HomeMy WebLinkAbout2009-038 Contract - Stream Fix
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Contract for PERSONAL SERVICES Less than $25,000
CITY Of
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONSULTANT: Russell Lawrence, DBA Stream Fix
CONTACT: Russ Lawrence, P.E., M.Sc
DATE AGREEMENT PREPARED: 4/16/09
BEGINNING DATE: 4/20/09
COMPENSATION: Not to exceed $4,990.00
ADDRESS: 19478 S. Starview Lane
Oregon City, OR 97045
TELEPHONE: (503) 631-8184
CELL: (503) 781-4885
FAX: 1503\631-8184
COMPLETION DATE: 6/30/09
SERVICES TO BE PROVIDED: Develop and submit applications for a joint DSUC.O.E. and DEQ 1200C
. oennits which are needed to construct the proposed extension of Jefferson Avenue.
ADDITIONAL TERMS:
FINDINGS:
Pursuant to AMC 2.52.040E and AMC 2.52.060, after reasonable inquiry and evaluation, the undersigned Department
Head finds and determines that: (1) the services to be acquired are personal services: (2) the City does not have
adequate personnel nor resources to perform the services: (3) the statement of work represents the department's plan for
utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and
capability 'Sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and
financial constraints provided: (5) the consultant's proposal will best serve the needs of the City; and (6) the
compensation negotiated herein is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings I Recitations. The findings and recitations set forth above are true and correct and are Incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service to which they will be
assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the Stale of
Oregon, are so registered, licensed and bonded.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified
above. Once work commences, invoices shall be prepared and submitted by the tenth of the month for work
completed in the prior month. Payments shall be made within 30 days of the date of the invoice. Should the contract
be prematurely terminated, payments will be made for work completed and accepted to date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.53O are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $18,088 or more, Consuitant 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
perfonning work under this contract and to any Subcontractor who performs 50% or more of the service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
rt will be seen by all employees.
9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmiess
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not
limrted to, Consultant's employees, agents, and others 'designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be heid responsible for any losses, expenses, claims, subrogations,
actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
10. Termination:
,...-_._-_.~__......______.....__.,___ ....._..:__..J"'...,"'..,"'............ ....___ ~ ~;"
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 whoie or in part, effective upon delivery of
written notice to Consultant, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
ill. If any license or certificate required by law or regulation to be held by Consultant to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Consultant may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
il. Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iil. 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/Liabilitv of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuimt to subsections a, b, cord of this section, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
13. Default. The Consultant shall be in default of this a9reement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its ORF status pursuant to the ORF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a ORF if
consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the benefrt of creditors; or ceases doing business
on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or
delegate duties under, the Contract. ~
14. Insurance. Consultant shall at its own expense provide the following insurance: ~l
a. Worker's Comoensation insurance in compliance with ORS 656.017, which requires subject em ers to
provide Oregon workers' com pensation coverage for all their subject workers
b. ProfessioAal liaBility iAS"r-aAoe .....itA a oomBiAed siAgle limit, or tAe e~"i.eleRt, of Rat less thll" enter one: .?
$200,000, $~,OOO, J 1.000.000, $2,886.888 VI f4vl A,",tJl;o"gbl... fG, (.."c1, G.li1i,.., iflG:aeRt 8f eeetJfFeRee. l~i3 is to ""I c.)'"
eG,sr dam8gl:s ciw3l:d by errsr, smissisR or RegligeRt aets relales Ie the wefessioRal se"iceg to be pro.ided '-\ (J., VI
URGer tRis eeFltraet.
c. General Uabilitv 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 Bodiiy Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
d. Automobile Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
e. Notice of cancellation or chanae. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coveraoe!s) without 30 davs' written notice from the Consultant or its insure;(~\ to
the City.
f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and
non-<:ontrlbutory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish
acceptable insurance certificates prior to commencing work under this contract. The certmcate will specify all of
the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of Insurance policies; trust agreements, etc. shall be provided to the City. The
Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
15. Governing Law; Jurisdiction; Venue: This contract Shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim.) between the City (and/or any other or department of the State of Oregon) and
the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Consultant, by the si9nature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BElWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
17. Nonapproprlations Clause. Funds Available and Authorized: City has sufficient funds currently availabie and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or olher expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further
liability to Consultant.
