HomeMy WebLinkAbout2009-178 Contract - A-Z Home Imp
C IT Y OF CONTRACTOR: A to Z Home Improvement
ASHLAND CONTACT: Scott Stranahan
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 3495 Randall Avenue, Central Point, OR
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-301-0207
DATE AGREEMENT PREPARED: Auoust 6,2009 FAX: 541-826-4895
BEGINNING DATE: Aunust 10, 2009 COMPLETION DATE: October 30,2009
COMPENSATION: Not to exceed $5,000. Per attached proposal #1301, dated July 23, 2009.
GOODS AND SERVICES TO BE PROVIDED: Brush Clearing and Vegetation Removal - Work to be
nerformed on an as-needed basis. ADDITIONAL TERMS: Workers' Compensation insurance is being waived because the contractor has no
employees and he will be performing the work himself. Contractor initial S' f ~
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnei
assigned to the work required under this contract are fully qualified to perform the work 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. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated, payments wiil be made for work completed and accepted to date of termination.
Compensation under this contract, including ail costs and expenses of Contractor, is limited to $25,000.00, unless a
separate written contract is entered into by the City.
5. Ownership of Documents: Ail documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 2798220, 2798.225, 2798.230, 2798.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $18,088 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a
living wage, as defined in this chapter, to ail employees performing work under this contract and to any subcontractor
who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached
hereto as Exhibit 8 predominantly in areas where it wiil be seen by all employees.
8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and ail 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.
9. 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 foilowing
conditions:
Contract for GOODS AND SERVICES Less than $25,000
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 1 of 5
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by 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.
i1i. The rights and remedies of CJty 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. Oblication/Liabilitv of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, c or d of this section, 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.
10. 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.
11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.11 0 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. 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
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.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. 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; if it loses its ORF status pursuant to
the ORF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
ORF if Contractor has qualified as a ORF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General 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 occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
c. Automobile Liabilitv insurance with a combined single limit. or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
d. Notice of cancellation or channe. There shall be no cancellation, material chance, reduction of limits or
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 2 of 5
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City.
e. 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 contractor's insurance is primary and non-contributory. 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.
17. 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.
18. 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.
19. 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 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 Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Councilor the Public Contracting Officer is
required before any work may begin under this contract. '
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
CONTRACTOR CITY OF ASHLAND:
BY /)vl ~ =-L'r
Signature
~. S C<9r-r-
Print Name
BY
#A
FINANCE DIR TOR
TITLE
cpwner
DATE
(/'3 of
DATE
g -/?J- .2-C>e?{
CONT
By:
W-g
One copy of a W-9 is to be submitted
with the signed contract and it will be
kept on file in the Finance Department.
ACCOUNT # /' / /? tP -;7 ? .;;2- IN?
(For City purposes only)
PURCHASE ORDER # t:Y .ct I ~ 7
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 3 of 5
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 10 (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:
5"".>
.55
.5"/
.7~
f5
55
(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.
/JM-:~~
Contractor
23-/0-;2-07
(Date)
Contract for Goods and Services Less than $25,000, Revised 06/30/2008, Page 4 of 5
---==--:=---..:--::..:-:=-===-----==- ----=---- --:'~PROPOSA~#~1301-=-~
A-.... Z HOMRIMPROVEMEI'ITS
3496 RANDALL AVENUE
-CENTRAL POINT,OREGON,--------
scorrSTRANAHAN
PH /I (541)301-0207 FAX /I (541)826-4895
LIC# OR. 173052
City Of Ashland
Purchasing Reprelletatlv9 I Kari Olson
90 N Mountian ave
Ashland Oregon 976:20
Fax /I ( 541"')488- 6320
.,
. ,'.
DESCRRIPTION OF WORK LISTED BELOW;
BRUSH CLEARING AND VEGETATION REMOVAL
We propose to supply the equipment and labor
necessary, to clear brush & vegetation
Residential & Commercial
Item
# 1.
Tax lot size 50' x 100' ( or 5,000 square feet )
#2.
Tax lot size 100' x 100' (or 5,001 to 10,000 sq ft. )
#3.
_oot
Tax lot size 1/2 acre ( or 10,001 to 21,780 sq ft. )
#4.
Tax lot 1 acre and larger, per acre ( 21,781 to
43,560 sqfI. )
.. -~
Tax lotI hill side requiring self propelled equipment
#5.
. TRACTOR FIELD MOWING I FIRE BREAKS
# 1.
--1-to.S;000'square feet
#.2.
. 5,D..01.!.0.10,QOO s'1uar~!eet_
#3_
10,001 to 21,780 square feet
#4.
21,781 to 43,560 square leet
#5.
