HomeMy WebLinkAbout2007-271 Contract - Sabel Painting
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: Sabel Painting Company
CONTACT: Jim Sabel
ADDRESS: 3181 Old Stage Road, Central Point, OR 97502
TELEPHONE: 541-773-1555
DATE AGREEMENT PREPARED: November 13, 2007 FAX: 541-773-1555
BEGINNING DATE: November 19, 2007 COMPLETION DATE: January 1,2008
COMPENSATION: $6,890.00 - Per proposal dated October 19, 2007
GOODS AND SERVICES TO BE PROVIDED: Secure lead abatement permit. Prep and paint Alice Peale
Stairway. Provide abrasive coating to stair treads. Use all materials outlined in attached paperwork.
ADDITIONAL TERMS:
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 2798.220, 2798.225, 2798.230, 2798.235, 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 $17,342 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 8 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 may be established by City under any of the followinq
Contract for Goods and Services Less than $25,000, Revised by Legal 06/30/2007, 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. Obliqation/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 Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.11 0 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.71 0, 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 Compensation 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,
includinq coveraqe for owned, hired or non-owned vehicles, as applicable.
Contract for Goods and Services Less than $25,000, Revised by Legal 06/30/2007, Page 2 of 6
d. 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 Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates of Insurance. Contractor 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 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 Requied Provision. Approval by the City of Ashland Councilor the Public Contracting Officer is
required before any wk ,ay begin under this contract.
21. Certification. Contr<. nail sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
CONTRACTOR,' t- CITY OF-,,~H,LAND:
BY 0---~"V ,~___ BY /V'/'.
't~~ . Sig,qature
v ~~ .J ~<.~%..
Print Name
TITLE
~~~
DATE
II/;o tJ/
DATE
15' ,A,uv {j r
~~NTRACT~WA~~ FINDINGS D~TERMINED BY:
I City Department Head
Date: I
FederallD#
G~-- ~018'j~:r
ACCOUNT #
'Completed W9 form must be submitted with contract
PURCHASE ORDER #
~/t? (JrZ "ttJ07c;/f/ICJ {/
(For City purposes only)
t~1 7 ,,/" ~ c'
o ;;r
Contract for Goods and Services Less than $25,000, Revised by Legal 06/30/2007, 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:
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(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.
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Cohtr~ctor
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(Date)
Contract for Goods and Services Less than $25,000, Revised by Legal 06/30/2007, Page 4 of 6
Form W-g
(Rev. March 1994/
OePattment oIlhe TleaSUIY
'"lema! AeverNe SeMce
Nam~ I" joi~ names. ~ist Iitst and circle die ,~ame of lhe person or entity whose number YO' enter in Part I below. See illStrucliOllS on page Z if 'lour name lias chang,
8. ,j 4'11<z~ V -~ ,(~j<::z:. .
~ Business /WIle lSoIe proprietors see lnsttudions y,n page 2.)
~ S--413~ . i''Jr.ltA47>' L.~~~..
.5
a. Please c:hedl appropriate boX: JndividuaIISOIe. proprieIOt" 0 CorparaIion
= Address (/!!mber. street. and apt. or suite no.)
:: rsiJ-( eLI_' S-;r7 ~ -c 12- e/
a:
City. stale. and.ZIP code
C~r;c,,--11JJ4- :?iF. .....,-- D,';;!.
11 r Identification Number
Enter your lIN in the appropriate box. For
incfMduals. this is your social seeurity number
. (SSN). For sole proprietors. see the instnJetidns.
on page 2. For other entities. it is your empfoyer
jdentification runber (ElN). .If you do not have a
number. see How To ~ a TIN below-
. .
Note: If the account is in mote than one name;
see the chait an page 2 for guicJeIines on whose
number to enter.
Qft1ificatiori
Under penaltieS 01 perjury. t certify that:
t. The number shown on this fof'm is my CClireCt ta.Cpayer idlot.tiIicaIiafi IlUmber (or I.... waiting for a number to be issued to me).. and .
2. I ~ not'subject ~ baekup .....~19- tJecaI-' (at I am_ _1 !pt. from b8cIcup wiIhhoIding, ~ ~ I have not been. notified".bV the IntemaI
. ReWnUe SenIc8 Itiat t am subject to backUP .'"Olding as.a result at a faIb1t. to report aI ..aerest or divtdends. or (c11he IAS' has notified
me that.' am no ~ subject. to badcup. .....~'9-. .
::...u..aUan ....ucIiOI.s.-you must' cross out item 2 above if you have been notified by ~ IRS that you are c:urrentfy subject to bac:Ilup
IllithhOldng becaUSe at ~.~1IJJg IntereSt 01' ~ an-your laX return. For real estate lraI.sac.liolls. item 2 does not apply. For mortgage
nterest paid. the acqulsition or abSndoil...ellt at secUred property. GalICeIIaIion at debt. contributionS to 1m individual retirement arrangement
IRA). and !)!neIaIy paym..nls other Ihan tnterest and dIvideods. you are not ~ to sign Ihe c.liIil.i.lIdof.. but you must pravkf4t yaw correct
nN.. (Also see Part t. . on page 2.) f} tj .
. Request for Taxpayer
Identification Number and Certification
Give form to
requester.. D(J
send to the IE
o Partnership 0 Other ~ -----------------....--....
~$ name and address (optionaq
c;:;- 5?J ~
OR
iign
iere
~~
iection re(erenCeS are to the
levenUe Code- .
'ui'pose ofFonn.-A person who i$
3QUired. to file an il4C1tmation return with
1e IRS musf get yow correct 11N to report
lC(Jn1e paid to yoU. rear. es1ate
-ansactions. mortgage int...,.est you paid.
'l8 acquisition or abai1donment.of secued
roperty. canceIIalion 0'- debt. at .
ontributionS you made to an IRA. Use
orm W--g to rpe your conect TIN to. the .
!qUeSter (!he person requesting your TIN)
nd. when appIcatlIe. (1) to certify the TIN
:JU are giving is CQr1l!Ct (or you are waiting
Jr a runber to be issued), (2) to certify- .
JU are not subject to backup withholding.
, (3) to cfaim exemption from backup
ithholding if you are an exempt payee..
iving your cOJTeCt TIN and making the
lpropriate certifications wi. prevent .
main payments from being subject to
lCkup withhokOOg.
ote: If a requester gives you a fonn other
an a W-9 to request your TIN, you must
:e the requesters form if it is substantially
nilar to this Form W-9.
hat Is Backup W"rthholding?-Persons
aking certain payments to you must .
thhold and pay to the IRS 31 % of such-
payments under certain COIIditiotis.'1hi$ is
. caIed "baicklIP VlrjtJ II .uUllg. · Payments
that cauId be "St~to backup-.
withholding include interest.'~
~ and barter -chaI1g8 _~tii:JIIS.
rents. royaIUes.. 1IOI.einp1oyee pay. and
certain paym.;. lis Iiom fishing boat -
operators. Real estate tranSacIklns are not
subject.to ta:kup wiIhhoIdirlg.
If you give the requester 'JOOI' correct
TIN, make the proper certittcafions. and
report aR 'JCC' taxable Interest.'.
dividends an your ~ return. your
-payments wilndt be subject to backup
withholding.. Payrnet lts you receive wiI be
Subiect-~ ~ witI~'9- if:
1. You do not ftmish your TIN to the
requester. or
2. The IRS tells the requester ~ you
furnished an incorreCt TIN, or
3. The IRS tells you that you are subject
to backup withhording because you did not
report all your interest and dividends on
your tax return (for reportable interest and
dividends only), or
4. You do not certify to the requester
that you are not subject to backup
withholding under 3 above (for reportable
List account numberfs) hell! (optloniil)
For Payees ~pt From Bac!ct
Withholding (See Part ri
instructions on page 2).
