
(Rev. January 2003)
Department of the Treasury
Illlernal Revenue SE!lVice
N
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GI III
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Name
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Business name. if different from above
r-I.-lndividuall
Check appropriate box: l..!::] Sole proprietor
o Corporation
Address (number, street. and apt. or site no.)
/ 'j 'I L () fi 1'1"~
City. state. and:S /fL A-~1J" QI2...
Ust account number(s) here (optional)
9 7~ ;).. c)
O Exempt from backup
. withholding
Requester's name and address (optional)
o Partnership 0 Other ~ ._u_.._u_.uuu.
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 (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
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 page 4.)
Sign I Signature of
Here .. u.s. person" 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-g 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 Personal 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.
~&,
~ For all hours worked under a
service contract between their
employer and the City of
Ashland if the contract
exceeds $17,342 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
tIEI!Iper hour effective June 30, 20
(Increases annually every June
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 $17,342.
~ If their employer is the City of
Ashland including the Parks
and Recreation Department.
~ In calculating the living wage,
employers may add the value
of health care, retirement,
401 K and IRS eligible
cafeteria plans (including
childcare) benefits to the
amount of wages received by
the employee.
~ Note: "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 Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 6 of 6
Jon Lange
194 Logan Dr.
Ashland, OR 97520
Diana Shiplet, Executive Secretary
City of Ashland
20 E. Main St.
Ashland, OR 97520
3/19/07
:-.~ ~ @[E 0 \JI-'~~m.~
l~l MAR 1 9 2ro~ i ~,:
IBy_______ . J
To whom it may concern,
This work responds to the Request for Proposal for a facilitator for the City of
Ashland's goal-setting session( s). Enclosed please find a one page outline of the
process I am proposing, as well as a client list. The first page of the list includes
some resume-like/demographic information; it also notes that I conducted the
City of Ashland's goal-setting sessions for several years in the 1980s.
To address the request for three references of similar work conducted within the
past two years, here are three local ones:
Tom Olbrich, Executive Director, or Jim Teece, Board Member
ashland independent film festival/488-3823
Paul Nicholson, Executive Director
Oregon Shakespeare Festival/482-2111
Elisabeth Zinser, President (former)
Southern Oregon University (Foundation)/Through: 552-6111
Regarding cost: I charge a government rate of $ 150.00/hour and have estimated
eleven hours of work so the estimated cost would be $1650.00--more or less
depending on what we finally agreed to. There would be no expenses.
Finally, I wish to add to this relatively formal letter, that I would enjoy working with
the council, department heads, city administrator and mayor. I have facilitated
similar work in this valley for over 25 years now, and would welcome the chance
to reacquaint myself personally with this group that I watch so many Tuesday
evenings. I wish you the best in your selection process and all future endeavors.
Sinc~rely,
." / ,-/- '1
.....-c-,'y\. ~"V-.?' L
.in Lange 0
CITY OF ASHLAND
GOAL SETTING
The following outline follows a standard, nominal group technique (dot-voting) goal-setting
process. My guess is that some of those reading this document are familiar with the process.
It is relatively simple and straightforward, thorough, democratic and holds potential for both
creativity and efficiency. At the end, participants are left with a prioritized list, much like
the one from last year. It is possible that Council and! or others will want to include
department heads in different ways; this can be discussed. One approach is proposed below,
in which department heads are included but not in the goal identification and! or voting.
However, they are included in other aspects of the work
I. Assessment
a. Meet with City Administrator and! or Mayor to learn more about
context, last year's remaining goals (validation and revision
possibilities), suggested adjustments and additions to the plan (below)
for goal setting and "sign off" to move forward. (One hour approx.)
b. Meet with Council and Department Heads to introduce myself to those
I don't know, discuss plan and let them know of impending e- mail
from me that will request any relevant information they would like to
share with me (kept anonymous) regarding upcoming goal setting
session. (With Council and Department Heads: 20 minutes approx.)
