HomeMy WebLinkAbout2008-024 Contract - Siskiyou Appraisal
Contract for PERSONAL SERVICES Less than $25,000
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONSULTANT: Siskiyou Appraisal
CONTACT: Christine M. Pellett MAl
ADDRESS: 972 Old Stage Road, Central Point, OR
97502 USA
TELEPHONE: 541.245.0503
DATE AGREEMENT PREPARED: 1-29-2008 FAX: 541.245.0503
BEGINNING DATE: 2-4-2008 COMPLETION DATE: 4-1-2008
COMPENSATION: Estimated at $4200.00 but not to exceed $5000.00.
SERVICES TO BE PROVIDED: Appraisal to estimate the market value of two lots on Strawberry Lane;
Appraisal to estimate the market value of four potential half acre lots on Westwood Street; and the
Review of an existinq appraisal for a 10 Acre property on Clav Street.
ADDITIONAL TERMS: Conducting the Appraisal work shall be CONFIDENTIAL as it is undertaken to inform the potential sale or
trade of property pursuant to ORS Chapter 94, and Article X, Section 2(c), and Article XIX A, Section 2, of the Ashland City Charter
and Ashland Municipal Code.
FINDINGS:
Pursuant to AMC 2.52.040E and AMC 2.52.060, after reasonable inquiry and evaluation, the undersigned Department
Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have
adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for
utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and
capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and
financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the
compensation negotiated herein is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings I Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service to which they will be
assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of
Oregon, are so registered, licensed and bonded.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified
above. Once work commences, invoices shall be prepared and submitted by the tenth of the month for work
completed in the prior month. Payments shall be made within 30 days of the date of the invoice. Should the contract
be prematurely terminated, payments will be made for work completed and accepted to date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $17,342 or more, Consultant is required to comply with
chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees
performing work under this contract and to any Subcontractor who performs 50% or more of the service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held resoonsible for any losses, expenses, claims, subroaations,
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 1 of 9
actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
tifI'
10. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
c. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
written notice to Consultant, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Consultant to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Consultant may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. 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, c or d of this section, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business
on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or
delegate duties under, the Contract.
14. Insurance. Consultant shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers ~
b. Professional Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,99g, $500,090, $1.000.000, $2,099,ggg or Not J\l'll3lic3blo for each claim, incident or occurrence. This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
c. General Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1 000000, CI''l,'''''','''''' . LU . for each occurrence for Bodily Injurv and Prooerty
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 2 of 9
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
d. 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 Applioablo 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. C nsultant shall si n the certification attached hereto as Exhibit A and herein incor orated b reference.
CONSULTAN CITY OF ASHLAND:
BY
BY
TITLE
1\-ppA IS' e r
DATI;
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DATE
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4C8 ~t?g- dhtS
~~ U t'A- r d &:
(For City pu ses only)
PURCHASE ORDER # t:J t3 ( 7-~
y
Federal 10#
'Completed W9 form must be submitted with contract
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 3 of 9
- -TJr--.----
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (Hi) 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.
'}~
(Date)
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 4 of 9
Fonn W-g
I~liffln!"fll fit IhP Jr~JI',I
Intl)fn<)j A:(....OfIllC. $(tr\lIC('
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
(Rev. Oc:tober 2007)
o;;::;'J:/;emc'M ~'~ /Ie
Buslneee name. W dlllerent from ..booIe
Check "PP'opri.bt box: [!( lndilliduallSol. prcpriatcr 0 Corporation 0 Partner.hip
n Limibtd fial:Ji1ily company Enbtr 1M btx d_ (D....iaregarded entity. Caeorporation. P..parlnorehip) ~ .
n Otho< (iti intlMtion;) ~
Add,_ (numbo<. meat, d apt.
r: Exempt
pay..
~te". nI,me and add,... (optional)
r;7S'6..2-
IN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Une 1 to avoid
backup wilhholdng. For individuals. this is your social security number (SSN). However. for a resident
alien. sole proprietor. or disregarded entity. 88e the Part I instructions on page 3. For other entities. it is
your employer identification number (EIN). If you do not have a m.mber. 88e How to get a TIN on page 3.
Not.. II thll account is n more than one name. see the chart on page 4 for guidelines on whose
number to enter.