Special rate for hand work,
I t:JsI- :J--
HOURLY TOTAL PRICE
$48_98 $146.94
$48.98 $195.92
$48.98 $Z93.88
$48.98 $391.84 \
$74.98
\
$59.98 $119.98
$59.98 $149.95
$59.98 $179.94
$59.98 $239,92
$24.98
Sd W~L~:60 600c ~c 'jn,
'ON' X~.oJ
,m"u
A to Z HOME IMPROVEMENTS: ,'Operatecfesasoleproprietor
ASHLAND BUSINESS.LlCENSE:-N/Aat-ltlis-time- - ---------
CAPABILITY:
1.( 2005 ) 40 horse four wheel drive traclor with 6' bush hog { rotary mower
2. self propeled lawn mowers, 2 weed eaters, 1 welk behind weed eater
1,2000 gmc picK up 1, 6'x 12' utility trailer hand tools ect-
AVAILABILITY:
4 days a week 8 hours a day
----INSURANCE:
General-tiability-&-Auto-liabilily-availablewithin-Iwo-business_days
REFERENCES I MOWING CUSTOMERS FOR; A to Z HOME IMPROVEMENTS
CLYDE SEVERSON, PH #- (541) 779-7196
MIKE BARR, PH # (541) 482-2510
JIMPOST,.PH # (541) 779-4102
Sincerely Scott Stranahan
:l p~ :J-
17d WCl9>::60 600<0 >:<0 'InI'
'ON XCI.oJ
WOeU
~... z 80ME IMPROVEMEl'OTS
3496 RANDALCAVENUE-----
CENTRAL POINT, OREGON.
SCOTT STRANAMAN
PH # (5411. 301-0207 FAX # (5411. 828-48!,-i;
LIC# OR. 173052
PROPOSAL # 1301
City Of Ashland
purchasing Represetativo I Karl Olson
90 N M~unt'~n aye
Ashland O....gon 97520
Fax I/. (541--1. 488- 5320
. ,
, ,.
DESCRRIPTION OF WORK LISTED BELOW;
Item
BRUSH CLEARING AND VEGETATION REMOVAL
We propose to supply the equipment and labor
necessary. to clear brush & vegetation
Residential & Commen$al
#5.
Tax lot I hill side requiring self propellad equipmen1
HOURLY TOTAL PRICE
$48_98 5148.94
$48.98 $196.92
$48.98 $293.88
$48.98 $391,84 ,
$74.98
tl1.
.-.\
# 2.
Tax lot size 50' x 100' ( or 5,000 squa.... feet I.
Tax lot size 100' x 100' (or 5,001 to 10,000 sq ft_ I.
#3.
,
Tax lot size 1/2 acre ( or 10,001 \021-,780 sq ft. )
#4.
Tax lot 1 acre and larger. per acre ( 21,781 to
43,560 sqft. )
TRACTOR FIELD MOWING I FIRE BREAKS
# 1.
1 to 5,000 square feet
$59.98 $119.98
#.2.
5,001 to 10,000 squere feet
$59.98 $149,95
tl3.
10,001 to 21,780 squa.... feet
$59.98 5179.94
# 4.
'-21,781 to.43;560squareleet.
-$59.98 _ $239.92
tl5.
. .__~ Speci~!..!~ta for han~ work. .
$24.98
I C'~ :2-
id W~SE:60 600c Ec 'Inr
.ON X~cl
WOClcl
~~/~t/~~~~ 11:~1
5417767514
PAGE "J
CERTIFICATE or: LIABILITY INSURANCE
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License: CA 806022 ______._._____ _. _____ .A_MClnsu"""'.Co"""'"y_________
InovNd:
.,
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Mic!lul Scott Stranahan
A'" Z Hom.lmP1Ovemenl!
349' Randall A....
Central Point, OR 97302
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BLANKET ADDITIONAL INSUREDS-
OWNERS, LESSEES OR CONTRACTORS
Thla endol1lement moolfIGs I""urance provided under the following:
COMMeRCIAL G",NF.RAL LIABIl.ITY COVeRAGe PART
--c'---=SCHI!tlULB=.ccc-- -------------------.--...