~ I~- A/a v 0 ':r--.
Date ~.
interest and dividend accountS opened
after 1983 onIy). or . .
S,; You do not certify your TIN. See the . .
Part UI instructIonS fOr exceptions;.
Certain payees and payments are
exempt from backup withholding and
~ reporting. See the Part n
instructions and f#1e separate Instructions
torthe;Requesti!r of'FOnn w;.a.
How To ~a TlN..:-ff YOU. dO not have a' .
TIN. apply for one imrnEld"latefy. To:BPP!Y.
get Form ss-s. AppBcation for a SoCiaf
Secuity Number Card (for individuaIs),:
from your loCal. office of the Social Security
AdminiStralion. ar Form 5S-4, Application .'
for Employer ldeirtification Number (for .
businesseS and aD other entities), from
your local IRS effice.
If you do not have a TIN, write "Applied-
F~ in the space for the nN in Part t, sign
and date the. fonn, and give it to the
requester. Generally. you will'then have 60
days to get a llN and give it. to the
requester. If the requester does not receive
your TIN within 60 days. backup
withholding, if applicable. will begin and
. continue until you furnish your TIN.
Form W-9
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
(Rev. January 2003)
Department of the Treasury
Internal Revel"'lJe Service
N
Cll
Ol
to
C.
C
o
~g
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~ ~
~ 1.1
o 2
1:1;;
.- c:
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'u
Cll
c..
ell
Cll
Q)
ell
Name
Business name. if different from above
O Individual!
Check appropriate box: Sole proprietor
Address (number. street. and apt. or suite no.)
o Corporation
City. state. and ZIP code
List account number(s) here (optional)
O Exempt from backup
withholding
Requester's name and address (optional)
o Partnership 0 Other ~ . _ u _ u. __ _ u. u u.
Enter your TIN in the appropriate box. For individuals. this is your social security number (SSN). I Social security number I . I
However. for a resident alien. sole proprietor. or disregarded entity. see the Part I instructions on ~. U
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. or
Note: If the account is in more than one name. see the chart on page 4 for guidelines on whose number
to enter.
Certification
Under penalties of 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
Here
Signature of
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-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.
Note: If a requester gives you a form other than Form W-9
to request your TIN. you must use the requesters form if it is
substantially similar to this Form W-9.
Foreign person. If you are a foreign person. use the
appropriate Form W-8 (see Pub. 515. Withholding of Tax on
Nonresident Aliens and Foreign Entities).
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. 10231 X
Form W-9 (Rev. 1-2003)
Contract for Goods and Services Less than $25,000, Revised by Legal 06/30/2007, 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.
~-,
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 $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
~per hour effective June 30, 2007
(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 $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 Goods and Services Less than $25,000, Revised by Legal 06/30/2007, Page 6 of 6
IJ........ I - J. :.~ - "- ':::.I ~ r 1O..t:... ~ iOj r- '-I ::;:.. H.v I::. L l:.:. NIt:. r:;: r- p.:: .L ;;::. r::..:::>
, "
:JCf-l.LLf-::>b<::f:::Jr
t'"' .. 1:0 ~
3161 Old Stage Rood. Central Point
Fax #541-173.1555
Fax
To: Dale Peters
Faxl 552-2304
Ph0ll8l5S2-2.292
Rea
From: Jim Sabel
P....a:1
DId_ 10/1912.007
ce:
~......,.....-
~-
-----
o Ul1lent 0 FOIl" RIWIew
o ,..... Comment
/
T
I
//6 Pi.._ R_ay
/
Proposar - Clean ana' refinisn Alice Peale WalkwaYt 51 Winburn Ashland as follows
A) Clean to remove dirt and contaminantst remove heavy rust scale.
S) Apply rust converter all surfaces.
C) Apply 2 coats industrial enamel or epoxy
D) Seed 2~ coat wet on stair walking surface with sand tor a non-skid resutt
E) AQply 3rd coat finish on walking surface to protect non...skid application.
· All preparation according to DEQ lead safe wor1< practices and disposal
... Coating material TBD
Cost
6890.00
nt(~ d-it
,,-,,,./
AM
CCK.
':'cr:i;~;.""...
The Next Generation of Amerlock 400
~_:.;,,; ',~:-'l.," :~;<rl:' ~::'i(;,i:'.~;'~ :'L><L-_;.':'; >.' ::.: ::::.~>~~;"
Fast drying surface tolerant VOC compliant epoxy
Product Datal
Application Instructions
· Fast dry. dry to touch in 2 hours at 700F (21 OC)
· Recoat in 3 hours at 700F (21 OC)
· Low temperature cure down to OaF (-180C)
· Exceptional corrosion protection in industrial and marine
corrosive environments
· Surface tolerant. excellent adhesion to tight rust and
prepared damp surfaces
· Self priming topcoat over most existing coatings
· Can be overcoated with a wide range of topcoats
· Meets all existing VOC regulations including SCAQMD Rule
1113 requirements for 2002
· Temperature resistance to 450"F on insulated or
uninsulated surfaces when mixed with Amercoat 880
glass flake additive.
Arnerlock 2's low solvent level meel,; VOC requirements. reduces
the chances for film pinholing and solvent entrapment at the
substrate-coating inteliace, often a major cause of coating failure
with conventional epoxies and lower solids systems.
Amerlock 2 is available in a variety of colors. and therefore
does not require a topcoat. For extended weatherability or
special uses, a topcoat may be desired.
Typical Uses
Amerlock 2 is designed for use in a variety of areas. even those
where surface preparation is impossible. As a maintenance
coating, Amerlock 2 protects steel structures in industrial
facilities. bridges, tank exteriors. marine weathering. offshore,
oil tanks. piping. roofs, water towers and other exposures.
Amerlock 2 has good chemical resistance to splash/spillage,
fumes and immersion in neutral, fresh and salt water (see
resistance table). Contact your Ameron representative for
specific information.
Qualifications (Amerlock 2)
1 . USDA - Incidental food contact
2. NSP Standard 61 * - For use in drinking water. @
3. FDA 21 eFR 175.300 extraction test for NS E
direct food contact
*For NSF application information. please visit au/' .
website at www.ameroncoalings.comlusalnsf
PhYSical Data
Finish
Color
Components
Curing mechanism
Volume solids
(ASTM D2697 modified)
Amerlock 2
Amerlock 2AL
Dry film thickness (per coat)
Coats
Theoretical coverage
1mil (25 microns)
Amerlock 2
Amerlock 2AL
5 mils (125 microns)
Amerlock 2
Amerlock 2AI.
VOC
Amerlock 2 mixed*
mixed/thinned (\2 pUgal)*
Amerlock 2AL mixed**
mixed/thinned (1& pUga!)**
* EPA method 24
** Calculated
Temperature resistancc,*
Amerloc/c Series
._" . -<; .,,:~;.-~ r ",
. .,.--.-,:C'.':., ,."..
