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Contract 1994
~ss~ AGREEMENT FOR SERVICES PERFORMED BY INDEPENDENT CONTRACTOR THIS AGREEMENT is made on the 25th day of May, 2007, between the CITY OF COLUMBIA HEIGHTS ("City"), whose business address is 590 40`'' Ave. NE, Columbia Heights, MN 55421, and All Safe Alarms ("Contractor"}, whose business address is 91.5 Washington Ave N, Minneapolis, MN 55401 THE CITY AND CONTRACTOR AGREE AS FOLLOWS: 1. Independent Contractor. The City hereby retains the Contractor as an independent contractor upon the terms and conditions set forth in this Agreement. The Contractor is not an employee of the City and is free to contract with other entities as provided herein. Contractor shall be responsible for selecting the means and methods of performing the work. Contractor shall furnish any and all supplies, equipment, and incidentals necessary for Contractor's performance under this Agreement. City and Contractor agree that Contractor shall not at any time or in any manner represent that Contractor or any of Contractor's agents or employees are in any manner agents or employees of the City. Contractor shall be exclusively responsible under this Agreement for Contractor's own FICA payments, workers ccmpensatior~ payments, unemployment compensation payments, withholding amounts, and/or self-employment taxes if any such payments, amounts, or taxes are required to be paid. by law or regulation. 2. Contractor's Services. The Contractor agrees to provide services as described in Exhibit A, Quotation #CCH518, attached and made a part of this Agreement. The Contractor shall, in the execution of services, conform to all applicable federal, state, and Ioca1 laws, codes, ordinances, and regulations. 3. Time for Performance of Services. The Contractor shall perform the services according to Exhibit A. 4. Compensation for Services. The City agrees to pay the Contractor for services as described in Exhibit A. Compensation shall be in accordance with Exhibit A, attached and made a part of this Agreement. 5. Method of Payment. The Contractor shall submit to the City an itemized bill for professional service performed under this Agreement. Bills submitted shall be paid in the same manner as other claims made to the City. 6. Termination. Either party, without cause, may terminate this Agreement by seven (7) days' written notice delivered to the other party at the address written above. After termination, the City shall have no further obligation to Contractor except to compensate Contractor far services performed before Contractor's receipt of notice of termination. 7. Subcontractor. The Contractor shall not enter into subcontracts for services provided under this Agreement, except as noted in Exhibit A, without the express written consent of the City. $. Assignment. Neither party shall assign this Agreement, or any interest arising herein, without the written consent of the other party. 9. Indemnification. Contractor agrees to defend, indemnify and hold the City, its officers, and employees harmless from any liability, claims, damages, costs, judgments, or expenses, including reasonable attorney's fees, resulting directly or indirectly from an act or omission (including without limitation professional errors or omissions) of the Contractor, its agents, employees, or subcontractors in the performance of the services provided by this Agreement and against all losses by reason of the failure of said Contractor fully to perform, in an_y respect, all obligations under this Agreement. 10. Workers Compensation Insurance. Worker's compensation coverage shall be furnished meeting minimum requirements of Minnesota law. The Contractor shall provide proof of workers' compensation coverage and shall execute the form attached hereto. ll. Records Access. The Contractor shall provide the City access to any books, documents, papers, and records which are directly pertinent to the Agreement, for the purpose of making audit; examination, excerpts, and transcriptions, for three years after _fi_nal payments and ai_l other pending matters related to this Agreement are closed. 12. General Liability Insurance. The Contractor shall provide the City a Certificate of Insurance complying with the standard contractor's minimum coverage requirements of $1,000,00©. combined single limit na-ning the City of Columbia Heights as ai] additional insured. Contractor's liability policy shall be so endorsed with a copy delivered to the City. 1.3. Data Privacy. The Contractor shall comply with Minnesota Stahrtes Chapter 13, The Minnesota Government Data Practices Act. The Contractor shall not disclose non-public information except as authorized by the Act. 14. Ownership of Documents. All plans, diagrams, analyses, reports, and information generated in connection with performance of the Agreement shall become the property of the City. The City may use the information as it sees fit. Such use by the City shall not relieve any liability on the part of the Contractor. 