HomeMy WebLinkAbout2009-154 Contract - Harrang Long Gary Rudnick
CONTRACT FOR PERSONAL SERVICES
FY 2009-2010
CI TY OF CONSULTANT: Jens Schmidt
ASHLAND CONTACT: Harrang Long Gary Rudnick P,C,
20 East Main Street ADDRESS: 360 E, 10th Ave, Suite 300
Ashland, Oregon 97520 P,O, Box 11620
T elephone:~541-488-6002 Eugene, OR 97440-3820
Fax: 541-488-5311
TELEPHONE: (541) 485-0220
DATE AGREEMENT PREPARED: FAX: (541) 686-6564
BEGINNING DATE: 07/01/2009 COMPLETION DATE: 06/30/2010
NORMAL COMPENSATION: $285.00 per hour for Bob Steringer; $350.00 per hour for Jens Schmidt; $235.00 per
hour for Jona Maukonen; $120.00 per hour for paralegals. Rates for attorneys or paralegals within the firm will be
reduced bv 10% for lenal services, Travel rates will be reduced bv 50% of the normal rate,
SERVICES TO BE PROVIDED: See Exhibit C
ADDITIONAL TERMS: Not to exceed $ 15,000.00
FINDINGS: Pursuant to AMC 2.52.040E and AMC 2,52,060, after reasonable inquiry and evaluation, the undersigned
Department Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not
have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's
plan for utilization of such personal services; (4) the undersigned Contractor 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 Contractor's proposal will best serve the needs of the City; and (6) the
compensation negotiated herein is fair and reasonable. This Contract is exempt from formal competitive selection
procedures pursuant to AMC.2,52.050.E.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONTRACTOR 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 Contractor: Contractor shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Contractor 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: Contractor shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Contractor for service performed, including costs and expenses, the sum specified
above, Once work commences, invoices shall be prepared and submitted by the tenth of the month for work
completed in the prior month, Payments shall be made within 30 days of the date of the invoice. Should the contract
be prematurely terminated, payments will be made for work completed and accepted to date of termination,
6, Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall 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. Livinn Wane Renuirements: If the amount of this contract is $18,088 or more, Contractor is reouired to complv with
Contract for Personal Services Approved for FY 2009-2010
Page 1 of4
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. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Contractor 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 of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor 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 Contractor, 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 reguiations 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 Contractor 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 Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice,
ii. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach may at any time terminate
the whole or any part of this contract if Contractor 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. Obliaation/Liabilitv of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardiess whether such notice is
given pursuant to subsections a, b, cor d of this section, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Contractor 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 Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Contractor is an independent contractor and not an employee of the City,
Contractor shall have the complete responsibility for the performance of this contract. Contractor shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Contractor is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Contractor 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. Contractor shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all
ersons em 10 ed b them, and the a roval b Cit of an assi nment or subcontract shall not create an
Contract for Personal Services Approved for FY 2009-2010
Page 2 of 4
contractual relation between the assignee or subcontractor and City.
13. Default, The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; its ORF status pursuant to the ORF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a ORF if
Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the 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, Contractor shall at its own expense provide the following insurance:
a. Worker's Comoensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. Professional Uabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each 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 Uabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
d. Automobiie Uabililv insurance with a combined single 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 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 Contractor or its insurer(s) to
the City.
f. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor 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 Contractor 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 Contractor 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. Contractor, 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.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
17. 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. Contractor
understands and aorees that City's oavment of amounts under this contract attributable to work performed after the
Contract for Personal Services Approved for FY 2009-2010
Page 3 of 4
CITY OF ASHLAND:
BY
BY
~ ~ .f'~
FINANCE ECTOR
Signature
Jens Schmidt
Print Name
Lee T uneberg
TITLE
President
DATE
? Izs- / Uc?
/ I
DATE
-/~
. / S- I 02009
I
CONTRACT AWARD AND FINDINGS DETERMINED BY:
By: Richard Appicello
93.0844033
City Department Head Date:
710-01-03-00-604100
FederallD#
ACCOUNT #
(For City purposes only)
Completed W9 form must be submitted with contract
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 Contractor, with no further
liability to Contractor.
Certification. Contractor shall siqn the certification attached hereto as Exhibit A and herein incorporated bv reference.
Contract for Personal Services Approved for FY 2009-2010
Page 4 of 4
OREGON WORKERS' COMPENSATION
CERTIFICATE OF INSURANCE
~'m...
~m:0.'C;:O~~iirf-
"..sal.
rc ~cbrporation
CERTIFICATE HOLDER:
CITY OF ASHLAND
ATTN: LEE TUNEBERG
20 EAST MAIN STREET
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named below for the policy
period indicated. The insurance afforded by the policy described herein is subject to all the terms,
exclusions and conditions of such policy.
