HomeMy WebLinkAbout2011-094 Contract - Hooper Spring Tree SRVC
Contract for Firewise Hazardous Ve etation Removal
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONTRACTOR: Hooper Springs Tree Service
CONTACT: Matt Ison
ADDRESS: PO Box 3258 Ashland, OR 97520
TELEPHONE: 541-488-1282
FAX:
DATE AGREEMENT PREPARED: May 5,
2011
BEGINNING DATE: Ma 15,2011
COMPENSATION:
$11 O/hour for 3 workers, all-inclusive of e ui ment and labor and time for ve etation dis osal
GOODS AND SERVICES TO BE PROVIDED: The work will be performed on public or private properties
designated by the Firewise Community's Action Plan, and approved by Ashland Fire & Rescue. Scope of work
includes removal of fuels that could be hazardous in a wildfire. Potential work includes, but is not limited to,
cutting of trees, brush, and limbs, pruning, chipping, transportation of materials to oft-site facility such as
landfill or golf course for wood chip collection, leaf blowing, raking, root removal, stump grinding, blackberry
removal, and weed- ullin . Material will not be burned.
ADDITIONAL TERMS:
. Ashland Fire and Rescue will approve all Firewise Action Plans and work plans for each Community. The
contractor will perform work based on agreed upon plans and hourly rates, and then submit an invoice to the City
of Ashland upon inspection.
. Contractor representative must attend the Ashland Fire & Rescue Fire Resistant Landscaping class offered by
Ashland Fire & Rescue in spring, 2011 in order to be eligible for contracting under this Contract or the Action
Plan. Contractor will not, however, be compensated by this contract for attending the class, Only contractors who
attend will be included on the Firewise Contractors list, which will be found on the City's website.
. Work is contingent upon community participation, and thus, no amount of work is guaranteed. Contractor will be
available to perform work on weekdays and weekends, as needed.
. Contractors will immediately advise City of any property damaged or destroyed on any property related to
activities of Contract work, and, subject to City reasonable review and direction, Contractor will be responsible for
completing, according to the City's final approval, repair or replacement of the subject property declared
dama ed or destro ed.
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
E-MAIL:
COMPLETION DATE: Ma 15,2013
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 $35,000.00, 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 2798.220, 2798.225, 2798.230, 2798.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Livin Wa e Re uirements: If contractor is rovidin services under this contract and the amount of this contract
Contract for Goods and Services, Revised 04/18/2011, Page 1 of 6
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/osses, 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 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 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.
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/Liabililv 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, 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.
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 recvclable products to the maximum extent economicallv feasible
Contract for Goods and Services, Revised 04/18/2011, Page 2 of 6
in the performance of the contract work set forth in this document.
15. Defal!lt. 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 insoivency; 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 $1 ,000,000 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 $1,000,000,
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 chanoe. 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 of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officiais, officers and employees as Additional Insureds on any insurance poiicies 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.
Contract for Goods and Services, Revised 04/18/2011, Page 3 of 6
Contractor:
BY~~&'~
Signature
!Vlt\1Thnv E,
Print Name
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Department ead
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Print Name
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Title
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Date
W-9 One copy of a W-9 is to be submitted with
the signed contract.
Purchase Order No.
Approved as to form:~;tA
City Attorney
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Contract for Goods and Services, Revised 04/18/2011, Page 4 of 6
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:
(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
CZ~
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(Date)
Contract for Goods and Services, Revised 04/18/2011, Page 5 of 6
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CITY OF ASHLAND
20 East Main Street
Ashland, Oregon 97520
(541) 488-6004
Payee name
Customer NO:
HOOPER SPRINGS TREE SERVICE
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Depatment of the Treasury
IntemaI Revenue SErvice
Name (as shown on your in
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Request for Taxpayer
Identification Number and Certification
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Taxpayer Identification Number (TIN)
. Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line
. ii\ , to avoid 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 have a number, see How to get a
.~ TIN on page 3.
1 ';e Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
li'4/: 'number to enter.
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Requester's name and address (optjona~
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IDIII Certification
Under penalties of perjury, 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 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 (IRS) 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 the
instructions on page 4.
Sign Signature of
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Section references are to the Internal Revenue Code unless otherwise
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4",;'" 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
" . ,Fbf debt, or contributions you made to an IRA.
