HomeMy WebLinkAbout2009-042 CONT Addendum - Carports of Washington
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ADDENDUM TO CITY OF ASHLAND
CONTRACT FOR GOODS AND SERVICES
Addendum made this 6th day of Mav
("City") and Carports of Washinqton
, 2009, between the City of Ashland
("Contractor") .
Recitals:
A. On October 6, 2008, City and Contractor entered into a "City of Ashland Contract
for Goods and Services Less than $25,000" (further referred to in this addendum as
"the agreement").
B. The parties desire to amend the agreement to "extend the date of completion" and
"increase the compensation to be paid to Contractor".
City and Consultant agree to amend the agreement in the following manner:
1. The date for completion as specified in the agreement is extended to June 30, 2009.
2. The additional compensation to be paid to the contractor is $8,700.00 for labor and
travel expenses to complete the carport installation. The project was halted due to the
concrete footings found underground, which required a Site Assessment Report to be
submitted to the Oregon State Historic Preservation Office. The Site Assessment
Report. found the concrete footings to be insignificant and the City of Ashland was
granted permission to proceed with the project.
3. Except as modified above the terms of the agreement shall remain in full force and
effect.
::","A.,O(1;
Its Pres; en+
Fed.ID# 20- 3,Cfi (POl ~
OR Social Security #
CITY OF ASHLAND:
BY ~ _'2. . e--.
FilJ.8~ce "Director
Date .5 ~?
CONTENT REVIEW: 0 L AJ,..d. ~~
(City Dept. Head)
Date:
Purchase Order #
tIJ {3 6 ,;2.1
DATE
5~Lf-09
Acct. No.: /1 t? t:? ~ /'.2 t:7,o "7 t:? ~ /' CJ-o
(For City purposes only)
1- CITY OF ASHLAND, ADDENDUM TO CONTRACT FOR GOODS AND SERVICES
" .
Carports of Washington, Inc.
P.O. Box 2389 ..
Buckley. W A. 98321
Phone and Fax (360) 829-2838
WA LIC#CARPOWI945BR
Changer Order Authorization
Altn:
To:
Dale Peters
City of Ashland
20 E. Main St
Ashland, OR 97520
Change Order No: I-revised
Date: 4/28/09
Phone:
Fax:
From:
(541 )552-2292
(541 )552-2304
Candv Ford
Job# 8121
Project: Ashland PD Bldg
Total Number of Pages:
Description
This change order is to your main contract with Carports of Washington. We have been requested to make
the following changes, additions, or deletions under tbe main contract:
'(4) additional days - (3) men, labor and travel $4,200.00
'Fuel, Lodging, Per Diem $1,310.00
'General Overhead (4) days, Y, crew $1,790.00
'Phase Fee $1,800.00
'CWII5% $1,600.00
'CWI to use City of Ashland Jackhammer and compressor to complete installation.
'Deduct from original time spent on job $-2,000.00
Total: $8,700.00
. The foregoing amount of this change order is agreed to as constituting full and complete equitable
_ '!.djust!Ile!!tl.nfull~atisfaction_andaccord fortbe contemplated work oftbis cbange to be incorporated and
made a part'ofthe main contract agreement previously executed between the parties.
Except for such changes as set fourth herein, all of the terms and conditions of the main contract, and as it
- may have'been heretofore~modifie"d irfwriting, shalloe and remaiilthesame. - -- - - --- - - - -
Increase by reason oftbis change order:
Original contract amount:
Previous change orde~:
New total contract amount:
$8,700.00
$18,300.00
$-0-
$27.000.00
The foregoing change order is accepted upon the terms and conditions above stated and those in the main
contract
Carnorts of Washington. J'213-ocJ
::~"~~ ff"~.
Company Name
Date
By
Authorized Signature
Title
This change order must be signed and returned to Carports of Washington, Inc.
THANK YOU!