POLICY NO.
277075
POLICY PERIOD
01/01/2009 TO 01/01/2010
ISSUE DATE
07/13/2009
INSURED:
HARRANG LONG GARY RUDNICK PC
PO BOX 11620
EUGENE, OR 97440-3820
BROKER OF RECORD:
LIMITS OF LIABILITY:
Bodily Injury by Accident . $l,DOO,OOO
Bodily Injury by Disease $1,000,000
Bodily Injury by Disease $1,000,000
each accident
each employee
policy limit
DESCRIPTION OF OPERA T10NS/LOCATlONS/SPECIAlITEMS:
IMPORTANT:
The coverage described above is in effect as of the issue date of this certificate. It is subject to
change at any time in the future.
This certificate is issued as a mailer of information only and confers no rights to the certificate holder.
This certificate does not amend, extend or alter the coverage afforded by the pOlicies above.
AUTHORIZED REPRESENTATIVE
PJr?}>- Jf~
President and CEO
@SAIFCORPORATION 1400 High Sl SE I Salem, OR 97312 I P: 800.285.85251 www.saif.com
Oregon
State
Bar
PROFESSIONAL LIABILITY FUND
2009 CLAIMS MADE PLAN
DECLARATIONS
Jens Schmidt
Harrang Long Gary Rudnick PC
360 E 10th Ave Ste 300
PO BOX 11620
Eugene, OR 97440
CERTIFICATE NO. 843417
NAMED PARTY:
Jens schmidt
COVERAGE PERIOD:
January 1, 2009 through December 31, 2009 unless terminated by the
Named party at an earlier date pursuant to PLF policy 3,400
. RETROAcrIVE DATE:
September 1, 1987
LIMITS OF COVERAGE:
$300,000 Aggregate / $50,000 claims Expense .Allowance
as provided in Section V and Section VI
DEDUCTIBLES:
NONE
Your copy of the 2009 claims Made plan is published in your 2009 oregon
State Bar Membership Directory and on the PLF website, www.osbplf.org.
please call us for a separate large print copy.
WARNINGS
This is a Claims Made Plan. This plan contains prOV1Slons that reduce
THE Limits of Coverage stated in the plan by the costs of legal
defense. See sections IV and VI of the Claims Made Plan.
various provisions in this plan restrict coverage. Read the entire
plan to. determine rights, duties, and what is and is not covered.
PROFESSIONAL LIABILITY FUND
M2J11na AddN!5S:
PO BOl( Z316CO
Tlgartl. OR 97281-1600
T~IP.nhnM NurrtbN
Accoonling Dired Ni.IIWer. 503924-1771
TOLL FREE IN OREGON 1-&00-452-1639
Fax: 503 62o.B637
SlI'P.l!'IAddress.:
SUile300
16037 SW Upper Boone5 Ferry Road
r,gard, OR 97224
WWtNnsbDUoro
Homeland Insurance Company of New York
One Beacon Lane
Canton, MA 02021
f1,
One Beacon~
r~SnR^1"iCe
DECLARATIONS
POLICY NUMBER: LSX-0211-09
Lawyers' Professional Liability Excess Policy
THIS SURPLUS LINES POLICY IS WRITTEN ON A CLAIMS MADE AND REPORTED BASIS. TO BE
COVERED, A CLAIM OR SUIT MUST BE FIRST MADE OR BROUGHT ANO REPORTED TO THE
COMPANY DURING THE POLICY PERIOD, OR SIXTY (60) DAYS THEREAFTER, OR DURING AN
EXTENDED REPORTING PERIOD IF APPLICABLE. THE LIMIT OF LIABILITY AVAILABLE TO PAY
JUDGMENTS OR SETTLEMENTS WILL BE REDUCED AND MAY BE EXHAUSTEO BY AMOUNTS
INCURRED AS CLAIM EXPENSES. DEDUCTIBLES APPLY TO CLAIM EXPENSES. PLEASE REVIEW
THE POLICY THOROUGHLY,
Item 1. Named Insured and Mailing Address:
Harrang Long Gary Rudnick, PC
360 E. 10th Ave., Ste. #300, PO Box 11620
Eugene, OR 97440
Item 2,
From: January 1, 2009
To: January 1, 2010
lIem 3, Limit of Liability:
$4,700,000 Each Claim
$4,700.000 Aggregate
12:01 a.m. Standard Time at the Named Insured's
Address slated in Item 1.
.
Item 4, Deductible:
$25,000 Each Claim
N/A Aggregate
'Where applicable pursuant to Insuring Agreement
Section I.B.