,.:~ Use Form Ww9 only if you are a U.S. person (including a resident
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':: ;' .1. Certify that the TIN you are giving is correct (or you are waiting for a
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. .'-i_. 3. Claim exemption from backup withholding if you are a U.S. exempt
(t, t 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.
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your TIN, you must use the requester's form if it is substantially similar
to this Form W-9.
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 w7).
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,
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Cat. No. 10231X
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CERTIFICATE OF INSURANCE
SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE
CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAVS PRIOR WRITTEN NOTICE TO THE
CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAVS FROM
THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BV
ANV POLlCV DESCRIBED BELOW.
This certifies that: I8l STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANV of Bloomington, Illinois
D STATE FARM FIRE AND CASUAL TV COMPANV of Bloomington, Illinois
D STATE FARM COUNTV MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas
D STATE FARM INDEMNITY COMPANY of Bloomington, Illinois, or
D STATE FARM GUARANTY INSURANCE COMPANY of Bloomington, Illinois
has coverage in force for the following Named Insured as shown below:
NAMED INSURED: MATTHEW ISON
ADDRESS OF NAMED INSURED: po BOX 3258 ASHLAND, OREGON 97520
POLICY NUMBER 012 1261-F02-37Q
EFFECTIVE DATE
OF POLICY 05/12/2011
DESCRIPTION OF 97 FORD F350
VEHICLE (Including VIN) 3FTHF36F4VMA62374
LIABILITY COVERAGE I8l YES DNO DYES DNO DYES DNO DYES DNO
LIMITS OF LIABILITY
aCo Bodily Injury 1 MILLION
Each Person
Each Accident 1 MILLION
b, Property Damage
Each Accident 1 MILLION
c, Bodily Injury &
Property Damage
Single Limit
Each Accident
PHYSICAL DAMAGE DVES I8l NO DYES DNO DVES DNO DVES DNO
COVERAGES
a, Comprehensive $ Deductible $ Deductible $ Deductible $ Deductible
DVES I8l NO DYES DNO DYES DNO DVES DNO
b, Collision $ Deductible $ Deductible $ Deductible $ Deductible
EMPLOYERS NON-OWNED DYES I8l NO DYES DNO DYES DNO DYES DNO
CAR LIABILITY COVERAGE
HIRED CAR LIABILITY DYES I8l NO DVES DNO DYES DNO DVES DNO
COVERAGE FLEET - COVERAGE FOR
ALL OWNED AND LICENSED DYES I8l NO DYES DNO DVES DNO DVES DNO
MOTOR VEHICLES
AGENTS ASSISTANT 37-2155 05/12/11
Title Agent's Code Number Date
Name and Address of Aoent
CITY OF ASHLAND
20 N MAIN
ASHLAND, OR 97520
BRIAN CONRAD
1806 ASHLAND ST
ASHLAND, OREGON 97520
INTERNAL STATE FARM USE ONLY: 0 Request permanent Certificate of Insurance for liability coverage,
122429.3 Rev. 07-26-2005 0 Request Certificate Holder to be added as an Additional Insured.
~
ACORVe CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
\-.- 04/25/2011
THIS CERT:F1CATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED. the policy(ies) must be endorsed. rt SUBROGATION IS WAIVED, subject to
the terms and conditions of the polley, certain poRcies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement{s).
PRODUCER CONTACT
NAME:
PAUL VOLZ INSURANCE AGENCY INC N'Cu~~ Ed}: I~Nol'
450 SISKIYOU BLVO. STE 5 icrD~ss:
INSURER(S) AFFORDING COVERAGE NAlC.
