HomeMy WebLinkAbout2009-062 CONT Addendum - Engineered Monitoring
, .
.
ADDENDUM TO CITY OF ASHLAND
CONTRACT FOR GOODS AND SERVICES LESS THAN $25,000
Addendum made this 18th day of Mav
("City") and Enqineered Monitorinq Solutions
, 2009, between the City of Ashland
("Contractor").
Recitals:
A. On October 28. 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 comoletion" and
"modifv the scooe of services".
City and Consultant agree to amend the agreement in the following manner:
1. The date for completion is being extended to June 30, 2009. The work must be
completed prior to the end of the current fiscal year.
2. The scope of services is being modified to include the replacement of a pair of
radios. One radio is damaged, but the radios are paired and EMS recommends both
radios be replaced. The radios are no longer being supported by Geomation. Used
radios will be provided "as- is" with no warranty. The cost for time and materials will not
exceed $4,500.00, per the attached letter dated January 30, 2009.
3. Except as modified above the terms of the agreement shall remain in full force and
effect.
CONTRACTOR:
CITY OF ASHLAND:
BY, ./"'5-:::; :/ ~
Its fPft?tE-:5/()~
BY
~J. ~
Finance Director
" h /0'
. / .
Date
Fed.ID# 8'1-oS1r.:3 "T8S
OR Social Security #
CONTENT REVIEW: m~ D~ruJ t~
/ _ M (City Dept. Head')"'
Date: ? 1<;, '1
Purchase Order # 08627
DATE
s-/; '7/0 "J
Acct. No.: 670-08-15-00-604.130
(For City purposes only)
1- CITY OF ASHLAND, ADDENDUM TO CONTRACT FOR GOODS AND SERVICES <$25,000
Engineered Monitoring Solutions
20345 SW Pacific Highway, Suite 104
Sherwood, OR 97140
503-925-1700 ph
503-925-1701 fax
January 30, 2009
City_ol-Ashland
. Public Works Department
20 East Main Street
Ashland, Oregon 97520
Attn: Mr. Pieter Smeenk, P.E.
Re: Additional Services Requested to Replace MCU Radios
Hosler Dam Failure Warning System
Dear Pieter:
During our site visit on January 6, 2009 we identified the likely cause of the communication problems
between the MCU at the Dam and the MCU at the treatment plant. The radio at the treatment plant
MCU is damaged and no longer functioning properly. Because the Geomation radios are paired, our
recommendation is to replace both radios.
As you know, the Model 2380 MCUs are no longer being supported by the manufacture, Geomation
Inc. However, we have identified a source where we can purchase two used radios that were part of
a system of Model 2380 MCUs that has been upgraded recently. We believe that we can configure
these radios to work with the Hosler Dam system. The radios would be supplied" as-is" with no
warranty. The services that will be required to replace the existing radios with these used radios
include procurement and configuration/testing of the radios, and a site visit to perform the
replacement work.
We estimate the total cost for these services would be on the order of $4,500. A breakdown of the
estimated labor effort and material costs is presented on the attached Table 1. The cost estimate
assumes that the on site work can be accomplished within one 1 0 hour day. We propose to perform
this work on a time and materials basis in accordance with the terms of Purchase Order #08627
dated October 28, 2008. We wduld perform the site visit to replace the radios within 2 weeks
following your notice to proceed.
Very truly yours,
Engineered Monitoring Solutions
by ~ -ffi(;
Greg Dutso
Senior Systems Integrator
Table 1 Work Breakdown and Cost Estimate
-----~
bY,~7~
Barry Myers, P.E.
President
Attachments
CC: File
'"
,::
""
"
>t;
~
w U
... ~
..
" .....
>= 0
'" -
w =
... d.l
'" E
0
(J d.l
'"
0 .!
z
..
z
;:
0
0
'"
..
w
a:
III '"
'" .
a: =
0
;: 'c
...
w "
..J :::
III
;:: E
"
Q
...
d.l
-;;;
0
~
E
"
~
~
c
o . .