".' :;;..~,..":c1'X.,.:, "0.;,, _~:,._':
" ,;i~ .:;, .j' 'it; ,~~,:;',;.~'~:;;:,~,:(-:L
Serl1lgJoss
Standard, Hapid Hesponse,
custom colors and aluminum
2
Solvent release and chemical
reaction between components
1)3% :t 30/"
1\5% 1: :~%
4-1\ mils (100-200 microns)
1 or 2
ft'/gal Ill'/!.
1331 32.6
1363 33.1
266 6.5
273 6.7
lb/gal g/L
1.5 180
1.1\ 216
1.0 123
2.0 234
wet dry
OF oC OF 0(:
100 38 200 93
100 38 350 177
continuous
intermittent
with 880 (1 gal can/ 2gal mix) wet
continuous 1 OO"F (38"C)
intermittent 100"F (38"C)
Flash point (SETA)
Amerlock 2/400 resin*
Amerlock 2 cure
Amerlock 2AL resin
Amerlock 2AL cure
Amercoat"' 8
Amercoat 65
Amerocat 101
Arnercoat 12
dry
425"F (21WC)
450"F (232"C)
OF
131
114
110
122
20
78
145
2
OC
55
4()
43
50
-7
25
63
-ll
. At temperatures above 200.f~ dryfilm thickness must not exceed 1 I) mils (250 milsl.
. Amerlock 2 resin andAmer(ock 400 rpSllI are identicrt/. and are [Jackaged
under a common la/wi as Amerlock 21401i resin. Amerlock:> mre rllld Anterlock
400 cllre are different. ami are labeled indil'idllfllly.
Page 1 of4
MATERIAL SAFETY DATA SHEET
~ECTION 1 - PRODUCT AND COMPANY INFORMATION
PPG Industries, Inc.
One PPG Place
Pittsburgh, P A 15272
EMERGENCY PHONE NUMBERS (412) 434-4515 (U.S.)
(24 hours/day):
(514) 645-1320 (Canada)
01-800-00-21-400 (Mexico)
0532-83889090 (China)
PRODUCT SAFETY/MSDS INFORMATION: (412) 492-5555 7:00 a.m.
- 4:30 p.m. EST
ProductlD:
PRODUCT NAME:
SYNONYMS:
ISSUE DATE:
EDITION NO.:
CHEMICAL
FAMIL Y:
AK2V-T3 (0882)
AMERLOCK 2 VOC NEUTRAL TI
None
07/12/2007
3
MIXTURE
EMERGENCY OVERVIEW:
Combustible. Keep away from heat, sparks, flames, and other sources 0
ignition. Do not smoke.CAUSES EYE IRRITATION. MAY CAUSE
SLIGHT SKIN IRRITATION. PROLONGED OR REPEATED CONTACT
MAY CAUSE AN ALLERGIC SKIN REACTION VAPOR AND/OR SPRAY
MIST MAY BE HARMFUL IF INHALED.MAY BE HARMFUL IF
SWALLOWED
I SECTION 2 - COMPOSITION INFORMATION
The following ingredient(s) marked with an "x" are considered
hazardous under applicable U.S. OSHA and/or Canadian WHMIS
regulations. If no ingredients are listed, then there are no U.S. OSHA
and/or Canadian WHMIS hazardous ingredients in this product.
Material! Percent Hazardous
CAS Number
EPOXY RESIN
25068-38-6
TALC
14807-96-6
DIISODECYL PHTHALATE
68515-49-1
TERT-BUTYL ACETATE
540-88-5
40 - 70
X
15 - 40
X
1 - 5
X
0.5-1.5
X
I SECTION 3 - HAZARDS IDENTIFICATION
ACUTE OVEREXPOSURE EFFECTS
EYE CONTACT:
Causes eye irritation. Redness, itching, burning sensation and visual
disturbances may indicate excessive eye contact.
SKIN CONTACT:
May cause slight skin irritation. Dryness, itching, cracking, burning,
redness, and swelling are conditions associated with excessive skin
contact.
SKIN ABSORPTION:
Skin absorption not expected to occur. Prolonged or repeated contact
may cause an allergic skin reaction
INHALATION:
Vapor and/or spray mist may be harmful if inhaled.
INGESTION:
May be harmful if swallowed.
SIGNS & SYMPTOMS OF OVEREXPOSURE:
Dryness, itching, cracking, burning, redness, and swelling are conditions
associated with excessive skin contact.
MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE: Not
applicable
w
.~
CHRONIC OVEREXPOSURE EFFECTS
Avoid long-term and repeated contact.
This product contains laic In a lifetime inhalation study female rats
exposed to an elevated respirable concentration (9 times the Permissible
Exposure Limit) of cosmetic grade talc developed lung cancer.
The effects of long-term, low level exposures to this product have not
been determined. Safe handling of this material on a long..term basis
should emphasize the prevention of all contact with tilis material to avoicl
any effects from repetitive acute exposures See Section 11, of this
MSDS for a detailed list of chronic health effects information available on
individual ingredients in this product
I SECTION 4 ~-~IRST AID MEA~URE~____~,_
If ingestion, irritation, any type of overexposure or symptoms of
overexposure occur during or persists after use of this product, contact a
POISON CONTROL CENTER, EMERGENCY ROOM OR PHYSICIAN
immediately; have Material Safety Data Sheet information available.
EYE CONTACT:
Remove contact lens and pour a gentle stream of warm water through the
affected eye for at least 15 minutes. If irritation persists, contact a poison
control center, emergency room, or physician as further treatment may be
necessary.
SKIN CONTACT:
Run a gentle stream of water over the affected area for 15 minutes. A
mild soap may be used if available. If any symptoms persist, contact a
poison control center, emergency room, or physician as further treatment
may be necessary.
INHALATION:
Remove from area to fresh air. If symptomatic, contact a pOison control
center, emergency room or physician for treatment information.
INGESTION:
Gently wipe or rinse the inside of the mouth with water Sips of water
may be given. Never give anything by mouth to an unconscious person.
Contact a poison control center, emergency room or physician right away
as further treatment may be necessary.
I
I SECTION 5 - FIRE FIGH"fING MEASURES
FLAMMABLE PROPERTIES
FLASHPOINT: 101 Degrees F ( 38 Degrees C)
FLASH POINT TEST METHOD:
Pensky-Martens Closed Cup
UEL: Not Available.
LEL: 1.7
AUTOIGNITION TEMPERATURE:
Not Available.
EXTINGUISHING MEDIA:
Use National Fire Protection Association (NFPA) Class B extinguishers
(carbon dioxide, dry chemical, or universal aqueous film forming foam)
designed to extinguish NFPA Class II combustible liquid fires. Water
spray may be ineffective. Water spray may be used to cool closed
containers to prevent pressure build-up and possible auto ignition or
explosion when exposed to extreme heat.
PROTECTION OF FIREFIGHTERS:
Fire-fighters should wear self-contained breathing apparatus and full
protective clothing.
:.~]
Page 1 of 4
MATERIAL SAFETY DATA SHEET
w
c::: SECTION 1 - PRODUCT AND COMPANY INFORMATION =:=J
PPG Industries, Inc.
One PPG Place
Pittsburgh, PA 15272
EMERGENCY PHONE NUMBERS (412) 434-4515 (U.S.)
(24 hours/day):
(514) 645-1320 (Canada)
01-800-00.21-400 (Mexico)
0532-83889090 (China)
PRODUCT SAFETY/MSDS INFORMATION: (412) 492-5555 7:00 a.m.