___I.1'~~y_"umb.t: 36..:10~1617 ___ U!'.rl_d<>~~1!I.l"It_~tl'1.e:_~L6L2QIJS ____ l
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! MICMAELSCOTT STRANA\.!AN L,.p . C'. - - ,
. CBA: A TOZ I"OME IMPROVEMENTS __~~ _~ ___..j
SCH&DULE
[N".m. 01 PlIr1IOll or Organl~Btlon:
. C\1YOF ASHI.ANO
i 20-e-MAINST
I ASHLANO, OR, 975:10
I Location: _
I L.OCATEO TMROUGHOUTTHE CITY OF ASHlANO, OR
(If no entry appea", ebove, InfOrmation required to complete this ~ndorsement will ~ shown In the Dec:erationa
a~ app:ic&b1e 10 thi@ endorsement)
A, Secllon II - WIlo 1$ An Insured ie amended lc include as an insured the perton cr
cr\l3nlzauon OhQwn In the Schedule, but only to [Me extent tMt the pen;on or organization
shown In IheScheclule ~ held Iimble for your !ICte 0' omillsions ~risjng out of your ol'Qoing
OpertltlQn$ pertormec for that insurld
B, With rllepect to the imlurance efforded to these add~iQNi In$ured~, the following exclusion Is
addl'ld:
2. Exeluslons
This Insurance doe$ not ep~y to "bOdily Injury" or "propeny aamage"' occurnng alter:
(1 J All worl<, II'1ClUOlng matlll'iSla, parts or eq",lprnent furnished In connection w~~ such
work. on the project (other lhiln service, malnlilnance or repairs) :0 be pMormed by
or on be"'''f ~ tne adclitlonallnsured(,>) at tl1e wite or the COWlr>id oPfi'l'llIions has been
CClmpl~; or
(2) That portion 01 "your worl<" Out of wt'Ilen the injury or dam~ arlsee h~ been put to
~lllntende<i wee Cy any pereon or organization other than anolner contraclar or
suboontractor engaged In performing operations for e pnnclpal a~ II part cf the same
project
- - -----..--C;..The VIIOftls-'yo,,"snd'''your''relel' IO.~-Named-' n su "d-ahOwn.'n-thlJ-O<<laratio~,
O. 'Vour worl( rTllllln$ mrK or o~one pem,rmed by you or on 'fOur behlllf: end mmeri.ls, parts
or l:lg\JiomelltJurn's.lle<:l.irLc_onneo::1i.or: With.sucb_\\'crr._oLoperatlorJ$.
PrimarY Wordina
"reqo;lred by wrllt<ln COMroct or AII,oem.nt: Such Ino.r;/IOo U IS aflordod by thio ~'io)' .h.1I ..
prl~.ry insurenoe, en-: any lr:eur.n~ pi' p~f.lf$\.lranc.. ma!n~ined D~ t~ above addItional
;"eur1!ld(s) shin be excMS of the ItrlluflU'tCrl ;l;1'Oro&d to the nl/T!ed in$l.;",Q and a~1I not CQntrlbute
to It
W.'N8r at Sub~.tiCl"
. l'Oquit.d by writton c;:orrtnlc:t or .a;r~: VJo Wlli.... t~y ~lgm of t"ll()owtry 'We 11'\4.y h.....e ejll\:,,!.t tlll'" .ntity
that illln al"kiltlOt"'lalll"1lkJred per ~he terrr:a C!f l:hitl endor&e:Pf\f'.nt beoaus!', of payments we maku ~Of ifljul'y or
damage .srial"; t:l.Jt 01 "YOUt work" done .,nd., a contra~ wtth ~lrt person or or,,:anlzet!on.
ANF. ES 043 (512006)
--~~~~1
Payee name
Customer NO:
CITY OF ASHLAND
20 East Main Street
6sbla.D<J,Oregon.97520
(541) 488-6004
A TO Z HOME IMPROVEMENTS
017420
00023412
Application
License type Business License
OFFICIAL RECEIPT
~~~,l~B~t~~w~i~! :OOO.19~07 --.
Receipt date 8/10/2009
Tender type Check
Check number 1246
'~EJ:{~[~ipttamp.[6J
.
100.00
100.00
Page 1/1
~A'
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
. ~8ME~i!iljj'1!
8/11/2009
_i?elNWMBER :"
09147
VENDOR: 014573
A TO Z HOME IMPROVEMENTS
3495 RANDALL AVENUE
CENTRAL POINT, OR 97502
SHIP TO: Ashland Fire Department
(541) 482-2770
455 SISKIYOU BLVD
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.: FIRE
Contact: Margueritte Hickman
Confirming? No
llI.!l:Qtl~i1WIill ~ull;~~ ~~!J!:~llii;iIlli:m4rrgmm~~t'r1i'i~~~"Wf'IW;.[~~~~~~ ~;iJ11i~ICe~ ~~~i~~i!ip.Yi~J.lll
Brush Clearing and Vegetation Removal, 5,000.00
Per attached fee schedule, Contract for
Goods and Services, Beginning date:
August 10, 2009, Completion date:
October 30,2009, Insurance required/On
file
.