Specialty Contractor and Supplier of Commercial Steel Carports & R.V. Storage Covers
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ACOR.Dm CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYVY)
01/21/09
PRODUCER THIS CERTIFICATE IS ISSUED AS.A MATTER OF INFORMATION
Pr~pellnsurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Tacoma Commercial Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1201 Pacific Ave, Suite 1000 . ..-..-->.- -
- .. ". . .... -.. ..-. .. I
Ta<;om~~.~A 98402 , INSURERS AFFORDING COVERAGE ..._... NAIC#..
\ , .- -- ---. -
INSURED , INSURER A: Ohio Casualty Insurance Company._ - . - -- -
. I r:. '-Ca{ports 'of Washington; Inc. -.
. ._L~.. .. ____ '__'''' __ _._ __ __ u_ _ " _'. .. .., __.__ _._ __ _ _ n__ _._._-~ .. INSURER B: .-. .--- - -,"- .-- .-- --. -. -- .'_. . -- ., ._.. , '--
; : : POBox 2389 i , " . ,,~': ~.;... ,:
!.--.---. _.----- ----.-, , INSURER C: , , -':1' ;,...,. ':oc
l..__ ! Buckley, WA 98321-238~ INSURER 0: , ------ -, .- .------- - --- -. - .----- ---
I" . ,.. " 'tc\;'f.J....," \ :
, . u I" ~."'" y" >', . I....... I , ! ~<". '.. ,
INSURER E: " '.
Clienl#' 119219
CARPWASH
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER PJ'}~~~ri~~~g,m'IE P~il.fll~X':'~~N LIMITS
A ~NERAL LIABILITY BR053576250 01/19/09 01/19/10 EACH OCCURRENCE .1 000 000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED .100000
I CLAIMS MADE [!J OCCUR MED EXP (Anyone person) .10000
2L PO Oed:250 PERSONAL &ADV INJURY '1 000000
- GENERAL AGGREGATE .2 000 000
~'L AGG~EnE LIMIT APnS PER: PRODUCTS-COM~OPAGG .2 000 000
PRO-
POLICY JECT LOC
A ~TOMOBILE LIABILITY BAA53576250 01/19/09 01/19/10 COMBINED SINGLE LIMIT
ANY AUTO (Eaaccident) '1,000,000
-
- ALL OWNED AUTOS BODILY INJURY
.. .!.. > {Per person) .
- SCHEDULED AUTOS -- - .- - -
.!.. HIRED AUTOS - .. .-. .- - - d_' - -- --.-. -. BODILY INJURY ...---'. - ._- --- - -- '..-... --
.!.. I .~.::;.,;!".: :.- .(Perac_ci.d(!~lt_ . .
NON-OWNED AUTOS -- _.... --. . _.. ..- ..- - -- - -- --- ..m ___
.', -- .,.
'.'~ .... . , , . :.:: 1~. ''''', I;!.ir :;~. .. .., -.. - -.----.- -.. --- ...... --. -- -- . --
- PROPERTY DAMAGE $ :
-
h, .~~ ':';-:x ,...:.: , . ."'- ..' . -- _... .-. ... (Peraccidenl)__ -- --,,-. ... ... ...-. ..
~~GE'L1ABiLlTv ' .. .,r. ...,.: .. .. AUTO ONLY - EA ACCIDENT . . -- -
: - - .. . - ..-... -
.. .. ",
- ANY AUTO . .- - . -- OTl-lER THAN - EAACC . .. - u.. _
t:, ";~' . ~. ",,.....,....,.
; ... .., . ,-' "'-.' ..- .. ... AUTO ONLY:
'. '" AGG .
=s~SS/lJMBRELLA 'L1ABILlTY EACH OCCURRENCE .
OCCUR D CLAIMS MADE AGGREGATE .
.
~ DEDUCTIBLE .
RETENTION . .
WORKERS COMPENSATION AND . .. - -.... -'.. --- I WC STATU- IOJ~
EMPLOYERS' LIABILITY '. '.
ANY PROPRI",TOR/P.A.RTNERf<.OXEr:::UT1VE ..E:.L. EACH AC.~.IDEN~___ L__.__
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
II yes, describe under
SPECIAL PROVISIONS below E.l. DISEASE.. POLICY LIMIT .