- 4:30 p.m. EST
Product ID:
PRODUCT NAME:
SYNONYMS:
ISSUE DATE:
EDITION NO.:
CHEMICAL
FAMILY:
AK2V-B (0882)
AMERLOCK 2 VOC CURE
None
07115/2007
6
MIXTURE
EMERGENCY OVERVIEW:
Flammable. Keep away from heat, sparks, flames, and other sources of
ignition. Do not smoke. Extinguish all flames and pilot lights. Turn off
stoves, heaters. electrical motors, and other sources of ignition during
use and until all vapors/odors are gone.CAUSES IRREVERSIBLE EYE
DAMAGE. MAY BE CORROSIVE. THIS PRODUCT CONTAINS A
MATERIAL WHICH CAUSES SKIN BURNS. MAY BE HARMFUL IF
ABSORBED THROUGH THE SKIN. PROLONGED OR REPEATED
CONTACT MAY CAUSE AN ALLERGIC SKIN REACTION VAPOR
AND/OR SPRAY MIST HARMFUL IF INHALED. MAY IRRITATE
LUNGS. VAPOR IRRITATES EYES, NOSE, AND THROAT. VAPOR
GENERATED AT ELEVATED TEMPERATURES IRRITATES EYES,
NOSE AND THROAT.HARMFUL OR FATAL IF SWALLOWED.
I SECTION 2 - COMPOSITION INFORMATION
The following ingredient(s) marked with an "x" are considered
hazardous under applicable U.S. OSHA and/or Canadian WHMIS
regulations. If no ingredients are listed, then there are no U.S. OSHA
and/or Canadian WHMIS hazardous ingredients in this product.
Materiall
CAS Number
BARIUM SULFATE
7727 -43-7
TALC
14807-96-6
TERT-BUTYL ACETATE
540-88-5
NONYL PHENOL
84852-15-3
N.J. TRADE SECRET
#80100337-5132
Percent tl~1'.!!!dol!-"-
10 - 30 X
10 - 30 X
10 - 30 X
5 - 10 X
5 - 10 X
1 - 5 X
1 - 5 X
1 - 5 X
1 - 5 X
1 ~ 5 X
1 - 5 X
0.5-1.5 X
0.5-1.5 X
0.1-1.0 X
X See Sections 8
and 15 lor
informatIon.
ALIPHATIC AMINE
Proprielary
ALKYL PHENOL
Proprietary
DIISODECYL PHTHALATE
68515-49-1
BENZYL ALCOHOL
100-51-6
XYLENES
1330-20-7
POL YOXY PROPYLENE
DIAMINE
9046-1 0-0
PROPRIETARY RHEOLOGICAL
ADDITIVE
Proprietary
PHENOL
108-95-2
ETHYL BENZENE
100-41-4
(As Nuisance Particulates)
Proprietary
I _. SECTION 3 - HAZARDS IDr::NTlFICATlOfoJ =~-=-~:-=-'_-=--=-J
ACUTE OVEREXPOSURE EFFECTS
EYE CONTACT:
This product contains a material which causes irreversible eye damage.
Redness, itching, burning sensation and visual disturbances may indicate
excessive eye contact.
SKIN CONTACT:
May be corrosive. This product contains a material which causes skin
burns. Dryness, itching, cracking, burning, redness, and swelling are
conditions associated with excessive skin contact.
SKIN ABSORPTION:
May be harmful if absorbed through the skin. Prolonged or repeated
contact may cause an allergic skin reaction.
INHALATION:
Vapor and/or spray mist harmful if inhaled. May irritate lungs Vapor
irritates eyes, nose, and throat. Vapor generated at elevated
temperatures irritates eyes, nose and throat.
INGESTION:
Harmful or fatal if swallowed.
SIGNS & SYMPTOMS OF OVEREXPOSURE:
Repeated exposure to high vapor concentrations may cause irritation of
the respiratory system and permanent brain and nervous system
damage. Eye watering, headaches, nausea, dizziness and loss of
coordination are indications that solvent levels are too high. Intentional
misuse by deliberately concentrating and inhaling the contents can be
harmful or fatal. Dryness, itching, cracking, burning, redness, and
swelling are conditions associated with excessive skin contact.
MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE: Not
applicable.
CHRONIC OVEREXPOSURE EFFECTS
Avoid long-term and repeated contact
Page 1 of 5
Amershield™VOC
'~z~i!.r~~;};m~~~~~~~ff;:;!l1i~~~~';:I.llitz~j~,tl;41;;,~~:~'d
.,;,',., . :~,_-~'~J:.~;~~:::i.~::;j~'~:~~' ;t~...f_
,"'- -~",.,' '.:,'
:;":,-~,,,,,,'"
- '"' .':~:.:.:',r. ~:' . >': '::
,;~:'>
Aliphatic polyurethane coating
Amershield Series
:i;fj}~N~~Ji~~fJ~~.r~:~:vDt~f.~r~\~:~~:~l!rZ2~~J;~;{tl'i2:rr~:(~}';;jS:',~t{~'~~~.~ ::.-.,::
Product Datal
Application Instructions
g Complies with SCAQMD Hule 1113
· Unique, high-solids, high-build, multifunctional coating
· High-gloss, self-priming coating
· Excellent gloss retention
. Direct to metal and concrete in selected environments
· Outstanding abrasion, reverse and direct impact resistance
. Good chemical and stain resistance
· Tough and flexible coating
Amershield VOC displays high gloss and excellent color and
gloss retention during extended service periods. The direct-to-
metal capabilities of Amershield VOC provide a single-coat
system at reduced installation cost for use in proteeted environ-
ments. Compatible over prepared, smooth cold-rolled steel and
abrasive blasted hot-rolled steel.
Amershield VOC has excellent adhesion to eonerete providing a
durable, glossy, easy-to-c1ean flooring system. May be used
over Amerloek'" as a durable, weather-resistant topeoat for
extra heavy duty service; over zinc-rieh epoxy eoatings as a
direct topcoat; over intaet, old paint as a maintenance product.
A full eolor range is available in the Ameron Hapid Response
color system to provide timely delivery.
Typical Uses
· OEM heavy equipment
· Structural steel
Bridges
· Tanks
. Piping
· Industrial plants
Power
Pulp and paper
Food and beverages
· Transportation
Hail car exterior and hopper lining
Vehicle equipment - buses, trucks, lifts
· Marine
Deeks Topside and superstructures on ships
Boottops Barges and offshore platforms
· Concrete walls and floors
Stadiwns
Wastewater treatment
Chemieal and petrochemical
" ':.~:~. '.
.~ ~ ;~~';~"'i:. ,:.
.,"1
Physical Data
Finish
Color
Gloss
See Ameron colur chart
Yellow. red and orange colors will.f(ulefaster than other colors due to
the replacement of lead-based pigments with lead:/i'ee pigments in
these colors.
Components
Curing meehanism
2
Solv(mt relnase ,lnd
chemical reaction
Volunw solids (ASTM ])2697 rnoditled)
'13%:l 3'1"0
Dry film thickness per coat 5 mils (125 microlls)
Coats 1
Theoretical coverage ft' /gal rn'/L
I mil (25 mierons) 1171 29
5 mils (125 microns) 234 5.7
VUC (EPA Method 24) Ib/gal g/L
mixed 1.4 no
mixed/thinned (1 ptJgal) 1.9 231
Temperature resistance (dry) UF 0(:
continuous 200 Y3
intermittent 250 121
Flash point (SETA) OF O(
cure 122 50
resin 112 44
mixed 116 47
Arnereoat 65 78 2"
,J
Amercoat 12 2 -17
Page 1 014
MATERIAL SAFETY DATA SHEET
I SECTION 1 - PRODUCT AND COMPANY INFORMATION ~
PPG Industries, Inc.