-g.2 ~
~~w
.
..
...
€ 'c .
"
" 0:
...
z
w
"
0-
S '"
0 0
w
c
"
. .
Ul ~ .
c=
W ~ c
'" 0
"
'"
I
()
" . .
0
.~ ~ 0
. 0
~ I
>-
'"
o
'"
w
...
'"
()
W
~
Ul
a:
:J
o
I
Z
~
10':;;:
]': ~~j
g5 i::.C' ~~_i
m rn a.. ~i:!
~
I
3!:!c>n;::o,,;'ii;O'';''_.',:~
,,,' 0 " ,." c h.,u c _~_':, ~
!:'l,.!,.::..il:
"I:!: -
:i.:;: ;:j~~:
::';,
" .,.".
i]:~~
l~~ ~ ~~1
i~i
~'::~i;
:;:H~
~ll~~
.",;
'l':;;
;i~~:
~;E;i
;
1;,';
;};:
,-""
::C(:;
~: ~
,~J;;'
.:':r.
;;U:i:
:"z.
:.:,,!
'~:f,:i
.."
!;)j;,
:Jim
:J,'
;,'F
1~I:i!l~i~1
c
E
~
'"
~ j,~i
~ HH!
~~
m~t!
, ~.,,;
.""',
:.'I~I
~ Hi
~i
""
~ ;::ii
!~r,
jF~
~i~:
c.~"
.'1~~
'I"
I:::~:
i.~~
".:'~
~"'"
';=~l
",
.... Ii> '" ,'''~ '<I" :~,'~-
~ f ~ r,"...',.:~,: ~;j~ r~~
UJ '"IS . ;"" ",.,
~~~~njr' h
i:
:;
;::
'"
'"
o
z
'"
'"
"'
'"
...
~
o
z
o
;::
0-
ii:
u
"'
w
o
:!;ij l~!iii !.'1.'.'~.'.. ','.".i:,
'~,;:~j: "
~~ !~1' ~1~~ ~t~
G ~~,1 :t~~ ~t~
!.'.i,'i,,-':~ ~.c ;!~.J:,t,l [t:tj;;i
I " :;;;! .. ~lM!f
,f, '" l!J~l! nill~ ,;""
;J~f
.;."';'
~!
>~~
..
t2~
.,..,,,
''''.
.
.~ "J',
It I
:~' : : ;::1 ~ :-..~'.l~;~.
'_i}
ftr
;:"j
!~;~ ~
~iii; 0
:i!TI,:
;,;i:
"J31 ~ij!~
:,ii:r
:i,~'_
T~ij
,",,,,
!;~S
".j
~~"l
,~.. 0
ITiri;
"I;:
Ii; 0
X
',:;1 . ~
,:.~:
",,,. ^
!;;~~ ::j
~ ~;;:1; .,.,
~~ji: :d w
+,1' i:i'j
;~~~ ..
::"..
.. ,
-:~!itl f,
~g:j
1::,':
~r~.t
~!~Ii
H-""
~~I
"..,',
:::l;:
j~1:!
,,,",, 1
'10'.':
~;C,
l,~ "
r~~ ""
,~"
._',~
I;~ ,e,'
Hliii
,,~'"
:~~m 'ilJi
,,:~"
"""
~i!m :n:'i
'~ ',...,
'i~". ,
0: .. ;"
g
~
o'
~
." ~~
, I
I
~If~i~
i"
c' .J
c
E
~
!
~
o
~
~
~
.
~
E
~
w
~
':liLt,
:~:b~
='i:';'
~~]
ito
.'-i'i;;
::.'.,
~i:j
'!ij;l
"1......
~
o
M
M
o
~~~
""',,
j~~
'.
,'~_b
~~1
'_.'l
~Sm
,','"
t,ljJ.
;~ilir
i~l~
~~~
""1
!in;!
;;:::1
'~,:;r
'n:
il"Ji
iS~
j~:#
,
'.