ASHLAND OR 97520 INSURER A: FIRST FINANCIAL INSURANCE COMPANY
INSURED INSURER B:
MATI IS ON INSURER c:
DBA HOOPER SPRINGS TREE SERVICE INSURER D:
PO BOX 3258 INSURER E:
ASHLAND OR 97520 INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
W.. TYPE OF INSURANCE INSR WVO POLICY NUMBER MMlDDNYVYI MMlDDIYYYY LIMITS
GENERAL LIABILIlY EACH OCCURRENCE $ 1,000,000"
~ COMMERCIAL GENERAL. LIABILITY PREMISES ~e occurrence) $ 100,000,
I-- ~CLAIMS.MADE ~ OCCUR MED EX? (AAy one person) $ 5,000,
A l- X 053FOO0584 OS/22/10 OS/22/11 PERSONAL & ADV INJURY $ 1,000,000,
'GEN'L AGGREGATE LIMIT ADPLlES PER: GENERAl AGGREGATE $ 1,000,000"
PRODUCTS - COMP/OP AGG $ INCLUDED
tJ1 POLICY n ~~9J- n lOC $
AUTOMOBILE LIABILITY lEe eccide~I~I"''''Lc LIMII $
f- ANY AUTO
f- - BODILY INJJRY (Per person) $
AlLOVVNEO SCHEDUlED
f- AUTOS - AUTOS BODILY IN..n..f/:Y (Per accident) $
HIRED AUTOS NON-OWNED rp~~~c~J:rt?AMAGE
f- - AUTOS $
$
UMBRELLA LIAB H OCCUR EACH OCCURRENCE $
f-
EXCESS L1AB CLAIMS-MADE AGGREGATE $
OED I I RETENTION $ $
WORKERS COMPENSATION AND I T~yS(fWfs I I OJ~-
EMPLOYERS' LIABILITY VIN
ANY PROPRIETORIPARTNER/EXECUTIVED NIA EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) E.L DISEASE - EA EMPLOYEE $
g~~~~~~~f~~ O~bPERATIONS below E.L. DISEASE - POLICY LIMIT I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional R.marka Sch.dul., If mort IPIC' II requlred)
TREE SERVICE
THE CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS SHALL BE NAMED AS ADDITIONAL INSUREO PER CG2013 - ADDITIONAL INSURED-
STATE OR POLITICAL SUBDIVISIONS - PERMITS RELATING TO PREMISES,
CERTIFICATE HOLDER
CANCELLATION
THE CITY OF ASHLANO
20 E MAIN ST
ASHLAND
SHOULD ANY OF THEI ABOVE! DElSCRIBElD POLICIES BE CANCELLElD BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THEi POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
4~_
OR 97520
ACORD 25 (2010105)
C) 1988-2010 A RD CORPORAnON. All rights reserved.
The ACOR D name and logo are registered marks of ACOR 0
w;.ww.salf.cOm
OREGON WORKERS COMPENSATION
CERTIFICATE OF INSURANCE
~ saif
"p corporation
CERTIFICATE HOLDER:
em OF ASHLAND
20 EAST MAIN
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
alrthe tenns, exclusions and conditions of such policy.
:-' --POUCY"NO.
955687
POUCY PERIOD
10/01/2010 to 10/01/io11
ISsUE DATE
04/25/2011
INSURED:
MAlTHEW EISON
HOOPER SPRINGS 'TREE SERVICE
PO BOX 3258
ASHLAND, OR 97520-0309
BROKER OF RECORD:
UNITED .INSURANCE AGENCIES LLC
2101 BAILEY HILL RD #B
EUGENE, OR 97405
UMITS OF UABlUTY:
Bodily Injury by Accident
Bodily Injury by Disease
Body Injury by Disease
$500,000
$500,000
$500,000
each accident
each employee
policy limit
DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS:
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 matter 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,
AllTHORIZED REPRESENTATIVE
~r?~ Jr Rcqd.iJ-
"President and CEO
--
&00 High Streot SE
Solom, OR 97312
P,800,285,8525
F,503,373,8020
FoIlcy_Batch_ CertificatEOftnsuranc:
rA'
CiTY RECORDER
Page 1/1
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
6/3/2011
.;,", f[o:NUMBER~',:;::
10205
/.;:,;.ti,\-\1DATEt~!gr,,;' ,;:,
VENDOR: 006726
HOOPER SPRINGS TREE SERVICE, MATT ISON,
POBOX 3258
ASHLAND, OR 97520
SHIP TO: Ashland Fire Department
(541) 482-2770
455 SISKIYOU BLVD
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req, Del. Date:
Speclallnst:
Req, No,:
Dept.:
Contact: AIi True
Confirming? No
;:~;;:QuaniiiY&1t) :'.~'l'-lCI':"'f'''.J r~,mtr~f.f~iY~~?!?fn-:j::~C~;~!;~:~f:lD:scriDffon5";T-:'. : '~: l[.7f~:;.":~}'r:Y!;~':1\.>1\ ::" ::;):J'F~' ~'P:F",'-!i".~~~V..lt. ~~,~:J?l~~U~:
!jitUnlt,k~ .~:,;Unlt P,rlce.:o:~~::
Contractor to remove fuels that could 5,000.00 I
be hazardous in a wildfire per the
attached contract.
