HomeMy WebLinkAbout2009-041 Contract - Leapfrog Training
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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: Leapfrog Training & Facilitation
CONTACT: Adrienne Graham
ADDRESS: 2975 NW Terra Meadow Drive, Bend OR 97701
DATE AGREEMENT PREPARED:
BEGINNING DATE: Mav 18, 2009 COMPLETION DATE: June 1,2009
COMPENSATION: $1,450 ($1,300 base rate plus $150 travel)
TELEPHONE: 541-482-4454
FAX: W482-4916
SERVICES TO BE PROVIDED: Assist city staff with Food and Beverage Tax public involvement/public
meetings. Provide up to two hours to review and finalize program details and to review draft questions and
materials. Draft and facilitate two (2) public meetings of up to 2 hours each. Take session notes and provide
the raw data of the findinos. Provide AV and any other eauioment.
ADDITIONAL TERMS: Upon signing of the contract, work will commence and 50% ($650) will be due from'
City of Ashland to Leapfrog. After the submittal of the raw data of the findings the remaining payment of
$$800 ($650 plus tavel) will be due.
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 personnei nor resources to per10rm 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 per10rm 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 eONSUL TANT 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, per10rm the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper per10rmance
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 per10rm the service to which they will be
assigned in a skilled and worker,like manner and, if required to be registered, licensed or bonded by the State of
Oregon, are so registered, licensed and bonded,
4. Completion Date: Consultant shall start per10rming 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 eonsultant for service per1ormed, 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 shalt be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C,520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $18,088 or more, Consultant is required to comply with
chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined, in this chapter, to all employees
per10rming work under this contract and to any Subcontractor who per10rms 50% or more of the service work under
this contract. eonsultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees. l...
9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the per10rmance of this contract by Consultant (including but not
limited to, Consultant's emoloyees, aqents, and others desiqnated bv Consultant to oer1orm work or. services
("'''',..,............t f........ 0".....................1 C'",..,.,;....",.. D"',,;............... r.7/n1/'l""O 0............ 1 "f n
,
attendant to this contract). Consultant 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,
10. 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 Consultant, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii, If any license or certificate required by law or regulation to be held by Consultant to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Consultant may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking terrnination shall give to the other party
written notice of the breach and intent to terminate, If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii, Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obliqation/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 pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
'Consultant shall deliver to City all contract documents, information, works,in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility,for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656,017.
12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all
persons ernployed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation iI 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 ORF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business
on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or
delegate duties under, the Contract.
14, Insurance. Consultant shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b, Professional Liability 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 claim, incident or occurrence, This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
c. General Liability 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 inctude contractual liability coverage for the indemnity provided under this contract.
d, Automobile Liabilitv insurance with a combined sinale limit, or the equivalent, of not less than Enter one:
f"'~~'F~"'+ -r.....F D.....F.................I C'..........,;,........... D.....,,;............ ("\,7/"1/..,,,no D.......... ').....-r n
$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 chanqe. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to
the City.
f, AdditionallnsuredlCertificates of Insurance. Consultant shall narne 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.contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish
acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of
the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies; trust agreements, etc, shall be provided to the City. The
Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions andlor self.
insurance.
15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts, In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise. from any claim or from the jurisdiction.
16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN, THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREiN REGARDING THIS CONTRACT.
eONSUL TANT, 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
eONDITIONS.
17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
. authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. eonsultant
understands and agrees that City's payment of amounts under this contract attributable to work performed after the,
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further
liability to Consultant.
Certification, Consultant shall sign the certification attached hereto as Exhibit A and herein incor orated b reference.
CONSULTANT CITY OF ASHLAND:
BY ttlL-- J;ature
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Print Name
BY
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FINANCE DIRE
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TITLE
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Approved as to
form by Legal:
Date:
-N'/A
'Completed W9 torm must be submitted with contract
ACCOUNT # '7 I't? t'? I t? p- ,p.t:?
(For City purposes only)
PURCHASE OROER # tJ ,g f??f r:;;
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Contractor
EXHIBIT A
(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 carqs 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.