;,'
:0;;:;
"~I'
,-':,
,
!Ji!;
~lJj
,J
:i~!;~
:i~4~
'i.::1
:,"
, i"
:i
1!17:"~~
e,""'o'o ...
g-~ g:~~~
~ ,~ ;,1
~~~:: ''',:;~
. ;<.':
a:~~~ ~~.
.""'jwon,'
2;51 .c.~:;
~;:-, ).'
1
c
-:.: .:'
., . ,,'
:,~ i~i~~
{: l:F'!
r~~ ~ ~~i:~ ;':''' '''nf,
:.~ I!: "'~~ ell,'" ..,.
~~ :'as C1."'i,' ",".1
,1 i,il tilt';,
.~i~-::U.~' tC.tt.
,...
1
)
lpj
i.I:',
f!;,
:I~:: i
"I~::
i:;~~
,;;
~~~
"""
:;:.1-
,:H!'
"01
',':;'
!iit~
i:~I
;:;
i~~~
::j;j~
:f:0_
-.
QC,
,
; i~'ig
:~ f'
!; ;~'
~
!~
C"
'[
::
.:j~~
-..;;;
jJ~
l~
,)
C<":
d!j~
::
,;:~,
,~
.....,
~.
:':
li
:;
W~
:.'
,:~\,
"".;;
"""i
';;~i'
'''~:
;],,'~
..~:,
:.
'" 0........
~....::;;}
...; --.;
~ ~
d.
'5
~
w
~
0 e "ii
~ 0 0
to ...
~ e ~
;; " .
0 0 ~
~ " u .c
~
0 0 0 :n
~ ~ 0
Q
<:'j
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID BW I DATE. (MMlDOIYYYYI
ENGIN-1. 05/20/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
RIS Insurance Services HOLDER:THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 1059 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Anacortes WA '98221
Phone: 360-293-21.35 Fax: 360-293-2385 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Western National Assurance 24465
INSURER B:
ENGINEERED MONITORING SOLUTION INSURER c:
20345 SW PACIFIC HWY # 1.04 INSURER D:
SHERWOOD OR 971.40 .
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WITHSTANDING
ANY REQUIREMENT. TERM OR CONDlTION 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.
INSR"'";A.UO" TYPE OF INSURANCE POLICY NUMBER Pc'1.~~irir:;rJtf;}!;;E P6.t~CEYr~~~b~,J!RN LIMITS
LTR NSR
~NERAL LIABILITY EACH OCCURRENCE ,
COMMERCIAL GENERAL LIABILITY PREMISES Ea occurencel ,
I CLAIMS MADE 0 OCCUR MEa EX? (Anyone person) ,
- PERSONAL & ADV INJURY ,
GENERAL AGGREGATE ,
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/O? AGG ,
4, (nPRO. n
POLICY JEer LOC
AUTOMOBilE LIABILITY COMBINEO SINGLE LIMIT
-"- S 1 fOOD I 000
A ANY AUTO . CF300003086 1.2/03/08 1.2/03/09 (Ea accidenl)
-
- ALL OWNED AUTOS BODILY INJURY
(Per person) ,
- SCHEDULED AUTOS
~ HIRED AUTOS BODILY INJURY
,
~ NON-OWNED AUTOS (Peracch:lenl)
PROPERTY DAMAGE ,
(PeraccJdenl)
GARAGE LIABILITY AUTO ONLY. EAACClDENT ,
=J ANY AUTO OTHER THAN EA ACC ,
AUTO ONLY: _ AGG ,
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ,
~ ~CCUR 0 ~LAIMS MADE AGGREGATE ,
,
=J ~EaUCT'BLE ,
RETENTION , ,
WORKERS COMPENSATION AND ITORy LIMITS I IU.!Ii-
EMPLOYERS' LIABILITY
ANY PRO?RIETORlPARTNERlEXECUTlVE E.L. EACH ACCIDENT ,
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE ,
If yes, describe under E.L. DISEASE. POLICY LIMIT ,
SPECIAL PROVISIONS below
OTHER
A Physical Damage CA300005750 1.2/03/08 1.2/03/09 $500 DED Comp & Co1.1.