One PPG Place
Pittsburgh, PA 15272
EMERGENCY PHONE NUMBERS (412) 434-4515 (U.S.)
(24 hours/day):
(514) 645-1320 (Canada)
01-800-00-21-400 (Mexico)
0532-83889090 (China)
PRODUCT SAFETY/MSDS INFORMATION: (412) 492-5555 7:00 a.m.
- 4:30 p.m. EST
Product ID:
PRODUCT NAME:
SYNONYMS:
ISSUE DATE:
EDITION NO.:
CHEMICAL
FAMILY:
AM-B (0882-F1)
AMERSHIELD CURE
None
01112/2007
1
ISOCYANATE
EMERGENCY OVERVIEW:
Combustible. Keep away from heat. sparks, flames, and other sources 0
ignition. Do not smoke.CAUSES SEVERE EYE IRRITATION. MAY
CAUSE MODERATE SKIN IRRITATION. MAY BE ABSORBED
THROUGH THE SKIN. PROLONGED OR REPEATED CONTACT MAY
CAUSE AN ALLERGIC SKIN REACTION.VAPOR AND/OR SPRAY
MIST MAY BE HARMFUL IF INHALED MAY CAUSE IRRITATION
AND/OR ALLERGIC RESPIRATORY REACTION IN LUNGS. VAPOR
IRRITATES EYES, NOSE, AND THROAT MAY BE HARMFUL IF
SWALLOWED STABLE - HAZARDOUS REACTIONS POSSIBLE AT
EXTREMELY HIGH TEMPERATURES/PRESSURES
I SECTION 2 - COMPOSITION INFORMATION
The following ingredient(s) marked with an "x" are considered
hazardous under applicable U.S. OSHA and/or Canadian WHMIS
regulations. If no ingredients are listed, then there are no U.S. OSHA
and/or Canadian WHMIS hazardous ingredients in this product.
Materiall Percent Hazardous
CAS Number
HEXANE-1 ,6-DI-ISOCY ANA TE
POL YMER
28182-81-2
N-BUTYL ACETATE
123-86-4
AROMATIC NAPHTHA
64742-95-6
1.2,4-TRIMETHYL BENZENE
95-63-6
HEXAMETHYLENE-DI-
ISOCYANATE
822-06-0
XYLENES
1330-20-7
(As Diisocyanates)
822-06-0
60- 100
x
1 - 5
x
1 - 5
x
1 - 5
x
0.1-1.0
x
0.1-1.0
x
x
See Sections 8
and 15 for
information.
I SECTION 3 - HAZARDS IDENTIFICATION
ACUTE OVEREXPOSURE EFFECTS
EYE CONTACT:
Causes severe eye irritation. Redness. itching, burning sensation and
visual disturbances may indicate excessive eye contact.
SKIN CONTACT:
May cause moderate skin irritation. Dryness. itching, cracking, burning.
redness. and swelling are conditions associated with excessive skin
contact
w
SKIN ABSORPTION:
May be absorbed through the skin. Prolonged or repeated contact lTlay
cause an allergic skin reaction.
INHALATION:
Vapor and/or spray mist may be harmful if inhaled. May cause irritation
and/or allergic respiratory reaction In lungs Vapor irritates eyes, nose,
and throat.
INGESTION:
May be harmful if swallowed
SIGNS & SYMPTOMS OF OVEREXPOSURE:
Repeated exposure to high vapor concentrations may cause irritation of
the respiratory system and permanent brain and nervous system
damage. Eye watering, headaches, nausea. dizziness and loss of
coordination are indications that solvent levels are too high. Intentional
misuse by deliberately concentrating and inhaling the contents can be
harmful or fatal. Dryness, itching, cracking, burning, redness, and
swelling are conditions associated with excessive skin contact.
~
MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE: Do not use if
you have chronic (long-term) lung or breathing problems, or if you have
ever had a reaction to isocyanates
CHRONIC OVEREXPOSURE EFFECTS
Avoid long-term and repeated contact.
Repeated exposure to vapors above recommended exposure limits (see
Section 8) may cause irritation of the respiratory system and permanent
brain and nervous system damage. Intentional misuse by deliberately
concentrating and inhaling the contents can be harmful or fatal.
Prolonged exposure to an ingredient(s) in this product may cause kidney
and/or liver damage. Prolonged inhalation of an ingredient(s) in this
product may cause lung sensitivity leading to pneumonitis. This product
contains isocyanates. Inhalation may cause a burning sensation of the
nose, throat and lungs. Allergic respiratory reactions to these materials
are characterized by asthma-like symptoms such as chest tightness.
wheezing, shortness of breath and coughing. These symptoms may
follow repeated exposure or a single massive exposure and may be
delayed. High exposures to xylenes in some animal studies have been
reported to cause health effects on the developing embryo and fetus.
These effects were often at levels toxic to the mother There is some
evidence that repeated exposure to organic solvent vapors in
combination with constant loud noise can cause greater hearing loss than
expected from exposure to noise alone. An ingredient in this product has
caused fetal toxicity in experimental animals The significance of these
findings for humans is unknown
The effects of long-term, low level exposures to this product have not
been determined. Safe handling of this material on a long-term basis
should emphasize the prevention ol-all contact with this material to avoid
any effects from repetitive acute exposures. See Section 11, of this
MSDS for a detailed list of chronic health effects information available on
individual ingredients in this product.
I SECTION 4 - FIRST AID MEASURES
If ingestion, irritation, any type of overexposure or symptoms of
overexposure occur during or persists after use of this product, contact a
POISON CONTROL CENTER, EMERGENCY ROOM OR PHYSICIAN
immediately; have Material Safety Data Sheet information available.
EYE CONTACT:
Remove contact lens and pour a gentle stream of warm water through the
affected eye for at least 15 minutes. If irritation persists. contact a poison
control center, emergency room, or physician as further treatment may be
necessary .
SKIN CONTACT:
Run a gentle stream of water over the affected area for 15 minutes. A
mild soap may be used if available. If any symptoms persist, contact a
poison control center, emergency room, or physician as further treatment
may be necessary.
INHALATION:
Remove from area to fresh air. If symptomatic. contact a poison control
center, emergency room or physician for treatment information
Page 1 of 4
MATERIAL SAFETY DATA SHEET
W
SECTION 1 - PRODUCT AND COMPANY INFORMATION ==:J
PPG Industries, Inc.
One PPG Place
Pittsburgh, PA 15272
EMERGENCY PHONE NUMBERS (412) 434-4515 (U.S.)
(24 hours/day):
(514) 645-1320 (Canada)
01-800-00-21-400 (Mexico)
0532-83889090 (China)
PRODUCT SAFETY/MSDS INFORMATION: (412) 492-5555 7'00 a.m.
- 4:30 pm. EST
Product 10:
PRODUCT NAME:
SYNONYMS:
ISSUE DATE:
EDITION NO.:
CHEMICAL
FAMll Y:
AMV-T3 (0882)
AMERSHIELD VOC NEUTRAL TI
None
09/18/2007
4
Acrylic Polyester
EMERGENCY OVERVIEW:
Combustible. Keep away from heat. sparks. flames, and other sources 0
ignition. Do not smoke CAUSES SEVERE EYE IRRITATION. MAY
CAUSE MODERATE SKIN IRRITATION. MAY BE ABSORBED
THROUGH THE SKIN.VAPOR AND/OR SPRAY MIST MAY BE
HARMFUL IF INHALED. VAPOR IRRITATES EYES, NOSE, AND
THROAT.HARMFUL IF SWALLOWED.