12
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(Date)
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Fo'" W-9
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
(Rev. Octobef 2007)
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Check appropriate box: Indil,'idunVSole pr netor Corporation!!J
D Umit"d liability company_ En!..... the lax dassific:ltion {D=disreg::lIded entity.
[J (Y.hH (&H jnstr~'C;ticrls) ...
Addr~~~5streN\JaPti~ ~1~ Or'
Crty, 0"", ood ZIP ,ode ~ q ?~ 6 )
O Exempt
. poyee
Requester's name and address (optionor)
~ I List accQl.Jnt nlJllb (s) her!! (op1ionaQ
WI
.m.~~Y~~ldentif!~tio~ Num~erjTIN)~__,_________________._.___,__._,___..___.,-,.------
8,ter YOllr TIN in the appropriate box. The TIN providGd must match the name given on Line 1 to a\'oid
backup Vlithholdin9. For individuals. this is your social sf:cllrity mnnbe (SBN). Howe'!er, for a resident
alien. sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identitication number (EIN). If you do not have a number. see How to get a TIN on page 3.
Note. If the a'ccount is in more than one name, see tlle chart OIl page 4 for guidelines on whos...
numbel to enter.
j Sodal security number
or
Certification
Under pennllies of perjury, I certify thot:
1. The number shown all this 10nn is my correct taxpayer identification number (or I 3rn waiting tor a l1umber to be issued to me), <lnd
2 I um 110t subject to backllp withholding because: (u) I am E:xempt horn bnckup withholding, or (b) I have not been notified by the Illterndl
Revenue Service (IRS) tllat I am subject to backup withl,oIding as a result of a failure to repor1 all interest or dividends. or (c) tile IRS has
notified me that I am no longer subjec~ to ba.t::kup withh~lding. arid
3. I am a U.S, citizen or C~ll6r. U.S. person (defined below).
Certification Instructions. Yoo.must cross out item 2 nbove if you have been notified by the IRS that you are currently subject to backup
witllholdingbecause you 110'le fuiled to report 0.11 interf:st and dh.idends on your tax retum. For reul est<ltG trunsnctions, item 2 does not upply
For mortgage interest paid, acq\lisition or abandonment 01 secured property. cancellation 01 debt, contributions to an individual retirement
arrangement (IRA), and 'g'enerally, payments other IIlan interest and dividends. you are not required to sign the Certification, but you must
provide your correct TIN. See tl16 instructions on page 4
Sign
Here
i Signature 01
l U.S. person ~
Dale ~
Purpose of Form
A person who is required to file an information return with the
IRS must obt<:>.in your correct taxpayer identification number (TIN)
to report, fcr 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 10' an IRA
Use Form W-9 only if you are a U.S. person (including a
resident alien), to provide your ccrrect 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 subjoct to backup v/ithholding, or
3. Claim exemption from backup 'withholding if you ar!? aU,S.
exempt payee. If applicable. you are also certifying th<lt 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.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if youar€!:
. An individu<:>.1 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 01 tl1e United
States,
. An estate (other than a foreign estate), or
. A domestic trust (as' defined in Regulations seclion
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 lax on any foreign partners' share of Income
from such business. Further. in certain caseS where a Fcrm W-9
has not been received, a partnership is required to prt:lsume that
a partner is a foreign person, and pay the withholding tax.
TherelOfe. if yoy rue a U.S. person that is a partner in a
partnt:lrship 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 ....Jho gives Form W.9 to the partnership for
purposes'of establishing its U.S. status and avoiding withholding
on its allocable stlare of net income from the partnership
conducting 8 tr"de or business in the United States is in the
fOllowing cases:
. The U.S. O\'mer of a disregarded entity and not the entity,
Section references are to the Internal Revenue Code unless
otherwise noted_
Cat. No. t023tX
Form W-9 (Re~. 10-2007)
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CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488.5300
61fV FtECORDER
Page 1/1
t~DP.>TE~
4/15/2009
~0TNOrv1BER!mI!