Hired Auto $ 50,000 Limit
OFSCAIPTlON OF O?ERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT I S?ECIAL PROVISIONS
attn:KARI OLSON
541-488-5320
;
i
i
i
I
I
I
I
I
I
,
I
I
i
I
I
i
I
I
CERTIFICATE HOLDER
CANCELLATION
CITY OF ASHLAND
90 N MOUNTAIN AVE.
CITYASl SHOULD ANY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICEi TO THE CERTIFICATE HOL.DER NAMED TO THli LEFT, BUT FAILURE TO DO SO SHALL
IMrO~!:: NO OOL10ATION OR LfADILITY OF ANY KIND U1"ON TIlE IN6UREA, IT6 AC[;;NH. on
REPRESENTATIVES.
AUT 0 REPR TATIVE
@ACORD CORPORATION 1988
ASHLAND OR 97520
ACORO 25 (2001108)
\::I:J-L..l- 1:;1:'" \:J"}, UL 1..llVlJ .J.l.Ul.'_J .J.l'''';;)'-<1 LUlU'--
ACORD CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMltmI'T"YYY)
TM. OS/20/2009
PRODUCER PhDn~: $03-365-7001 Fil~: 503-365-7354 THIS CE~nFICATE IS ISSUED AS A MAlTER OF INFORMA110N
MID VALL.EY GENERAL AGENCY lLC ONLY AN!) CONFERS NO RIGHTS UPON THE CERTlFICATE
4305 RIVER ROAD N ~~~~R. Tl'iIS CERTlFICA TE DOE7 ~3T AMEND, EX~~?, ~~
KEIZER OR 97303
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: SCOTTSDALE INSURANCE COMPANY 41297
ENGINEERED MONITORING SOLUTIONS lLC INSUR5R.B:
20345 SW PACIFIC HWY, SUITE 104 INSURER c:
SHERWOOD OR 97140
INSURER D:
INSURER 1:::
COVERAGES
THE POLICIES OF INSlIRANCE: LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCYPERIOD INDlCAH.D, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCU,'.\ENT vl,rlli RESPeCT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR.
MAY PERTAIN, THE INSURANCE MFOROE.-P 8Y tHc POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE T~~MS, E:\.Cl.USJON$ AND CONDITIONS OF SUCH
POLlCIIOS. AGGREGATE. LIMITS SHO'M\' MAY HAVI:: BEEN REDUC~().BY PAID CLAIMS,
IrleR. t.,DD'L TYPE OF INSURA,Nce POLlC'/' NUMBER ~!\~~ ~~~~~~ p~;~J,~W=~ LIMITS
em "OR
G!;:NeRAI.1.1A6IU1'I' CLS1296015 12/03/08 12/03/09 "tACH OCCURRE.NCE . 1!000,OOO
X COMMEP.C1AL GENERAI.1.1II.6111TY ~~E1~E~~<znc.li . 100,000
I CLAIMS MADE 0 OCCUR MED. E.XP (Anyone paf6(0) $ 5,000
A r- PERSONAL & ADV INJURY . 1,000,000
GeNgRAl.AGCRECATE , ~,OOO,OQO
r-eEN'L AGGREGATE LIMIT APPLlE:.S PER; PRODUCTS.COMPIQP AOG. , 2,000,000
h-POLlCY n j~?r nLOC
~MOElILE LIABILITY COMBINED SINGLE: LIMIT .
(EllSccldenl) .
e- Nl',' AUTO ,
ALL OWNED AUTOS aooll.Y INJURY
'-- (Pttrptt~on) S
$CHED\J\..ED AUTOS
-
- HIRED AUTOS BOPII- Y INJURY
NON-OWNED AUTOS (ptI(<iccidttnl) S
-
- PROFcRlY DAMAGE S
lP~r ;:II::cidl:lnl}
GARAGE L1ABIUTY A\ IT" -ri"~,,';.-;-~,,-- A;'CIO-ENT - S. --. u__ .-
~ AN'( AUTO .u -..-
OTHER THAN EAACC .