I SECTION 2 - COMPOSITION INFORMATION
The following ingredient(s) marked with an "x" are considered
hazardous under applicable U.S. OSHA and/or Canadian WHMIS
regulations. If no ingredients are listed, then there are no U.S. OSHA
and/or Canadian WHMIS hazardous ingredients in this product.
Material! Percent Hazardous
CAS Number
TERT-BUTYL ACETATE 10 - 30 X
540-88-5
ETHYL 3- 1 - 5 X
ETHOXYPROPANOATE
763-69-9
N-BUTYL ACETATE 1 - 5 X
123-86-4
NAPHTHALlNE. 1,2.3,4- 0.5-1.5 X
TETRAHYDRO
119-64-2
I SECTION 3 - HAZARDS IDENTIFICATION
ACUTE OVEREXPOSURE EFFECTS
EYE CONTACT:
Causes severe eye irritation. Redness. itching, burning sensation and
visual disturbances may indicate excessive eye contact.
SKIN CONTACT:
May cause moderate skin irritation. Dryness, itching, cracking, burning,
redness, and swelling are conditions associated with excessive skin
contact.
SKIN ABSORPTION:
May be absorbed through the skin.
INHALATION:
Vapor and/or spray mist may be harmful if inhaled. Vapor irritates eyes,
nose, and throat.
INGESTION:
Harmful if swallowed.
SIGNS & SYMPTOMS OF OVEREXPOSURE:
Repeated exposure to high vapor concentrations may cause irritation of
the respiratory system and permanent brain and nervous system
damage. Eye watering, headaches, nausea, dizziness and loss of
coordination are indications that solvent levels are too high Intentional
misuse by deliberately concentrating and inhaling the contents can be
harmful or fatal. Dryness, itching, cracking, burning, redness, and
swelling are conditions associated with excessive skin contact.
MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE: Not
applicable.
CHRONIC OVEREXPOSURE EFFECTS
Avoid long-term and repeated contact
Repeated exposure to vapors above recommended exposure limits (see
Section 8) may cause irritation of the respiratory system and permanent
brain and nervous system damage Intentional misuse by deliberatoly
concentrating and inhaling the contents can be harmful or fatal. An
ingredient in this product has caused fetal toxicity in experimental
animals. The significance of these findings for humans is unknown
The effects of long-term, low level exposures to this product have not
been determined. Safe handling of this material on a long-term basis
should emphasize the prevention of all contact with this material to avoid
any effects from repetitive acute exposures. See Section 11. of this
MSDS for a detailed list of chronic health effects information available on
individual ingredients in this product.
I SECTION 4 . FIRST AID MEASURES ---==-__::J
If ingestion, irritation, any type of overexposure or symptoms of
overexposure occur during or persists after use of this product, contact a
POISON CONTROL CENTER, EMERGENCY ROOM OR PHYSICIAN
immediately; have Material Safety Data Sheet information available.
EYE CONTACT:
Remove contact lens and pour a gentle stream of warm water through the
affected eye for at least 15 minutes If irritation persists. contact a poison
control center, emergency room, or physician as further treatment may be
necessary.
SKIN CONTACT:
Run a gentle stream of water over the affected area for 15 minutes A
mild soap may be used if available If any symptoms persist, contact a
poison control center, emergency room, or physician as further treatment
may be necessary.
INHALATION:
Remove from area to fresh air. If symptomatic, contact a poison control
center, emergency room or physician for treatment information.
INGESTION:
Gently wipe or rinse the inside of the mouth with water. Sips of water
may be given. Never give anything by mouth to an unconscious person.
Contact a poison control center, emergency room or physician right away
as further treatment may be necessary.
I SECTION 5 - FIRE FIGHTING MEASURES_-=-:J
FLAMMABLE PROPERTIES
FlASHPOINT: 114 Degrees F ( 46 Degrees C)
FlASHPOINT TEST METHOD:
Pensky-Martens Closed Cup
UEL: Not Available.
LEl: 1.3
AUTOIGNITION TEMPERATURE:
Not Available.
EXTINGUISHING MEDIA:
Use National Fire Protection Association (NFPA) Class B extinguishers
(carbon dioxide, dry chemical, or universal aqueous film forming foam)
designed to extinguish NFPA Class II combustible liquid fires. Water
spray may be ineffective. Water spray may be used to cool closed
containers to prevent pressure build-up and possible autoignition or
explosion when exposed to extreme heat.
Page 1 of 4
ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP ID D~ DATE (MM/DDfYVYY)
SABEL-1 11/13/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance Marketplace, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1998 Skypark Dr Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504
Phone: 541-779-0177 Fax: FAX 772-8235 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Austin Mutual Ins
INSURER B:
Sabel Painting CO INSURER C:
Jim Sabel
3181 Old Sta~e Rd INSURER D:
Central Po in OR 97502
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSRi TYPE OF INSURANCE POLICY NUMBER POLJ~~ EFFEg~E POLLC,\FXPIRA'J;!gN LIMITS
LTR DATE MM/DDNY DATE MM/DDfYY
GENERAL LIABILITY EACH OCCURRENCE $
- DAMAGt:
COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $
I CLAIMS MADE D OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
-
GENERAL AGGREGATE $
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1000000
A ANY AUTO BA 190082702 06/13/07 06/13/08 (Ea accident)
f--
ALL OWNED AUTOS BODILY INJURY
f-- $
~ SCHEDULED AUTOS (Per person)
~ HIRED AUTOS BODILY INJURY
$
~ NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
o OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORY L1Mm3 I IU~R-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
1990 Chevrolet C2500 PICKUP 1GCGC24KXLE262449
CERTIFICATE HOLDER
CANCELLATION
BLANK-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland all officers DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
and Employees NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Kari Olson IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
20 E Main St
Ashland OR 97520 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Kevin Cope
ACORD 25 (2001108)
@ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
ACORD,. CERTIFICATE OF LIABILITY INSURANCE OP ID D~ DATE (MM/DDIYYYV)
SABEL-l 11/13/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance Marketplace, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1998 Skypark Dr Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504
Phone: 541-779-0177 Fax: FAX 772-8235 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Saif Corporation
INSURER B:
Sabel Painting CO INSURER C:
Jim Sabel
3181 Old Sta~e Rd INSURER 0:
Central Poin OR 97502
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN"K ;rs~~ POLICY NUMBER POL!~i~ EFFECT~E PgktCEY(~~b'b'}~~N LIMITS
LTR TYPE OF INSURANCE DATE MM/DDIYY
GENERAL LIABILITY EACH OCCURRENCE $
- UAMA\jt: I U Kt:N I t:u
COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $
~ CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
I--
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
n .nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
I-- $
ANY AUTO (Ea accident)
I--
ALL OWNED AUTOS BODILY INJURY
I-- $
SCHEDULED AUTOS (Per person)
I--
HIRED AUTOS BODILY INJURY
I-- (Per accident) $
NON-OWNED AUTOS
I--
I-- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND TTORY L1Mm3 I IU~k-
A EMPLOYERS' LIABILITY 970729 07/01/07 07/01/08 E.L. EACH ACCIDENT $ 500000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500000
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland All Officers DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
and Employees NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Kari Olson IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
20 E Main St
Ashland OR 97520 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Kevin Cooe
ACORD 25 (2001/08)
@ACORD CORPORATION 1988
ACORDN CERTIFICATE OF LIABILITY INSURANCE OP ID n1 DATE (MM/DDIYYYY)
SABEL-l 11/13/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance Marketplace, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1998 Skypark Dr Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504
Phone: 541-779-0177 Fax: FAX 772-8235 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Safeco Ins Co. 24724
INSURER B:
Sabel Painting CO INSURER C:
Jim Sabel
3181 Old Sta~e Rd INSURER D:
Central Poin OR 97502
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSR[ TYPE OF INSURANCE POLICY NUMBER PD'l~~lri~rJ~~E PQLLC...,YtFXPIRA1!,.~N LIMITS
LTR DATE MM/DDIYY
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
- 11/14/07 11/14/08 UAMA<.;t: I U Kt:N I t:u
A X X COMMERCIAL GENERAL LIABILITY 01-CG-910242-3 PREMISES (Ea occurence) $ 200,000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10,000
PERSONAL & ADV INJURY $ 1000000
-
GENERAL AGGREGATE $ 2000000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ea accident) $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
r- (Per person) $
SCHEDULED AUTOS
r-
HIRED AUTOS BODILY INJURY
r- (Per accident) $
NON-OWNED AUTOS
r-
r- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 1TORy LIMITS I IUJ~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~~~~lttS~~~v~~~c3~s below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Ashland, its officers, employees and agents are additional
insured
CERTIFICATE HOLDER
CANCELLATION
ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland All Officers DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
and Employees NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Kari Olson IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
