HomeMy WebLinkAbout2011-058 Contract - Rogue Valley Heating & Air
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Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Rogue Valley Heating & Air
ASHLAND CONTACT: Eric Armstrong, Owner
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 2820 Foothill Blvd., Grants Pass, OR 97526
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-476-3211
DATE AGREEMENT PREPARED: March 9, 2011 FAX: 541-476-2694
BEGINNING DATE: March 14,2011 COMPLETION DATE: April 28, 2011
COMPENSATION: Not to exceed $11,047.00
GOODS AND SERVICES TO BE PROVIDED: Contractor to replace existing 10 ton heat pump outdoor
section with new Carrier Heat Pump, Model #38AUQA12AOA6. Install new matching R-410a coil in existing air
handler, includes new TXV's, solenoid valves, crane service and refrigerant. Clean and flush refrigerant lines
and recharge with Puron. All necessary materials and labor for complete operating system included. Per
orooosal attached as Exhibit A. Location: Waste Water Treatment Plant
ADDITIONAL TERMS:
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 personnel
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 will be made for work completed and accepted to date of termination.
Compensation under this contract, including all 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: All documents prepared by Contractor pursuant to this contract shall be the property of
City. ,
6. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 279B.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 $18,703 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 all 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 B predominantly in areas where it will be seen by all employees.
8. 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.
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 mav be established bv Citv under anv of the followino
Contract for Goods and Services Less than $25,000, Revised 12/20/2010, Page 1 of 5
,
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 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.
[i. 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 (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 ComDensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liabilit lDS!JlgQce 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'1Or BDally Injury and Property
Damage. It shall inclu e actual liability coverage for the indemnity provided under this contract.
c. Automobile Lia 'Ii surance with a combined single limit, or the equivalent, of not iess than Enter one:
$200,000, $500,000 1,000,00' or Not Applicable for each accident for Bodily Injury rom t->ropeflyD-amage,
includin covera e for ired or non-owned vehicles, as a licable.'
Contract for Goods and Services Less than $25,000, Revised 12/20/2010, Page 2 of 5
d.' 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 Contractor or its insurer(s) to
the City.
e. Additional Insured/Certificates oflnsurance. 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, ihe 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 shal,l sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
:~n::v~
Signature
~j/ I;'" AVI11 '$ f-vOrtl
Print Name
tPrf/;<<{rd~
Title
City of Ashland
By ~~\t~,-
Department Head
~1\-,.c"^iJ\.€.t R FA,;r/.,r
Print Name)
S/,^S-/;}.P~I
Date
W-9 One copy of a W-9 is to be submitted with
the signed contract.
Purchase Order No.
{ /JeJ '1 '7
Contract for Goods and Services Less than $25,000, Revised 12/20/2010, 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 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 f'lilure 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:
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(1) I carry out the labor or services at a location separate from my residence or is in a
c/ 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.
V (3) Telephone listing is used for the business separate from the personal residence listing.
V (4) Labor or services are performed only pursuant to written contracts.
V (5) Labor or services are performed for two or more different persons within a period of one
yepL .
~) 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.
3-1?-//
(Date)
Contract for Goods and Services Less than $25,000, Revised 12/20/2010, Page 4 of 5
.03/10/2011 10:59
5414762964
ROGUE VALLEY HEATING
PAGE 02/02
IiOGUE .
aVALLEY
'-leating & Air Conditioning
2820 Foothill Blvd. Gr~nts Pass, OR 97526
541_476_3211,541-779-8333
Fa, 541-576-2964 eCl'! 114839
wwW.roauevallevheat-air.com
EXh~~~11
HVAC BID...PROPOSAL
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turn to the expe~~#
COA 001
I~ROPOSAI. NO.
DATe
03/09/2011
OWNER'S ADDRE~6
OWl'lERlBUyER NAME
....Giiy-D.tAsbJaolL---.._.-...__..._-- 2~io-
OWNER'S CITY, STATE & POSTAL CODE INNER S HOME PHONE
-AsllJamLQR..S7..520
pR.OJECT NAME .
...was.leJl\laleLT.realr:nenU~Janl,"OfficeJ:l"'~t PI Imp
PROJr.:CT CITY. STATE & POSTAl cr:mr:i
~.123)A5IhZa.90
PROJISCT ADORllSS
\:"'SW~"
1-552,2292....-.__
12.95..Oak..Slr:eeL
priO.I~CT PHONE
~.PHONE2.
