HomeMy WebLinkAbout2009-026 Contract - Brotherton Pipeline Corp
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: Brotherton Corporation
CONTACT: Mike Cantrell
ADDRESS: 11 Frontage Road, Gold Hill, OR 97525
TELEPHONE: 541-855-7075
DATE AGREEMENT PREPARED: 02-26-2009 FAX: 541-855-7284
BEGINNING DATE: 03-02-2009 COMPLETION DATE: 03-20-2009
COMPENSATION: Not to exceed $14,065.00, per attached proposal dated 02/06/2009
GOODS AND SERVICES TO BE PROVIDED: Contractor to bore or trench as needed to install conduit.
Location #1: 331 Oxford St. (2" Conduit/Street to Transformer), Location #2: 349 Tudor St. (4" Conduit/Street
to Transformer), Location #3: 254 CambridQe St. (2" Conduitffransformer to Transformer)
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, 2798.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $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 50% 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. 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
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 1 of 9
written notice to Contractor, 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 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. 710, 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 Lia .. sur e with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,00 $1,000 , $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall inclu e contractual liability coverage for the indemnity provided under this contract.
c. Automobile . . I nce with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, 0 Not A Iicable for each accident for Bodil In'ur and Pro ert Dama e,
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 2 of 9
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. 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.
CONTRACTOR
BY
~
CITY OF ASHLAND:
?;L~
FINANCE DI
BY
TOR
Print Name
DATE
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I
DATE ..3 /0/ ZoV
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CONTRACT AWARD AND FIND
By:
Date: '3
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TITLE
~l-{ ,pp / \J ~ .\ u'y
FederallD#
(pC . cC'-f\ Olfv
ACCOUNT #
*Completed W9 form must be submitted with contract
(For City purposes only)
PURCHASE ORDER # (!J ~ g 8 C;;
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 3 of 9
. r
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer 10 (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
/
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./
/
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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.
~~
Contr tor
tJ~/t;31 L~ (1
(Date)
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 4 of 9
Form W-g
(Rev. October 2007)
Deparlinent of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
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Name (as shown on your income tax return)
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Business name, if different from above
Check appropriate box: 0 Individual/Sole proprietor % Corporation II Partnership
o Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) ~ 0 ~;::t
o Other (see instructiClns) ~
Address (number, street, and apt. or suite no.) Requester's name and address (optional)
\ \
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List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. Tile TIN provided must match the name given on Line 1 to avoid
backllp withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see tile Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If YOll do not have a number, see How to get a TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
\ Social secu~ity num~r
or
Certification
----1
Employer identification number
q?:>: II to 1-'1(3
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2, I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. I am a U.S. 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 interest paid. acquisition or abandonment of secured property, cancellation of debt. contributions to an individual retirement
arrangement (IRA). and generally, payments other than interest and dividends, you are not reqLlired to sign the Certification, but you must
provide your correct TIN. See the instructions on page 4.
Sign
Here
Signature of
U.S. person ...
C-1 '\,t.~
General Instructions
Section references are 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 identification number (TIN)
to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
Use Form W-9 only if you are a U.S. person (including a
resident alien), to provide your correct TIN to the person
requesting it (the requester) and, when applicable, to:
1. Certify that the TlN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S.
exempt payee. If applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income from
a U.S. trade or business is not subject to the withholding tax on
foreign partners' share of effectively connected income.
Note. If a requester gives you a form other than Form W-9 to
request your TIN. you must use the requester's form if it is
substantially similar to this Form W-9.
Date ~
Definition of 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 than a foreign estate), or
. A domestic trust (as defined in Regulations section
301.7701-7).
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners' share of income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding
on its allocable share of net income from the partnership
conducting a trade or business in the United states is in the
following cases:
. The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231 X
Form W -9 (Rev. 10-2007)
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 5 of 9
02/09/2009 15:30
(FAX)
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~~01HERl'O~
'. ..~: .~'~i~:.~. BROTH ERTON
~ ...,.
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GOLD HILL, OREGON
CORPORA TION
11 Frontage Road · P.O. Box 738 · Gold Hill, Oregon 97525
(541) 855-7075 · Fax (541) 855-7284. CCB 106728
P.ROPOSAL
NAME; CITY OF ASHLAND DATE: 2/6/2009
90 N. MOUNTAIN AVE.
ASHLAND, OR. 97520
PHONE: 488-5357
FAX; 552-2436
ATTN: DAVE TYGE~SON CELL: 951-0387
LOCATION: QUIET VILLAGE
WO#:.
