HomeMy WebLinkAbout2009-128 Contract - CVO Electrical Systems
Contract for Personal Services
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONSULTANT: CVO Electrical Systems, LLC
CONTACT: Jerry Witkowski, P.E.
ADDRESS: 1600 SW Western Blvd, Suite 160
Corvallis, Oregon 97333
TELEPHONE: 541-752-2829
DATE AGREEMENT PREPARED: 09/30/2008 FAX: 541-752-4830
BEGINNING DATE: July 1,2008 COMPLETION DATE: JUne 30, 2011
COMPENSATION: Not to exceed $55,000 per fiscal year and the total of $165,000 for the term of the contract.
Perattached Proposed Hourly Billing Rates for Three-Year Service Agreement dated 08/08/2008 for the fiscal
vears - FY 2008-2009, 2009-2010, 2010-2011. '
, ,SERVICES TO BE PROVIDED: Electrical Enaineerina Services
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 personai 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 reasonabie.
, NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings f 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 arid, 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 State 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 ihe completion date indicated above. '
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the Sum specifil~d
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 compieted and accepted to date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
C~ '
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
performing 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 predominantiy in areas where
it wili be seen by all employees.
9. Indemnification: C9nsultant agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance 01. this contract by Consultant (includin'g but not
limited to, Consultant's ernployees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations,
'actions, costs, iudqments, or other damaqes, directlv, solelv, and proximatelv caused bv the negligence of City.
Contract for Personal Services, Revised 07/01/2008, Page 1 of 9
/
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 maii 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 Consuitant, or at such later date as may be established by City under any of the foliowing
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 reguiations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer aliowable or appropriate for purchase under this contract or are
no longer eligibie 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 termination shall give to the other party
written notice of the breach and intent to terminaie. 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 duiy 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 faiis to provide services called for by this
contract within the time specified herein or in any ex1ension thereof. '
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
additioQ to any other rights and remedies provided by law or under this contract.
e. Obliqation/Liabilitvof Parties, Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabiiities 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 penormed in accordance with the Contract. '
11, Independent Contractor Status: Consultant is an independent contractor and',not an employee of the City.
Consultant shall haye 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 agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant has qualified as a QRF for this agreement; institutes an action for relief in bahkruptcy 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 followihg 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. Professionai Liabilitv 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 Liabiiitv 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
Damaoe, It shall include contractualliabiiitv coveraoe for the indemnity provided under this contract. .
Contract for Personal Services, Revised 07/01/2008, Page 2 of 9
d. Automobile Liabilitv insurance with a combined singie limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1.000.000, or Not Applicabie 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 coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to
the City,
f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its
elected officiais, officers and empioyees as Additional Insureds on any insurance policies required herein but only
with respect to Consultant's s'ervices to be provided under this Contract. 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 wili specify all of the parties who are Additional Insureds. Insuring companies
or entities a(e 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 reiates 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.
CONSULTANT, BY SIGNATLiRE 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. Nonappropriations Clause. Funds Available and Authorized: City has sufficienUunds currently available 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 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 si n the certification attached hereto as Exhibit A and herein incor orated b reference,
CONSULTANT CITY OF ASHLAND:
BY 'i.e; a7~
:.e rr t-t.I~'r~ ~
Print Name
BY
~
FINANCE DIRE OR
TITLE
?P'Y;"'~P4 r
DATE
Il>J{) cJr-
DATE
/,f) /" /&.8
/ ,
Crz' partment Head
Approved as
form by Legal
ACCOUNH '
FederallD#
20- 212- -:>'1/f;'
'Compieted W9 form must be submitted with contract
(F
PURCHASE ORDER # tJ g -"fl7 2>
Contract for Personal Services, Revised 07/01/2008, Page 3 of 9
"
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-g form 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 Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (Hi) the IRS
,has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to. perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria: '
,/
./
/
.r
./
(1) I carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
year.