I - AuTO ONLY: AGG .
~-'~._'~- E.ll,CH OCCURRENcE S
OCCUR D CLAIMS MADE AGGREGATE S
.
I DEDUCTIBLg ,
RETENTlotJ S ,
IWORJl;EFlS COMPENSATION AND I ~~~T~~e I 10000R
EI.1PLOYER$' UABILITY
AN"f PROPRll!:TOWPloRT"'EIlJE.lECUnvE E.L. EACH ACCIDENT .
Offl<::EIlIME.M8Efl.E)(<':;WP~O-1 E,L. DISEASIi_EA ~MPI,.OYI>e: ,
II Y"-/>, ,j,u~".I,,", ..~d". E,L. DISEASE.POLlCY LIMIT ,
::lPt-CI!\L PROVISIONS ~elo~
OT'HER:
DESCRIPTION OF OPERATIONS/LOCATIONSNEHIClES/EXCLUSIONS ADOED BY ENDORSEMENT/ SPECIAL PROVISIONS
CITY OF ASHLAND IS INCLUDED AS ADDITIONAL INSURED PER CG2010(7/04)
CERTIFICATE HOLDER
CANCELLATION
CITY OF ASHlAN"D SHOULD ANV OF THE ABOVE DESCRIBf.D POLICIES aF. CANCELLED BEFORE THIO
90 N MOUNTAIN AVE 1:;1';F'lftATlON DATE THEREOF, THE ISSUING INSURER 'MLL ENDEAVOR 10 MAIL 30 DAYS
WRITTEN NOTICE TO 1'Hl: cemlFICATc HOLDER NAMED TO THE Le~, BUT FAIl.URE TO
ASHLAND, OR 97520 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANV KlNP UPOO THE INSURIiR, rrs
AGEl'll'S OR REPRESENTATIVES.
AUTHORizeD REPRESENTATIVE .
MID VALl.fY GENERAL AGENCY f-l ~ ::() ~;
LLC
2
Attention: KARl OLSON Herman R Deiss
ACORD 25(2001/08)
Certificate #
41365.
@ACORDCORPORATlON 1988'
05-21-'09 09:32 FROM-Slater Insurance
5036240H4ti
I-~61 r~l!~6 U-~D~
ACORD,. CERTIFICATE OF LIABILITY INSURANCE I DATE: (MMIDDfrrY'f)
0>/21/2009
PROOUCER (>03)624-0466 FAX (503)624-0846 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Sl~ter & Assoc, In~urance. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P,O, Box 1462 ALTER THE COVERAGE AFFORDED BY THE' POLICIES BELOW.
Tualatin, OR 97062-1469
Dee Tudor INSURERS AFFORDING COVERAGE NAIC#
INSUR~D INSU!:I!:;RA SAIF Corp
INSURER B:
Engineered Monitoring Solutions LLC INSURl>R c;
20345 SW Pacific Hwy Suite 104 INsuRER D:
Sh~rwood. OR 97140 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED B!:l,.OW HAVE BEEN ISSUED TO THE INSURED NAMi?:D 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 aE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCI<IBE:D HEREIN IS SUBJECT TO ALL rHE TERMS, EXCI.USIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE llMITS SHOWN MAY HAVE BEEN REDUCE;O BY PAlO CLAIMS.
