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HomeMy WebLinkAbout2008-257 Contract - Ashland Roofing FULLY BONDED AND'INSURED WORKMAN8COMPENSAnON ALL EMPLOYEES Bul"'" BcNwcI _t ASHLAND ROOFING COMPANY INC. IPIClA' .~N. .N ....U My........ 1ftIIMI, WOOD 1IlMIII. _IN.. .., ~Oll. nu ..0" ALL ...-i,. & IIIIA'-". ..0. .. SSM .........~.. .7.. (MI) an.141. YOI Dale Peters ( City of Ashland) (........) D"'I a"a'2'" ,...p.... ... ..2.2aM (8....'" ...) (CIty .... ....., ....... ...... c..,.., I.... H......... _II_ ... C..lr....r, ......... .. ....... .11 ................... ..e."...., .......... ee--LI.-d........ .................. ........... ../I_ .........I.AI....... ....&.-1-41........ Mausoleum Normal ~treet .... .... '... eta New Duro-Last Roofinq System -- $ 24,875.00 Dollars ...Ul.... tI_......... ......... 10% ....,. WII.....,. '11M ..............11....... .........~...... tile CeIllnMl8". _/In.. ....1'...'. .........r........ 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C..~I' ...lIIlwl"'a' ACaPIID ......) -~T-- 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: Ashland Roofing Company Inc. CONTACT: John Shipley ADDRESS: PO Box 3294, Ashland, OR 97520 TELEPHONE: 541-482-5418 DATE AGREEMENT PREPARED: 10/30/2008 FAX: 541-552-2304 BEGINNING DATE: 10/30/2008 COMPLETION DATE: 11/28/2008 COMPENSATION: Not to exceed $24,875.00 per attached proposal dated 03/18/2008 GOODS AND SERVICES TO BE PROVIDED: Contractor to remove as needed and install new Duralast roof on Mausoleum at Mountain View Cemetery per the attached proposal dated 03/18/2008. 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 279B.220, 279B.225, 279B.230, 279B.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 $18,088 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 500/0 or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B 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. Citv'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 following Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 1 of 9 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. Obliaation/Liabilitvof 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, including coverage for owned, hired or non-'owned vehicles, as applicable. Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 2 of 9 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. 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, lithe 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 Required Provision. Approval by the City of Ashland Councilor the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. CONTR TO CITY OF ASHLAND: Bye BY \ i \ TITLE DATE DATE / )-o2o-:JoofS CONTRACT AWARD AND FIND By: ~ City Department Head Date: 12./, ~ ) () re, FederallD# 13-- 0 0/ 8'/& 15-5 ACCOUNT # ~ f IJ ft} @ -:zc/ ~ 7 0 ~ /' t9,,~ (For City purposes only) PURCHASE ORDER # tJ 13~ ( 9 *Completed W9 form must be submitted with contract Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 3 of 9 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: ~' y ,~ ~ r y . (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. Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 4 of 9 FORn W-9 (Rev. October 2007) Department of the Treasury Internal RevenUe Service Request for Taxpayer Identification Number and Certification Give fonn to the requester. Do not send to the IRS. C\i <D Cl ~ Check appropriatel::!ox: 0 Individual/Sole proprietor Corporation 0 Partnerslip o Limited liability company. Enter the tax classification (O=diaregarded entity, C=corporation, P:partnership) ~ _ _ _ _ _ _ _ o Other (.ee il'l.tru~lions) ~ Address (number, streErt, and apt. or suite no.) ,a..lj 0 s:-r- 1'LII L &t \11 ity, state, and ZIP c04)f Ofd! Li$t account nU"l'lber(s) ere (optionaQ TaxpaY$r Identification Number (TIN) D Exempt payee Requester's name and address (optiona~ I Social 8ei ~mir Enter your TIN in the appropriate box. The TIN provided must match the name given on Une 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien. sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other entities, it is your employer identificatron number (EIN). If you do not have a number, see How to get 8 TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for gUidelines on whose number to enter. . Certification Under penalties of perjury, I certify that: 1. The nl.lmbershown 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 ama U.S. citizen or other U.S. person (defined below). 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 int&rest paid. acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other tha interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the'n Ctions n pa e 4. Sign Here Date ... J j- :J-Cr-;)ea Deftntuon 01 a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: . An individual who is a U.S. citizen or U.S. 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 thana foreign es~ate), or . A domestic trust (as defined in Regulations section 301.7701-7). SpecIal rules10r ~nershlps. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding, tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner isa foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner ina partnership conducting ~ trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from tM partnership conducting ~ trade or business in the United states is in the following cases: . The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W-9 (Rev. 10-2007) General Instruc io s Section references are to th Internal Revenue Code unless otherwise noted. Purpose of Form A persQn who is required to file an information return with the IRS must ob~~in your correct taxpayer identificatiQn 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 Use FormW-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 fora 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. If appliCable, you are also certifying that as a U.S. persQn, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. Note. If a requester giVes you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 5 of 9 ---r'~-'- BeecherCarlosn/JBLK 12/5/2008 11:41:39 AM PAGE 001/002 Fax Server ACORD... CERTIFICA TE OF LIABILITY INSURANCE DATE (NMKJOIVYVYI 12/5/2008 PRODUCER (541)"2-1111 FAX: (541)772-3785 THIS CERl1F1CATE IS ISSUED AS A MATTER OF INFORMAll0N ONLY AND CONFERS NO RIGHTS UPON THE CERnFICA TE Beecher Carlson :Insurance hJency LLC HOLDER. THIS CERlIFICATE DO~S NOT AMEND~ EXTEND OR 707 Hu.xphy Rd Al TER THE COVERAGE AFFORDE' BY THE POLlCI S BELOW. Medford OR. ~?504 INSURERS AFFORDING COVERAGE NAfCN INSURiO IN~RER A:. Acilairal :Insurance CoIaDany Aahland RoofiDg 00 :Inc INl:iUIiI::IHI:North Pacific :Insurance 23892 2240 starling LaDe INSURER c. DeveloDers Suxety ~ IN!=;! ,RFIt IT Medford OR 9?501 INSURER E. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICAlED. NOTWITHSTANDING N4Y REQUIREMENT, TERNlOR CONDfTtON OF ANY CONTRACT OR OlHER DOCUMENT WITH RESPECT TO w-f1CH 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, II..IT~ Y loIaVJ; R~ REDUCED 8Y PAlO CLAMtS It!:: =~ TYPE OF INSURANCE POliCY ......BER ~-~!,!!~ P~~~ LIMITS GENl:RAlllABIUlY EACH OC::URREN~ $ 1,000,000 i-- ~~JOREN1ED 1!... :=rMl::~Cw. (x;1\l:;HJ\l LIAljlll Y $ 100,000 A CL.t,)MSMADE ~ OCCUR CAOOOOO123904 6/30/2008 6/30/2009 MW E><f" (Nt'l one ~n) $ EXCLUDED - - PERSOW.... & N:N IN.l..RY $ 1,000,000 - GENE~Al AGGREGATE $ 2,000,000 GEN'l. AGGRE:>ATE UNIl .APPlES PER. PR~Dl JeTS - CCII.t:JK)P AG(; $ 2,000,000 Xl FOLlCY r--r ':t~ n LOe AUTOMOBILE LIABILllV COM81'JED SINGLE L NIT 1,000,000 - $ ~ flNY AUTO (~a "a:idsntJ B J't.L O"ftflCD !'oUTOS C16124816 6/30/2008 6/30/2009 30DlL'( l:-l-URY - per pcroon) $ - SCI-EOlLEO AUTOS - HIRED AlJTOS BOOL V IN.AJRY I.wecadnl $ - NON OffiEO /'UTOS - PRJPERTY O/INI\GE $ (1 Ar.cirlov1ll GARAGE UABll..m RHO ON_Y - ~}lCCIDE'JT ~ R :>NY ALlTO OT-lER THAN EA Aa::- s !WTO OM'_'t: AGG S EXCESSlUMBRELLA L1ABllIlY ~~ $ tJ OCCUR D a..A1YIS MAC€ AGGRFGAF $ S R DEDUCTIBlE $ RETENT ON $ $ 'o'IORKERS COMPENSA nON AND I W:;SM,Us I IOl~ EMPLOYERS' LIA8IL1lV .IWY oP.OPP.ETORiPART~ER:E)(EaJT lyE F L EAa-: ACC()E~ $ OFFIr.=RlMFlilRFR FXnIIOHY1 E.L D~ - EA "MF1...0,.,EE $ II \IRS. ffiscrbl; 110031' SPFCIIJ ~OVI:::;IONfihp'1mv =L DISEASE - pcu-:y L1~ ( C OTHER Contractors License 84232JC 4/10/2007 4/10/201.0 LUDit: $10,000 Bond DESCRIPTION OF OPERAl1ONSA.OCATIONSNEHlCLESEXCLUSlONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Verification of Insurance. Subject to Po1iey Te~, Conditions and KxcLusions. CERl1FICATE HOLDER I City o~ Ashland Attn: Dale Peters 90 North Mountain street Asbland, OR 9'520 CANCELLA 110N I SHOUlD AIfY OF THE ABOW DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSUReR WILL ENDEAVOR TO MAL ~ DAYS NUTTeN NOTICE TO THE CERTIFICATE HOLDER l'MMEO TO THe LeFT. BUT FAILURE TO DO SO SHAll IMPOSE NO OHUGA nON OR LIABIlITY OF ANY KINO UPON THE INSURER, IT8AGENT8 ORREPREISfrATIVE8. AUTHORIZED REPRESENTAnVE S Wilson, AAI I AIC/SU S<l"'C~ ~. J</~ @ACORDCORPORAnON1988 ACORD 25 (2001108) IN8025 (0108100<'1 Psge 10'2 SAIF Corporation 12/5/2008 10:39:13 AM PAGE 1/001 Fax Server OREGON WORKERS' COMPENSATION CERTIFICATE OF INSURANCE .!!l~ CERTIFICATE HOLDER: CITY OF ASHLAND ATTN: DALE PETERS 90 N MOUNTAIN ST ASHLAND, OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. POLICY NO. 436530 POUCY PERIOD 04/01/2008 TO 04/01/2009 BROKER OF RECORD: ISSUE DATE 12/05/2008 INSU RED: ASHLAND ROOFING CO INC 2240 STARLING LN MEDFORD, OR 97501-4387 LIMITS OF LIABILITY: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Bodily Injury by Disease $500,000 palicy limit DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: IMPORTANT: The coverage described above is in effect as of the issue date of this certificate. It is subject to change at any time in the future. ThiS certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. AUTHORIZED R.EPRESENTATIVE JlJrapp-. J~ ~iJ.