:~~Mm>ber I
'~q8: [}66S
or
Employer ldenlIfioation number
Certification
Under penalties of perjury. I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me). and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding. or (b) I have not been notified by the Internal
R$venue Service (IRS) that I am slJlject 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 wlthholdlng. and
3. I am a U.S. citizen or other U.S. person (defined below).
Certlftcatlon Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
witl'lhalding because you have failed to rGport III interest and dvidends on your tax return. For real estate transactions. item 2 does not apply
For mortgage interest paid. acqusition or abandonment of secured property. cancellation of debt. contributions to an individual retirement
arrangement (IRA), and generally. paymen ther than interest and dividends. you are not required to sign the CertIfication. but you must
provide your correct TIN. See th instructi s on page 4.
Sign
Here
on. ..
/-
Section references ....e to the Internal Revenue Code unless
otherwise noted.
Purpose of Form
A person who Is reqUired to file an Information return with the
IRS must obtain your correct taxpayer id9ntification number (TIN)
to report. for example. income paid to you. real estate
transactions. mortgage interest you paid. acquisition or
abandonment of S&ClI'ed property. cancellation of debt. or
contributions you made to an IRA.
Uss Form W-9 only if you are a U.S. person (including a
resident alien). to provide yoII' correct TIN to the person
requGSting it (the rlilquester) 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 US.
exempt payee. If applicable. you ..... also certifying that as a
U.S. person. your allocable share of any partnership income from
a US. trade or business is not subject to the withholding tax on
foreign partners' share of effectively connectllCl 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 sin'ilar to this Form W-9
Definition of a U.s. person. For federal tax purposes. you are
conSidered a U.S. person II you are:
. An IndIVidual who is a US citIZen or US resident alien.
. A partnership. corporation. company. or association created or
organiZed In the United States or under the laws of the United
States.
. An estate (other than a foreign estate). or
. A domestic trust (as defined in Regulations section
301.7701-7).
Special lUes for partnerships. Partnershlps that conduct a
trade or business in the United States are generally requi"ed to
pay a withholding tax on any foreign partners' share of income
from such business. Further. in certain cases where a Form W-9
has not been received. a partnership is requi'ed 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 estabhsh your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
pur~s of establishing its U.S. status and avoiding withholding
on Its aHocable 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 Farm W-9 (Rav.10-2007)
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 5 of 9
Form W-9 (Rev. 10-20(7)
Page 2
· The U.S. grantor or other owner of a grantor trust and not the
trust, and
. The U.S. trust (other than a grantor trust) and not the
benefICiaries of the trust.
Foreign person. If you are a foreign person, do not use Fam
W-9 Instead, use the appropriate Fam W-8 (see Publication
515, Withholding of Tax on Nonresident Aliens and Foreign
Entities).
Nonresident alien who becomes a resident aIen. Generally.
only a nonresident alien individual may use the terms of a tax
treaty to reduce or eUmnate U.S. tax on certain types of Income.
HowElVer, 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 sven after the payee 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 rnJSt
attach a statement to Form W-9 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
aHen.
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 fac1s to justify the exemption from tax under the
terms of the treaty artiele.
E1campIe. Mlcle 20 of the U.S.-China income tax treaty allows
an exemption from tax for scholarship income received by a
Chinese student temporarily present In the United States. Under
U.S. law, this student win become a resident alien for tax
purposes if his or her stay in the United States exceeds 5
calendar years. However, paragraph 2 of the first Protocol to the
U.S.-China treaty (dated April 30, 1984) allows the provisions of
Miele 20 to continue to apply even after the Chinese student
becomes a resident alien of the United States. A Chinese
student who quaUfles for this exception (under paragraph 2 of
the fll'st protocol) and is relying on this exception to claim an
exemption from tax on his or her scholarship a fellowship
income would attach to Form W-9 a statement that includes the
Information described above to suppal that exemption.
If you are a nonresident alien a a foreign entity not subject to
backup withholding, give the requester the appropriate
completed Form W-8.
What Is backup WI1hholdlng7 Persons making certain payments
to you must under certain conditions withhold and pay to the
IRS 28% of such payments. This is called "backup withholding."
Payments that may be subject to backup withholding include
interest, tax-exempt Interest, dividends, broker and barter
exchange transactions, rents, royalties, nonemployee pay, and
certain payments from fishing boat operators. Real estate
transactions are not subject to backup withholding.