rN-S.R'AD~.~ TYPE Of INSURANCE POLICY NUMBER po,,~r'''''mJYg: b~tlf~~b~~~~ LIMITS
LTR INSR OATE MM/DO!YYY
GENERAL L1ABILln' EACH OCCURRE.NCE I
- rJAMAGE'ffl'"R=, w
COMMIORCIAL GE:NERAL LIABILITY PREMISES IEaOCC\lrrenCJ3\ I
I CLAIMS MADE 0 OCCUR MED EXP (.Any em. p,m;on} I
-- - PERSONAL S. AOV INJURY ,
- GENERALAGGR6GATE I
GEN'L AGGREGATE LIMIT APnSIPER: PRODUCTS - COMP/OP AGG ,
-C.-1 .f'''f PRO-
POLICY ,IEeT LOe
eOMOelLE L""ClTY em.mlNED SINGLE LIMIT ,
ANY AUTO (EaaccldtlJ'1l}
i ALL OWNED AllrOS BODILY INJURY
,~ (Perp&rson) ,
SCHEDULED AUTOS
I I---
HIRED AUTOS BOOIL Y INJURY
.-. I
NON-OWNED AUTOS (Perecc.ldel'lll
f--
f-- PROPERTY' DAMAGE ,
(Peraccldenl)
. ~GE. LIABILITY AUTO ONl..Y -fA AGCIOtNT ,
) ANY AUTO -. .- -- .OTHERTHAN EA ACe .
-:--r-r ._~___.n._
AUTO ONLY: AGG ,
pESS I UMBRELLA LIABILITY EACH OCCURRENCE .
OCCUR 0 CLAIMS MADE AGGREGATE ,
R: ,
DEDUCTIBLE I
RETENTION , .
WOfl.I(ERS COMPENSATION ~58900 12/01/2008 12/01/2009 X I T'6~ ,I IU~~
AroIO EMPLOYERS' Ll~BI!..ITY . Y I N LI
A ANY PROPRI~TORlPARTNERfEX.ECUTIVED E.l. EACH ACCIOENT . 1,000 000
OFFIC12R1MEMBER EXCLUDED?
(ManoMoryln NH) E.L DISEASE - EA ~MPl.OY~E I 1 000,000
Ilf v..~, dO-'ionbG under 11000,000
i SPECIAL P~OIJISIONS billow g.!.., DISEASE - POLICY L.IMIT .
! OTHER .
I
DESCRIPTION OF OPERATIONS I LOCATIQ'-'S I VEHICLeS/ E.x:CLUS.10NS liDDED BY ENoORSEMENT I SPECIAL PROVISIONS
..
CERTIFICATE' HOLDER CANCELLATION
SHOULD ANY OF TI-IE: ABove Cle$C~leED POLICIES BE CANCELU;:b 6cFORE THE EXPIRATION
DATe THEREOF, 'THE I$SUINClII\lSURER WILL ENP~VOR TO MAll ~ DAYS WRITTEN
CITY OF ASHLAND NonCE TO THE CERTIFICATE HOLDER NAMED to THE LEfT,.BUT FAtLURt! 'fa DO so SHALL
Attn: Karl Dlson IMPOSE NO OaUGATION OR I.IABlllTY OF ANY' KIND UPON THE INSURER, ITS AGENTS OR
90 N Mountai n Ave REPRESENTAtiVES.
Ashland, OR 97520 AUTHOf\r,GED REPRESENTATIVE /)R.L TMrJY
I Dee Tudor 10MT It,
ACORD 25 (2009/01) FAX: 541.488.5320 @1988-2009ACORD CORPORATION. All righn. r...",ed.
The ACORD name and logo are registered marks of ACORD
~~-n -' ~~ ~~: jj l' I1UI"J-j~a"( er HlSUrdfJC;e
.
POLICY NUMBER: CLS1296015
ENGINEERED MONITORING SOLUTIONS LLC
::J~wUL.'-j\:10'-jU
1 .....U.l. 1 \'J-.Jf "-'oJ V UV'"
COMMERCIAL GENERAL LIABILITY
CG 20 10 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person!s)
. Or Oraanizationlsl: Loc3tion(s) Of Covered Ooerations
CITY OF ASHLAND
90 N MOUNTAIN AVE
ASHLAND, OR 97520
POLICY PERIOD: 12.03-2008 TO 12-03-2009
Information reQuired to comclete this Schedule, if not shown above, will be shown in.th'e Declarations.
A. Section II - Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property
. damage" or "personal and advertising injury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s) desig-
nated above.