SUBTOTAL
TAX
FREIGHT
TOTAL
5 000.00
0.00
0.00
5,000.00
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
~~9~QtlNmn~~ irlilifl?1'1lill'CtWlilTiiler_ _i'Amotmf"._~ !!f~6jJiftj~tijjTB:e'm\1l1 .1I~~tr~u~~ ~:E.'in<rfi1f~"S
E 1 10.07.12.00.60410 5 000.00
~~
Autho d Signature
VENDOR COPY
FORM #10
CITY OF
ASHLAND
CONTRACT APPROVAL REQUEST FORM
Contractor/ConsulWlt: . C\ /I
/T 0/--...:2 6;4----...,.-c:if:""n-,.e ;--~y"",..h'L.L~
/--BrV-$-L da~<'<.A<d!tf,;.-~~""-..ll';:h....%"""'v.
~ Per attached contract ,r
PUBLIC CONTRACTING REQUIREMENTS - Solicitation Process
Total Amount
0 Exempt from Competitive Biddina 0 Invitation to Bid (Copies on file) 0 Emeraencv
Reason for exemption: 0 Written findings attached
./ 0 Quote or Proposal attached
u::r Small Procurement & Personal Services 0 Reauest for Proposal (Copies on file) CooDerative Procurement
Less than $5,000 Please check one: o State of Oregon
Note: Total contract amount, including any 0 Goods & Services Contract #
amendments may not exceed $6,000 o Personal Services 0 Stale of Washington
Intermediate Procurement 0 Sole Source Conlract #
GOOOS & SERVICES 0 Written findings attached 0 other government agency contract
$5,000 to $75.000 0 Quote or Proposal attached Agency
o 13\ Written Quotes Contract #
PERSONAL SERVICES 0 Boecial Procurement 0 Interagency Contract
$5,000 to $50.000 0 Written findings attached Agency
o (3) Written Proposals 0 Quote or Proposal attached Contract #
Have all public contracting requirements been satisfied?
YES
...----'
NO
Have funds been budgeted for the purpose of this contract?
If "NO", City Council approval is required. City Council approval was received on
,......-------
(Date)
YES
NO
If "NO", City Council approval is required. City Council approval was received on
Please provide: Account Number~'::':: ."'. ~ .(.q, -tf:t? kt2 ,,/.!'~.(J
(Date)
Is the amount of the contract less than $25,000?
YES
.-----'
NO
If "NO', Legal review is required. Contract was "Approved as to form" by the Legal Department on
lDate)
Is the amount of the contract less than $75,000 for Goods & Services
or $50,000 for Personal Services?
YES
.~
NO
If "NO', City Council approval is required.
City Council approval was received on
/
(Date)
Is the contract for a period of 24-months or less?
YES
NO
If "NO', Cily Council approval is required. Cily Council approval was received on
(Date)
Please provide lerms:
Start date: 06 -/ C -:-61-; Completion date: c?? - '3 0 .- 0 'j'
Can the contract be terminated for convenience thirty (30) or fewer days
fOllowing delivery of written notice to the contractor? YES
~..
NO
Prepared by:
If "NO", City Councii approval is required. City
/" ,/7
//'ji.-7/ ~/
eAJ'L~
uncil approval was received on
(Date)
Department:
Date:
Please circle'
Approved Not Approved
tf97A~
Lee Tunebe~ f
Date: ~ .Jf/} '1
I
Form #10 - Contract Approval Request Form, Page 1 of 1, 8/ /2009
A request for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
Date of Request:
THIS REQUEST IS A:
D Change Order(existing PO #
Required Date of Delivery/Service:
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
~ ~"" 2.. ~ c:-J~r"-.d-V .d._~_
SOLICITATION PROCESS
Small ocurement
I!::r \.e8S than $5,000 (
@/Quotes(Optional) k/b
y2- (/-- ~)
Intermediate Procureme
D (3) Written Quotes
(Copies attached)
D Sole Source
D Written findings attached
D Quote or Pro sal attached
Cooocrative Procurement
D State of ORIWA contract
D Other government agency contract
D Copy of contract attached
D Contract #
D Invitation to Bid
(Copies on file)
D Request for Prooosal
(Copies on file)
D Soeciall Exemot
D Written findings attached
D Quote or Pro sal attached
D EmerQencv
D Written findings attached
D Quote or Pro sal attached
Description of SERVICES
~-y- v.-.-;-.t{ )e ~ ,:j va-f
~attached PROPOSAL
Item #
Quantity
Unit
uDescriptionofMATERIALS _
_____ _Unit.Price
Total-Cost
Project Number __ ____ - ___
D Per attached QUOTE
, Account Number LLQ- !l1-a. -QQ - f2j)!:/Jpp
. Items and services must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately.
By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements,
and the documentation can be provided upon request.
Emplo,.. S1,"""m,'2f f! tdf ;/tr.k..-
SupervisorlDept Head Signature:
G: Finance\ProcedureIJl.P\Forms\8_Requisition form revised.doc
Updated on: 81612009