Certification. Consultant sh
CONSULTANT
n the certification attached hereto as Exhibit A and herein incor
CITY OF ASHLAND:
BY
BY
R
TITLE
OWtJet'--
DATE
DATE
~/?
oq
CONTRACT AWARD AND FIN INGS DETERMINED BY:
By:
-c:...9-
City Department Head
Approved as to
form by Legal:
Date:
FederallD#
813 4'1 11/)3
ACCOUNT #
;26 0 t::J fP !' ,p.cf2CJ 7 tJ ~
(For City purposes only)
Ct3--tfr ()
'Completed W9 form must be submitted witl1 contract
PURCHASE ORDER #
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 fonm 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 Intemal 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 perfonm the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its tenms, (c) the work under the Contract shall be perfonmed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perfonm 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:
............(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.
i/ (4) Labor or services are perfonmed only pursuant to written contracts.
i/ (5) Labor or services are perfonmed for two or more different persons within a period of one
V year.
(6) I assume financial responsibility for defective workmanship or for service not provided
as evidenced by the ownership of perf6nmance bonds, warranties, errors and omission
insurance or liability insurance relating to the labor or services to be provided.
J?44dlCl ~
Contractor
04~/b-tl1
(Date)
Fo'm W-9
(Rev. October 2007)
Department of the Treasury
Internal RevenuoService
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS,
~e (as shown on your income tax return)
f\1.-L-S~f;f....L I .
BUSine,ss ~ame, if different f~\ above
::--;.e . v n
Check appropriate box: D-rndividual/Sole proprietor 0 Corporation 0 Partnership
o Limited liability company. Enter the tax classification (D.=disregarded entity, C",corporation, P=partnershipj .. _ _ _ _ _ _.
o Other (seeinstnJctions) ~
~ddress (number, street, and apt. or suite no.)
qi70 6 .',,: -~2.L-jG?') LtJ
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 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 identification number (EIN). If you 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.
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report aU interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. '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 required to sign the Certification, but you must
provide your correct TIN. See the instructions on page 4,
Sign Signature of
Here u.s. person ... . ./ ~i/ Date ...
'"
ID
0>
.
0.
C
o
ID .
0.5
Z'..
" u
02
~~
c.
.- c
a:~
'0
.
0.
"'
ID
ID
U)
Taxpayer Identification Number IN)
General Instructions
Section references are to the Intemal Revenue Code unless
otherwise noted.
O Exempt
payee
Requester'S name and address (optional)
, ~
')<1::;
Social security number . _
5'i8 i 4'i : 77Cj
or
Employer identification number
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
o 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. 10231X Form W-9 (Rev. 10-2007)
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 TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S.
exempt payee. 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.
!f!]Yi6Mf'E&
April 15, 2009
Jim Olson
Engineering Services Manager
City of Ashland
51 Winburn Way
Ashland, OR 97520
Subject:
Professional SelVic:es Agreement Jefferson A venue Extension
Dear Mr. :
Stream Fix is pleased to submit this proposal for your consideration. The scope of work under
consideration is the development and follow up of state and federal pennitting as required for
the installation of the stream crossing work associated with the cited project and complete the
DEQ 1200C pennit forms based on the plans developed by KAS & Associates.
Stream Fix proposes to provide these services on a time and materials basis not to exceed
$4,990.00. Our 2009 Hourfy Rate Schedule is attached hereto as Exhibit A and by this
reference made a part hereof. We customarily charge for travel time and mileage in
agreements of this nature. This rate schedule is subject to at least annual review.
We understand time is of the essence in the prosecution of the of the described scope of work
and shall expend all reasonable effort to complete the permitting process before the up coming
'in stream work window'
Thank you for considering StreamRx as part of the project team in completing this work.
Sincerely,
~t2.~
Russell A. Lawrence, P.E.
