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Home My WebLink About2008-123 Contract - Univar USA CITY OF ASHLAND CONTRACT FOR PURCHASE OF GOODS AND SERVICES Contract made this Ashland ("City") and 7th day of Univar USA. Inc. May ,2008, between the City of ("Contractor") . City and Contractor agree: 1. Contract Documents: This contract is made as a result of an Invitation to Bid issued by City entitled "INVITATION TO BID" for CHEMICALS FOR THE WATER TREATMENT PLANT. Bid No. #2008-102. Contractor was awarded the bid as the lowest responsible bidder on May 6. 2008 . In the event of any inconsistencies in the terms of this contract, the contract documents defined in the invitation to bid and Contractor's bid, this contract shall take precedence over the contract documents which shall take precedence over the bid. 2. Scope: Contractor shall produce and deliver the goods and services described in the contract documents within the time prescribed in the contract documents. The following exceptions, alter- ations or modifications to the contract documents are incorporated into this contract: 3. Price and Payment: City shall pay Contractor the following prices for the following chemicals: Chemical #3 Cvtec SUDerfloc N-300 LMW Flocculant $3.175/Lb Estimated usage - July 2006 through June 2007 - 24 Bags 55.12 Lb/Bag, (6) Bags per order, (4) Orders, Delivery charge per order $65.00 FSC 4. Terms: The contract terms will begin on July 1, 2008 and expire on June 30, 2009. This contract may be extended annually for two additional fiscal years, for a total of three years, if mutually agreed upon by both parties. 5. This contract may be cancelled by either party with 30-days written notice. CORPORATE OFFICER BY8>~,~~tJ ignature Lwm WlrJlh~ Print Name CITY OF ASHLAND ~. BY ~-tn~ebe~g7- Finance Director Title: ~j(\,~ {~a> 5pQ.f~1~r- R Fed 10 #..:} / - J '3Lf 7 q 35 Purchase Order (for city use only) PAGE 1 of 1 - BID FORM/CONTRACT --urn 1 ADDENDUM TO CITY OF ASHLAND CONTRACT FOR PURCHASE OF GOODS AND SERVICES Addendum made this 7th day of May. 2008, between the City of Ashland ("City") and Univar USA. Inc. ("Contractor"). Recitals: A. On May 7. 2008, City and Contractor entered into a "City of Ashland Contract for the Purchase of Goods and Services (further referred to in this addendum as lithe agreement") . B. The parties desire to amend the agreement to include insurance requirements that will apply to the contractor and transport carrier if different then contractor. City and Contractor agree to amend the agreement in the following manner: 1. 1. Insurance. Contractor shall at its own expense provide and maintain the following insurance: a. Worker's Comoensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. General Liabilitv insurance with a combined single limit, or the equivalent, of not less than $1,000,000 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 $1,000,000 for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or chanae. 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. AdditionallnsuredlCertificates 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 andlor self-insurance. 2. Except as modified above the terms of the agreement shall remain in full force and effect. CONTRACTOR: l.)n~v<V" LJ~W1-j:O(.... BY~J~~.w- Its rY\. n:,"': '(X' \ ~9P..e j 01 ~ CITY OF ASHLAND: ::te ~7~ CONTENT REVIEW: ~ 1) (City Dept. Head) Date: Q '{ !.l _~ Purchase Order # (J ~ ~ 'i b I Acct. No.: b '7# p~ IA &t! G tI ( G:" C;& of Ashland Contract for Purchase of Goods and Services, Page 1 of 0l:~t / Fed. 10 # If OR Social Security # ------ -- - ~nr I PRODUCER Aon Risk Services Central, Inc. fka Aon Risk services, Inc. of PA One Liberty place 1650 Market Street Suite 1000 philadelphia PA 19103 USA PHONE. 