(6) I assume financial responsibility for defective workmanship-or for service not provided
as evidenced by the ownership of performance bonds, warranties, errors and omission'
insurance or liability insurance relating to the labor or services to be provided.
, , 'rytJ-~L"",~
Contractor '
/0 ;;." ~'/3 '
(Date) ,
Contract for Personal Services, Revised 07/01/2008, Page 4 of 9
, ,
Form W-9 Request for Taxpayer Give form to the
(Rev. October 2007) Identification Number and Certificati~n ,requester. Do not
DeparlmerrtoftheTreasuty send to the IRS.
In'lemal Revenue Service
Name (as shown on your income tax return)
oJ CVO Electrical Systems, llC
m
0> Business name, If different from above
ro
0.
c
0
~" Check appropriate box: 0' IndividuaVSola proprietor 0 Corporation 0 Partnership .
0.5 IZJ UmJted HabJlity company. Enter the tax classification (O-=disregarded entity, C=corporatlon, P=partnershlp) JJ>- J?.~.. o Exempt
~.- payee .
~" o Other(seelnstructions)'"
OS
1:" Address (number, street, and apt. or suite ~o.) Requester's name and address (optionaQ
"\:.5 -
0.0 1600 SW Western Blvd, Suite 160
'"
'u City, state, and ZIP code
~
0. Corvallis, OR 97333
'"
m Ust account number(s) here (optJonaQ
"
C/)
. n Taxpayer Identification Number fTlNl
Enter your TIN in the appropriate box. The TIN provided must match the name given on Une 1 to avoid Social security number
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 hava a number, see How to get a TIN on page 3. or
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, r certify that:
1. The number shown on t~ls 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 QRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below).
Certification Instructions. You must cross out item 2 above if you have been notified by the _IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends,_ you are not required to sign the Certification, but you must
provide your correct TIN. See th nstructions on age 4.
Sign
Here
Signature of
U.S. person ..
General Instructions
Section references are to the lnte a evenue Code unless
otherwise noted.
Purpose of Form
A person who is required to file an Information return with the
IRS must obtain your correct taxpayer identification number (TIN)
to report, for example, income paid to you, real estate
transactions, mortgage Interest you paid, acquisition or
. abandonment of secured property, cancellation of debt, or
contributions y~u made to an IRA.
Use Form W-9 only If you are a U.S. person uncluding 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 simliar to this Form W-9.
Date ~
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
. An Individual who is a U.S. citizen or U.S. resident alien,
. A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
States, .
. An estate (other than a foreign estate), or
. A domestic trust (as defined In Regulations section
301,7701-7),
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners' share of Income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, .and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U,S.
status and avoid withholding on your share of partnerShip
income.
The person who gives Form W-g to the partnerShip for
purposes of estabiishing 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)
August 8,2008
evo
Electrical
Systems, LLC
Mr. Scott Johnson
Operations Superintendent
City of Ashland
90 North Mountain Avenue
Ashland, OR 975520
Subject:
Engineering Services Billing Rates
Dear Scott:
We are very pleased to have the opporhmity to continue providing engineering services to the
City of Ashland. Our current billing rates for General Engineering Services, through the end of
this Fiscal Year (2008/2009) are as listed in the attached Rate Schedule and have been the same
since 2006.
Beginning the next Fiscal Year, 2009/2010 our rates will increase slightly as shown in the
schedule, and also as follow for subsequent fiscal years.
, The current 2008/2009 rates reflect an approximate 10% discount for repeat client work from
our standard rate structure, and although we will have rate increases in-line with the cost of
living increases, we will continue to offer this discount to the City of Ashland.
Should we acquire new staff, depending on their classification, their rates will be in-line with
those noted in the schedule.
It is our goal to offer quality services at reasonable,rates'and maintain clients on a long-term
basis. We hope our products meet the City's objectives and we enjoy working on City of
Ashland project and with the City' 5 staff. Again we are very pleased to have the opportunity
continue working for the City of Ashland.
Please give us a call if there are any questions with our services or rates.