You will not be SUbject to backup Withholding on payments
you receive if you give the requester your correct TIN, make the
proper certifications, and report all your taxable interest and
dividends on your tax return.
Payments you receive will be subject to backup
withholding if:
1. You do nol furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II
instructions on page 3 for delails),
3. The IRS tells the requester that you furnished an incarect
TIN,
4. The IRS tells you that you are SUbject to backup
withholding because you did not repal all your interest and
dividends on your tax relurn (for reportable interest and
dividends only), a
5. You do not certify to the requesler that you are not subject
to backup withholding under 4 aboVe (for reportable interest and
dividend accounls opened after 1983 only).
Certain payees and payments are exempt from backup
withhOkling. See the instructions below and the separate
Instructions for the Requester of Form W-9.
Also see Special rules for partnerships on page 1
Penalties
Fallm-e to fUrnIsh nN. If you fail to furnish your correct TIN to a
requester, you are SUbject to a penalty of $50 for each such
failure unless your faiiure is due to reasonable cause and not to
willful neglect,
C1vH penalty for false Infonnallon willi respect to
withholding. If you make a faise statement with no reasonable
basis that results in no backup withholding, you are subject to a
$500 penalty.
CrlJrinaI penalty for falsifying information. Willfully falsifying
certifications a affirmations may subject you to criminal
penalties including fines and/or imprisonment.
MIsuse of TINs. If the requester discloses or uses TINs In
violation of federal law, the reqU9Sler may be subject to civil and
criminal penalties.
Specific Instructions
Name
If you are an individual. you must generally enter the name
shown on your income tax return. However, if you have changed
your last name, for instance, due to marriage wtthout Informing
the Social Security Administration of the name change, enter
your first name, the last name shown on your social security
card, and your new last name.
If the account is in joint names, list first. and then circle. the
name of the person or entity whose number you entered In Part I
of the form.
Sole proprietor. Enter your individual name as shown on your
income tax return on the "Name" line. You may enter your
business, trade, a "doing business as (DBA)" name on the
"Business name" line.
Lhlted IIaIlIIIty company (LLC). Check the "Limited liability
company" box only and enter the appropriate code for the tax
classification ("0" for disregarded entity, "C" for corporation, "P"
fa partnership) in the space provided.
For a single-member LLC (Including a foreign LLC with a
domestic owner) that is disregarded as an entity separate from
its owner under RegUlations section 301.7701-3, enter the
owner's name on the "Name" line. Enter the LLC's name on the
"Business name" line.
For an LLC classified as a partnership or a corporation, enter
the LLC's name on the "Name" line and any business, trade, or
DBA name on the "Business name" line.
au- enliliCls. Enter your business name as shown on required
federal tax documents on the "Name" line. This name Should
match the name shown on the charter or other legal document
creating the entity. You may enter any business, trade, or DBA
name on the "Business name" line.
Note. You are requested to check the appropriate box for your
status (indlvlduaVsole proprietor, corporation, etc.).
Exempt Payee
If you are exempt from backup withholding, enter your name as
described above and check the appropriate box for your status,
then check the "Exempt payee" box In the i1ne following the
business name, sign and date the form.
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 6 of 9
Fonn W-9 (Rev. 10-20(7)
Generally. Individuals (Including sole proprietors) are not exempt
from backup withholding. Corporations are exempt from backup
withholding for certain payments, such as Interest and dividends.
Note.. If you are exempt from backup withholding. you should
still COl'1lliete this form to avoid possible erroneous backup
withholding.
The following payees are exempt from backup withholding:
1. An organization exempt from tax under section 501 (a). any
IRA, or a custodial account under section 403(b)(7) if the account
satisfKlS the requirerrKlnts of section 401 (1)(2),
2. The United States a any of its agencies or
instrumentalities.