Item 6, Underlying Insurance:
$300,000 Each Claim
$300,000 Aooreoate
Item 5, Retroactive Date: None
Item 7. Premium: $56,133
~ Gross Premium: The Company will pay a percentage of the premium shown above as
brokerage commission. The Company does not pay contingent or deferred commissions. Consult your
broker for information concerning commission.
_ Net Premium: The premium shown above is net, and the Company will pay no brokerage
commission of any kind thereon.
Item 8, Named Insured Is a:
~ Corporation
Individual
_ Sole Proprietorship
Other:
lIemS,
Optional Extended Reporting Period:
$70,166 12 Months
$103,846 24 Months
$112,266 36 Months
$168,399 Unlimited
w Partnership
LLC I LLP
These Deciarations, the application and its attachments, and the policy together with all endorsements
thereto constitute the entire agreement between the Company and the Insured(s).
Homeland Insurance Company of New York
By:
-r: tv.. tr.~
January 13, 2009
Its Authorized Reoresentative
Date:
PF0006 (Ed. 11-06)
Page 1 of 1
ACORD. CERTIFICATE OF LIABILITY INSURANCE I DATE (MWDD'Y'NY)
~ 03/10/Z009
PRODUCER (541)484-66Z4 FAX (541)686-Z7Z6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Pacific Benefit Consultants, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
450 Country Club Road #330 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Eugene, OR 97401
INSURERS AFFORDING COVERAGE NAIC#
INSURED Harrang Long Gary Rudnlck PC . INSURER A:. American Economy Insurance 19690
360 E lOth Ave Suite 300 INSURER B:
PO Box 116Z0 INSURER c:
Eugene, OR 97440 INSURER 0;
INSURER E;
I
I
i
I
I
I-
I
I
I
I
,
COV","AGES
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. ..
INSR DO' TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY OZCE19Z85ZZ 04/14/Z009 04/14/Z010 EACH OCCURRENCE $ 1,000.000
~ I g~~~JO RENTED
X COhVdERCIAL GENERAL LIABILITY $ ZOO,OO
.....:....:... h ClAIMS MADE 0 OCCUR MED EXP (Any one person) $ 10,00t
A PERSONAl & ADV INJURY $ Excluded
- Z 000 000
- GENERAL AGGREGATE $
m'L AGGREGATE LIMIT APASIPER: PRODUCTS - COMP/OP AGG $ Z 000 000
(n ~Ro-
X POLICY JECT LOC
~TOMOBlLE LIABIUTY COMBINED SINGLE LIMIT $
I-- ANYAUTO (Eaaccldoot) 1 000 000
AlL OWNED AUTOS BODILY INJURY
f- OZCEl9Z85ZZ 04/14/Z009 04/14/1910 (Par PfnOn) I
SCHEDULED AUTOS
A "x
HIRED AUTOS BODILY INJURY
"x $
NON.()WNED AUTOS (Par accident)
f-
f- PROPERTY DAMAGE $
(Per accident)
RRAGE UABlUTY AUTO ONLY. EA ACCIDENT $
Am AUTO OTHER THAN EA ACe I
AUTO ONLY: AGG I
EXCESSlUMBREllA LIAB1UTY EACH OCCURRENCE I
rrOCCUR 0 CLAIMS MADE AGGREGATE I
I
=i ~EDUCTlBLE $
RETENTION $ I
WORKERS COMPENSATION AND WC STATU: I 10TH-
EMPLOYERS'LlABIUTY
ANY PROPRIETORJPARTNERlEXECUTIVE E.L. EACH ACCIDENT I
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYE I
g~~~'t~~Q'NS bekwi E.L. DISEASE - POLICY LIMIT I
OntER
DESCRlPnON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAl. PROVISIONS
Except 10 days notice of cancellation for non payment of premium
SHOULD AHY OF THE ABOVE DESCRIBED POLICIES BE CANCELlED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NonCE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT,
BUT FAILURE TO MAil SUCH NonCE SHALL IMPose NO OBLlGAnON OR LIABilITY
City of Ashland
Attn: Lee Tuneberg
ZO East Main Street
Ashland, OR 975Z0
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
CY.<lU/ /)<YLeruv
Pat Koreen PK
ACORD 25 (2001/08)
eACORD CORPORATION 1988
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury,
certifies that (a) the number shown on the attached W-9 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 (iii) the IRS has notified it that it is no longer subject to backup
withholding, Contractor further represents and warrants to City that (a) it has the
power and authority to enter into and 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:
(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,
Contractor
(Date)
Fo<m W-9
(Rev. 0c10be.- 2007)
Departmelrtot1heTreasury
~emalRwenueStrvlce
Name (as shown on your Income tax retLXn)
Harrang Long Gary Rudnick
Request for Taxpayer
Identification Number and Certification
oJ
.