Sincerely,
CVO Electrical Systems, LLC
Jerry Witkowski, P.E.
Principle
1600 SW Western Blvd, Suite 160 III Corvallis, OR 97333 . Phone (541)752-2829 . Fax (541)752-4830
CVO
Electrical,
Systems, LLC
City of Ashland Electric Department
Proposed Hourly Billing Rates For Three-Year Service
Agreement
CVO Electrical Systems, LLC
Submitted 8/8/2008
Classification FY 200,8-2009 FY 2009-2010 FY 2010-2011
Senior Engineer (Principal)
, David Castor $110 $115 $120
,
Jerry Witkowski $100 $105 $110
Engineer
Martin Stoddard ' $85 $90 $95
Junior Engineer $75 $78 $80
,
CAD Tech $60 $63 $65
,
Office Support $50 $53 , $55
Expenses
Direct Expenses billed at cost.
Hourly Rates include all computer and communication charges
160(j SW Western Blvd, Suite 160 . Corvallis, OR 97333 . Phone ,<541)752-2829 . Fax (541)752-4830
-
ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
6/13/2008 '
PRODUCER (541) 757-1321 THIS CERTIFICATE IS ISSUED AS A MA ITER OFINFORMA TION
Barker~Uerlings Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
340 N W 5th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
POBox 1378
Corvallis, OR 97339 "
INSURERS AFFORDING COVERAGE' , NAIC#
INSURED ' , CVO J,le.ctrj,caISystems, lLC INSURERk Hartford Casualty Insurance CO,mpanY ,
, ':'1,6QQ,~Wvvestern Blvd., Suite 160 INSURER B: Twin' City Fire InsufCirice"Company ;
,:',CorVailis, -OR 97333- ,
, :':.'<1..""':."" ,". , INSURERC, U S,Specialty Insurance Compan,y _, -
.",. :
r INSURER 0:
, INSURER E: . , Ii
CVOElEC 01 LIST
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWlTHSTANDIN(;
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCEAFFOROEO BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
~OL1CIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '
INSR DO' ~<^< POLICY EFFECTIVE POI,l-S,V EXPIRATION
POLICY NUMBER LIMITS
~NERAL LIABILITY EACH OCCURRENCE $ 1,000,00
A X COMMERCIAL GENERAL L1ABlLlTY . 52SBATl7259 7/5/2008 7/5/2009 PREMISd YE~~~~~~nce' , , 300,00
I CLAIMS MADE 0 occUR MED EXP (Anyone person) $ 10,00
e- PERSONAL & AnV INJURY , 1,000,00
"- \ GENERAL AGGREGATE , 2,000,00
m'lAGG~EnE LIMIT APrlS PER: PRDDUCTS-COM~OPAGG $ 2,000,00
X POLICY ~!W.; lOC
~TOMOBllE UABILITY COMBINED SINGLE LIMIT , 1,000,00
,A e- At{'( AUTO 52SBA TL7259 7/5/2008 7/5/2009 (Ea .a~ident)
"- ALL OWNED AUTOS . BODIlY-INJURY ,- <-..
- $
- ~~~.~~U.l;,D ~UTOS - ,- (P~r~~n). .. u .. -
~ HIRED AUTOS " ' ,
'.... ,,-', - BODILY INJURY' .. " $ ...-
.!5.. NON-QWNSD AUTOS _.. '. . (P~~'a~ido~I)':::.. -.. '"
,,' ....".'.. 'h" .t .' ,- .. "
- .. - d....
