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HomeMy WebLinkAbout2011-307 Contract - Thornton Engineering Inc Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: Thornton Engineering, Inc. -ASH LAND CONTACT: Michael Thornton, P.E., President 20 East Main Street Ashland,Oregon 97520 ADDRESS: P.O. Box 476 Telephone: 541/488-6002 Jacksonville, OR 97530 Fax: 541/488-5311 TELEPHONE: (541)899-1489 DATE AGREEMENT PREPARED: 11103/11 FAX: 541 899-3419 BEGINNING DATE: 11/03/11 COMPLETION DATE:06130/12 COMPENSATION: $11,068.20 SERVICES TO BE PROVIDED: See attached proposal dated November 2, 2011 for Project No. 2011-33 ADDITIONAL TERMS: FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1)the services to be acquired are personal services;(2)the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4)the undersigned consultant has specialized experience,education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5)the consultant's proposal will best serve the needs of the City; and (6)the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings/Recitations.The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall,at its own risk and expense,perform the personal services described above and, unless otherwise specified,furnish all labor,equipment and materials required for the proper performance of such service. 3. Qualifled Work: Consultant has represented,and by entering into this contract now represents,that all personnel assigned to the work required under this contract are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and,if required to be registered, licensed or bonded by the State of Oregon,are so registered,licensed and bonded. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service 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. 6. Ownership of Documents:All documents prepared by Consultant pursuant to this contract shall be the property of City. 7. Statutory Requirements:ORS 279C:505,279C.515,279C.520 and 279C.530 are made part of this contract. S. Living Wage Requirements: If the amount of this contract is$18,890 or more,Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage,as defined in this chapter,to all employees performing work under this contract and to any Subcontractor who performs 50%or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification:Consultant 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 Consultant(including but not limited to, Consultants employees,agents,and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses,expenses,claims,subrogation, action, costs,judgments,or other damages,directly,solely,and proximately caused by the negligence of City. 10. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. G:Vub-wrksleng\1133 2012 Misc.Concretes Admin%Eng VendorltContract Documents%Final Contr DocsX1 1-33 Thornton Engineering Contract.dorx,Page t of 5' b. City'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 Consultant, 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 stale 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 Consultant to provide the services required by this contract is for any reason denied, revoked,suspended,or not renewed. d. For Default or Breach. L Either City or Consultant may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the parry 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 Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant 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. Obligation/Liability 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,Consultant shall immediately cease all activities under this contract,unless expressly directed otherwise by City in the notice of termination. Further,upon termination, Consultant shall deliver to City all contract documents, Information,works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers'compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all . persons employed by them,and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant,warranty,certification,or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license,certificate or certification that is required to perform the Services or to qualify as a ORF if consultant has qualified as a QRF for this agreement;institutes an action for relief in bankruptcy or has instituted against it an action for insolvency;makes a general assignment for the benefit of creditors;or ceases doing business on a regular basis of the type identified in its obligations under the Contract;or attempts to assign rights in,or delegate duties under,the Contract. 