20 E. Main St.
Ashland OR 97520 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Kevin CODe
ACORD 25 (2001/08)
@ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
r::Gl 5 A FEe 00
r~
CG 75 35 10 00
LIABILITY PLUS ENDORSEMENT
COMMERCIAL GENERAL L1ABILllY
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL L1ABILllY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of Ashland
ADDITIONAL INSURED . BY WRITTEN CONTRACT,
AGREEMENT OR PERMIT. OR SCHEDULE
Tile following paragraph is added to WHO IS AN INSURED
(Section II):
5. Any person or organization shown in the Schedule or
for whom you are required by written contract,
agreement or permit to provide insurance is an
insured, sUbject to the following additional provisions:
3. The contract, agreement or permit must be in
effect during the polley period shown in the
Declarations, and must have been executed prior
to the "bodily injury," "property damage,"
"personal and advertis ing injury."
h. The person or organization added as an insured
by this endorsement is an insured only to the
extent you are held liable due to:
(1) The ownership, maintenance or use of that
part of premises you own, rent, lease or
occupy, subject to the following additional
provis ions:
(a) This insurance does not apply 10 any
"occurrence" which talms place afler
you cease to be a lenant In any
premises leased to or rented to you;
(b) This insurance does not apply to any
structural alterations, new construction
or demolition operations performed by
or on behalf of the person or
organization added as an Insured;
(2) Your ongoing operations for that insured,
whether the worl( is performed by you or for
you;
n...... .f _r.,
(3) The maintenance, operation or use by you
of equipment leased to you by such person
or organization, subject to the following
additional provisions: .
(a) This Insurance does not apply to any
"occurrence" which takes place after
the equipment lease expires:
(b) This insurance does not apply to
"bodily injury" or "property damage"
arising out of the sole negligence of
such person or organization;
(4) Permits issued by any state or political
subdivision with respect to operations
performed by you or on your behalf, SUbject
to (he following additional provision:
This insurance does not apply to "bodily
injury," "property damage," "personal and
advertising injury" arising out of operations
performed for the state or municipality:
G. Tile insurance with respect to any architect,
engineer, or surveyor added as an insured by this
endorsement does not apply to "bodily injury,"
"propmiy damage," "personal and advertising
injury" arising out of !tIe rendering of or l~le
failure to render any professional servicos by or
for you, Including:
(1) The preparing, approving, or falling (0
prepare or approve maps, drawings,
opinions, reports, surveys, c~lange orders,
designs or specifications; and
(2) Supervisory, inspection or engineering
services.
d. Hlis insurance eloes not apply to "bodily injury"
or "property damage" inclueled witrlin trle
"products-completeel operations hazard."
A person's or organization's status as an insured
under trlis endorsement ene!s wtlen your
operations for nlat insured are completed.
No coverage will be provicjed if, in the absence
of trlis endorsement, no liability woule] be
imposeeJ by law on you. Coverage srlall be limited
to the extent of your negligence or fault according
to the applicable principles of comparative fault.
NON-OWNED WATERCRAFT AND NON-OWNED AIRCRAFT
L1ADILlTY
Exclusion g. of COVERAGE A (Section I) is replaced by HIe
following:
g. "Bodily injury" or "property damage" arising out
of ttle ownerstlip, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insured. Use includes operation
and "loading or unloading."
HIls exclusion does not apply to:
(1) A watercraft while astlOre on premises you
own or rent;
(2) A watercratt you do not own that is:
(a) Less than 52 feet long; and
(b) Not being useel to carry persons or
property for a charge;
(3) Parking an "auto" on, or on the ways next
to, premises you own or rent, provided the
"auto" is not ownee! by or rented or loaned
to you or tile insured;
(4) Liability assumed umler any "insured
contract" for the ownerstlip, maintenance or
use of aircratt or watercratt; or
(5) "Bodily injury" or "property elamage"
arising out of the operation of any of the
equipment listed in paragraptl L(2) or f.(3)
of trle clefinition of "mobile equipment."
(6) An aircratt you do not own provided it is not
operated by any insuree!.
TENANTS' PROPERTY DAMAGE LIABILITY
When a Damage to Premises Rented to you Limit is stlOwn
in trle Declarations, Exclusion J. of Coverage A, Section I is
replaced by the following:
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy;
, ,
CG 76 35 10 00
COMMERCIAL GENERAL LIABILITY
(2) Premises you sell, give away or abandon, if the
"property elamage" arises out 01 any part of
ttlOse premises;
(3) Property loaned to you;
(4) Personal property in the care, custody or control
of the insured;
(5) Tllat particular' part of real property on wtlicrl you
or any contractors or subcontractors working
directly or indirectly on your betlalf are
performing operations, if the" property damage"
arises out of those operations, or
(6) That particular part of any property that must be
restoree!, repaired or replacee! because "your
work" was incorrectly performed on it.
Paragrapt\s (1), (3) and (4) of this exclusion do not
apply to "property damage" (other Hlan damage by
fire) to premises, including trle contents of such
premises, rentecl to you. A separate limit of insurance
applies to Damage To Premises Rented To You as
described in Section III - Limits Of Insurance.
Paragraptl (2) of nlis exclusion eloes not apply if the
premises are "your work" and were never occupied,
rented or helel for rental by you.
Paragraphs (3), (4), (5) and (6) of this exclusion do
not apply to liability assumed uncler a sidetracl(
agreement.
Paragraph (6) of this exclusion ~Ioes not apply to
"property damage" included in the
"proeJucts-completed operations hazard."
Paragraph 6. of Section III is replaceel by the following:
6. Subject to 5. above, the Damage To Property Limit is
Hle most we will pay under Coverage A for damages
because of "property eJamage" to anyone premises,
wtlile rented to you, or in HIe case of damage by fire,
wtlile rented to you or temporarily occupied by you
winl permission of HIe owner.