B. With respect to the insurance afforded 10 these.
additio"nal insureds, the following additional exclu-
sions apply:
This insurance does not apply to "bodily injury" or
"property damagell occurring after:
1. All work, including materials, parts or equip-
ment furnished in connection with such work,
on the project (other than service, maintenance
or repairs) to be performed by or on behalf of
the additional insured(s) at Ihe location of the
covered operations has been completed; or
2. That portion of "your work" out of which the
injUry or damage arises has been put to its in-
tended use by any person or organization other
than another contractor or subcontractor en-
gaged in performing operations for a principal
as a part of the same project.
Pag9 1 of 1
CG20 10 07 04
@ ISO Properties, Inc" 2004
o
Page 1/1
~~,
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY RECORDER
;_'~_;_;%,_~'JDATE:. ::-~-{/}t~~:; ;,;:; PO'lI\.JLirJfEn~:FeJ ,::
10/28/2008 08627
VENDOR: 009478
ENGINEERED MONITORING SOLUTION, LLC
20345 SW PACIFIC HWY STE 104
SHERWOOD, OR 97140
SHIP TO: Ashland Public Works
(541) 488-5587
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Pieter Smeenk
Confirming? No
~: \'Ouaiitiit>t3 f'<unft':~.' ..:>-r:,=-,'~;.-r;';'~ T ;"^ .~-'~-;"1r,-'-{~:~:_~~L~::. -Bes~crinfion~'. l--CZ'~ ' .~'~:,::';'~r. -'''-,'',..._'; -i"i::';-~;'.:;1:nfi1ifFificel>:':':
;F"_,_l.JEx't.~F?-fice~,:."!t::
THIS IS A REVISED PURCHASE ORDER
Siren Maintenance, Per attached
proposal dated August 20, 2008
4,469.00
Contract for Services
Date of agreement: 10/28/2008
Beginning date: 11/03/2008
Completion date: 02/03/2009
Processed change order 05-14-2009
Radio at WTP is damaged, Geomation
radios are paired and EMS recommends
replacing both radios. This model radio
is no longer being supported by
Geomation. Used radios are beinQ
purchased "as-is" with no warranty.
Cost estimate for time and materials IS
,.
$4,qOO.00. Per attached Letter and
Table 1 Work Breakdown and Cost
Estimate dated January 30, 2009.
4,500.00
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
8 969.00
0.00
0.00
8,969.00
~~~,~1A'Cc~OUI{t1Numl)_er;~~~~ 5r~~fojErCrN'umbe;!~2!~t t;M~.t~lfAmoTIf1t'-~:i~~gffi''i "~~"?fA'~"'.!: ._~=~._-_....-,:~. ''''~:''';y' )l"iK~~'\':V"-' --,;_.~:"",-,.... -- ''"'-'''''-'''-',';}
,,\!..::_::.t,"f ;~b~';Arr'-our{f~G~l!
;J"j,:~cc-ount-jNuml:jer~~~;:.1 :...,.f,.:<.:,:;f?roJect!Number'~r.t:ot'J.,~I
E 670.08. 1 5.00.6041 3 E 200124.400 8 969.00
--:-
,
~
~ "o/"/'
A horized Signature
VENDOR COpy
I FORM #11 I
,GOODS: AND S'ERVI:CES
-.-...\.. _._':'.;:~. ~:. ,;.> ;.,~'...' . --~..--.'.- -.' .=...-..",,',-' .', ..
CHANGE ORDER/CONTRACT AMENDMENT
APPROVAL REQUEST FORM
.CITY OF
ASHLAND
Description of Change Order I Contract Amendment to original contract
Contractor: ~"f/,,.tu><bY'<L--<t ?--11.,I.--t-u.:i!-,Jr< ''ff- .;::)]; t'",<. ~(' eX-
Purchase Order Number: 6/ @ .6 P- 7
Description: /:J ~ /?
C:::.-,?! -?{ {"-r a e.-~.rY C.J7J r.., up c a e..-e-
rP ~ r cJ-if /(;{ c& ~ eJ .