14. Insurance. Consultant 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. Professional Liability insurance with a combined single limit,or the equivalent,of not less than Enter one: $200,000,$500,000,$1.000.000.$2,000,000 or Not Applicable for each claim, incident or occurrence. This is to cover damages caused by error,omission or negligent acts related to the professional services to be provided under this contract. C. General Liability insurance with a combined single limit,or the equivalent,of not less than Enter one: $200,000,$500,000,51.000,000.$2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contract. d. Automobile Liability 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. e. Notice of cancellation or change. There shall be no cancellation,material change,reduction of limits or G:\pub-wrks\eng\11-33 2012 Misc.Concrete% Admin\Eng Vendorl\Contract DommentsWinal Contr Docs\11-33 Thornton Engineering Contract.dom,Page 2 of 5 intent not to renew the insurance coverage(s)without 30 days'written notice from the Consultant or its insurer(s)to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon,and its elected officials,officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Consultant's services to be provided under this Contract.The consultant's insurance is primary and non-contributory.As evidence of the insurance coverages required by this Contract,the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. The certificate 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 Consultant shall be financially responsible for all pertinent deductibles,self-insured retentions and/or self- insurance. 15. Governing Law;Jurisdiction;Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim,action,suit or proceeding(collectively,'the claim's between the City(and/or any other or department of the State of Oregon)and the Consultant 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. Consultant,by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution,or otherwise,from any claim or from the jurisdiction. 16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE,SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS,AGREEMENTS,OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE,HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT,AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 17. NonappropdaUons 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. Consultant understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations,or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion,to continue to make payments under this contract. In the event City has insufficient appropriations,limitations or other expenditure authority,City may terminate this contract without penalty or liability to City,effective upon the delivery of written notice to Consultant,with no further liability to Consultant. Certification. Consultant shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Consultant: City of Ashland ByP/ — By MSS �_aSL� Signature / Department Head LPrint Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. G:tpub-w*sWngN 1-33 2012 Misc.Concrete\A Admin\Eng Vendorl\Contract DocumentsTinal Contr DocsN 1-33 Thornton Engineering Contract.docx,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 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: y (1) 1 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. f (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. V-'f (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor.or services to be provided. �� Contractor (Date) G:\pubwrks\eng\1133 2012 Misr.ConcreteW_Admin\Eng Vendort\Contrad Documents\Final Contr Docs\11.33 Thornton Engineering Contract.dom,,Page 4 of 5 NORNION INGINURING INC. EXHIBIT A-SCOPE AND COST 10:54 AM: 11118rzot t TASK 2011 MISC.CONCRETE PROJECT. THORNTON ENGINEERING,INC Role:0ZM=M1 RiUmLimmm Mgnmcimim o Hourly Rafe: $1051hr) (5951hr) I (5851hr) I ($751hr) r ¢Schematic Design 4 19 10 0 I.J.•5 Topographic Survey 10 10 1.2"! RNJ Boundary Survey To be determined if required 1.3." Preliminary Design 1 8 Project Startup Meetng 1 1 1.5'` Project Management 2 I Construction Documents 1 10 0 1 Construction Documents Set 60% 1 8 2.21 ; Submittal 1 2.9 Meeting Two: Comment Review 2 m Prepare Final Bid Set 7 6 0 2 3:1'. Develop Fnal Bid Set-Full and Half Size Sets 1 4 3:2, Submit Final Bid Set Documents for Review 2 3.3;.� Prepare Technical Specifications 6 2 M Prepare and Submit Construction Permit Applications 0 0 0 0 5.1" Available to assist the City upon request • r IM Bidding 1 2 0 0 6 1;:•. Respond to Bid Inquiries 1 2 - r 019 Construction 2 20 10 0 7:1: Attend Pre Construction Meeting 2 2 72..; Construction Staking _ 10 10 T3 ;, Respond to RFIs,Submittals and Change Orders 4 7(4=.'