Fluvial geomorphologist
Attachments
C\DOCUME....l\olSOnj\LOCALS....l \ Temp\StreamFiX.proposal.doc
Exhibit A
StreamFix 2009
HOURLY RATE SCHEDULE
Description
1. Office Tech
2. Instrument person/GPS assistant, CAD Drafter
3. Party Chief, GIS Tech
4. Engineer I, Inspector
5. Engineer II, Survey Tech II, Cad Drafter, GIS Analyst
6. Sr. Engineer
7. Sr. Project Engineer, Survey Project Manager
8. Sr. Principal/owner
REIMBURSABLES
HOURLY RATE
$ 40.00
$ 70.00
$ 75.00
$ 85.00
$ 95.00
$105.00
$125.00
$145.00
A. Sub-consultants, Professional and Technical Cost + 12%
B. Maps, reports, materials, permit fees, express delivery and
Messenger, pass-thru bills and similar items necessary for work
In progress Cost + 12%
C. Technology expenses associated with computers, software,
Electronic survey equipment, telephone, cell phone, photo copies
Standard field supplies, transportation and standard postage will be
Invoiced as the Technology Charge 2%/ Billable
Hour
D. Out-of-Town travel per diem and cost of commercial
Transportation
E. Transportation within 30 mile radius*
Transportation beyond 30 mile radius
* On job inspection will be billed $0.55 per mile
F. Special Printing
Large format Blueprints & reproduction - bond
Large format Blueprints & reproduction - mylar
Color photos
G. Expert Witness
Cost + 10%
No Charge
$ 0.55/mile
$ O.SO/ tt2
$ 1.50/ tt2
$ O.SO/page
Rate x 1.5
Note:
1. All payment is due within 30 days from date of invoice. A monthly service
charge of 2% will be added on all accounts older that 30 days from date of
invoice.
2. The foregoing rate schedule of charges is incorporated into the agreement for
the services provided effective March 1, 2009. After December 31, 2009,
invoices will reflect the schedule of charges in effect at that time.
AkORD.' LIABILITY INSURANCE I UrI'lIll.~_U1.n""1
CERTIFICATE OF 4/28/2009
RODU~R. THIS CERTIFICA1f' IS ISSUED AS A MATTER Of INFORMATlON
Hotchkiss :Insurance Agency ONLY AND CONfERS NO RIGIfTS UPON TKE CERTifiCATE
HOLDER. TKIS CERTifiCATE DOES NOT AMEND, EXTEND OR
845 East Berkeley Street AL1f'R TKE COVERAGE AFfORDED BY THE POUC1E$ BELOW.
Gladstone OR 97027
.5.Q3J'.2.3.fiJlM UolSURERS AffORDING COVERAGE NAlC'
~S1JRED ROSSELL A. LAWRENCE lNSUReA A:. Fl\RMEI\S INStlRANCK PClIAllGE
DBA: STREAMFIX IN$URER B: raIlIaIRS ...........~ OCMJ/'MIY OF ~
19478 S S'rARVIEW LANE IN~C:
OREGON CITY, OR 97045 INSURER D:
I INSIJA'iR E.:
COVERAGES
TIE. F'OUCIES Of IN8UAANCE I.leTEDBElOWl-lAIJE"~ ISSUe) 10 THE. INSUAID NAMeD ABOVE mR THE POUCY pefttOO INDICA"I'ED. NorwrrHSTAI'IOlNG
1HV Rl!.QUIREMENT, TERM OR COf\IJlTlON Of At<< CONl'IV.CT OR. orneR. 00C\Jt,IENT wmt RESPEC'f TO WHIQl THIS ~T\FI~TE MAY BE ISSUED oR
MAY PERTAIN, n1E INSU!\ANCE AFf!OR[)EO BY TIoG POLIClea DESCRIBeD HEREIN IS suBJECT TO ALL THE lBWS. EXClU510NS NlO OONDIT1ON$ OF SUCH
POUCIES. ~re UNITS 5t-IOWN)MY I-lAVE BEEN fU!DUCED BVPAlD C1AIMS
::: e~ ""'~""- pouCV NUMBER ~CY CTIVE P8JiW nON UIllTS
n"
~ERI\L L1^B1UTY E1oCI< OCClJAAENCE . 2 000 000
X OOw.teRCW. GEJ.j!RI\L LlABlIJTY PREMISES n;", ooc:ul'trcl I 75 000,00
1 ",-,,'MS"""" IJU ocCUR toED EXP (AIlYQflCIpCl!'Klnl . 5 000.00
A X f- 60472-76-66 04/01/09. 04/01/10 ~1.' MNINJURV . 2.000.000
- GENERH.. AMREG"TE . 4 000.000
n1.AG~n~N'PUn PROOVOT9 . coMPIOP AGG . ,.ooQ....Q.O.!l
. POLleY .ECT lOC
~OElIUi llAB'LrN COMBINeD SINGLE UWT .