866 283-7122 FAX- 847 953-5390 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED UNIVAR USA INC 500 108th Avenue NE, Suite 2200 Bellevue WA 98004-5580 USA INSURER A: INSURER B: National union Fire Ins Co of pittsburgh Insurance company of the State of PA Illinois National Insurance Co 19445 19429 23817 INSURER C: INSURER D: INSURER E: 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 DESCRillED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' L TR INS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA nON DATE(MM\DD\YY) DATE(MM\DD\YY) 03/01/08 03/01/09 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurence) v one person LIMITS $3,000,000 $300,000 A 2802979 ~NERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ~ OCCUR X SIR: $2,000,000 PERSONAL & ADV INJURY $3,000,000 $3,000,000 $3,000,000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: ~ POLICY D i:g; D LOC PRODUCTS-COMWOPAGG A AUTOMOBILE LIABILITY 4806890 03/01/08 03/01/09 X ANY AUTO Truckers Liability (AOS) A 4806891 03/01/08 03/01/09 ALL OWNED AUTOS Truckers L i abi 1 i ty (MA) A SCHEDULED AUTOS 4806892 03/01/08 03/01/09 Truckers Liability (VA) HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $5,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) A GARAGE LIABILITY B ANY AUTO EXCESS /UMBRELLA LIABILITY ~ OCCUR D CLAIMS MADE AUTO ONLY - EA ACCIDENT EA ACC OTHER THAN AUTO ONLY: AGG 03 01 9 EACH OCCURRENCE AGGREGATE 03/01/08 BE7235031 DDEDUCTlBLE [JRETENTION $500,000 B OTH- ER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 1591222 ANY PROPRIETOR / PARTNER / EXECUTIVE CA OH OR & WA OFFICER/MEMBER EXCLUDED? 15;n22 3 If yes, describe under SPECIAL PROVISIONS WI below AOS $1,000,000 = $1,000,000 = $1,000,000 _ ~ Ii ~ ~ ~ ~ ~ ~ ~ ai ..... r;;- ifi ~~c9~~~~ - 03/01/09 03/01/09 A 03/01/08 03/01/08 E.L. DISEASE-EA EMPLOYEE c E.L. DISEASE-POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHlCLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Bid #2008-101 & Bid 2008-102, superfloc N-300 LMW; Calcium Hypochlorite; caustic soda; sodium Hypochlorite; SBS; Location: portland. City of Ashland and all employees are included as Additional Insured on the General Liability and Automobile Liability policies wi-th respect to written contract. univar is self-insured for physical City of Ashland Attn: Kari Olson 90 N. Mountain Avenue Ashland OR 97520 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE a.. ~ c ~ = ~ "Cl """" a.. ~ "Cl C$ = ro\ 00 ~ o 1.0 ~ 00 N o o ...... ~ = Z ~ .... ~ (,j c t ~ u Attachment to ACORD Certificate for UNIVAR USA INC The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURER INSURED UNIVAR USA INC 500 108th Avenue NE, Suite 2200 Bellevue WA 98004-5580 USA INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. ADD'L POLICY NUMBER POLICY POLICY INSR INSRD TYPE OF INSURANCE POLICY DESCRIPTION EFFECTIVE EXPIRATION LIMITS LTR DATE DATE AUTOMOBILE LIABILITY 4806893 03/01/08 03/01/09 combined A Commercial Auto single Limi $5,000,000 4806894 03/01/08 03/01/09 A Comme rei a 1 Auto 4806895 03/01/08 03/01/09 A Commercial Auto WORKERS COMPENSATION 1591221 03/01/08 03/01/09 B FL 1591224 03/01/08 03/01/09 C TX DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS damage to their vehicles. Certificate No : 570028460481 . .. -.- .-- ...----- .- -..... -- - -- - -- - - ---- --.. ---.. --- -- ..--..- --- --...--. .- ...---- --.. ENDORSEMENT FOR MOTOR CARRIER POUCIES OF INSURANCE FOR PUBUC LIABILITY UNDER SECTIONS 29 AND 30 OF THE MOTOR CARRIER ACT OF 1980 Issued to UNIVAR USA INC Form Approved OMS No. 2125-0074 Dated at 101 HUDSON STREET. JERSEY CITY. NJ 07302 of 6100 CARILLON PT KIRKLAND. WA 98033-7357 Februarv 2008 Amending Policy No. CA 480-68-90 Effectj~ Date this 29'" day of Name of Insurance Company Telephone Number L2R..) 770-7000 Countersigned by The Policy to which this endorsement is attached provides primary or excess Insurance, as Indicated by "~", for the lim its s ~This insurance is primary and the company shall nol be liable for amounts in excess of S 5 000 000 for each accident UThiS insurance Is excess and the company shall not be Hable for amounts in excess of $ for each accident in excess of the underlying Imlt of $ for each accident. Whenever required by the Federal Highway Administration (FHWA) or the Interstate Commerce Commission (ICC), the company agrees to fumish the FHWA or the Ice a duplicate of said policy and all its endorsements. The company also agraes, upon