'0- PROP.E.RTY'DAMAGE $
(Per accident)
~RAGE UABIUTY AUTO ONLY - EA ACCIDENT ,
ANY AUTO OTHER THAN EAACC ,
AUTO ONLY; AGG ,
~ESSJUMBRElLA LIABILITY EACH OCCURRENCE $ 1;000,00C
A X OCCUR 0 CLAIMS MADE 52SBA Tl7259 , 7/5/2008 7/5/2009 AGGREGATE , 1,000,000
$
:;i DEDUCTIBLE $
X RETENTION . 10,000 $
WORKERS COMPENSATlO!'l AND X I TVXc;.~Tffr,~"is I IOJ,\'-
B EMPLo.YERS' LIABILITY 52WECNZ9065 7/5/2008 7/5/2009 . E.L EACH ACCIDENT , 500,00C
ANi PROPRIETORIP ARTNERlEXECUTIVE 500,00C
OFFjCERlMEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYEE S
If yes, describe under E.L. DISEASE - POLICY LIMIT 500,OOC
SPECIAL PROVISIONS bolow ,
OTHER
C Professional Liability' US071147103 911/2007 9/112008 1,000,000
DESCRIPTION OF OPERATIONS' LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS ,
CERTIFICATE HOLDER
CANCEllATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3L- DAYS WRITTEN
Attn: Kari Olson
90 North Mountain Ave, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAILURE TO 00 SO SHALL
Ashland, OR 97520- IMPOSE NO OBLIGATION OR UABILllY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTA TlVES.
AUTHORIZED REI:'RESENTATIVE ~-:"'s. ..:s;;.- ~ IS' ~
-
ACORD 25 (2001/08)
@ACORDCORPORATION 1988
ACORD,;, 'CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDD1YYYY)
6/24/2009
PRODUCER (541) 757-1321 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Barker-Uerlings Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
340 N W 5th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
POBox 1378
Corvallis, OR 97339 INSURERS AFFORDING COVERAGE NAIC#
INSURED CVO Electrical Systems, lLC INSURER A: Hartford Casualty Insurance Company
1600 SW Western Blvd., Suite 160 INSURER B, Twin City Fire Insurance Company
Corvallis, OR 97333- INSURER c, U S Specialty Insurance Company
INSURER 0"
INSURER E:
CVOElEC-01 liST
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 OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1$ SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REOUCEO BY PAlO CLAIMS,
~~ ~.o no '.<"04.CO POUCY NUMBER P~4~~~~~~E P~k'.m'f~JJ,~~N , UMITS
~NERAL UABIUTY EACH OCCURRENCE $ 1,000,00
A X COMMERCIAL GENERAL LIABILITY 52SBATL7259 7/5/2009 7/5/2010 PREMISES Ea occurence) $ 300,00
I CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ '10,00
PERSONAL & ADV INJURY $ 1,000,00
- 2,000,00
- GENERAL AGGREGATE $
GEN'L AGG~EnE LIMIT APPlS PER: PRODUCTS - COMP/OP AGG $ 2,000,00
Xl POLICY ~~RT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00
A ANY AUTO 52SBATL7259 7/5/2008 7/5/2009 (Ea accident)
-
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
X (Per accident) $
- NON-0WNED AUTOS
- PROPERTY DAMAGE $
(Per accident)
~RAGE UABIUTY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
:!]ESSJUMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,OOC
A X OCCUR 0 CLAIMS MADE 52SBATl7259 7/5/2009 7/5/2010 AGGREGATE $ 1,000,OOC
:;j DEDUCTIBLE $
$
X RETENTION $ 10,000 $
WORKERS COMPENSATION AND X I T~~~IfJNs ! I Ol~-
B EMPLOYERS' LIABILITY 52WECNZ9065 7/5/2009 7/5/2010 500,00
E.L EACH ACCIDENT $
ANY PROPRIETORlPARTNER/EXECUTlVE 500,00
OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $
~~~61~~s~~~J!~6~s below E.L DISEASE - POLlCY LIMIT $ 500,00C
OTHER
C Professional liability US081,147104 9/1/2008 9/1/2009 1,000,00
DESCRIPTION OF OPERATIONS f LOCATIONS' VEHICLES-' EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
-
City of Ashland
Attn: Kari Olson
90 North Mountain Ave,
Ashland, OR 97520-
CANCElLATtON
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION'
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
--=- ~ S. ..::;>-c ~ '~ - -17 -
@ACORD CORPORATION 1988
CERTIFICATE HOLDER
ACORD 25 (2001/08)
.