3. A state, the District of Columbia, a possession of the United
states, or any of their political subdivisions or instrumentalities,
4. A foreign government or any of its political subdivisions,
agencies, or instrumentalities, or
5. An International organization a any of its agencies or
instrumentalities.
other payees that may be exempt from backup withholding
include:
6. A corporation.
7. A foreign central bank of issue.
8. A dealer in secll'ities or corTl'TlOdities required to register in
the United States. the District of Columbia, or a possession of
the United States,
9 A futures commission merchant registered with the
Comnodity Futures Trading Commission,
10. A real estate investment trust,
11. An entity registered at all times during the tax year under
the Investment company Act of 1940,
12. A common trust fund operated by a bank under section
584(a),
13. A financial Institution,
14. A middlllman known in the investment community as a
nominee or custodian, or
15. A trust exempt from tax under section 664 or described In
section 4947.
The chart below shows types of payments that may be
exempt from backup withholding. The chart applies to the
exempt payees listed above, 1 through 15.
IF the payment Is for . . .
THEN the payment Is uempt
for .. .
All exempt payees except
for 9
Exempt payees 1 through 13.
Also. a person registered under
the ....vestment Advisers /V:;t of
1940 who regUlarly acts as a
broker
Exempt payees 1 through 5
Interest and dividend payments
Broker transactions
Barter exchange transactions
and patronage dividends
Payments over $600 required
to be reported and direct
sales over $5,000 I
Generally, 9lrempt payaas
1 through 7
's.. Ferm 109ll-MISC, MaceII8no.oue Incoma, and Italre1rudJona.
'How"".... the foIowIng pGymenlll mede to " corporlltion (including grOO&
prOCMda pllid 10 an allamII)' under ..aion 6045(ll, ...... ~ the attamay ill .
cor_non) _ "'pcr1llble on FOIlIl 101Kl-MISC ,n not exempt from
bac:lu4> withholding: mttdical and "-llh care paym_. aIIomll)'.'..... and
peym_ fer aeMCtlll paid by "fecl....1 exe<:u1iva llllency.
Pllll,,3
Part I. Taxpayer Identification
Number (TIN)
Enter your TIN In 1he appropliale box. If you are a resident
alien and you do not have and are not eligible to get an SSN,
your llN is your IRS individual taxpayer identification number
(ITIN). Enter it in the social security number box. If you do not
have an mN. see How to get 8 TIN below.
If you are a sole proprietor and you have an EIN. you may
enter either your SSN or EIN. However. the IRS prefers that you
use YOll' SSN.
If you are a Single-member llC that Is disregarded as an
entity separate from its owner (see Limited Dabmty company
(LLC) on page 2), enter the owner's SSN (or EIN, if the owner
has one). Do not enter the disregarded entity's EIN. If the LLC is
classified as a corporation or partnership, enter the entity's EIN.
Note. See the chart on page 4 for further clarification of name
and llN combinations.
How to get a llN.lf you do not have a llN. apply for one
immediately. To apply for an SSN, get Fam SS-5, Application
for a Social Security Card, from your local Social Security
Administration office or get this form online at www.ssagov. You
may also get this form by calling 1-800-772-1213. Use Form
W-7, Application for IRS Individual Taxpayer Identification
Number, to apply for an I11N, or Form SS-4. Application for
Employer Identification Number. to apply for an EIN. You can
apply for an EIN online by accessing the IRS website at
www.llS.govlbuslnesS6S and cllcklng on Employer Identification
Number (EIN) under starting a Business. You can get Forms W-7
and SS-4 from the IRS by visiting www.irs.gov a by calling
1-800- TAX-FORM (1-800-829-3676).
If you are asked to complete Form W-9 but do not have a llN.
write "Applied Fa" In the space for the llN, sign and date the
form, and give it to the requester. For interest and dividend
payments. and certain payments made with respect to readily
tradable instruments. generally you will have 60 days to get a
TIN and give it to the requester before you are subject to backup
withholding on paymenls. The 6Q-day rulll does not apply to
other types of paymenta. You will be subject to backup
withholding on all such payments untU you provide your TIN to
the requester.
NoIe. Entering "Applied For" means that you have a"eady
applied for a TIN a that you Intend to apply for one soon.
caution: A d/81'9g81'd6d domestic entity that has a foreign OWI16f
must use the appropriate Fonn W-8.
Part II. Certification
To establish to the withholding agent that you are a U.S. person.
or resident allen, sign Form W-9. You may be requested to Sign
by the withholding agent even If /terns 1, 4, and 5 below indicate
otherwise.