I- mflO/JTO lEI er:cIdant)
I- ~!,.OWNED AUTOS SODIL V INJURY
~ scHEl>U\,ED ^"""" (!'of""") . 500,000
B - HlREO I<lTOS ~6700-21-56 12/27/08 06/27/09 BOOlL y """""
$ 500,000
- """"""'"' AUTOS ~-
X mLL; 500 f'ROI'ETffi'_
X 500 il'O"_ . 100,000
=fUAB'urr AU1'O ONly. EAACOme.T .
ANYAUTO OT><ER """ EAACe $
AlJTOONI.'f; "'G .
~SSAJMBRElJ,..A.lIABILtTY EACH occURRENCE: .
1--1 OCCUR 0 CLAIMS....OE AGGAe<lATE .
.
R~E $
ReTE""'" . I
WORKERS OOMPENSAT~ AND 11OR'I....rrS I I' OF\'
ENPLm'EfU>' UABIlITY
Nf( PROPR1EfOMNlTNEREXEClITl'v' E.l. EACH ACCDENT .
OFFICDWEMBER E)(CLUDEO'l' E.l. 0tSEASE- EAEMPI.OYEE $
lfyca,d8tcrl~undl:l'"
SPECIAl. PROVISIONS beloW E.L DI5EASli.. POllevUMtT I
O1HER
tJ~rPTION OF OPERATIONS (lOCATIONS I'II!:HlOU!S I EXCWSI0N9 1<00&0 BYENOORSEMENT IsPeCw.. PROV1SJON8
The City of Ashl~d, its employees, elected officers. and au~rised agents are
listad as Additional Insurad.s
Project: 2006-07 3efferson Street extension
CERTll'lCAlE MOLDER
CANCELLA TlON
SHOVI.Q ANY OF THE NJCtJEOESCRlBED POl.lClES liE CAHCEU..eO BEFORE THE exPtAAllON
OI\TE ~EOF. TloIE ISSUING \NSlJI!U;R WIU ENDS/I.\IOR TO MAIL .3..0-- DAYS WRlT'l'EN
NOTICE TO THE cERTlFlCl\n! HOlDER NAWD TO l11E LeFT, DllT FAIlURE TO 00 GO SHl\U
IMF'otE NO 09U~TIO'" QA L1A8IUTY OF No('( ~ UPON THE. INSURER.. ITS AGENTS oR
ASPR&SENTATlVE5.
AUTHORIZED ~^TM:
@ACORDCORPORATlON1~
Ci ty of ABhland
51 Wi.nburn Way
Ashland OR 97520
Attn: James Olson
Engineering Manager
ACORD25 (2001108)
~A....,.
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CITY RECORDER
CITY Of
.ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488.5300
VENDOR: 014147
STREAM FIX
19478 S STARVIEW LANE
OREGON CITY, OR 97045
'(:i.,t:
.er"s: Net
Rec: . Ill. ~ ~,e:
~,.Jeci"" :.\st:
12f:lf.HJantityo ~~uni(" ..~.._ ~ ::", ,: """'f~~' ,. ;'.~-'- _~- _ 7-_~bescriJ)tion'
Develop and submit applications for a
ioint DSUCOE and DEQ 1200 C permits,
which are needed to construct the
proposed extension of Jefferson Avenue.
I
I
Not to exceed $4,990.00
Per attached letter of engagement and
hourly rate schedule
Contract for Personal Services
Date of agreement: 04/16/2009
Beginning date: 04/20/2009
Completion date: 06/30/2009
Insurance required/On file
I
!
i
31LL TO: Account Payable
20 EAST MAIN ST
541.552-2028
ASHLAND, OR 97520
I - ~8A7fE'.'~. ~L:~
4/29/2009
Page 1/ 1
;':::;'3P'0,ilil'JMsER 3J
08910
SHIP TO: City of Ashland-Warehouse
(541) 488-5354
90 N MOUNTAIN
ASHLAND, OR 97520
Req. No.:
Dept.: PUBLIC WORKS
Contact: Jim Olson
Confirming? No
.r :~~"=_~i'_=:. - ~=!~'L~:::~~ C]urlifP'rice?)':l L.".JEkt~B'fiC-e~~:::-':::i1
4,990.00
SUBTOTAL
TAX
FREIGHT
TOTAL
4990.00
0.00
0.00
4,990.00
[ '~'C~('t!nt Number J I l~_ jF?,r_ojecrNu"miJer.~~~-:~---Z ~~L--:~fnoufit -=. tA"cc_o_unt;Nuiiilfer~::J ['" ~-~roW~!NiJmoe_Lt.:--: J r~L,~/Ainou_nt~~o;. -~
E 26C'1~'.00.70420 E 200510.100 4990.00
.
