HomeMy WebLinkAbout2007-222 Contract - The Art of Change
Contract for PERSONAL SERVICES
C I T Y OF CONSULTANT: The Art of Change, LLC
ASHLAND CONTACT: Dr. Rick Kirschner
20 East Main Street ADDRESS: 360 Merrill Street
Ashland, Oregon 97520 P.O. Box 896
Telephone: 541/488-6002 Ashland, OR 97520
Fax: 541/488-5311
TELEPHONE: (541) 488-2992 (541) 210-0678 - Cell
FAX:
BEGINNING DATE: September 2007 COMPLETION DATE: March 2008
COM PENSA TION: Per attached proposal and agreement, consultant is to be paid $12,000 for the first month,
then $5,000 per month for the following five months, for a total of $37,000.
SERVICES TO BE PROVIDED: As per the attached proposal and aqreement dated September 6,2007.
ADDITIONAL TERMS: Please note that per paragraph #2 of the attached proposal and agreement - Individual
Coaching, a separate agreement must be approved prior to any sessions being scheduled for councilors
wishing to work on personal issues.
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 on a pro
rata basis.
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, subroaations,
Contract for Personal Services - Page 1 of 5
actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
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 10 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. Obliqation/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, cor 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. Fees will be prorated for a
partial month.
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 ORF status pursuant to the ORF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a ORF if
consultant has qualified as a ORF 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. ($500,000)
b. B;ofessional Liability insurance with a combined single limit, or the equivalent, of not less than
. \0\ ",~o,600 for each claim, incident or occurrence. This is to cover damages caused by error, omission or
t' VI." negligent acts related to the profeSSional services to be provided under thiS contract.
~.J!;.O c. General Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 for
v- each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coveraqe for the
Contract for Personal Services - Page 2 of 5
indemnity provided under this contract.
d. Automobile Liabilitv insurance with a combined single limit, or the equivalent, of not less than $1,000,000
for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned
vehicles, as applicable.
e. Notice of cancellation or chanqe. 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 Consultant or its insurer(s) to
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 si n the certification attached hereto as Exhibit A and herein incor orated b reference.
CONSULTANT c--;) .K/ r. I ~ CITY OF ASHLAND:
BY I",., cJc -I \ I c'CLJ"~ BY /1/"
Rick Kirschner
Signature
,.f _'
,ll.--L~~------
FINANCE 01 0
Print Name
President, The ^rt of Change LLC
TITLE
DATE
, ,
ci,,'! ---,~ 7
// Z.S . d
Septcmber 25, 200?
CONTRACT AWARD AND FINDINGS DETERMINED BY:
By .
l~".' ~ f'~NtJ ~-T 1m"" l{1"crJ
City Department Head Date:.{ it (/~-
DATE
lOIN: 20-428046
ACCOJNT #
7/o.ol.c'l,oo t::,o'-/tOC)
(For City purposes only)
Federal 10#
'Completed W9 form must be submitted with contract
PURCHASE ORDER #
Contract for Personal Servlces - Page 3 of 5
(~fiSto
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I .' .' ,'"\',_ ':... .__' c." '_
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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:
x
X
X
X
X
(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.
~..L/ i ~
1'Z."c.l ~l rSCb,rs/ ~(/';'jb'
September 25, 2007
Contractor
(Date)
Contract for Personal Services - Page 4 of 5
Foem W-g
DepG.riment of Ihe Treasury
IntornillRevc)r1unServiuJ
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
(Rev. November 2005)
(\J Name (as shown on your Income tax return)
Q) Richard M. Kirschner
rn
ro
D-
c
o
Business name, if different Irorn above
he Art of Change LLC
~~
z;-E
~ u
02
]~
0::;
'"
'0
.
0.
Ol
.
.
U)
n Individual! III Co'po.ot,'o" [, P h nO.... rvl Exempt from backuo
Check appropriate box: L,J Sole proprietor ~ """ .J artners Ip [,...1 ther.... LXJ withholding
p Od~~x(O~~r~:~': ,;t 0, ~wt"-o;-I --------- --- ---j-Reqoe,tec, come ood addm" (opt,oo,')
I City, state ctfld ZIP code
Ashland, OR 97520
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid
backup withholding. 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.
List account numher(s) IlBre (optional)
_,,__,T,,_xp~xe!_,~~_e,lltification Number (TIN)
ImII
Certification
E----------------j
Social security number
U_LLLJ_l_L
or
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 bQckup 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
Witl1holding 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 cort'eet TIN. (See the instructions on page 4.)
Sign
Here
I Signature of
I U.S. person ..
'!~~"K\ r5C~ "9f~
Purpose of Form
A person who is required to file an Information return with the
IRS, must obtain your correct taxpayer identification number
(TIN) to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
(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.
In 3 above, if applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income
from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively
connected income.