. Respond to Construction Inquires 4 .: r ) Review and Submission of as-built information 0 8 0 0 8iv' Prepare and Submit 'Record Drawing"Set 8 Individual Totals(hours) 15 65 20 3 - Fimn Totals(cost) $9,676.00 4.0% Reimbursable Expenses $387.00 0%Subconsultant Management 50.00 Consultant Total Fee $10,062.00 10%Contingency $1,006.20 TOTAL FEE ?a,°''-- =57:1.068:26 OrfIce(541)899'1489 Fax(541)899.3419 P.O.66x 476,260 N.3rd Street,Jacksonville,OR 97530 0 0 0 0 0 0 0 0 0 0 N N G - N n O (4 (C o] h CO M w O w N O O O O M � � �q � M � Q v of U 2 C _ L Z0 0 CI O O O O O (O O N co z co W W ' Z z 2 W Z 0 L W � � co O 00 N to V N N N V w w c o , F H N U L Z , N I P r �- b O r .- N N in o Q w W a 0 U N m L O 2 o m m w = 6 a ti c m a 0 o v U) 3 Q 0 R « E m N N > E Vi m O U E U � a � m `c 0 C W a o 3 = y w 4 a m m N N a c c V O C c '� W D 0 N > N N N — E d m c CL H w LL0 cL• m � = � o 0 _ d F T d o aci p a�i V U o .0 C = L" N « n N N 0) W TO E y N .... m _. r = U m7 U N C W a d2cQ, m > > — E (n0N � 2 � U) u_+ rO dem c � m @ o a m E N c Y E ... a A a U rn , - E U a a U a . v m c E n K Z N a N o o ._ U m _ 'C O N a c a p H N W U d , co m j3 Cl ACNU DO m CUc � U Na p `_mc0 0 L C Z. N N O O U 3 C c N C Q O 0 0 0 0 0 .O C F N '� ~ 0 W U U d ] f0 fn 2 " U ~ LL lL ~ A N a +' U a a C .0.� C C W (A r E O c O ` Ul m d N C O a ` C C {C N L° N c LL m m E U U U1 C E N OI O a O O 0 7 C '� 07 GI d d 0 0 N C o N a >m W CL :E N 0 N c N h N N > ~ E V N s Q r 0 C O p N z w > N C O N N O ur aa` a` 0U (o2 ° 0U) a � ¢ 4a O ¢ Uww ma O € •m � oo0 N N U a a m U K clLm O F a f L: NMV N — � NM�.r —e) c - L N (VLN�_ M My.M (O- r r I`.h m-__ Y -- N F .�� 9THOREN OP ID:JS A`iRO. CERTIFICATE OF LIABILITY INSURANCE DATE MWD°"" 11107f11 THIS CERTIFICATE 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: N the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 endorsements. PRODUCER 541-7794232 NAME: Hart Insurance 541-772-3'96 PHONE INC.c N E41: ac No: 1123 Royal Ave. Medford, OR 97504 12 011 S: Hart Insurance/Medford INSURERS AFFORDING COVERAGE NAIC R INSURERA:Mutual of Enumclaw 14761 INSURED Thornton Engineering Inc INSURER13:TravelersCasual Surety PO Box 476 INSURER Jacksonville,OR 97530 : NSURER D INSURER F - IN$URERE: 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 POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AUDL SUB UMBE POLIO LICYEX LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CPP000633900 07101111 07/01/12 PREMISES Ea accunence $ 300,00 CLAIMS-MIA E FX OCCUR MED EXP(Any one person) $ 10,00 B X Professional E&O 105350491 10/01111 10/01/13 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEM AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY PRO Loc Prof E&O $ 1,000,00 AUTOMOBILE LIABILITY Ee accident $ 1,000,00 A X ANY AUTO CPP000633900 07101/11 07101112 BODILY INJURY(Par person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS NON6 ED art DN HIREDAUTOS Per accident) $ $ UMBRELLAUTAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMSNADE AGGREGATE $ WORKERS COMPENSATION RSTATU- OTH- ANDEMPLOYERS'LIABILITY YIN ANY PROPPETORPARTNERiE ECUTIE E.L.EACH ACCIDENT $ OFFICERdEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under As OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATONS I LOCAnONSI VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if...space Is required) itv of Ashland Oregon,its elected officials,officers and employees are Inc uded as additional insured as respects general liability per form CG30261 0105 attached. ERTIRCATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main Street Ashland,OR 97520 Hart Insurance RES I Medford Hart Insurance/Medford ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CPP000633900 COMMERCIAL GENERAL LIABILITY CG 32 61 10 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Ashland, Oregon, and its elected officials, officers and employees Location(s)Of Covered Operations: Information required to complete this Schedule if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sion applies: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury' or damage" or "personal and advertising injury' 'property damage"occurring after: caused by your ongoing operations for the addi- tional insured(s) at the location(s) designated 1. All work, including materials, parts or equip- above and only to the extent that such "bodily in- ment furnished in connection