ARCHITEcr ENGINer:R
sblanCLOB.,..91.52JL...._..
CON5fRUr;:TION"0 BG.GIN GONTAACT COMPLETION DATE
CtA TE. Or pL.ANS
We hereby propose to furnish the following work:
Replace existing 10 ton Heal Pump outdoor section with new Carrier Heal Pump 38AUQA12AOA6, Also install new
marohlng R-410a coil in e~istlng air handler, includes new TXVs, solenoid valves, crane service and refrigerant. All
..~----.....-----,.
--'
necessary materials and labor for complete operating system Included.
.__._---'""1------.---.....---.
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---
PROPOSED PAYMENT: Owner agrees to pay ContrEc!or a PROPOSED total cash price of $_ti,.Q47_QO Doilers.
OWNER represents that this agreement is e cash transaction wherein no financing is contemplated and contractor acts in reliance on said
representation.
THE PAYMENT SCHEDULE Wll.L BE AS FOLLOWS:
1. Down payment of $
,2. Payment schedule as follows:
_D.ua.ln1ull "pnn camp.tetlOIL-_
NOTE: This proposal may be withdrEwn by us If not accepted within 30 days.
ACCEPTANCE OF PROPOSAl.
yOU ~r. hereby authorized to return e fonnal contract between us to accomplish the work described In the above proposal for which the
undersigned re to pay th ~mount stated In said proposal and according to the tem'ls thereof, '
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Own~lBuyer AuthoriT.Od S(gnalU"9
D.w
Dell;!
GQl'1\rAOlOl'/SOllor Sl~nllluf'l:l
Dale
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Dat",
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ACORD' .. ..
'CERTIFICAtE OF LIABILITY INSURANCE .1 ~Te (M'-lIOOlYYYVI
~ . .3/17/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONlY.AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA11VEL Y AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. . THIS CERT1FICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRO~UCER. AND THE CERTIFICATE HOLDER.
IMPORTANT: I' the certificate holder is an ADDIMNAllNSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the tenns and conditions of the policy, certa~~rIlCles may require an endorsement. A statement on this 'certificate does not confer rights to the
certificate holder in lieu of such endorsement 5 .
PRODUCER ~=~.M;- Sue Noakes, CI~R, CIC
Beecher Carlson Insurance Agency LLC ~~~~~ (541)485-6633 .~I rt;, No\: (541)485-351415
59 E 11th Ave i=b sue. DoaJtes8beecbercar.1soD. com
PO Box 70206 PROOUCfR 00017146
EUl"lene' OR 97401 INSURE'"'S AFFORDING'COVERAGE NAIC#
INSURED , II'tSJRBuJ\merican Hallmark Ins Co of TX 43494
INSURERB:
Rogue Valley Heating , Air Condi tioning Co lNSURERC:
2820 Foothi11.B1vd.. INSURER D:
INSURER E:
Grants Pass OR 97526-4126 INSURER F:
. COVERAGES
'THIS IS TO CERTIFY THAT 1HE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TI-lE POUCY PERIOD
INDICAlED. N01W1'THSTANDlNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER CXX::UMEm "MTH RESPECT TO \NHICH THIS
.CERTlFICATE MAY BE ISSUED OR MAY PERTAIN, TI-lE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INaR TYPe 01'" INSUItANCe ADDLlIUBIt &W6WrWV\ ,:=~ UMlrs
LTR INSR WVD POLICY NUMBER
GEt.ERAL UABa..m EACH OCOJRRENCE \.; :1 $ 1,000,000
1f. _.fQr~ERCIAl GENERAL UA8IllT'f ~~~~J,lO~~E~ __, . 100,000
A CI.AIMS.M~E rx OCCUR X 44CL46517~ 11/20:10 711/201:1 MED EXP (Anyone person) . 5,000
PERSONAL& AJ:N INJURY . 1,000,000
GENERAL AGGREGATE . 2,000,000
~AGG:~ELlMIT ?S~. PRODUCTS. CQMPIOP AGG I 2,000,000
X POLICY I ~R.Q: lOC . .