~ ~ YP'~J
A orized Signature
VENDOR COPY
FORM #10
CI T Y 0 F
ASHLAND
CONTRACT APPROVAL REQUEST FORM
~er attached contract
PUBLIC CONTRACTING REQUIREMENTS - Solicitation Process
.;Z:.~~ Fx-
')<2~ ~(.(_u--~~
Total Amount
Contractor/Consultant:
D Exempt from Competitive Biddina D Invitation to 8id (Copies on file) D Emeraencv
Reason for exemption: D Wntlen findings attached
./ D Quote or Proposal allached
lkf Small Procurement & Personal Services D Reouest for ProDosal (Copies on file) Cooperative Procurement
Less than $5,000 . Please check one: D State of Oregon
Note: Total contract amount, including any' D Goods & Services Contract #
amendments may not exceed $6,000 D Personal Services D State of Washington
Intermediate Procurement D Sole Source Contract #
GOODS & SERVICES D Wrillen findings allached D Other government agency contract
$5,OOO.to $75,000 D Quote or Proposal attached Agency
DC. (3) Wnllen Quotes Contract #
PERSONAL SERVICES D Special Procurement D Interagency Contract
$5,000 to $50,000 D Wnllen findings allached Agency
D (3) Wntten Proposals D Quote or Proposal attached Contract #
I
Have all public contracting requirements been satisfied?
YES
..----. .
NO
If "NO", City Council approval is required. City Council approval was received on
(Date)
p.~.-r
d5l-~
(Date) 0.. Ch "^---l
o'fJ.--,;Uf -09
(~?
Have funds been budgeted for the purpose of this contract?
YES' ./
NO
If "NO", City Council approval is required. City Council approval was received on
Please provide: AccountNumber~~ - ~ "!' -(_~-6>:-~. '! q ~~~
Is the amount of the contract less than $25,OOO?
YES
~
NO
If "NO", Legal review is required. Contract was "Approved as to form" by the Legal Department on
Is the amount of the contract less than $75,000 for Goods & Services
.or $50,000 for Personal Services?
(Date)
YES
~.
NO
II "NO", City Council approval is req'uired. City Council approval was received on
(Date)
Is the contract for a period of 24-months or less?
YES
/
NO
If "NO", City Council approval is required. City Council approval was received on
(Date)
Please provide terms:
Start date: # (.<z,; /M
Completion date: 6-/ q.~ / &Jq
Can the contract be terminated lor convenience thirty (30) or fewer days
following delivery of written notice to the contractor? YES
~
NO
If "NO", City Council approval is required. City Council approval was received on
(Date)
Prepared by:
~~('O~
~~.~
o
,0 -f/ - :2-51-- &>)
Please cirde:
CAppr~~ . / Not Approved
'A9&.-~
Lee Tuneberg
l-)scJ/#/,
/
Date:
Department:
Date:
Form #10 - Contract Approval Request Form, Page 1 of 1, 4/29/2009
CITY OF
ASHLAND
REQUISITION
No. PW - FY 2009
Date April 28, 2009
Requested Delivery Date
Deliver To Mike Faught
Via Betsy Harshman
100% (. Note: Please allow approximately two(2) weeks for delivery on items not
generally caried in stored, and approximately two (2) months on printing jobs.)
Department PUBLIC WORKS
Vendor Russell Lawrence, DBA Stream Fix
19478 S. Starview Lane
Oregon City, OR 97045
Account No. 260.08.12.00.704200
Item No. Quantity Unit Description Use of Purchasincr Office Only
Unit Price Total Price PO No.
Develop and submit applications for a joint
DSUCOE and DEQ 1200 C permits, which are
needed to construct the proposed extension of
Jefferson A venue. $4,990.00
for Kari:
BID /RFP / EXEMPT: BID
Contract Start Date: ASAP
Contract Completion Date: 6/30/2009
Insurance on file: IYES X INO
Proiect No: 2005-10
Job No.
Unit No.
I hereby certifY that the above items are necessary fOf the operation
of this department and are budgeted .
~.,o f:>-4-
. nepar1ment Head 0; AUUI;-~U rerson
Issued By
Date
Received By
~.l'
G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT\2005\05-1 0 Russell Lawrence Requisition.xls