A OTHER Stop Gap CT053576250 01/19/09 01/19/10 $1mm/$1mm/$1mm
,-
DESCRIPTION OF OPERATIONS I LOCATIONS 'VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS
RE: Ashland City Building at1155 E Main St, Ashland, OR.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland, OR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil -AS- DAYS WRITTEN
& its elected officials, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
officers & employees IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
20 E Main St REPRESENTATIVES.
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
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ACORD 25 (2001/08) 1 of 2
#M249360
KMKOO
@ ACORD CORPORATION 1988
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CCB Business Detail for License: 186051
Page 1 of2
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BUSINESS DETAIL FOR:
CARPORTS OF WASHINGTON INC
License: 186051
The business detail record includes business contact information and information about the business'
bond, liability insurance, worker's compensation insurance, licensing category, business entity and
other associated CCB licenses.
LicenseJ'Jumber: 186051
License Status: ,o,ctiv_e
Click I:lEI'.E for associated Records
Date First Licensed: 4/14/2009
Expiration:
4/14/2011
Name: CARPORTS OF WASHINGTON INC
Address: PO BOX 2389 BUKCLEY WA 98321
Work Phone: (360) 829-2838
.Class_of Non-Exempt
Indep_endent
Contractor:
License' Commercial: CSC2 - Specialty Contractor 2
Category / Endorsements:
Entity Type: COrporation
OTHER CERTIFICATIONS/LICENSES
- .. -'-- -..
-.-
~ WORKERS'COMPENSA~NSURANCEINFORMATION
WC Compliance Number: Insurance Carrier: OHIO CAULTY
Policy Number: CT053576250
LIABILITY INSURANCE INFORMATION CI:lISr'oB'l')
Insurance Amount: $1,000,000.00 Insurance OHIO CASUALTY INS CO
Company:
Effective Through: 1/19/2010
CC8 COMMERCIAL BOND INFORMATION (tlIS:r:OI'.Y)
Bond Amount: $20,000.00 Bonding 400 - COLONIAL AMERICAN
Company: CASUALTY & SURETY CO
Effective Through: 4/14/2011
ASSOCIATED PEOPLE (Ii'JI:.O)
PRESENT
https://ccbed.ccb.state.or.us/ccb__ frames/consumer __infolbusiness __ detail.asp?license __number... 5/8/2009
. .
CCB Business Detail for License: 186051
Page 2 of2
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\
~ Corporate Officer
- Corporate Officer
- RMI Employee
PAST
GRANGER, RAY L
ROMERO, JOSE CEJA
CORNETT, TYSON
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ASSUMED BUSINESS NAMES (INi'Q)
PRESENT
PAST
CIoss~r:ef.er_e~ced_CCB_Licen_ses and Associated Records:
1231'90
MOUNT TAHOMA
CONSTRUCTION
.
Not Active - Expired
I B",O<:
)
https://ccbed.ccb.state.or.us/ccb__ frames/consumer _infolbusiness __ detail.asp?license _number... 5/8/2009
Page 1/1
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CITY OF
ASHLAND
20 E'MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY REeD :..
E'.:2~:;':t::.1
iL[>;;~~O;NIlJMBERf~'~
10/27/2008
08621
VENDOR: 013765
CARPORTS OF WASHINGTON
PO BOX 2389
BUCKLEY, WA 98321
SHIP TO: City of Ashland - Police Depl.