telephone request by an authorized representative of the FHWA or the ICC, to verify that the policy is in force as of a particular date. Cancellation of this endorsement may be effected by the company or the insured by giving (1) thirty-fIVe (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice Is mailed. proof of mailing shall be sufficient proof of notice), and (2) lithe Insured is subject to the ICe's jurisdiction. by providing thirty (30) days notice to the ICC (said 30 days notice to commence from the date the notice is received by the Ice at Its office in Washington. D.C.). DEFINITIONS AS USED IN THIS ENDORSEMENT ACCIDENT includes continuous or repeated exposure to conditions which result in bodily injury, property damage, or environmental dam- age which the insured neither expected nor intended MOTOR VEHICLE means a land vehicle, machine, truck, tractor. trail- er, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. BODilY INJURY means injury to the body, sickness, or disease to any person, including death resulting from any of these. ENVIRONMENTAL RESTORATION means restitution for the loss, damage, or destruction of natural resources arising out of the acciden- tal discharge, dispersal. release or escape Into or upon the land, at- mosphere, watercourse, or body of water, of any commodity trarwported by a motor carrier. This shall Include the cost of removal and the cost of necessary measures taken to minimize or mitigate damage to human health, the natural environment, fISh, shelfish, and wildlife. PROPERlY DAMAGE means damage to or loss of use of tangible property. PUBue LIABIUTV means liability for bodily injury, property dam- age, and environmental restoration. The insurance policy to which this endorsement Is attached provides automobile liability Insurance and Is amended to assure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Highway Administration (FHWA) and the Interstate Commerce Commission (ICC). In consideration of the premium stated In the policy to which this en- dorsement Is attached, the Insurer (the company) agrees to pay, within the limits of liability delCft)ed herein, any final judgment recovered against the Insured for public Uabillty resulting from negrlgence In the operation, maintenance or use of motor vehicle. subject to the finan- cial responsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not each motor vehicle is specifically described in the policy and whether or not such negli- gence occurs on any route or in any territory authorized to be seNed by the insured or elsewhere. Such insurance as Is afforded, for pub- lic liability, does not apply to injury to or dellh of the insured's em- ployees while engaged in the course of their employment. or property transported by the Insured, designated as cargo. It Is understood and agreed that no condilion, provision, stipulation, or Omltallon contained in the polley, this endorsement, or any other endorsement thereon. or violation thereof, shill relieve the company from IlablHty or from the payment of any ftnal Judgment, within the Imils of liability herein . described, irrespective of the financial concilian, Insolvency or bankruptcy of the Insured. However, aU term~. conditions, 8nd limi- tations In the policy to which the endorsement II attachld shall.... main In fuU force and effect as binding between the insured and the company. The Insured agrees to reimburse the company for any pay- ment made by the company on account of any accldlrt claim, or suit involving a breach of the tenns of the policy, and for any pay. rnent that the company would not have been obligated to make un- der the provisions of the policy except for the agreement c:ontalned in this endorsement It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against the insured as provided herein the judgment creditor may maintain 8n action In any court of competent jurisdiction againat the company to c:ompelluch payment . The limits of the c:ompany's liability for the amounts prescribed in this endorsement 8pply separately, to each accident, and any pay. ment under the policy because