Fa a joint account. only the person whose TIN is shown in
Part I should sign (when required). Exell1't payees, see Exempt
PaysEl on page 2.
SIgnature requirements. Complete the certification as indicated
in 1 through 5 below.
1. Interest, dividend, and barter exchange accounts
opened before 1984 and broker accounts considered active
dwIng 1!l83. You must give your correct TIN, but you do not
have to sign the certification.
2. Interest, dlvlclend, broker, and bartier exchange
accounts opened after 1983 and broker accounts considered
lnacllve during 1Sl83. You must sign the certification or backUP
withholding will apply. If you are subject to backup withholding
and you are merely providing your correct TIN to the requester.
you must cross out item 2 In the certification before signing the
form.
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 7 of 9
--nr-r
Form W-9 (Rev. 10-2007)
3.. Real estate transacIIons. You must sign the certification.
You may cross out Item 2 of the certification.
4. Other payments. You mJst giVe your correct TIN. but you
do not have to sign the certification unless you have been
notl1'led that you have previously given an Incorrect TIN. 'Other
payments' include payments made In the course of the
requester's trade or business for rents. royalties. goods (other
than bills for Imrchandise), medical and health care services
(including payments to corporations). payments to a
nonemployee for services. payments to certain fishing boat crew
members and fishermen. and gross proceeds paid to attorneys
(Including payments to corporations).
5. Mortaage Interest paid by you, acquIsI1Ion or
abandonment of SCICUI'8d proparty, canclIIlatIon of debt,
quallflecl tuIUon progran payments (under section 629t. IRA,
CCMIIdoII ESA, Archer MSA or HSA contrllUllons or
ClI8trIbuIIons, and pension CllsblbutIons. You roost giVe your
correct TIN. but you do not have to sign the certification.
What Name and Number To Give the Requester
I
I
I
I
I The gnntor-lruslee
For the type of_
Give name lIhd SSN ot
1. lndividLal
2. Two or more individ....... Gaint
account)
The lndividLal
The acluel own.... of the account or.
if ccmbined funcb. 111. first
individual on the IICCOUnt'
The minor '
3. Custodian aCCO<nt of a minor
(Uniform Gift 'to Mnora Ad)
4. a. The ueuol revoc:able _ings
lruat (grantor i8 .Iso -I
b. 8o-caIed IrUllt account that is The aclLlaJ owner .
net a iegaII or vllid IruIt under
.._law
5. Sale praprietor8hip or diaregerded The owner .
entIIy owned by an indlvidU81 I
For the type of _ I
6. Oiereglllded entity not owned by llIl The owner
individuel . I
7. A WIld truat, eelll.., or penaion _I I Legal entity .
8. Corporat. or LLC ..acting The corporation
corp<<ate 81a1ue on Form 8832 i
9. Aoolociaticn, c:1ub, raligiouo, I The organization
charitable. edueatiOMl. or other
tax_...pt orgenizaticn
10. PGrtner6hip or muttl-member LLC The plIl1ner8hIp
". A broker "" regiatered "",,"in.. Th.. broker or "",,"in..
12. Aocount wi1l1 the ~ent of
AgriaJltu-e in 1I1e "."e of . p<1>6c I
entity (auch M a -.. or local I
gov.mm_, achooI ditrtrict, or
~ that receiv.. agricul1urel I
program pay- I
, u:st In3t I!Ild 0;;111..'''' UHf 11111111 ul thv !J'Vflf.Ul whose rlUlnlJoir you lurl1l3h II ully Uf1~ IJ"'flf.UIl
m a lant accomt ha& an SSN, rhar PMN'ln's. nlJmb9r muN ~ furnitihN't
2ClrCle the- mir'W)/":;' namo.:md furni.d'l the mlf'l('{'t: SSN
,
You ftl1J31sh<NI yuJl 1I1d1vtUualnarrl9 Bud yw flliiY *0 'iJntltf yuur tJu3mns Of "L)lJA"
namA m thA t.Kond name hM Y\xJ msy UM ~tMr Y('Jjf SSN nr rlN (if vnJ hav@;Mt\),
t)J1 ttlCIlR$ (oO(;OOI'JQ(I!o yoo to ~C> yoJr SSN
.. II&t firM oW'II"l clrr.1A thtllJ n:untll ('j It'lA' rru"t, 4llMaM. nr pAn!x.n rrl~t (rH"l not f1.,mllth ThA TIN
IJl tht pefWUi1l repreSlnllltlw u lrl.3tH unlvu the Je~w enUI.)' It:sell13lVJt OtSlgt',.led 111
thto lIlCoCoont tlh l AlVJ ,.. S~/i8J ru~ f<:or part".nmN en pag. I
No1It. If no name is circled when more than one name is listed.