WE SUBMIT THE FOllOWING ESTIMATE:
BORE OR TRENCH AS NEEDED TO INSTALL CONDUIT FOR POWER
lOCATION #1 331 OXFORD ST 1 - 2" CONDUIT FROM STREET TO TRANSFORMER
$6.375
lOCATION #2 349 TUDOR ST 1 - 4" CONDUIT FROM STREET TO TRANSFORMER
$3,364
LOCATION #3 254 CAMBRIDGE ST 1 - 2" CONDUIT FROM TRANSFORMER TO
TRANSFORMER UNDER CAMBRIDGE ST.
$4,326
eSTIMATED TOTAL
$14.065
CITY OF ASHLAND TQ PROVIDE ALL PERMITS AS NEEDED.
IF ROCK OR OTHER OBSTICAlS ARE ENCOUNTERED THAT CANNOT BE BORE AND
MUST'BE OPEN CUT THEN ADDITIONAL CHARGES MAY BE ADDED TO COVER SELECT
BACKFILL AND ASPHALT OR CONCRETE REPLACEMEN~.
~ :l:. / /7__
AUTHORIZE.D SIGNATUR .. , ~ ~ _' .
THIS PROPOSAL MAY BE WITHDRAWN BY BROTHERTON IF NOT ACCEPTED
WITHIN 30 DAYS.
ACCEPTED SIGNATURE
The accepti;lnce of this proposal constitutes a binding contract and is subject to all
applicable state and local laws. Material and labor in this agreement may be subject to
state lien laws.
MAR/03/2009/TUE 03: 11 PM
HART INSURANCE-GP
FAX No. 541 474 1209
P. 002/003
ACORD.
CERTIFICATE OF LIABILITY INSURANCE crBim~I 1 DA~;=)
THIS CERTIFICATE IS ISSUED AS A MATTER OF 1NFORNATlON
ONLY AND CONFERS NO RIGHTS UPON THE CERT1FICA TE
HOLDER. THIS CERTlFlCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE P0L1C1ES BELOW.
PRODUCER
Hart :Insurance
P. O. 80. 1240
Grants pass OR 97528
Phone: 541-479-5521
INSU~D
Brothe~ton Pipeline, Inc.
11 South Wrontaqe Road
Gold Hill OR 91525
COVERAGES
INSURER B:
INSURER C:
INSURER I);
INSURER E:
'h'a._llln Propea:\y caeusalty Co
SAIl' CORP
General YDS Co of America
NAle #
10647
10647
Fax: 541-414-1890
INSURERS AFFORDING COVERAGE
INSURER A: Travelers Indemni tv Co.
THE POLICl1!6 OF INSURANCE LISTED BElDW tMVE 8tEN ISSueD TO THE INSURED NAMED ABOVE FOR"'l'HE POUCY PERIOD INDlCAlED. NOlWlTHSTANDING
ANY ReQUIREMeNT. TERM OR CONDITION Of Nt'( CONTRACT OR 0Tt1EA DOCUMENT WIlli RESPECT TO WHICH THIS CERTIFICAtE PMY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY TME POlICIES DE8CRI8ED HEREIN IS eUBJECT TO ALL ntE TERMS. EXC~U$IONS AND cONol'YIONS OF SUCH
POLICIES. AGGREGATE LMTS SHOW. MAY HAVE BEEN REDUCED BY PAlO ClAIMS.
LTR NSRil TYPE OF IN&UAANCE POUCY NUMBER ~~lMMIDoIYV) DATE rMMIDDNVl UMITS
GENERAL LlABlUlY EACH OCCURRENC& S 1,000,000
i--
A ~ COMMERCIAl.. GENERAL lIABILrrY DTC0526D9764 INDO? 06/10/08 06/10/09 ~~~ifES'ti:~1 $ 50,000
- =:=l CLAIMS MADE ~ OCCUR MED EXP (Atty one penIOf'l) $10,000
p~80NAl. &. JI,OV INJURY 11.000,000
-
GeNERAL AGGREGATE 12,000,000
-
G1:N'L AGGREGATE UMIT APPLIES PER: PRODUCTS. COMPIOP AOG $2,000,000
Xl POLICY h ~~ . n Loe
AUTOMOBIl.E UABI\J1Y COM9lNiD SINGLE LMT S 1,000,000
....--..,
B X ANY AUTO DTB10526D9?64TIL01 06/10/08 06/10/09 (Ea ecc:Idertl)
I--
All DV'l'NED AUTOS 800IL Y INJURY
- $
8C1-1EDULED AUT'08 (Per person)
--=-
HIRED AUTOS BODILY INJURY
- I
NON.oYMED AUTOS (pet acx:ldenl)
-
X Hired Auto P.D. DT810526D9764TIL07 06/10/08 06/10/09 PROPERTY DAMAGE
i-- (Per ecclctent) $
GARAGE L1AB1UTY AlITO ONLY - EA ACCIDi:NT $
=iANY~ OTHI:.R lliAN EA ACC .