of anyone accident shall not operate to reduce the llabllty of the company for the payment of fll'lal judg- menta reluling from any other accident. The Motor Carrier Act of 1980 requires Imits offlnanclal responsibility according to the type of carriage and commodity transported by the motor carrier. It is the MOTOR CARRIER'S obligation to obtain the required Omits of financial r&sponsibilily. THE SCHEDULE OF UMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE. The limits shown in the schedule are for Information purposes only. Form MCS-eo lQuer) UNIFORM PAINTING I. SUPPLY, INC. IIC112Z1 (Ed. 3-80) Type of Carriage (1) For-hire (In interstate or foreign commerce) . (2) For-hire and Private (In Interstate, foreign, or intrastate commerce). (3) For-hire and Private (I n interstate or foreign commerce: In any quantity) or (In intrastate commerce: in bulk only). (4) For-hire and Private (In interstate or foreign commerce). SCHEDULE OF LIMITS Public LIability Commodity Transported Minimum Insurance Property (nonhazardous). $ 750,000 Hazardous substances, as defined in 49 CFR 171.8, transported in cargo tanks, portable tanks, or hopper-type vehldes with capacities in excess of 3,500 water gallons: or in bulk Divisions 1.1, 1.2, and 1.3 materials; any quan- tity of Division 2.3 Hazard Zone A or Division 6.1, Packing Group 1, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. 5,000,000 Oil listed in 49 CFR 172.101; hazardous materials and hazardous substances defined in 49 CFR 171.8 and listed in 49 CFR 172.101. but not mentioned in (2) above or (4) below. 1,000,000 Any quantity of Division 1.1, 1.2 or 1.3 material; any quan- tity of a Division 2.3. Hazard Zone A, or Division 6.1, Packing Group 1. Hazard Zone A material; or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. 5,000,000 Note: The type of carnage listed under numbers (1), (2), and (3) applies to vehicles with a gross vehicle weight rating of 10,000 pounds or more. The type of carriage listed under number (4) applies to all vehicles with a gross vehicle weight rating of less than 10,000 pounds. SCHEDULE OF LIMITS Public Uablllty For-hire motor carriers of passengers operating in interstate or foreign commerce Vehicle Seating Capacity Minimum Insurance (1) Any vehicle with a seating capacity of 16 passengers or more. (2) Any vehicle with a seating capacity of 15 passengers or less. ENDORSEMENT FOR MOTOR CARRIER POUCIES OF INSURANCE FOR PUBUC LIABIUTY UNDER SECTIONS 29 AND 30 OF THE MOTOR CARRIER ACT OF 1980 Form Approved OMB No. 2125-0074 Dated at 101 HUDSON STREET. JERSEY CITY NJ 07302 of 8100 CARILLON PT. KIRKLAND WA 98033-7357 Issued to UNIVAR USA. INe Amending Policy No. CA 48Q.68-91 Effective DIte this 29'" day of Februarv 2008 03101/2008 Name of Insurance Company Telephone Number L2.12J 770-7000 Counbnlgned bY. The Policy to which this endorsement Is attached provides primary or excess insurance, S ~This insurance is primary and the company shall not be liable for amounts in excns of S 5.000.000 for each accident U"fhis insurance Is excess and the company shall not be liable for amounts In excess of $ for each accident In excess of the underlying limit of $ for each accident. Whenever required by the Federal Highway Administration (FHWA) or the Interstale Commerce Commission (ICC), the company agrees to fumish the FHWA or the ICC a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FHWA or the ICC, to ve~ that the policy I' In force as of a particular date. Cancellation of this endorsement may be effected by the company or the irllured by giving (1) thirty.five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice is mailed, proof of mailing aha. be sufficient proof of notice), and (2) if the insured II subject to the ICC's jurisdiction, by providing thirty (30) days notice to the ICC (said 30 days notice to commence from the date the notice Is received by the ICC at Its office In Washington. D.C.). DEFINITIONS AS USED IN THIS ENDORSEMENT ACCIDENT includes contlnuOU$ or repeated exposure to conditions which result in bodily injury, property damage, or environmental