-- President and CEO (~) S^IF CORPOMTlON 1100 HiQh St SE I Salem, OR 97312 I P: 800.285.8525 I www.saif.com Cil'Y RECORDE'R Page 1 / 1 r~' , CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 DATE 12/11/2008 PO NUMBER 08713 VENDOR: 002029 ASHLAND ROOFING COMPANY, INC. PO BOX 3294 ASHLAND, OR 97520 SHIP TO: Ashland Cemetery (541) 488-5358 440 NORMAL STREET ASHLAND, OR 97520 FOB Point: Terms: Net 30 days Req. Del. Date: Speciallnst: Req. No.: Dept.: PUBLIC WORKS Contact: Dale Peters Confirming? No ,', , Cfoil , ,." [)e~crlption UnifPrice' E~t.,eilcf3 Remove as needed and install new 24,875.00 Duralast Roof on Mausoleum at Mountain View Cemtery Contract for Services BeQinninQ date: 1 0/30/2008 Actual completion date: 12/11 /2008 Insurance required/On file SUBTOTAL 24 875.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 24,875.00 ASHLAND, OR 97520 '>'.":... " 'b,f~,f"'T:f,;;-;>. '., ,f,':"""),>' '",. .ProjectNMrrib~.r AmQynt .Ac'count'NLJmber PrQjec~Nyfu,bf3r }AmOunt . " E 4 1 0 .08 .24.00 .704 1 OC 24.875 .00 ~ ~ /0?4r~/ Authorized Si~nature VENDOR COpy ---. CITY OF ASHLAND REQUISITION FORM Dale of Request: I c..r ~;l D4 Required Date of Delivery/Service: I cB No\) 6~ ASHLIANJO '1?oo-P;- ~C; ~ F~f\::JV 'I'"~Q 1>6 ~o~ 52.9 '-i I { ASI4L~N.P, diC. ~ rS2a 5'+'.- lf2:>~ - 5~ '8 -s't ( - 5S2-e5o i ..TO &41\.1 SH. P lE-l THIS REQUEST IS A: D Change Order(existing PO # ) . Vendor Name Address City, State, Zip Telephone Number Fax Number Contact Name SOLICITATION PROCESS Small Procurement D Sole Source D Invitation to Bid D Less than $5,000 D Written findings attached (Copies on file) D Quotes (Optional) D Quote or Proposal attached Coooerative Procurement D Reauest for Prooosal D State of OR/WA contract (Copies on file) Intermediate Procurement D Other government agency contract D Soeciall Exemot 121' (3) Written Quotes D Copy of contract attached D Written findings attached (Copies attache~ D Quote or Proposal attached Ho~ 'Roe .~ CJ,.o~ D Contract # D Emeraencv -tVO t ~ ~~ ", c.~f~:te . D Written findings attached D Quote or Proposal attached Description of SERVICES ~erY\o\JS:- 14 l"ee.beD lqNfi) :I:NoS'bll 0~w :DlA. {2.'k\ l~S' r Ro~.(l ~ '^';\4lA.S'C> lE--~ @2 vY\ot.tA^-~~7~ tJ~~u.J C~"tC-.a.) . D Per attached PROPOSAL Item # Quantity Unit Description of MATERIALS Unit Price Total Cost Project Number ______. ___ D Per,attached QUOTE Account Number !/ltJ.. ~-#.t;Q.. $!..~~QO * 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 docume~on:: ~quest. I Employee Signature: \.~ SupervisorlDept. Head Signature: ~Y\.LJ~.r~.l9- ~-1\0 J- ~. G: Finance\Procedure\AP\Forms\8_Requisition form revised.doc Updated on: 10/27/2008 CITY OF ASHLAND Memo DATE: 30 June, 2008 TO: Public Works Director FROM: Dale Peters, Facility Maintenance RE: Re-roof of the Mausoleum at Mountain View Cemetery We have selected Ashland Roofing Company Inc to complete this job due to three reasons: The first is the additional 2 year installation warranty. The second is the additional breather vents that will be required for the off gassing of the mausoleum rather than the minimal requirements of the manufacture for'a structure in general. And the third is the understanding of the contractor in applying the drip edge moldings to the parapet walls, these will be key in the ability for the sealing of the DuraLast material to the plaster walls. These are our justification in the selection over Bleser Built Roofing Inc. Thanks for your assistance in completing this process. BUILDING MAINTENANCE DEPARTMENT Dale Peters 90 North Mountain Ave Ashland, Oregon 97520 petersd .ashland .or .us Tel: 541-488-5300 Fax: 541-552.2304 TTY: 800-735-2900 r~' -~~--'----~--T