the number wRI be considered to be that of the first name listed
Gi.. __ and ElM of:
The public entity
Page 4
Secure Your Tax Records from IclenUty Theft
Identity theft occurs when someone uses your personal
Irtormatlon such as your name, social security number (SSN), or
other identifying irtormatlon. without your permission. to commit
fraud or other crimes. An identity thief may use your SSN to get
a job or may file a tax return using your SSN to receive a refund.
To reduce your risk:
. Protect your SSN,
. Ensure your employer is protecting your SSN, and
. Be careful when choosing a tax preparer.
Call the IRS at 1-800-829-1040 if you thinK your identity has
been used Inappropriately for tax purposes.
Victims of identity theft who are experiencing economic harm
or a system prOblem, or are seeKing help In resolVIng tax
problems that have not been resolved tl'lough normal channels,
may be eligible for Taxpayer Advocate Service (TAS) assistance.
You can reach TAS by calling the TAS toU-free case intake line
at 1-877-777-4778 or TTYfTDD 1-800-829-4059.
Protect yourself from suspicious emalls or phlshlng
schomas. Phishing is the creation and use of email and
websltes designed to ml'Tic legitimate business emalls and
websites. The most common act is sending an email to a user
falsely claiming to be an established legitimate enterprise in an
attempt 10 scam the user into surrendering private information
that wRI be used for identi1y theft.
The IRS does not initiate contacts with laxpayers via emails.
Also. the IRS does not request personal detailed IrtormatiOn
tl'lough emall or ask taxpayers for the PIN numbers, passwords,
or similar secret access irtormation for their credit card, banI<. or
other financial accounts.
If you receive an unsolicited emall clairring to be from the IRS.
forward this message to phIShIngOirs.gov. You may also report
misuse of the IRS name, logo, or other IRS personal property to
the Treasury Inspector General for Tax Administration at
1-800-366-4484. You can forwll'd suspicious emails to the
Federal Trade Commission at: SpsmOuC9.goVor contact them at
www.consumer.govlidtheft or 1-877-IDTI-lEFr(438-4338).
Visit the IRS webslte at www.lrs.gov to learn more about
identity theft and how to reduce your risl<.
Privacy Act Notice
8ection 8109 of the Internal Revenue Code requi'eG you 'to provide YWl carect l1N to pe"""'" who muGt file Infermalion returnG w1111 1he IRS to rep<X't interest,
dividends, end certain other lncon:>e peid 10 you, mortgOIge intereet you paid, tha IlCquiaition or abandonment of eecured property, cancelation or debt, or
contributions you made 'to an IRA. or Archer MSA or HSA Th.. FlS 1J!l8Il1he numbers lot identilica1ion _ and 'to help verify the accuracy aI you" tax relum.
The FlS may a180 provide 111.. informalion 10 the [)epertment of .Justice b civil end crirninallitigGtion, and to citieG, <I1IIte&, !he District of Columbia, and U.S.
poo;sllll8ions to C8'ry out their tax 1lIwa. We may al80 dWclose 1his Information 'to other counlri... ...der a tax treaty, to federal and $_ agenc:iea 10 enforce federal
non1aX aiminallawa, or 'to federal law enforcem_ end irUlligence agenciae 10 combat terRlriem.
You muGt prOllId.. yoll TIN _ or not you..... reqlired 'to fI.. a tax relu'n. Peyerllmust generally wi1Il""'d 28% of laxabl..lnhlreBt. dlllldend. and e_n ofher
payments 'to a polY" who does net giv.. a TIN 'to a payer. C_n ~es may also apply.
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 8 of 9
CITY OF ASHLAND, OREGON
EXHIBIT B
City of Ashland
LIVING
r.:. ,
Employees must be paid a
living wage:
l:fI:Dper hour effective June 30, 2007
(Increases annually every June 30 by the
Consumer Price Index)
~ 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
portion of business of their
employer, if the employer has
ten or more employees, and
has received financial
assistance for the project or
business from the City of
Ashland in excess of $17,342.