II. Preparation: Receive, read and summarize relevant e-mail information and
ready it for presentation to council via e-mail and in the first part of the first
meeting session (Three hours approx.)
III. Goal-Setting. Nominal Group Technique (Dot-Voting) (Six hours)
Introduce sessions
Reach agreement on "left over" 2006 goals
Nominal Group Technique:
· Silent Generation of Ideas in Writing By Council (Actionable/Do-
Able)
· Round Robin Feedback! Goals written on flip charts and displayed
· Discussion: darification, Understanding and Advocacy
· Synthesis of Ideas. dustering similar goals.
· Rank Ordering with Dot-voting By Council (if necessary)
. Each person gets a five, four, three, two and one point vote.
These are added and goals are prioritized, though even lower-
scoring goals are possible to retain.
· Identify Objectives. Add to goals (if necessary)
· Delegating/ Assigning (if necessary)
· Write up
· Final Check with Council and Department Heads (One to two
additional hours, if desirable)
JON LANGE
194 LOGAN DRIVE. ASHLAND. OREGON. 97520
. 541.552.6425 .
lange@sou.edu
EDUCATION
University of Washington, Ph.D., 1981
NIajor Emphases: Conflict NIanagement, Organizational Communication and Development
Portland State University, M.S., 1975
NIajor Emphases: lntetpersonal and Small Group Communication
Minor Emphases: Counseling and Psychotherapeutic Communication
Pennsylvania State University, B.A, 1973
NIajor: Speech Communication
Minor Emphases: Psychology and Social Psychology
TEACHING AND ADMINISTRATIVE POSITIONS
Southern Oregon University
Professor, Department of Communication (1992-present)
Director of Training and Organization Development (1990-2005)
Associate Professor and Chair, Department of Communication (1986-1990)
Assistant Professor (1980-1986)
University of Washington
Department of Speech Communication
Pre-doctoral Teaching Associate (1979-1980)
Graduate Teaching Assistant (1977-1979)
Portland State University
Department of Speech Communication
Graduate Teaching Assistant (1973-1975)
2
CLIENT LIST
Please note that clients are sometimes repeated in different categories. Also, some
listings represent one day projects; others represent years and with different
departments. Asterisks (*) represent groups with whom I've conducted goal-setting
sessions similar to the one I am proposing. Also, I conducted this kind of work for the
City of Ashland Councilors and department heads for several years in the 1980s.
SELECTED APPLIED DISPUTE RESOLUTION CLIENTS
Applegate Partnership*
Asante Health System
Ashland Community Hospital
Cascade Siskiyou National Monument
Collaboration Assistance Network (Various Federal Land-use Agencies)'~
Illinois Valley Community Response Team
Mercy Medical Hospital
Oregon Shakespeare Festival'~
Prime Care
Rogue Community College
Scattered Apples Timber Sale
Scott River Watershed Coordinated Resource Management Planning*
Siskiyou County Employees Union
Southern Oregon Health Trust
United States Forest Service, Rogue River National Forest'~
United States Forest Service, Siskiyou National Forest
Water Resource Steering Committee, Rogue River Basin
SELECTED FACILITATION CLIENTS
Asante Health System'~
Ashland Community Hospital'~
Ashland Food Cooperative'~
ashland independent film festival'~
Bureau of Land Management, Western Oregon Plan Revision (WOPR)
Cardiology Consultants
Gty of Ashland'~
Gtyof Grants Pass'~
College of the Siskiyous
Jackson County'~
Jackson County Medical Society
Jefferson Regional Health Alliance
Josephine County
Mail Tribune
Medford Radiological Group
Oregon Institute of Technology
Oregon University System of Higher Education'~
Providence Hospital'~
Providence Rehabilitation Services Council
Rogue Basin Restoration Technical Team
3
Rogue Valley Gmntry dub'~
Siskiyou County Mental Health Department