AUTOMOBILE LIABILITY COMBINED SNGI!E U'-IT , . 1,000,000
(Eaaccident)
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A All OWNED AUTOS 44CL465175 11/2010 7/1/20U
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~ SCHEDULED AlITOS PROPERTY DAMAGE
HIREDALITOS (Pereccid8nt) I
~ NON--O'MIlEDAUTOS Plp.Ba&ic I 15 ,000
IJnlnsll'edIl.Jnderlnsured I 1,000,000
~ UMBREllA LIAB ht OCCUR EACH OCCURREOCE . 1,000,000
EXCESS LIAB X CLAIMS-MADE AGGREGATE . 1,000,000
I- DEDUCTIBLE .
A X RETe.mON 5 10 000 44CU4651 76 11/20:10 711/2011 I
WORKERSCOMPENSA'TlON IOCSTATUsl 10TH.
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OESCRIPTIONOFOPERATIONSI LOCATIONS IVEHCLES (Atta;h ACORD 11)1: Addltfonal ~D'Ialks SC:h~ul., If mor'll spae4l11 ~unG) -
certificate holder inolud.ed .lI' add.1t1onal insured. as respect.$ general liability where ~i~'bY written contract.
Th1s form is subject to policy terms, conditions, and. exolusions.
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CERTIFICATE NUMBER'CL107287639
REVISION NUMBER'
CERTIFICATE HOLDER
CANCELLATION
(541)488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION OATE THEReOP, NOnCE WILL. BE DELIVERED IN
City of ABh1and ,fI~', ACCORDANCE WITH THE POLICY PROVISIONS.
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90 N MOuntain Ave. .~""
_. AUTHORIZED REPRESENT ATlVE
Ashland, OR 97520 , -
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ACORD 25 (2009109)
INS025 (ZOOOO)
<<> 1988-2009 ACORD CORPORAT10N. All ~ghl5 reserved.
The ACORD name and logo are registered marts of ACORD
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3/17/2011 4: 21: 2, .PM PAGE
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ACORH CERTIFICATE OF LIABILITY INSURANCE I DATE(MMlCOrvvYVj
\,....../ 3/17/2011
nus CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TlfE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CO,lERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERnFlCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BElWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATNE OR PRODUCER. AND THE CERTlFlCATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed If SUBROGATION IS WAIVED; subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement's). .
PRODUCER NAMe~' Sue Noakes, CISR, CIC
Beecher Carl.son Insurance Agency LLC ~N~hwr (541)485-6633 .lrMNo:(5.1l485-Ji46
59 Ii: 11th A"" :~~b sue '" noakes8beecbercarlson. com
PO Box 70206 PftOCUCER 00017146
~ene OR 97401 INSURER/S' AFFORCING COVERAGE NAIC#
INSURa:) IN5lJR~A:SAIF '. 2412
INSURERB: ,
Rogue Valley Rea ting , Air Conditioning Ine 'INSJRERC:
2820 'Foothill Blvd. INSURERC:
INSURER E:
Grants Pass OR 97526-4126 INSURER F : .
COVERAGES
CERTIFICATE NUMBER:CL1081889845
REVISION NUMBER:
THIS IS TO CERllFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICAlED. NOlWTHSTANDlNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT lMTH RESPECT TO \N1"'llCH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSlOOS AND COOOTIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA!DCLAIMS.
IMSR TYPl!! 0' INSURANCe ADCL$UBR ~f1.!lvF.r.~~ LIMITS
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EXCESS LIAB CLAIMS-MADE AOORSOATE .
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AND EMPLOYERS' LIABILITY YI. X TORY UMIT$ ER
ANY PROPRIETORIPAfHNERIElIEClJnVe 0 ",., E,L. EACH ACCIDENT . 1 000 000
OFFICER/MEMBER EXCLUDED1 .,. 0/1/2010 10{1/2011
(MandalorylnNH) 520190 E,L. DISEASE. EA EMPLOYEE $ 1,000,000
~~~ro~ ~tQpERATIONS below '. EL DISEASE- POLICY WAT . 1 000 000
. ,.
';':'
.... .
OESCRIPTION OF OPERA TIONSI LOCATIONS / VEHCLES (Attach ACORD 1 Gl, Addtl:~.tl Rel!larb SChedule, If mo,," 5lHlee .. R'quhdj .,-,
'.