~ If their employer is the City of
Ashland including the Parks
and Recreation Department.
~ In calculating the living wage,
employers may add the value
of health care, retirement,
401 K and IRS eligible
cafeteria plans (including
childcare) benefits to the
amount of wages received by
the employee.
~ Note: "Employee" does not
include temporary or part-time
employees hired for less than
1040 hours in any twelve-
month period. For more
details on applicability of this
policy, please see Ashland
Municipal Code Section
3.12.020.
For additional information:
Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,
20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us.
Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all
employees.
CITY Of
ASHLAND
Contract for Personal Services Less than $25,000, Revised by Legal 03/26/2007, Page 9 of 9
- ~---_..._--~----- -~'--'.- '~'-"----------.----_.__. ---.-----.,--------.---.----.----,,--.. ... ._~.__._-------~------^._--- .""
r.,
CITY Of
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY RECORDER
Page 1 / 1
08129
VENDOR: 013042
SISKIYOU APPRAISAL
872 OLD STAGE ROAD
CENTRAL POINT, OR 97502
SHIP TO: Ashland Planning Department
(541) 488-5305
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speclallnst:
Req. No.:
Depl: COMMUNITY DEVELOPMENT
Contact: Brandon Goldman
Confirming? No
Appraisal to estimate the market value
of two lots on Strawberry Lane
4,200.00
Appraisal to estimate the market value
of four potential half acre lots on
Westwood Street.
Review of an existinQ appraisal for a
10-acre property on Clay Street.
Contract for Personal Services
Date of aQreement: 01/29/2008
BeQinninQ date: 02/04/2008
Completion date: 04/01/2008
AlP Note:
110092716704100 - $1,600 plus 50%
of amount in excess of $4,200
221 12 02 01 604 160 - $2,600 plus 50%
of amount in excess of $4,200
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
B 920.21100
E 110.09.27.16.70410
~ ~ o/zr/or
Auth zed Signature
VENDOR COPY
~.~ n;-':'............ '" ~ ,. _...,.~"""."""";"..,.""-'...._,. ..._- "~." ",_..,.,;c. -'~- ,.- '--I~~i.'"'-''-""-<'_'
,,'j' '"" '""- .,..,.....,.
.,,-~d
.~ ._,4' ..,
A request tor a Pw,::t1ase Order
REQUISITION FORM
CITY OF
ASHLAND
THIS REQUEST IS A:
o Change Order(existing PO #
Date of Request: 11-29-2008
Required Date of Delivery/Service: 2-4-2008 to
4-1-2008
Siskiyou Appraisal
972 South Stage Rd.
Central Point. OR 97502
541-24~: FAX: 541-24~ lcall firstl
Vendor Name
Address
City, State, Zip
Telephone Nurllller
Fax Number
Contact Name
Contact. Chri~tinA M PAIIAtt MAl
~Iate Proc:.IwnAnt
(3) Written QlIDIes
(Copies attached)
State of ORlWA contract
Other government agency contract
o Copy of contract attached
o Contract #
Descriptio. of _avle
Appraisal to estimate the market value of two lots on Strawberry Lane;
Appraisal to estimate the market value of four potential half acre lots on
Westwood Street;
Review of an existing appraisal for a 10 Acre property on Clay Street
Per attached PROPOSAL
The cost of these services is to be shared by the Parks Department and the Community Development Department per the amounts
indicated below. Any amount over the $4200.00 estimate, but less than $5000, shall be shared equally between the departments
Community DeVlllopment Department
Account Number 110-09-27-16.704100
Charge $1,600 + 50% of any amount in excess of $4200 total project cost
Parks Departnwrt
Account Number 221-12-02-01-604160
Charge $2,600 + 50% of any amount in excess of $4200 total project cost
· Items and services must be charged to the appropriate account numbers for the financia/s to reflect the actual expenditures accurately.
By signing this rsquisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can be pfC!vided u t.
Employee Signature:
Community DeWllopment Dept. Head Signature:
Parks Dept. Head Signature:
G: Finance\ProcedureUlPlForms~Requisition fonn.doc
Updated on: 112912008