dam- age which the insured neither expected nor intended MOTOR VEHICLE means a land vehide, machine, truck, tractor, trail- er, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property. or any combination thereof. BODILY INJURY mean. Injury to the body, sickness, or disease to any person, Including death resulting from any of these. ENVIRONMENTAL RESTORATION means restitution for the loss, damage, or deltructlon of natural relourcel arising out of the acciden- tal discharge, dispersal, releas. or escape into or upon the land, at- mosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shaUlnclude the cost of removal and the cost of necessary measures taken to mlninize or mitigate damage to human health, the natural environment, fish, shellfish, and wildlife. PROPERTY DAMAGE means damage to or loss of use of tangible property. PUBUC LIABlUTY meanallability for bodily Injury, property dam- age, and environmental restoration. The inlurance policy to which this endorsement is attached provides automobile liability insurance and Is amended to assure compliance by the insured, within the limits lta1ed herein, as a motor carrier of property, with Sections 29 liInd 30 of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Highway Administration (FHWA) and the Interstate Commerce Commission (ICC). In consideration of the prem tum stated In the policy to which this en- dorsement is attached, the IMurer (the company) agreel to pay, within the limits of liability described herein, any final judgment recovered against the Insuted for public liability resulting from negligence In the operation, maintenance or use of motor vehicles subject to the finan- cial responsibility requirements of Sections 29 Ind 30 of the Motor Carrier Ad. of 1880 regardlesl of whether or not each motor vehicle is specifically described in the policy and whether or not such negli- gence occurs on any route or in any territory authorized to be served by the Inlured or elsewhere. Such insurance as II afforded, for pub- lic liabUity, does not apply to injury '0 or death of the Insured's em- ployees while engaged in the course of their employment, or property transported by the inlured, designated as cargo. It Is unc:lerstood and agreed that no condition, provision, stipulation, or limitation contained In the policy, this endorsement. or any other endorsement thereon, or viol8tion thereof, shall relieve the company from liability or from the payment of any final judgment, within the limits of liability herein descrtbed. Irrespective of the financial condition, Insolvency or bankruptcy of the insured. However, all terms, concllions, and limi- tations in the policy to which the endorsement Is attached shall re- main In fuR force and effect IS binding between the Insured and the company. The insured agrees to reinburH the company for any pay. ment made by the company on account of any accident, claim, or suit involving I breech of the terms of the policy, and for any pay- ment that the company would not have been obligated to make un- der the provislonl of the policy except for the agreement contained in this endorsement It Is further understood and agreed that, upon failure of the company to pay any final Judgment recovered against the Insured IS provided herein the Judgment creditor may maintain an action In any court of competent jurisdiction against the company to compel such payment The limits of the company's lIab1Rty for the amounts prescribed in this endorsement apply separately, to each accident, and any pay- ment under the policy because of any one accident shaD not operate to reduce the liability of the company for the payment of finsl judg- ments resulling from any other accident. The Motor Carrier Act of 1980 requireslinits of financial responsibility ac:c:ordlng to the type of carriage and commodity transported by thl motor carrier. It is the MOTOR CARRIER'S oblgatlon to obtain the required Imlts of hnclal responsibility. THE SCHEDULE OF UMITS SHOWN ON THE REVERSE SIDE DOeS NOT PROVIDE COVERAGE. The limits shown in the schedule are for i.fGn..alion purposes only. fonn MCS-90 ~Ir) UNIFORM PRINTING & SUPPLY. INC. MC'lI22J (Ed. 3-96) Type of Carriage (1) For-hlre (In Interstate or foreign commerce) . (2) For-hire and Private (In interstate, foreign. or intrastate commerce). (3) For-hire and Private (In interstate or foreign commerce: In any quantity) or (In intrastate commerce: in bulk only). (4) For-hire and Private (In interstate or foreign commerce). SCHEDULE OF LIMITS Public Uability Commodity Transported Minimum I..unnce 750.000 Property (nonhazardous). Hazardous substances, as defined in 49 CFR 171.8, transported in cargo tanks, portable tanks. or hopper-type vehicles with capacities in excess of 3,500 water gallons; or in bulk Divisions 1.1. 1.2. and 1.3 materials; any quan- tity of Division 2.3 Hazard Zone A or Division 6.1 t Packing Group 1. Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Cla&& 7 material as defined in 49 CFR 173.403. Oil listed in 49 CFR 172.101; hazardous materials and hazardous substances defined in 49 CFR 171.8 and listed in 49 CFR 172.101. but not mentioned in (2) above or (4) below. Any quantity of DMslon 1.1, 1.2 or 1.3 material; any quan- tity of a Division 2.3, Hazard Zone A, or Division 6.1, Packing Group 1, Hazard Zone A material; or highway route controlled quantities of a Class 7 material as defined In 49 CFR 173.403. s 5,000,000 1.000,000 5,000,000 Note: The type of carriage listed under numbers (1), (2), and (3) applies to vehicles with a gross vehicle weight rating of 10,000 pounds or more. The type of carriage listed under number (4) apples to all yehlcles with a gross vehicle weight fating of less than 10.000 pounds. . SCHEDULE OF LIMITS Public Liability For-hire motor carriers of passengers operating in interstate or foreign commerce Vehicle Seating Capacity (1) Any vehicle with a seating capacity of 16 passengers or more. (2) Any vehicle with a seating capadty of 15 passengers or less. Minimum Insurance ENDORseMENT FOR MOTOR CARRIER POUCIES OF INSURANCE FOR PUBLIC LIABILITY UNDER SECTIONS 21 AND 30 OF THE MOTOR CARRIER ACT OF 1980 Issued to UNIVAR USA lNC Form Approved OMS No. 2125-0074 of 6100 CARILLON PT KIRKLAND WA 98033-7357 Februarv 2008 Dated at 101 HUDSON STREET JERSEY CITY NJ 07302 Amending Policy No. CA 480-68-92 Effective Date this 2911I day of 03/01/2008 T=I:'~any :rx;:UNIONFIREI~~ i ~ :i:- ~~~. The Policy to which this endorsement Is attached provides primary or excess Insurance, as Indicated by -161". for the Imits shown: I2SJThis Insurance is primary and the company shan not be liable for amounts in excess of S 5000 000 for each aCCident UThlS insurance Is excess and the company shall not be liable for amounts In elCCeS$ of $ for each accfdent in excess of the underlying limit of $ for each accichtnt. Whenever required by the Federal Highway Administration (FHWA) or the Inters"" Commerce Commillion (ICC), the company agrees to fumlsh the FHWA or the ICC a duplicate of said policy and al its endorsements. The company also agrees, upon telephone request by an authorized representative of the FHWA or the ICe, to verify that the policy is in force as ,of a particular date. Cancellation of this endorsement may be effected by the company or the Inlured by giving (1) thirty.five (35) days notice in writing to the other party (said 35 days notice to commence from the date the nata is mailed, proof of maing Shall be sufficient proof of notice), and (2) if the insured is subject to the ICC's jurisdiction, by providing thirty (30) days notice to the ICC (Mid 30 days notice to commence from the date the notice is received by the ICC at its office in Washington. D.C.). DEFINITIONS AS USED IN THIS ENDORSEMENT ACCIDENT inclUde. continuous or repeated expolur. to conditions which result in bodily injury. property damage, or environmental dam- age which the insured neither expected nor Intended MOTOR VEHICLE means a land vehicle, machine, truck, tractor. trail- er, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. BODILY INJURY means Injury to the body, sickness, or disease to any person. including death resulting from any of these. ENVIRONMENTAL RESTORATION means