~r attached contract amendment
...~. ..~-.. . ,. .., ,--. .-. ,.c<- ''',' :', '. "~.. ..:' ..... .-:' , .:-in-'~-"_ ~ .._,' ,- .'. ~ - '. . '," .. V" _~. ,,' -, -:. . _j
'Contract:~mendri1entfot.'.GOODS & SERVICES
$ ~~6-q,
Co
c:-->
Original contract amount ~.y"-"'-"-
. V'h t1LL,,,-:>{Z-.
Total amount of previous contract amendments
'If!?d'f' e",-U!-
Amount of this contract amendment t" <u<_v, "7J
. ra.d:..("..e
TOTAL AMOUNT OF CONTRACT
~ejcJ~; ,!1.,&
$ @96'7. cfl '"
Is the total ag9regate cost change for the Goods & Services contract
tess than or equal to 350/6' of the original contract amount?
:;;notiJJ:af!19~Dt(o'fl~hlrl!J~'orMr: '"
~ . ",JW'jY/J 'L
'rt ..:. ',~ :j~~: .<',,: :.
~) ~~;;O,;,a...ej "
~ ".
f(.,-
. "
"l'I.'
';'
,. ..... ,,_to.
~ % of original contract
% of original contract
(' d-<'f') % of original contract
;;:;:cfl-eJ % of original contract
YES_NO ~NotApplicable_
C7.6 -CJ ,:2- CJ '7 (Dat@
Are there any applicable performance or payment bonds and insurance coverages
that need to be adjusted to account for the change in the contract amount? YES _ NO .-- Not Applicable
If "No', City Council approval is required. City Council approval was received on
Was the original contract approved by the City Council, or is it exempt?
YES (Approved by Council)
NO (Exempt/Not Required)
(Date)
<: ~7/C
(Reason for exemption)
~ 'V"l~ PleasecirCI.e:
~..~ / 6/L4--.:-''__ .
_ . ~~ Not Approved
~<Ltc<L~^- '" ) ~ cA- If? 0-
' Y Lee Tuneberg
OC;--c:<.CJ-~=1 Date:: ~.b/;/
Additional information:
Prepared by:
Department:
Date:
Form #11 - Contract Amendment Approval Request Form, Page 1 of 1,5/20/2009
A request for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
'-"
Date of Request:
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
SOLICITATION PROCESS
Small Procurement D Sole Source D Invitation to 8id
g Less than $5,000 D Written findings attached (Copies on file)
D Quotes (Not required)
CooDerative Procurement D Reauest for Prooosal
D State of ORfWA contract (Copies on file)
Intermediate Procurement D Other government agency contract D Special I Exemot
D (3) Written Quotes D Copy of contract attached D Written findings attached
(Copies attached) D Emeraencv
D Contract # D Written findings attached
Description of SERVICES
R:tf~~T Of ~\~~\~(;, m'DS 11-\AT
fArt.~J) w I L\ 'IX kl\ID . .
Per attached PROPOSAL
Total Cost
,"
'$ -
~--4-.~."
~,4~tX4 .
'CL\~:_-.'~::~,~,i~T~ ~. '. :
Item # Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
--c-
Project Number _ll L _ . _~"i
''":TOTAt'COST (
; l' . r -~ o;:-~; ~,~;~ r~.,~b~~~'~;
~ . ~.' - '., .f,'
'0 .~. _'.~ "} ~;~
$, .. ".\.. _ A'':1
r
~ Per attached QUOTE
Account Number6.1l2. .re. L'S. 00 - maD
. Items and services ;;,Js1 be charged 10 the appropriale accounl numbers lor the linancials to reflect Ihe actual expenditures accurately.
By signing this requisition fonn, I cerlify that the i formation provided above meets the City of Ashland public contracting requirements,
and the documentation c rovid u on re uest. I
Employee Signature: SupervisorJDept. Head Signature: -{\(\., ~~ \l ~r"---
G: Finance\Procedure\AP\Forms\8_Requisition form revised.doc
Update<! on: 11/7/2008