15. Governing Law. The laws of the State of Minnesota shall control this Agreement. Executed as of the day and year first written above. CITY OF CO ,~~ City Administrator FIEI(~HTS 1 CONTRACTOR: ~` -- l~- F y Attest ~ 4 ~/ -*. J `y City Clerk PROOF OF WORKERS' COMPENSATION INSURANCE COVERAGE Minnesota Statutes Section 176.182 requires every governmental subdivision entering into a contract for doing any public work to obtain acceptable evidence of compliance with the workers' compensation insurance coverage requirement of Section 176.181, subd. 2. The information required is: the name of the insurance company, the policy number, and dates of coverage or the permit to self-insure. This information will be collected by the licensing agency and put in their company file. It will be furnished, upon request, to the Department of Labor and Industry to check for compliance with Minnesota Statutes Section 176.181, subd. 2. This information is required by law, and a contract for the doing of any public work may not be entered into if it is not provided and/or is falsely reported. Furthermore, if this information is not provided and/or is falsely reported, it may result in a penalty assessed against the applicant by the Commissioner of the Department of Labor and Industry payable to the Special Compensation Fund. Provide the information specified above in the spaces provided, or certify the precise reason your business is excluded from compliance with the insurance coverage requirement for workers' compensation. :. ~~U.~ . INSURANCE COMPANY NAME: ~~T (NOT the insurance agent) POLICY NO. OR SELF-INSURANCE PERMIT NO.: ~~(\r ® ~ I ~ ~ Q DATES OF COVERAGE: ~'/~'`` l ~ ~ ~~ `~f ~-~ ~a -OR- I am not required to have workers° compensation liability coverage because: ^ I have no employees covered by the law. ^ Other (specify): I HAVE READ AND UNDERSTAND MY RIGHTS AND OBLIGATIONS WITH REGARD TO PUBLIC CONTRACTS AND WORKERS' COMPENSATION COVERAGE, AND I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT. c~._. _ Co actor (Signature) °~~~`~ Cf ~ 915 Washington Avenue North Direct 612-455-2569 '~~=~i~?' ~ Minneapolis, MN 55401 Main 612-332-3473 Al~-°t~~ email: ian~all-safe.net Fax 612-321-9177 ~~ QUOTATION # CCH518 DATE: May 18/2007 ATTN: Gary Gorman -Fire Chief, Columbia Heights FD Phone: 763-706-3652 DESCRIPTION: Fire alarm inspections as described below. NOTE -the Inspection Charge for 2008 will increase by 7.5% (total = 698.75 plus tax) and another 7.5% in 2009 (total = 751.16 plus tax). ITEM QTY DESCRIPTION UNIT PRICE EXTENDED 1 1 Fire Alarm Inpsection - 555 Mill St NE (City Hall, FD, PD) - as per 250.00 250.00 NFPA 72 requirements, conduct sensitivity test on all SD's, test pull stations, heat detectors, horns, panel communications, panel condition and batteries. 2 1 Fire Alari~i Inpsection - 530 MIII St NE (iviurzyn Haii} - as per NFPA 250.00 250.00 72 requirements, conduct sensitivity test on all SD's, test pull stations, heat detectors, sprinkler switches, horns, panel communications, panel condition and batteries. 4 1 Fire Alarm Inspection - 637 - 38th Ave NE (Public Works} - as per 150.00 150.00 NFPA 72 requirements, conduct sensitivity test on ali SD's, test pull stations, heat detectors, horns, panel communications, panel condition and batteries. Sub-Total $ 650.00 Sales tax (if applicable) 43.23 Sub-Total $ 693.23 Quote Valid for 30 days All Terms Are contingent Upon Approved Credit Balance Due Net 30 Days. Finance charges of 1.5% per month will be charged on all overdue (past 30 days) accounts. All Prices Subject to Verification at Time of Order with All Safe Alar ms The acceptance of this proposal has been executed by a duly authorized officer of the Company below and is binding on the Company. iviodifying, inconsistent or additional terms and conditions on any company purchase orders or any other Companies originated writing shall in no matter become binding on All Safe Alarms unless expressly accepted by it in writing. Company acknowledges that the acceptance of this proposal is subject to All Safe Alarms approval. Proposed by: Printed Name -All Safe Alarms Signature Date Accepted by: Printed Name -Customer Signature Date AV®~I®Tm CERTIFICATE QF LIABILITY INSURANCE DATE(MMIDD/Y 4/4/2007 PRODUCER (651) 460-6014 FAx (651) 460-6625 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATI~ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA first national insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND ~ Ross Nesbit Agencies ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 324 Oak St, PO Box 130 Farmington MN 55024-0130 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:W2St Bend Mutual 15350 INSURER B All Safe Alarms 915 Washington Ave N Minneapolis MN 55401 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERT THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIC A(';(:RFr:ATP I I<,AITC CI-JIIVAIAI AAAV 41A\/G RGG~I RFllI1CFl1 RV PAI(1 CI AIMS INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MMIDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , X COMMERCIAL GENERAL LIABILITY PREMISES Ea o~ccurrDence _~-, _~_ $ 2 00 , A CLAIMS MADE OCCUR NSN0638436 4~21~2007 4~21~2008 MED EXP (Any one person) $ 10r PERSONAL S ADV INJURY $ 1 , 0 00 , GENERAL AGGREGATE $ 2 , 000 , GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2 , 0 0 0 , X POLICY JET LOC AU TOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 000 ANY AUTO (Ea accident) , , $ A ALL OWNED AUTOS NSN0638436 4~21~2007 4~21~2008 BODILY INJURY X SCHEDULED AUTOS (Per person) $ X. HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE _ __ $ --- $ DEDUCTIBLE ~ i I ~ $ RETENTION $ $ WORKERS COMPENSATION AND ' WC STATU- OTH- TORYLIMITS ER ___ EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT 100 ~ $ r A OFFICER/MEMBEREXCLUDED? SCN0699702 4~21~2007 4~21~2008 E.L. DISEASE - EA EMPLOYEE 100 i $ , If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT 500 $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ~~ p.. g~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE T R, ~„t ~ £~''~ - ~ @'Ji '~''/ ~~ EXPIRATION DATE THEREOF, THE ISSUING ENSURER WILL ENDEAVOR TO M! 10 DAYS WRETTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Bi FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON T INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ First Natianai ins./BG L-- `~~°--`~~~`~~~ ACORD 25 (2oavaa} ©ACORD CORPORATION ~ INSO25 (0108).06 AMS VMP Mortgage Solutions, Inc. (800}327-0545 Page Farrn ~1f7 ® ~q~4,g~~~ `~®r ~~~~~~~9' Give form to the (Rev. January 2002) reques'ter' ~O ntat ~~~~$~ta~a~a~rs ~u~~s ~P~d ~~~~-~~a~~~r~ send to the ii~s. department of the Treasury I nte: nal Revenue Service N Name ' J 19 ~ q ~~ 11 l6 ~- Business name, if different rrom above c N ~, Q Individual/ Exempt from bacitup _ ____ ^ withholding ~'~~ Check appropriate box: ^ Sale proprietor Corporation ^ Partnership ^ Other ~ ...___._____.__ O ~ Requester's name and address (optionap N Address (number, st~r~e~etl1 and apt. o~ suits no.} a ~ ~ ~ .J W O~.S ~~ 1ri t~i t..cQ. ~ ~~ ~ "' Cite, state, and ZIP code , ~ i ~ ~ ~ w„ in fist account numbers} ere (optiona } m m . _ '~aae~aver (l~EriC9TIGi~L1OC1 ~Ufrtl®er ~~~~ Enter your TIN in the appropriate box. For individuals, this is your social security number (SSN), e""r'' ~ "" F7owever, fior a resident alien, sale proprietor, or disregarded entity, sea the part i instructions on ~~~~--~! _J page 2. For other entities, it is your employer identification number (EINj. If you do not have a number, or see i~nw to aet a TiN on page 2. E in er identication Hamper `dote: !f the aocoun: is in more rt:an one name, see the chart on page 2 for guidelines on whose number mP~y ~ I~~-31E~1~1 fll Ir~~ to enter. __ a '.artaiar_nfiir~n Under penalties of perjury, i certiy 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 (!RS? that 1 am subject to backup withholding as a result or` 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, t am a U.S. person (including a U.S. resident alien). 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 ±ax return. For rea( 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 2.J ~--- Sign Signature of ~~__ ...,_-_..-- - ~ O~-q1` v5 ~~~ Here U.S. person i§> Date ~ ~ttr~ar~se ~f Ff~rrr+ A person who is required to File an Information return with the IRS must get 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 of debt, or contributlons you made to an lRA. Uss Form Vif•g only if you are a U.S. person (including a resident alien), to give your caned. TiN to the person requesting it (the requester} and, when applicable, to: 1. Certify the TIN you are giving is correct (or you are waiting for a number to be Issued), 2. Certify you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If you are a foreign person, use the appropriate Form W-8. See Puh. 5'15, Withholding of Tax an Nonresident A!(ens and Foreign Entities. :`:ota: tf a requester gives you a form other trhan Fcrm W-9 iv i aquest your Tlhl, you must use the requssrer`s form if it is substantially similar to this Form W-9. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 3D% of such payments after December 31, 2D01 (29% after December 31, 2003). This is called "backup withholding." Payments that may be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonempioyee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup ~: hholding. You will not 6e subject to backup withholding on payments you receive If you give the requester your correct TIN, make the proper certifications, and report al! your taicabi@ interest and dividends on your tax return. Payments you receive will he subject to backup withholding if: 1. You do not furnish your TIN to the requester, or 2, You do not certify your TIN when required (see the Part lI instructions on page 2 for details), or 3. The iRS tells the requester trial you famished an incorrect TIN, or 4. The IRS tells you that you are subject to Backup withholding because you aid not report ail your interest and dividends on your tax return (for reportable interest and dividends only}, or 5. `(t}u do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only): Certain payees and payments are exempt from bacl<uo withholding. See the instructions on page 2 and the separate Instructions for the Requester of Form W-8. ~ierft~iiies Failure to famish TIN. If you fail to famish your correct TIN to a requester, you are subject tb a penalty of 550 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civic penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no Backup withholding, you are subject to a X500 penalty. Criminal penalty for falsifying information. Willfully falsirying certifications br affirmations may subject you to criminal penalties including lines and/or imprisonment. Misuse of TINS, if the requester discloses or uses TINS in violation of Federal law, the requester may be Siibje,.t to Civil and Crimiinal penalties. Cat. Na. 1D231X Form ~-9 (Rev, ~-ZD02}