restitution for the 10$1, damage, or dNtruction of natural resources arIsing out of the ~iden. tal discharge, dispersal, release or escape Into or upon the lancl, at- mosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shall include the cost of removal end the cost of necessary measans taken to minimize or mitigate dnage to human health, the natural environment, fish, shellfish, and wildtife. PROPERTY DAMAGE means damage to or loss of use of tangible property. PUBLIC LIABILITY means liability for bodily injury, property dam- age, and environmental restoration. The insurance policy to Which this endorsement is att8Ched provides automobile lability insurance and Is amended to assure compUance by the Insured, within the limits stated herein, as 8 motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Highway Administration (FHWA) and the Interstate Commerce Commission (ICC). or violation thereof, shall relieve the company from liability or from 1he payment of ar'tf final judgment, within the limits of liability herein desCfl)ed, irrespective of the financial condlion, insolvency or bankruptcy of the Insurad. However, all terms, conditions. and lini- tatlons In the policy to which the endorsement Is attached shall re- main In full force and effect II binding between the Insured and the company. The Insured agrees to reimburse the company for any pay- ment made by the company on account of any accident, claim, or suit fnvolvtng 8 breach of the terms of the polley, and for any pay. ment that the company would not have been obligated to make un- der the prOVisions of the policy except for the agreement contained In this endorsement In consideration of the premium stated In the policy to which this .... dorsement is attached, the insurer (the company) agrees to PlY. within the limits of liabilly described herein, any final judgment recovered against the insured for public liability resulting from negligence In the operation, maintenance or use of motor vehicles subject to the finan- cial responsibility r&quirementa of Sedionl 29 and 30 of the Motor Carrier Acl of 1980 regardless of whether or not each motor vehicle Is speclficaMy described In the policy and whether or not such negU- gence occurs on any route or In any territory authorized to be serwd by 1he insured or elsewhere. Such insurance as is afforded, for pub- lic rl8bi1ily, does not apply to injury to or death of the insured's em- The linltt of the company's lability for the .mouMs prescribed in pIoyees whle engaged In the course of their employment. or property this endorsement apply separateIV, to each accident, and any pay- trBnsported by the insured, designated as cargo. It is understood and ment under the policy because of any one accident shaD not operate agreed that no condition, provision, stipulation, or IImlatlon contained to reduce the liability of the compar'tf for the payment of final judg- In the policy, this endorsement, or any other endorsement thereon, ments resulting from any other accident. The Motor Canter Act of 1980 requires limits of financial responsibility according to the type of carriage and commodity transported by the motor carrier. It is the MOTOR CARRIER'S obBgation to obtain the required Imits of financial responsibility. THE SCHEDUlE OF LIMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE. TM-lImltc Ehown In th. cchedut. are for Infonnatlon plIfpOi" only. S:Orm Mel-ta It Is further underwtood and agreed that. upon failure of the company to pay any final judgment r8CCMK8Cl against the insured as provided herein the judgment creditor may maintlln In action In any court of competent jurisdiction against the company to compel such payment (Over) UNFORM PRINTING & SUPPLY. INC. MC1tz2j (Ed. 3.ge) Type of Carriage (1) For-hire (In interstate or foreign commerce) . (2) For-hire and Private (In Interstate, foreign, or intrastate commerce). (3) For-hire and Private (In interstate or foreign convnerce: in any quantity) or (In intrastate commerce: in bulk only). (4) For-hire and Private (In interstate or foreign commerce). .....-_.... ..... .... -...... I'" ..