08896
VENDOR: 011704
LEAPFROG TRAINING
2975 NW TERRA MEADOW DRIVE
BEND, OR 97701
SHIP TO: eity of Ashland
(541) 488-6002
20 E MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: ADMINISTRATION
Contact: Ann Seltzer
Confirming? No
LIaUaiiiftvw l.(Uni(J r-:- . ..-..-~~ , 'iOescription .,.....'""1. .'\..... ;(;~J' ~t.C "'~~~~. } ;:b~'1Unit1P'j-jce~ ~Ext!{P.'iice~
~. . _ .'. ' .. ~'). l' ,-'~
Assist eity staff with Food and 1,450.00
Beverarle Tax public involvement/public
meetinrls. Provide up to two hours to
review and finalize prowam details and
to review draft questions and
materials. Draft and facilitate two (2)
public meetinrls of up to 2 hours each.
Take session notes and provide the raw
data of the findinrls. Provide A V and
any other equipment.
eontract for Personal Services
Berlinninrl date: 05.18-2009
Completion date: 06-01-2009
Compensation: $1,450 ($1,300 base rate
plus $150 for travel) .
Additional terms: Upon sirlninrl of the
contract, work will commence and 50%
($650) will be due from City of Ashland
to Leapfrorl. After the submittal of the
raw data of the findinrls the remaininrl
payment of $800 ($650 plus travel) will
be due.
SUBTOTAL 1 450.00
IILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 1,450.00
ASHLAND, OR 97520
L1~c_co_un!lNuml5er, I ~rojectlt!iiiiiberi...:..-.1 L..Z..l~rno:unt'=::J Ul\ccount.ll!qm~. ""l ~p'f<)jectJHumbTELJ ['0 . 'j~lT!ount~
= 710.01.02.00.60410 1 450.00
/f:A~
e:~Si~ur!,9
VENDOR COPY
A .requEist for a Purchase Order
REQUISITION FORM
CITY OF
'ASHLAND
THIS REQUEST IS A:
o Change Order(existing PO #
Date of Request: I: ~i2~!29>' - ,I
Required Date of DeliverylService: I. ~(i8/09' ' I
Vendor Name
Address
City, Stale, Zip
Telephone Number
Fax Number
Contact Name
lp::Ipfmg Tr::lining Po ~::l('ilit::!tinn
2975 NW Terra Meadow Drive
Bend, OR 97701
541-482-4454 phone, 541-482-4916 fax
Adrienne Graham
SOLICITATION PROCESS
~II Procurement D Sole Source D Invitation to Bid
Less than $5,000 D Written findings attached (Copies on file)
Quotes (Not required)
Cooperative Procurement D Reauest for Proposal
D Slate of ORJWA contract. (Copies on file)
Intermediate Procurement D Other government agency contract D Special I Exempt
D (3) Written Quotes D Copy of contract attached D Written findings attached
(Copies attached) D Emeraencv
D Contract # D Written findings attached
Description of SERVICES
a~ 4 dfI U; /klU!lc ,?~tl-h7tM ~ ju,{ 'i-J1tit;y- 0ij/'
Total Cost
. ~': .,.
.c-
o
Per attached PROPOSAL
.-' .,
:(-.i: ~ ':;::.:-:*:,,'::
1,$:... _'. ,:;)'-72'''''''_ ~~.Jt.,l,,"," .r~; ..1'-;
.,....,
.. ~r';'.__;,
Item #
Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
.1TOTALiCOST "
0 Per attached QUOTE r - .
,
" ,~,,-
"., " t( .:.". ". " .
i' ,'.., ',:. ~' " pl..,/' ."1
Project Number ______ - ___ "v.iij.5{) ~;,
-$,. . '. " "
~_'_._,'" _.__-......J.
Acc.Qunt Number JLD.. {!L - fbL()J- tf.fJ.Y1 fZD
. Items and services must be charged 10 Ihe appropriate accounl numbers for the financials to refiect the actual expenditures accuralety,
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.