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.
For federal tax purposes, you are considered a person if you
are:
Date ..
September 25,2007
. An individual who is a citizen or resident of the United
States,
. A partnership, corporation, company, or association
created or organized in tile United States or under the laws
of the United States, or
. Any estate (other than a foreign estate) or trust. See
Regulations sections 301.7701-6(a) and 7(a) for additional
infonnation.
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required
to pay a withholding tax on any foreign partners' share of
income from such business. Further, in certain cases where a
Form W-g has not been received, a partnership is required to
presume that a partner is a foreign person, and pay the
withholding tax. Therefore, if you are a U.S. person that is a
partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to
establish your U.S. status and avoid withholding on your
share of partnership income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding
withholding on its allocable share of net income from the
partnership conducting a trade or business in the United
States is in the following cases:
. The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231X
Form W-9 (Rev_ 11-2005)
CITY OF
ASHLAND
Memo
TO:
FROM:
DAlF:
RE:
Lcc Tunchcrg. Administrative Servic' lircc\or
Martha Bcnnett. City Administrat
Septemher 20, 2007 /'
Contract Il)r Project to Improve J:lTecti\ eness or City Council
The Mayor and City Council want to initiate a project to improve thcir ahility to work together Ill!' the
purpose of incrcasing their effectiveness and eflicil'nL'l in conducting City Business.
Aftcr discussions with the Council ahout their desires Ill) LlCilitation of this project. I request an
exception to compctitivc hickling rcquiremcnts Ill!' personal scrviccs contracts under AMC 2.52.050 (C).
to allow thc City to award a contract to Rick Kirschner in the amount or $]7.000 without ohtaining threc
written quotes.
Ik Kirschner is an Ashland consultant with experience in helping groups improve their ahility to work
together. lie has done similar projects with a numher or clients that arc like the City or Ashland.
including a recent project with the Ashland school hoard. In addition. he has the trust of all seven
memhers of the Council. As such. the seniees that he is offering arc unique and could not he ohtained
through the traditional competitive procurement process.
I havc attachcd a copy of Kirschner's proposalll)r this proJect.
ADMINISTRATION
20 East Main Street
Ashland. Oregon 97520
wwwashland.oru$
Tel: t>41-488-6002
Fax 541488"5311
TTY: 800-735-2900
....
....,
~
the i
ARTofChange
. skills for life.
Dear Mayor Morrison. et. aI.,
Re: Project to improve the effectiveness of the Ashland City Council
After watching the council meeting, talking with the Mayor and given the tremendous
city related workload carried by the councilors on top of what I'm sure is their al-
ready busy personal lives, I've rethought my proposal and the revised proposal fol-
lows this letter.
I do not want the work that I do with the city council to be a time burden to any-
one. And I want any work that I do to be integrated and actionable by everyone in-
volved. I am convinced that the challenges inpeding the successful interaction of the
council are resolvable to the mutual benefit and satisfaction of all concerned.
In that light, what follows is probably more realistic in terms of availability and af-
fordability at this time.
If anyone is interested in knowing more about me and the work that I do, please visit
my website, TheArtofChange.com, where you will find my bio, client list, testimonials
and the like.
Sincerely,
i?d 1<\r5d~
Dr. Rick Kirschner
Speeches and Training
Private Consulting
http://TheArtofChange.com
P.O. Box 8961 Ashland, OR 97520 1541.488-2992 mobile 541.210.06781 email: rick@theartofchange.com
Pn)posal alld ;\gn'('IlH'1I1
the
ARTofChange
skills for life.
Today's Date:
Thursday, September 6,2007
Project Name:
The City Council Project
Client:
City of Ashland, Oregon
Participants:
Ashland City Mayor, Ashland City Councilors, and Ashland City Administrator
Duration of Agreement:
September 2007 through February 2008.
Objectives:
Improve the City Council's ability to conduct the city's business in a respectful and
effective manner, by reducing stress, improving communication and teamwork, and
developing appropriate conflict resolution skills.
Date & Time:
Training and facilitation will be scheduled at mutually agreed upon times that take
existing commitments into account. All parties will make every effort to be flexible
in finding time for the Project.
Dr. Kirschner will provide the following services to the participants:
I. Group Training and Facilitation:
Five meetings are proposed over a six month term. (I) One three and a half hour
group training session in the first month with the entire council, towards the end of
September. (2) A two hour group training or facilitation in October. (3) A two hour
group session in November. (4) In January, a two hour group session, to consider the
challenges, pressures and work for the coming year. (5) In February, the final group
session. There will be no training or facilitation sessions in the month of December.
2. Individual Coaching:
The first group training session will be preceded by a phone interview with each
INDIVIDUAL participant. After the first council meeting following the group training
session, there will be a phone interview with each participant.