-- SCHEDULE OF UMITS Public Uability Commodity Tran.ported Minimum Insurance Property (nonhazantous). $ 750,000 Hazardous substances, as defined in 49 CFR 171.8, transported in cargo tanks. portable tanks, or hopper-type vehicles with capacities In excess of 3.500 water gallons; or In bulk Divisions 1.1. 1.2. and 1.3 materials; any quan- tity of Division 2.3 Hazard Zone A or Division 6.1. Packing Group 1, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. 5.000,000 Oil Hated in 49 CFR 172.101; hazardous materials and hazardous substances defined in 49 CFR 171.8 and listed in 49 CFR 172.101,. but not mentioned in (2) above or (4) below. ',000,000 Any quantity of Division 1.1, 1.2 or 1.3 material; any quan- tity of a Division 2.3, Hazard Zone A, or Division 6.1, Packing Group 1, Hazard Zone A material; or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. 5,000,000 Note: The type of carriage listed under numbers (1), (2). and (3) applies to vehicles with a gross vehicle weight rating of 10,000 pounds or more. The type of carriage listed under number (4) applies to all vehicles with a gross vehicle weight rating of less than 10,000 pounds. SCHEDULE OF LIMITS Public Liability For-hlre motor carriers of passengers operating in interstate or foreign commerce Vehicle Seating Capacity Minimum Insurance (1) Any vehicle with a seating capacity of 16 passengers or more. (2) Any vehicle with a seating capacity of 15 passengers or less. r., CITY RECORDER Page 1 1 1 CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 DATE 7/1/2008 PO-NUMBER 08376 VENDOR: 000191 UNIVAR USA INC, ACCT#146175 FILE #56019 LOS ANGELES, CA 90074 SHIP TO: Ashland Water Treatment Plant (541) 488-5345 ASHLAND, OR 97520 FOB Point: Terms: Net 30 days Req. Del. Date: Speciallnst: Req. No.: Dept.: PUBLIC WORKS Contact: Daryl McVey Confinning? No ... """........,." ,y> .."y. ..... ., .-....J. .. .. .. . ~.. ... ....... '" ..... .......uru,.. ....... <..' ... ... . ... ,.. " ... THIS IS A REVISED PURCHASE ORDER 4.00 Del WTP Chemicals FY 2008-2009 1 ,114.95 4,459.80 Invitation to Bid #2008-102 Cytec Superfloc N-300 LMW Flocculant $3.175 per pound Cost per order (6) BaQs, 55.12 Lbs/BaQ Delivery chQ per order $65.00 FSC Per attached contract dated May 7, 2008 Approved by Council May 6, 2008 SUBTOTAL 4459.80 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 4,459.80 ASHLAND, OR 97520 . ....~'.... "..., 'L',.. ... ...:........... ,.' Ac:coul1tNumbel' ... ... ...~.' ..... .,. .'.,,,,,-,,, ...". ~... .. ., .. '. E 670.08.19.00.60150( 4.459.80 , ~ ~ c.e" ~ ?h~r Auth;:led Signature VENDOR COpy A request for a Purchase Order REQUISITION FORM C IT Y OF ASHLAND Date of Request: THIS REQUEST IS A: D Change Order(existing PO# Required Date of Delivery/Service: Vendor Name Address City, State, Zip Telephone Number Fax Number . Contact Name l)1lJl v'fCrfL SOLICITATION PROCESS Small Procurement o Less than $5,000 o Quotes (Not required) Intermediate Procurement o (3) Written Quotes (Copies attached) Coooerative Procurement o State of ORIWA contract o Other government agency contract o Copy of contract attached o Contract # Inyltation to Bid (Copies on file) Sole Source o Written findings attached Reauest for Prooosal (Copies on file) o Soeciall Exemot o Written findings attached Emeraencv o Written findings attached Description of SERVICES /5c.~w I(,z.:. .. (). nf'< ?; f)1 '9 - ~ > "9 W t4-1'i1t- 7!t./f..4-r M ~n/~ {l #,{,.M ten c...f o Per attached PROPOSAL Total Cost Item # Quantity Unit Description of MATERIALS I ~{)UlS ~ ~ s lw"fL Unit Price Total Cost Project Number ______. ___ 111I II BIll_ . I III III -I ~ ... .. . o Per attached QUOTE Account Numbe~!~. !~. !f.I!.!. ~~~~q * Items and services must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. By signing this requisit~ I c.ertify that the information provided above meets the City of Ashland public contracting requirements, and the documentation can be Im?vided ~uest. Employee Signature: \J ~ \.. (A SupervisorlDept. Head Signatu~ (" _ ~.. / ~ ~ ~~. G: Finance\Procedure\AP\Fonns\8_Requisition form revised.doc Updated on: 6/1512007