Contract for Firewise Hazardous
Vegetation Removal
Beginning date: May 15, 2011
Completion date: May 15, 2013
Insurance required/On file
FY 2011 - $5,000 ,
FY 2012 - $20,000
SUBTOTAL 5 000.00
BILL TO: Account Payable rAX 0.00
20 EAST MAIN ST FREIGHr 0.00
541-552-2028 TOTAL 5,000.00
ASHLAND, OR 97520
~ccountlNumljjjr~ liIll}fp'i'OjectlNumberlllilill':l liItilf~ountlIllllil iar~ccounflNwn~e~ IIIIIilIP.i'OjOci1Num~er~ m'.- ~l11ount-
E 670.08.29.00.60416 E 000239.400 5000.00
~~ .dL
.~ 6~
Au ed Slgnatufa
VENDOR COpy
I FORM#3 I
A request for a Purchase Order
REQUISITION
CITY OF
ASHLAND
Date of request:
Required date for delivery:
5/31/11
6/2/11
Vendor Name
Address, City, State, Zip
Contact Name & Telephone Number
Fax Number
Hooper Springs Tree Service
PO Box 3258 Ashland, OR 97520
Mall Ison M 1-4~~-lL~L nooperspnngs@gmall,com
SOLICITATION PROCESS
o Exemot from Comoetitive Biddlna 0 Emeraencv
Reason for exemption: o Invitation to Bid (Copies on file) 0 Written findings attached
Date approved by Councii: o Quote or Proposai attached
o Small Procurement CooDerative Procurement
Less than $5,000 o Reauesllor Prooosal (Copies on file) o State of Oregon
Note: Total contract amount, inciuding any Date approved by Councii: Contract #
amendments may not exceed $6,000 o State of Washington
Intermediate Procurement 0 Sole Source - Contract #
GOODS & SERVICES 0 Written findings attached o Other government agency contract
$5,000 to $100,000 0 Quote or Proposal attached Agency
~ (3) Written quotes attached Contract #
PERSONAL SERVICES 0 Soeclal Procurement 0 Intergovernmental Agreement
$5,000 to $75,000 o Written findings attached Agency
o Less than $35,000, by direct appointment o Quote or Proposal attached Contract #
o (3) Written proposals attached Date aooroved bv Council: Date approved by Council:
Description of SERVICES
The work will be performed on public or private properties designated by the Firewise
Community's Action Plan, and approved by Ashland Fire & Rescue. Scope of work
includes removal of fuels that could be hazardous in a wildfire. Potential work includes,
but is not limited to, cutting of trees, brush, and limbs, pruning, chipping, transportation of
materials to off-site facility such as landfill or golf course for wood chip collection, leaf
blowing, raking, root removal, stump grinding, blackberry removal, and weed-pulling.
Material will not be burned.
Item # Quantity Unit
Total Cost
$5000,00
N/A
":rOTAil',cOST. .-
0 Per attached QUOTE -FY ? tJ t- { ,$:: ,. , , . '
Description of MATERIALS
Unit Price
Total Cost
Project Number 000239,400 Account Number 670.08.29,00,604160 Account Number _ _ _ - _ _ - _ _ - _ _ . __
'Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. Affach exlre pages if needed,
By signing this requisffion form, I certify that the information provided aoove meets the Cfty's public contracting requirements, and the documentation can be provided
upon request.
Employee Signature:
~'/~
Department Head Signature: ~ ~ WVv"I
N- ~ ?6A/
Finance Director Date
Additional signatures (If applicable):
Funds appropriated for current fiscal year: GD NO
Comments:
Amount desianated for FY 2011
G: FinanceIProcedure\APIForms\2011 HooperSpnngsRequisllion.doc
Updated on: 5/31/2011