CERTIFICATE HOLDER
CANCELLATION
(541)488-5320 SHOUlD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCElLED BEFORE
- . THE EXPIRATION DATE THEREOF, NOnCE WILL BE DELrvERED IN
Ci ty of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
90 N Mountain Ave. ,
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
,
H Godfrey, CIC/S1lENOA ?l1,,,, 1/J~;r,'y ,
ACORD 25 (2009109)
INS025 (:00909)
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and !~o are registered marks of ACORD
~S,\ ''''~'.~."".
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CiTY RECORDER
Page 1/1
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
3/30/2011
,"'" ,PO NUMBER
10099
.r i'.:' , ';DATE. ~:l~'~~',
VENOOR: 001239
ROGUE VALLEY HEATING & AIR
2820 FOOTHILL BLVD
GRANTS PASS, OR 97526
SHIP TO: Ashland Building Maintenance
(541) 488-5358
90 N MOUNTAIN AVENUE
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:.
Speclallnst:
Req. No.:
Dept.:
Contact: Dale Peters
Confirming? No
j:,Qu~H1Hhi;: : ~':'Unit' _~ '.:: ..;,<:1 .;. /'.:~:'J:'-": ,,' : .' ,.Description
Contractor to replace, provide and
install a new 10 ton heat pump at the
Waste Water Treatment Plant - Per the
attached proposal and contract.
" .',; '.
;:.: \ :~;_t; .: "'[:..Unit 'Price'
;, '. Ext:P.rice' i, ;
11,047.00
Contract for Goods & Services
Beginning date: March 14, 2011
Completion date: April 28, 2011
Insurance required/On file
.
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
11 047.00
0.00
0.00
11,047.00
t.:}:!ACCO'lrnfNumber,Z7,+'~ ;j~':~.'i=tro}e_cf Number' ':',;! ~ ": .'Ainount": , 't:AccounfNumbei:: ;;-. ,': ~,::; ProjecTt~iumtier;] " ~~;::;',;<:Amounf: .,:'..,....
" ...~~. .',;.....;
E 410.08.24.00.70420 E 000231 .999 1 1 047.00
Q~~
Authorized Signature
VENDOR COpy
~ request for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
THIS REQUEST IS A:
o Ch~nge Order(exisling PO #
Dale of Request: Y/M~Y 20i 1
Required Dale of Delivery/Service: I ASAP
Vendor Name
Address
City, State, Zip
Telephone Number
Fax Number
Contact Name
Rn~lll:: \/AI I I=V I-lI=ATINr, Jl. AIR
28?O Fnnfhill Rlvrl
GRANTS PASS OR 97526
541.476.3211
541.476.2964
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
Coooerative Procurement 0 Reouest for Prooosal
o State of ORfWA contract (Copies on file)
Intermediate Procurement o Other government agency contract 0 Soeciall Exemot
~(3) Written Quotes 0 Copy of contract attached 0 WrittEn findings attached
(Copies attached) 0 Quote or Proposaf attached
0 Contract # 0 Emeraencv
0 WrittEn findings attached
0 Quote or ProDosaf attached
Description of SERVICES
"YEDlIqQ6 j'O:><''S''t'NG. o......,.."ooR. col"\1'RSSSOR l.U11H N.el-<>
l\ I 4J<"'''''AU''-AIE.J\l!S''1lo MOlll'tL..1(1=.'Pu4CG COIL,"ll<l's "''''0
C,q/i:.12..:l2. .>0 "" il. CI-".", ....,n
ScIl3.Ne.,O VAL-illS:';; ,,,, tl.,e '....IlO""R AIR. H"''''OL.tS:. co
1',L\St-l 'ReF('!"OG.E~"'''' ,-,"'a<;-. 'K..sc."''''O!je wITH'1>l.\RD>l.
Per attached PROPOSAL
Total Cost
'<n .::
11047.00 .
$
Item #
Quantity
Unit
Description of MATERIALS
Unit Price
Total Cost
Project Number 000231.999
fi3~: t:Jg-,,~-//
~ ~,-:-\t< er>o. aA.Y"" 'r;; ~ p.~ _ / I
o Per attached QUOTE
Account Number 410.08.24.00.704200
'Items and services must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accuratety.
By signing this requisition form, I certify that the information provided above meets the City of Ash/and public contracting requirements,
and the documentation can be provided upon request.
Employee Si9nature~ - ~
SupervisorlDepl. Head Signature: <r' t ~I..........QQ. {,
--
G: Finance\Procedure\AP\Forms\8_Requisition form revised.doc
Updated on: 3/112011