Emp'oy" .,"",,", ttuJ:J ~,/, S"p,re',,'".''''' S1g",,"~.r
(/ ~
G: Finance\Procedure\AP\Fonns\8_Requisition form revised.doc
Updated ani 3/2712009
CITY OF
ASHLAND
Memo
DATE:
April 15,2009
TO:
Lee Tuneberg, Finance Director
FROM:
Kariann Olson, Purchasing Representative
RE:
PO 08896, Leapfrog Training
Lee,
Can we have permis~ion to waive the requirement to "provide insurance certificates" with the attached
Contract for Personal Services less than $25,000? Insurance is still required, just the requirement to
provide "copies of insurance certificates" will be waived.
Reasons for request:
1. Compensation is minimal. $1,450.00
2. Risk assessment: low/minimum (Tasks include reviews w/City staff and the facilitation
of two 2.hour meetings with the public)
3. Contracts for Personal Services are "optional" and/or not required for services less than
$5,OQO.00
4. Requested by Ann Seltzer
~:o~
Kari Olson
Purchasing Representative
Please circle:
~/
Not Approved
~.A. ~f'
Lee Tuneberg
,f-...
7"';':~7'
ate
PURCHASING
Finance Department
90 N. Mountain Avenue
Ashland, Oregon 97520
WWW.ashland.or.us
Tel: 541-488-5354
Fax: 541, 488.5320
m: 800-735.2900
~~,
C'ONTRACT APPROVAL REQUEST FORM
For contracts less than $75,000
CITY Of
ASHLAND
I FORM #10 I
"
Description of GOODS or SERVICES
~tJ L'/f3@?f6
~er attached contract ~U? ~;p C+-~ ' '2J7ra~ A.A:. ;; .
Total Amount
$ /~G"(), ~
PUBLIC CONTRACTING REQUIREMENTS - Solicitation Process
0 Exemct from Comoetitive Biddina 0 Invitation to Bid (Copies on file) 0 Emeraencv
Reason for exemption: 0 Written findings attached
/' o Quale or Proposal attached
t=f4'lmall Procurement & Personal Services 0 Request for ProDosal (Copies on file) Coooerative Procurement
Less than $5,000 Please check one: o 'State 01 Oregon
Note: Total contract amount, including any o Goods & Services Contract #
amendments may not exceed $6,000 0 Personal Services o State of Washington
Contract #
Intermediate Procurement 0 Sole Source o Other government agency contract
GOODS & SERVICES 0 Written tindings attached Agency
$5,000 to $75,000 0 Quote or Proposal attached Contract # .
o '(3) Written Quotes 0 Interagency Contract
Agency
PERSONAL SERVICES 0 Soecial Procurement Contract #
$5,000 to $50.000 0 Written findings attached
o (3) Written Proposals 0 Quote or Proposal attached
Have all public contracting requirements been satisfied?
YES 1/
NO
If "NO', Council approval is required. Council approval received on
(Oate)
Have funds been budgeted for the purpose of this contract?
YES
............/
NO
If "NO", Council approval is required. Council approval re'ceived on
Please provide: Account Number'!!'? . ~ ~ . t:' t!-.l? t!? . ~ {/_~ ~ ~
(Oate)
Is the amount of the contract less than $25,000?
YES
V"
NO
If "NO', Legal review is required: Contract was "Approved as to form' by the Legal Oepartment on
......--'
(Date)
Is the amount of the contract less than $75,000?
YES
NO
If "NO', Council approval is required. Council approval received on
(Date) /
Is the contract for a period of 24-months or less?
YES
~
NO
If "NO', Council approval is required. Council approval received on
(Oate)
Please provide terms:
Start date:
Completion date:
Can the contract be terminated for convenience thirty (30) or fewer days
following delivery of written notice to the contractor? YES
V'"
NO
If "NO", Council approval is required. Council approval received on
(Date)
By completing and signing this selection and justification form, I certify that the information provided above meets the City of Ashland public
contracting requi ements, and if ~PPlicapjrflie additionai documentation can be provided upon request.
Prepared by: ~frIU.::7r~LeeTUneberg: ~ .,;fL- 6 0- Date: %}6:9
.
form #10-ContractA praval Request Form, Page 1 of 1, 4/16/2009