h
~~,
CITY RECORDER
Page 1/1
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND,OR 97520
(541) 488-5300
~W~l~~ JDA;Y;E;-~:'~?L::::;
fi'<<-1p-01Nl!JMBER~";,1Xj
7/2/2009 -
09018
VENDOR: 010860
CVO ELECTRICAL SYSTEMS, LLC
1600 SW WESTERN BLVD, STE 160
CORVALLIS, OR 97333
SHIP TO: Ashland Electric Department
(541) 488-5354
90 N MOUNTAIN
ASHLAND, OR 97520
FOB Point:
Terms: Net 30 days
Req, Del. Date:
Speciallnst:
Req. No.:
Dept.: ELECTRIC
Contact: Scott Johnson
Confirming? No
~QUantitVff.~ ftJUnltr;~lr, "' " :,:~ ;',' ~ ,_..~~;Descri-r)tion:; :":~';:~~-:-:l'::: :-:~ ,;.;_~"" ::'<"::;: ~ ,:~~~;f ;.~ G~-:}{UnW:P.rjcErL':~~}11 fL'q~Ext~eiice'!~t\1.~
Engineering Services, Year 2 of 3-year 55,000,00
contract for engineering services, FY
2010
.
,
SUBTOTAL 55 000,00
Bill TO: Account Payable TAX 0,00
20 EAST MAIN ST FREIGHT 0,00
541-552-2028 TOTAL 55,000,00
ASHLAND, OR 97520
rk~~Wccouiit{Numi)er}:;;1r;2J ~~p.rojectlNum6er~ ,~);,~~ ~i L,_fAmorrnt~>~:~_ J '.,' !Acd)lintlNurrf6er},~'~p ;'f;:,: ~l~ro]ectlNiJ'mOe'i';A~~~ [::ii),Q:i1A'nlouniil'Eiit1!
i
E 690,1 1,18,00,60410 55 000,00
,
~ ?' /7 ?:fAf9
A\.ithorized Signature VENDOR COpy
A request for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
THIS REQUEST IS A:
o Change Order(existing PO #
Date of Request I 6-10-2009
Required Date of Delivery/Service' I
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name'
r.\/O FI Fr.TRIr.AI !,;Y!,;TFM!,; II r.
,
1600 SW WESTERN BLVD, STE 160
CORVALLIS, OR 97333
SOLICITATION PROCESS
Small Procurement o Sole Source 0 Invitation to Bid
o Less than $5,000 o Written findings attached (Copies on file)
o Quotes (Optional) o Quote or Proposal attached
CooDerative Procurement 0 Reauest for ProDosal
o State of ORlWA,contract ' (Copies on file)
Intermediate Procurement o Other governmenl agency contract 0 Soecial f Exemot
o (3) Written Quotes 0 Copy of contract ~ttached 0 Written findings attached
(Copies attached) 0 Quote or ProDosai attached
0 Contract # 0 Emeraencv
0 Written findings attached
0 Quote or Proposal attached !
Description of SERVICES
Total Cost
IZl Per attached PROPOSAL Second year pf 3 year contract for engineering services
~. ,...,", ,. --.,. .., '. -.
L
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I
I
[it., :~51~O:O\O]),
L, ,,',
Item # Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
,
, '5tO;l:Ai'.1cosf,l.
- f
0 Per attached QUOTE , ;.,>>,'~: t
I
I
L, ,
[st ...
Project Number - -- --- . - -- ",-".,... ,.
Account Number 690,11.18,00,604100
. Items and services must be charged to the appropriate account numbers for the financiats to reflect ihe actual expenditures accurateiy.
By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can rovided up,on re es: 1\, rrlt A A ,/ / /
, Employee Signal e: .&-. - Supervisor/Dept. Head Signature: ~
G: Finance\Procedure\AP\Forms\8_Requisition form revised.doc
Updated on: 6/1012009