11.55 E MAIN STREET
ASHLAND,OR97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: POLICE
Contact: Dale Peters
Confirming? No
~jlQuantH~T~~ :~ ~Onit~;j ~-~J's~": h.?1./t:~i~~]~'tf~~.;~~ - - ,,: ,;, . _15e:s-cril3tion-..'.:::t~j.::~~~ ~:~~"3' ".'1 < ~x ,~:t:: :~j ti.:c1fUriit~:B1 ~1JE~URrrce_: ' ;)
THIS IS A REVISED PURCHASE ORDER
Contractor to build and install 40' x 18,300.00
48' covered carport using all steel
construction. Location: Police
Department
Contract for Goods & Services
Date of agreement: 10/06/2008
Beginning date: 11/01/2008 _ ~)
Completion date: ~e()B )fJ6 - ~ - ~ ~
Insurance required/On file
Processed change order 05-08-2009
Amount for additional labor and travel
expenses - total aggregate cost change
is 47.5% - approved by City Council on
May 5, 2009.
8,700.00
.
31LL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
27000.00
0.00
0.00
27,000.00
ill:A?~cutfLiilirNurnBer.~f.i:;:~~IL{~~{vn?roJeciTNltmbe'rtJ'.:'Jjr;! ~~~:iAm()l"nff:~~~~:~ ~3?Acco"un'tjNumHEfrX)H:~ -~i.?;;.4RroJectmumtler:J~~ ~ii~:;1rf1AmJ;uJl~~,EL3
E 1 1 0.06. 1 2.00.7041 0 E 0001 20.999 27 000.00
~ ~~ -~ze~~(
VENDOR COpy
I 'FORM#ul'
GQODS AN~, SE~VICE$
CHANGE ORDER/CONTRACT AMENDMENT
APPROVAL REQUEST FORM
C IT Y OF
ASHLAND
Description of Change Order I Contract Amendment to original contract
contractor:C:~t..rr rye';!: d--r ~/c~jL(V<tr0!:'.-,:0
Purchase Order Number: CJ 'i3 67- /
Description: aj!t.~ />t.~ ~ ,L.",A-iZ r &~
4..ALd! zrr~~ c.LkJ ~~ ~ ~ "
rL."I~ ~ c..L:F'Le. If' C?~~ c' ~ 'lPd_b!.~" ^ .
o Per attached contract amendment
:Tot~raijlol,lnl'c)!;chang!lqrCfe:rJ. <,:':'
(-_~: '~~,.'~_": ::?",:~)-:~~,".:~'~ ..'~ :.,:'>~~"~!: f~;t_,~,:' -",' \:',"
1$ "';" .., .. ',' .,
....0..71:fJ..&.~. ,:"
.'-,'.,-.,'.;),:, -: ::: . \,:~':..' ';\:.::
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'H.~ '.' . 't.~;" _' _'; ",1_'_'_' ~. 'L, _"_~~,'~"~;'~"""."';/' ._._'_ ~;., "_'..~.~"
Contract. Amendment_ for: GOODS,&'SERVICES
Original contract amount
~
$ t'g 3~,
/!/' / A
g. 'ldd. "-&
$ ;;Z 7" bY tfJ tJ, tfL&
----1Q!L % of original contract
Total amount 01 previous contract amendments
% of original contracl
r..,a7, 5' % of original contract
c
t' ..<f77. '" % of original contract
Amount of this contract amendment
TOTAL AMOUNT OF CONTRACT
Is the total aggregate cost change for the Goods & Services contract /'
less than or equal to 35% of the original contract amount? YES NO V
If "No", City Council approval is required. City Council approval was received on 0L"'_~- ::;--:~.&-CJ-q (Date)-
'/ .
Are there any applicable performance or payment bonds and insurance coverages <!!: "'-.....;;<-<--~ (!' <L.r'l" 1<2! -<<L.",iZ..L'If- f<2<!.<L<<i"
that need to be adjusted to account for the change in the contract amount? YES ~ NO _ Not Applicable _ ~
Was the original contract approved by the City Council, or is it exempt?
YES (Approved by Council)
NO (Exempt/Not Required)
< if 7"7 f:::....
(Date)
(Reason for exemption)
Additional information:
Prepared by:
Department:
Not Approved
'fr/.-'Vr! ~ ~.::L ~,
Lee Tuneberg
() t7 -Og -&1 Date: 5~07'
Date:
Form #11 - Contract Amendment Approval Request Form, Page 1 011, 4/29/2009