Southern Oregon Business Advisory Council
Southern Oregon Historical Society
Southern Oregon University
Southern Oregon University Foundation*
United States Forest Service, Rogue National Forest*
United States Forest Service
White Gty School District'~
White House Conference on the Family
Workforce Information Network
SELECTED TRAINING AND ORGANIZATION DEVELOPMENT CLIENTS
Applegate School District
Asante Health System
Ashland Community Hospital
Ashland High School
ashland independent film festival
Ashland Middle School
Ashland School District
Ashland View Manor
Bear Creek Corporation
Boeing Computer Services, Division of The Boeing Company
Bureau of Land Management, Medford District Office
Children's Services Division
Gty of Ashland
Gty of Grants Pass
Gty of Medford Public Works Department
dinica Del Valle
College of the Siskiyous
Darex Corporation
Deschutes County
East Main Dental Associates
Foris Wmery
Golden Plains (Texas) Community Hospital
Headwaters Environmental Group
Hearthstone Manor Nursing Home
Jackson County
Jackson County Federal Savings and Loan
Jackson County Human Services Committee and Human Service Department
Jackson County Shelter and Evaluation Center
The Job Council
Josephine County Mental Health Department
L 1M Construction
Medford Chamber of Commerce
Medford dinic
Medford Mail Tribune
4
Oregon Public Broadcasting, Public Information Department
Oregon Shakespeare Festival
Peace House
Professional Tool Manufacturing
Providence Hospital
Providence Hospital Rehabilitation Services
Red Lion Hotel
Rogue Federal Credit Union
Rogue Institute of Ecology & Economy
Rogue Valley Ovic League
Sacred Heart Hospital, Oregon Rehabilitation Center
Scala Electronics
Siskiyou County Leadership Team
Talent Middle School
Roseburg Veteran's Hospital
r.,
CITY RECORDER'S COpy
Page 1 / 1
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
~
7/11/2007
r'~7~~:J
VENDOR: 012397
LANGE, JON
194 LOGAN DRIVE
ASHLAND, OR 97520
SHIP TO: City of Ashland
(541) 488-6002
20 E MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: ADMINISTRATION
Contact: Diana Shiplet
Confirming? No
Facilitate City of Ashland Goal SettinQ
Session, Plus set-up of system for
trackinQ proQress over next 12 months.
1,650.00
Contract for Personal Services
Date of aQreement: 07/02/2007
BeQinninQ date: 07/02/2007
Completion date: 08/31/2007
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
1
~ $,._ ~ 7~~
AU&6rize~i~at.?re
VENDOR COpy
A request for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
Date of Request:
THIS REQUEST IS A:
o Change Order(existing PO #
Required Date of Delivery/Service:
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
SOLICITATION PROClESS
Small Procurement o Sole Source 0 Invitation to Bid
~ Less than $5,000 o Written findings attached (Copies on file)
Quotes (Not required)
CooDerative Procurement 0 Reauest for ProDosal
o State of ORflNA contract (Copies on file)
Intermediate Procurement o Other government agency contract 0 SDecial1 ExemDt
o (3) Written Quotes 0 Copy of contract attached 0 Written findings attached
(Copies attached) 0 Emeraencv
0 Contract # 0 Written findings attached
Description of SI!RVlCES
~u'{ik+l.. Ci~ 0(- A5kW Gad ~tti~ SL~IOI1 P lA.S .se-+- ~
dbstJS~ -f-- ~;~t;p~ ~ fl~ fa MO~
r.o~\vt\M. ~ 6f5 k(3'r(07
D Per attdched PROPOSAL
Item # Quantity
Unit
~r'l.Of-+O
Description of MATERIALS Unit Price
Total Cost
Project Number ______. ___
D Per attached QUOTE
Account Number 11Q . Q L . Q 1. fJJ. ~Q ~H QO
"Items and services must be charged to the appropriate account numbers forthe financia/s to reflect the actual expenditures accurately.
By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can be provided upon request.
Employee Signature: ~@ ~ Supervisor/Dept. Head Slgnature~
G: Finance\ProcedureIAP\Forms\8_Requisition form revised.doc
Updated on: 716/2007