The Tenants' Property Damage to Premises Rented to You
limit is Hle higher of $200,000 or HIe amount shown in the
Declarations as Damage to Premises Rented to You Limit.
WHO IS AN INSURED - MANAGERS
The following is aclcled to Paragraprl 2.a. of WHO IS AN
INSURED (Section II):
Paragraph (1) eloes not apply to executive officers, or to
managers at the supervisory level or above.
SUPPLEMENTARY PAYMENTS. COVERAGES A AND B -
BAIL DONDS
a. Paragraph 2. of SUPPLEMENTARY PAYMENTS
COVERAGES A AND B is replaced by the following:
Page 2 or 3
2. Up to $2,000 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any verlicle to whicll trle
Bodily Injury Liability Coverage applies. We do
not have to furnish these bonds.
EMPLOYEES AS INSUREDS - HEALTH CARE SERVICES
Provision 2.a.(1) d. of WHO IS AN INSURED (Section II) is
deleted, unless excluded by separate endorsement.
EXTENDED COVERAGE FOR NEWLY ACQUIRED
ORGANIZATIONS
Provision 4.a. of WHO IS AN INSURED (Section II) is
replaced by trle following:
a. Coverage under this provisi':ln is afforded only
until the end of the policy period.
EXTENDED "PROPERTY DAMAGE"
Exclusion a. of COVERAGE A. (Section I) is amended to
read:
a. "Bodily injury" or "property damage" expected or
intended from the standpoint of the insured. This
exclusion does not apply to "bodily injury" or
"property damage" resulting from the use of
reasonable force to protect persons or property.
'"
c
~
...
ADDITIONAL INSURED - VOLUNTEERS
1. WHO IS AN INSURED (Section II) is amended to
include as insureds any persons who are volunteer
workers for you, but only while acting at the direction
of, and within the scope of their duties for you.
However, no volunteers are insureds for:
a. "Bodily injury" to:
(1) Co-volunteers or your employees arising out
of and in the course of their duties for you,
or
(2) You, any of your "employees," any partner
or member (if you are a partnership or joint
venture), or any member (if you are a limited
liability company).
b. "Property damage" to property owned, occupied
or used by, rented to, in the care, custody, or
control 01, or over which prlysical control is being
exercised for any purpose by:
CG 76 35 10 00
COMMERCIAL GENERAL LIABILITY
(1) A co-volunteer or your employee; or
(2) You, any of your "employees", any partner
or member (if you are a partnership or joint
venture), or any member (if you are a limited
liability company).
2. Exclusion 2.a. of COVERAGE C (Section I) is replaced
by the following:
a. To any insured, except volunteer workers who are
not paid a fee, salary or other compensation;
INCREASED MEDICAL EXPENSE LIMIT
The medical expense limit is amended to $10,000.
KNOWLEDGE OF OCCURRENCE
The following is added to Paragraph 2.. Duties In The Event
Of Occurrence, Offense, Claim Or Suit of COMMERCIAL
GENERAL LIABILITY CONDITIONS (Section IV):
Knowledge of an "occurrence," claim or "suit" by your
agent, servant or employee shall not in itself constitute
knowledge of the named insured unless an officer of the
named insured has received such notice from the agent,
servant or employee.
UNINTENTIONAL FAILURE TO DISCLOSE ALL HAZARDS
The following is added to Paragraph 6. Representations of
COMMERCIAL GENERAL LIABILITY CONDITIONS (Section
IV):
If you unintentionally fail to disclose any hazards existing
at the inception date of your policy, we will not deny
coverage under Ulis Coverage Form because of such failure.
However, this provision does not affect our right to collect
additional premium or exercise our right of cancellation or
non-renewal.
LIBERALIZATION CLAUSE
The following paragraph is added to COMMERCIAL
GENERAL LIABILITY CONDITIONS (Section IV):
10. If a revision to trlis Coverage Part, which would
provide more coverage with no additional premium,
becomes effective during lrle poiicy period in the state
shown in the Declarations, your policy will
automatically provide trlis additional coverage on the
elfective date of the revision.
Page 3 of 3
Page 1 / 1
r6'
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
~i
VENDOR: 011256
SABEL PAINTING CO
3181 OLD STAGE ROAD
CENTRAL POINT, OR 97502
SHIP TO: Ashland Building Maintenance
(541) 488-5358
90 N MOUNTAIN AVENUE
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Special Inst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Dale Peters
Confirming? No
Secure lead abatement permit. Prep and
paint Alice Peale Stairway. Provide
abrasive coatinQ to stair treads. Use
all materials outlined in the attacted
documentation.
6,890.00
Contract for Goods & Services
BeQinninQ date: November 19, 2007
Completion date: January 1, 2008
Insurance required/On File
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
6 890.00
0.00
0.00
6,890.00
#-
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Au orized Signature
VENDOR COPY
CITY OF
ASHLAND
REQUISITION FORM
THIS REQUEST IS A:
D Change Order(existing PO #
Date of Request: I Cj AloV' {) 7-1
Required Date of Delivery/Service: I / ~,.::J CJtS I
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
S14SCL ?Jq/Nr'AI<'- c.Ob1r'lAJY
"3 , Q l to Id S-l~(; ~I
c..eNr~L :;:PO;IU~ r 0 R r 11tJ :z.-
5~ 1- 7- ?~- lSSS-
59 \ - "T::t5 - I ss-s:-
::J, YYl 9&413 r:s: L-
SOLICITATION PROCESS
Small Procurement [d Sole Source 0 Invitation to Bid
o Less than $5,000 o Written findings attached (Copies on file)
o Quotes (Optional) o Quote or Proposal attached
Cooperative Procurement 0 Reauest for Proposal
o State of ORN/A contract (Copies on file)
Intermediate Procurement o Other government agency contract 0 Special I Exempt
~ (3) Written Quotes 0 Copy of contract attached 0 Written findings attached
(Copies attached) 0 Quote or Proposal attached
\L<-'O S'T\rfS b\~ i':o I 0 0 Emeraency
~Sfol0l) Contract # 0 Written findings attached
0 Quote or Proposal attached
Description of SERVICES
SE"c...vdi!.E!. l-~P Ajii~'T~MEI\JT"" -=r~~~::tl' ~"P ANI> ~It-JT
A"~e:.1>E"\L.e:.. ~l i2 ~A'I' ~C\1 IDe" A ~(2JC191 ve C!Of&\,-, N t;.
\0 S"t",.q 1" T,z e~ ~ ~ lASE ALL IVfA Te~ I,,:JLS' 01-\.,. L I "'ED
'tV 'fA T1' I:\c"H~.D ~".pS2 ~~k I
o Per attached PROPOSAL
Total Cost
" :(;";'. "~;' ...... ;~..\~.,. i,:O<)/'
$ ............."..............".."~'.
. " '.....,",;..,' ,"',':,' ,"., ":",,,-,,'1
Item # Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
TOTAL COST
0 Per attached QUOTE
Project Number _ _ _ _ _ _ - _ _ _ (..P'''' $
II) nl) PaJL,.f L--7
Account Numbe~C~- !_I ~'.(~_'!~_~/ t?-t:J
. Items and services must be charged to the appropriate account numbers for the financials 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. ~ d
Employee Slgn;;;;;:'- ~ ~ SupervlsorlDept. Head Signalure: .~
G: Finance\ProcedurelAP\Forms\8_Requisition form revised,doc
Updated on: 5/1712006