AUTO ONLY: AGG S
EXCl!SSlUMBRELLA UABIUTY ~CH OCCURRENCE '2,000..000
B !J OCCUR o ClAIMS M,\DIi DTSMCUP526D9764TILO 7 06/10/08 06/10/09 AGGREGATE s
S
~ lJEOUCT1BLE s
Ix RETeNTION s10.000 $
WORKERS COMPENSA11ON AND X 1,.o~3~1~ I IU~-
~ EMPLOYERS. L1A8IUTY 810614 10/01/08 10/01/09 E..L EACH ACCIDENT 11,000,000
-ANY-PRBPRIe:1UM'AR'f.NERJEXEC\J.T
OFFICERlMEMBER EXCLUOED? E.\.. DISEASE ~EA -n: . 0-0-0-;0-00 -
~...'....
~:.a~J=N8 be'- E.L DISEASE - POUCY UMrr S 1.000,000
OTHER
0 Ranted Equipment 01CG567879 06/10/08 06/10/09 Limit/ded 250,000/500
0 Contents 01CG567B79 06/10/08 06/10/09 Limit/dad 310.600/500
DESCRIPTION OF OPeRATIONS I LOCATIONS / VEHIClES I EXCLUSIONS ADDED BY ENDOR9EMENT / SPECIAL PROVISIONS
- - . .
. . . .
Ci ty of Ashland
90 N. Mountain Avenue
Ashland OR. 97520
CANCELLA nON
stfOULD Nt( M THE ABOVE DESCRIBED POlJCIU Be CANCB..LED B!FORl! THE ElCPlRAll0N
DATE THEREDF, THI!: ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAllEO TO lliE LEFT, BUT FAILURE TO 00 90 SHALL
IMPOSE Me O8LlGAllON OR LJABIUTl' OF AHV KIND UPON THE INS ITS AGENTS OR
REPRESENTAmlEI.
AUTMOfUZED RVAdENlA11VE
Mark O'Hara
CERTJFICA TE HOLDER
ACORD 25 (2001'08)
-- r
C!TY FiECORDER
Page 1 / 1
r~'
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
DATE,
3/6/2009
I I
PO NUMBER
08835
VENDOR: 008118
BROTHERTON PIPELINE CORP
11 S FRONTAGE ROAD
PO BOX 738
GOLD HILL, OR 97525
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
SHIP TO: Ashland Electric Department
(541) 488-5354
90 N MOUNTAIN
ASHLAND, OR 97520
Req. No.:
Dept.: ELECTRIC
Contact: Scott Johnson
Confirming? No
QuantitY Unft':'" '.'/.2/} ..Description
Contractor to bore or trench as needed
to install conduit. Location #1: 331
Oxford Street (2" Conduit - Street to
Transformer), Location #2: 349 Tudor
Street (4" Conduit - Street to
Transformer), Location #3: 254
CambridQe Street (2" Conduit -
Transformer to Transformer)
Unit Price
Ext. . Price
14,065.00
Contract for Services
Date of aQreement 02/26/2009
BeQinninQ date: 03/02/2009
Completion date: 03/20/2009
Insurance required/On file
BILL TO: Account Payable
20 EAST MAIN ST
(
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
14 065.00
0.00
0.00
14,065.00
AccoLJofNumber i' .projecfNumber Amount Account Number Project Number Amount
E 690.1 1 .1 8.00.7041 DC E 0001 63.999 1 4,065.00
I
# ~ ~~l
Aut . ed Signa re
VENDOR COPY
- r
CITY OF
ASHLAND
REQUISITION FORM
Date of Request:
2-25-09
THIS REQUEST IS A:
o Change Order(existing PO #
Required Date of Delivery/Service:
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
RROTHFRT()N r.ORPORATI()N
11 FRONT Ar,F ROAn P 0 ROX nR
GOLD HILL OREGON 97525
(541.855.7075) FAX (541.855.7284
MIKE CANTRELL
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 Proposal
o State of ORIWA contract (Copies on file)
Intermediate Procurement D Other government agency contract D Soeciall Exemot
181 (3) Written Quotes D Copy of contract attached D Written findings attached
(Copies attached) D Quote or Proposal attached
D Contract # D EmerQencv
D Written findings attached
D Quote or Proposal attached
Description of SERVICES
Total Cost
[gI Per attached PROPOSAL
BEGINNING DATE 3-2-09 COMPLETION DATE 3-20-09
$14,065
PROJECT NUMBER ( E )000163.999
Account Number 690-11-18-00-704100
* Items and services must be charged to the appropriate account numbers for the tinancials to reffect the actual expenditures accurately.
By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can be provided upon request. ~
Employee Signature:DAVlD TYGERSON Supervisor/Dept. Head Signature: ~