(Continued on next page)
P.O. Box X()61 Ashland, OR 97520 I 541-488-2992 mobile 541.21O.067H I cmail: rick@lheartofchan~c.com
pl"()posal and i\gl"(~('m('nl
the - /
ARTofChange
skills for life.
(Continued from previous page)
Additionally, there will be one to two phone sessions per month with the Mayor, and
shorter phone sessions with other councilors as determined by Dr. Kirschner or as
needed by participants. not to exceed three hours per month. There will be no indi-
vidual sessions during the month of December. Councilers wishing to work with Dr.
Kirschner on personal issues may schedule individual sessions under a separate
agreement subject to Dr. Kirschner's availability.
3. Availability:
During the term of this agreement, if an individual councilor has a pressing need re-
lating to council business prior to council meetings or following council meetings,
Dr. Kirschner asks to be contacted by phone or email as soon as possible. Addition-
ally, Dr. Kirschner may make contact with any of the participants when he determines
it to be necessary or useful.
Fee:
$12,000 for the first month, then $5000 per month for the remaining 5 months of
the term for a total of $37,000, with the full amount to be paid in full over the term
of the agreement.
Deposit:
First month paid immediately on acceptance of this proposal. Remaining months
paid by the 5th of each month for the duration.
~ V I ~N
1~ld ~l r5Cl]f\.9j-~
September 6,2007
The Art of Change LLC (authorized signature and date)
City of Ashland (authorized signature and date)
P.o. Box 8961 Ashland, OR 97520 I 541-4R8-2992 mobile 541.210.06781 email: rick@lheartofchangc.com
Page 1/1
~~,
CITY OF
ASHLAND
DATE
9/28/2007
PO NUMBER
07837
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 012698
ART OF CHANGE LLC, THE, KIRSCHNER, RICHAI
PO BOX 896
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.:
Dep\.: ADMINISTRATION
Contact: Lee T uneberq
Confirming? No
Quantitv Unit Description Unit Price Ext. Price
Group traininq and facilitation for 37,000.00
6-month period. Per attached proposal
dated September 6, 2007.
Contract for Personal Services
Beqinninq date: September 2007
Completion date: March 2008
Exempt per AMC 2.52.050(c)
SUBTOTAL 37 000.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 37,000.00
ASHLAND, OR 97520
Account Number Project Number Amount Account Number Project Number Amount
E 710.01.01.00.60410 37000.00 --
--
--
Ah< ~&.
Auth~ignature
VENDOR COPY
REQUISITION FORM
CITY OF
ASHLAND
9/2',/0 7
THIS REQUEST IS A:
D Change Order(existing PO # __)
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
Iff€. -172 r c,c ~I/ I'rNC~
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1'0 BlJ)/ !?9f.
4;11 L"I^.I!J ore <) 75 ZO
VIC.. 12/ '-/( K If'_ sof^,U
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PUBLIC CONTRACTING REQUIREMENTS - Solicitation Process
~ Exempt from Competitive Biddina 0 Invitation to Bid (Copies on file) 0 Emerqencv -
Reason for exemption: 0 Written findings attached
~c. ;l. 52. 050 (c) 0 Quote or Proposal attached
0 Small Procurement & Personal Services 0 Reauest for Proposal (Copies on file) Cooperative Procurement
Less than $5,000 Please check one: 0 Sfate of Oregon
Note: Total contract amount, including any 0 Goods & Services Contract #
amendments may not exceed $6,000 0 Personal Services
- -- - . 0 State of Washington
Intermediate Procurement 0 Sole Source Contract #
GOODS & SERVICES D Written findings allached
$5.000 to $75.000 D Quote or Proposal attached D Government agency of Oregon or W
D (3) Written Ouotes Agency
Contract #
PERSONAL SERVICES 0 Special Procurement .~------
$5.000 to $50,000 D Written findings attached D Interagency Agreement
0 (3) Written Proposals 0 Quote or Proposal attached Agency
Contract #
-'
ashinglon
Description of SERVICES
&~ 1l--A1f\JLN& 4Wh FA::LIUT4-"noI\J Fbl'L G, t\.loNjif
P/t.--\'Lll! (}
Total Cost
~ . Per attached PROPOSAL
Nor T1> E.'l-Cket>
$ 37,000'00
1
Item #
Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
-._------ ---."--~-----
~- -----. ----- -
-
-
TOTAL COST
$
o Per attached QUOTE
Project Number _ _ _ _ _ _ - _ __
Account Number "1~o. - q~ -?{ - fJo. - Y2tLo_O_
. Items and services must be charged to the appropriate account numbers for the fJ'nancials 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: M f)ftJN HT Prul. I\nJ\<:.I-tG:..o
Supervisor/Dept. Head Signature: JM ~
G: Finance\ProcedureIAP\Forms\Requisition Form #8 Revised 04 162007
Updated on 9/27/2007