with such work, jury", "property damage"or"personal and advertis- on the project(other than service, maintenance ing injury' is caused by your negligence or the or repairs) to be performed by or on behalf of negligence of those performing operations on your the additional insured(s) at the location of the behalf covered operations has been completed, or 2. That portion of 'your work' out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 32 61 1006 0 ISO Properties, Inc., 2005 Page 1 of 1 ❑ w W.Saifxom OREGON WORKERS COMPENSATION saiF CERTIFICATE OF INSURANCE corporation CERTIFICATE HOLDER: CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND, OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. POLICY NO. POLICY PERIOD ISSUE DATE 910109 07/01/2011 to 07/01/2012 11/18/2011 INSURED: BROKER OF RECORD: THORNTON ENGINEERING INC THORNTON ENGINEERING PO BOX 476 JACKSONVILLE, OR 97530-0476 LIMITS OF LIABILITY: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Body Injury by Disease $500,000 policy limit DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: Misc Concrete 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. AUTHORIZED REPRESENTATIVE P Iz�d.�►—� President and CEO 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Poliry_cert fic tes_cenifcateOHnsumnce `:QTY RECORDER Page 1 / 1 �. CITY OF ASHLAND SHLAIVD DATE_ 6`t:°: P.O NUMBER.' 20 E MAIN ST. 11/29/2011 1 10569 ASHLAND, OR 97520 (541)488-5300 - VENDOR: 003753 SHIP TO: Ashland Public Works THORNTON ENGINEERING, INC (541)488-5587 PO BOX 476 51 WINBURN WAY JACKSONVILLE, OR 97530-0476 ASHLAND, OR 97520 FOB Point: Req.No.: Terms: Net Dept.: Req.Del.Date: Contact: Karl Johnson special Inst: Confirming? NO ce E ,- xt:P ,.. f .Unit Pn ::`..�..' .:�.- tice S.ta Engineering services for the design and 11,068.20 construction of the 2012 Miscellaneous Concrete Project 2011-33 Contract for Personal Services Beginning date: November 3, 2011 Completion date: June 30, 2012 Insurance required/On file SUBTOTAL 11 068.20 SILL To:Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 11,068.20 ASHLAND, OR 97520 r. , _ r1-_Account Number;.. , =„'P.roject Number.-I, .�'�'. Amount ' � �:.Aciount Number . - , ;i`Project Numbs r E 260.08.12.00.704200 E 201133.100 11 068.20 Autficirized Signature VENDOR COPY FORM #3 CITY OF A request for a Purchase Order ASHLAND REQUISITION Date of request: I t%15/2011:_'• Required date for delivery: .ASAP- r" Vendor Name Thornton Enclineering Inc Address,City,State,Zip P.O.Box 476 Jacksonville OR 97530 Contact Name&Telephone Number Michael Thornton P E President (541)899.1489 Fax Number (541)899.3419 SOLICITATION PROCESS ❑ Exempt from Competitive Bidding ❑ Ememencv ❑ Written Findings(Form attached) ❑ Invitation to Bid (Copies on file) ❑ Written findings attached ❑ Quote or Proposal attached Date approved by Council: ❑ Quote or Proposal attached ❑ Small Procurement Cooperative Procurement Less than$5.000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon Note:Total contract amount,including any Date approved by Council: Contract# amendments may not exceed$6,000 ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract# GOODS&SERVICES ❑ Written Findings(Form attached) ❑ Other government agency contract $5.000 to$100.000 ❑ Quote or Proposal attached Agency ❑ (3)Written quotes attached Contract# PERSONAL SERVICES ❑ Special Procurement E] Intergovernmental Agreement $5.000 to$75,000 ❑ Written Findings(Form attached) Agency ® Less than$35,000,by direct appointment ❑ Quote or Proposal attached Contract# ❑ 3 Written proposals attached Date approved by Council: Date approved by Council: Description of SERVICES Total Cost Provide engineering services for the design and construction of the 2012 Miscellaneous Concrete "` I Project. $1�1,068.•20 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL CO TS ❑ Per attached QUOTE S Project Number 2011.33 Account Number 260.08.12.00.704200 Account Number___-__-__-__-______ Account Number -__-_ •__-______ Account Number___•__-__-__-_ ____ 'Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. Attach extra pages if needed. By signing this requisition form, 1 certi that the information provided above meets the City's public contracting requirements,and the documentation can be provided upon request. Employee Signature: Department Head Signature: t(tM)•r.n.o R,<�� Additional signatures(if appli e): Funds appropriated for current fiscal year: 9/ NO Finance Directofl Date Comments: G:FlnancelProcedurel4PlForms111-33 Thornton Engineering Requisition.dou Updated on: 11/152011