'"
.
0-
"
o
P,C.
BIJSlrw!$S name. If different from above
Give fonn to the
requester. Do not
sand to the IRS.
CII- lit Check appropriate box: 0 IndividuallSole proprietor IX! Corporation 0 PartnershIp
..& 0 0 Exempt
~;J Umited liability company. Enter the tax classiflca1ion (DsdIsregan:led errtfty, C=coIpora.t1on, P=partnershlp) ~ __m.. payee
s~ 0 """'...~~
C.5 Address (number, street. and apt 01', suite no.) Requestar's name end address toptJona~
;t u 360 E. 10th Avenue, Suite 300.
S
g City, state, and.ZIP code
Ii Eugene, OR 97401
g Ust account nLn1ber(s) here (optional)
Cf)
Tax a er Identification Number
Enter your TIN in the appropriate box. The TIN provk:led must match the name given on Una 1 to avoid
backup withholding. For IndMdual9. this Is your social security number (SSN). However, for a~resident
alien. sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other entities, It is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
I Soc~ sei rwmier
or
Employer IdanUfleation number
93 :0844033
Certification
Under penalties of peqwy, I certify that
1. The number shown on this form is my correct: taxpayer identification number (or I am waiting for a number to be. ~uad to me), and
2. I am not subject to backup withholding because: (a) I am exempttrom backup withholding, or (b) I have not been notified by the Intemal
Revenue Service ORS) that ] am subject to backup withholding as 8 result of a faIlure to report all interest or dIvidends, or (c) the IRS M.S
notffled me that lam no longer subject to backup withholding, and
3. I am a u.s. citizen or other U.S. person (defined below).
Certification insb'uctions. You must cross out Item 2 ~e rr you have been notified by the IRS that you are currently subject (0 backup
withholding because you have fculed to report aIJ interest and dividerlds on your tax return. For real estate transactions, Item 2 does not apply.
For mortgage Interest paid, acquisition or abandonment of sewred property, cancellation of debt, contributions to ail indMdual retirement
arrangement ~RA). and generally, payments other than interest and cflVidends, you are not requIred to sign the Certification, but you mlJSt
provide your correct TIN. See the instructlons on page 4.
Sign I Sign..... of <l . rJ
Here . u.s.penon ~ '~ I ~
General Instructions
Section references are to the Internal Revenue'Code unless
otherwise n'oted.
Purpose of Form
A person who is required to ~re an information retum with the
IRS must obtaln your correct taxpayer Identification number (TIN)
to report. for example. income paid to you, rem estate
transactions, mortgage Interest you paid, BCQuisitlon or
abandonment of secured property. cancellation of deb~ or
contributions you made to an IRA
Use Form W-9 only If you are a U.S. person ~ncJudlng a
resident allen), to provide your correct TIN to the person
requesting it (the requester) and, when applicable, to:
1. certtfy that the TIN you are glvlng is correct (or you ae
waiting for a number to be issued),
2. certify that you are not subiectto backup .nthholding, or
3, Claim exemption from backup withholding n 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 withholo1ng tax on
foreign partners' share of effectively cOMected Income.
Note. If a requester gives. you a form other than Form W-IJ to
request your TIN, you must use the reques1er's form if It is
substantially similar to this Form W-9.
Dale ~
. - 7 /13/"9
DefinItion of a U.s. person. For federal tax purpo'ses, you are
considered a u.s. person if you are:
. An individual who Is a U.S. citizen or U.S. resident allen,
. A partnership, corporation, company, or association created or
organized In the United States or under the taws 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 10r partnerships. Parmerships 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 tha.t
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. parson that Is a partner In a .
partnership conducting a trade or business in the United States,
provide Form W-Q to the partnership to establish your U.S.
status and avoid withholding on your share 01 partnershIp
Income.
The person who gives Form W-9 to the partnership for
purposes of establishing fts 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 disregaraed entity and not the entity,
Cat No. '0231X Form W.9 (Rev. 10-2007)
EXHIBIT C
2009-2010
NAME OF CASE CASE NO, NOT TO EXCEED
1. Art Bullock v. City of Ashland CA A-131252
Consolidated cases (2 cases) CA A-133660
(2004 Nevada St. LID Cases (04-3971-Z3 & 04-
3972-E7)
2. State of Oregon ex rei Park St. Appeal No,
Apartments, LLC v. City of Ashland, A137118
Art Bullock and Phil Lang,
Intervenors
[Appeal to Court of Appealsl
3. Art Bullock, Edward Peutkowski, 07-2167-Z2
Judith Pentowski and Mary Dutton Being appealed
v. City of Ashland
4. TOTAL: $15,000.00