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Contract 2061
2069 AGREEMENT FOR SERVICES PERFORMED BY INDEPENDENT CONTRACTOR THIS AGREEMENT is made on the 1st day of_March , 2008, between the CITY AT. !}Ar itH.r nr • irT ~!'trl mll .n/'. •. - „ih yr wi,viv,niti nr,iuriia t any"j, whose busii~~ess address is ~~~ ~u___ Ave. iv E, Cohimbia Heights, MN 55421, and ,iohnson's Outdoor Services ("Contractor"), whose business address is 5011 179`'' Lane NW, Ramsey MN 55303. 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 ar~d methods of performing the work. Contractor shall fin-nish airy and all supplies, eduipmer~lt, and incidentals necessary for Co1~ltractor's performance Luider 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 compensation payments, unemployment compensation payments, withholding amounts, and/or self-employment taxes if airy stitch payments, amoLUits, or taxes are reduired to be paid by law or regulation. 2. Contractor's Services. The Contractor agrees to provide services as described in Exhibit A, attached and made a part of this Agreement. The Contractor shall, in the execution of services, conform to all applicable federal, state, and local laws, codes, ordinances, and regulations. 3. Time for Performance of Services. The Contactor shall perform the services according to Exhibit A. 4. Compensation for Services. The City agrees to pay the Contactor for services as described in Exhibit A. Compensation shall be in accordance with Exhibit B, attached and made a part of this Agreement. 5. Method of Payment. The Contactor shall submit to the City, on a monthly basis, itemized bills for professional services 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 Contactor except to compensate Contractor for services performed before Contactor's receipt of notice of termination. 7. Subcontractor. The Contractor shall not enter into subcontacts for services provided under this Agreement, except as noted in Exhibit A, without the express written consent of the city. 8. 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, judgYnents, or expenses, including reasonable atto~~ley's fees, resulting directly or indirectly fi-om an act or omission (inchiding without limitation professional errors or omissions) of the Contractor, its agents, empioyees, or subconu-actors in the performance of the services provided by this Agreement and against all losses by reason of the failure of said Contractor frilly to pel-form, in any respect, all obligations under this Agi°eement. l0. 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. 11. Records Access. The Contractor sha11 provide the City access to any books, documents, papers, and records which are directly pertinent to the Agreement, for the purpose of making audit, e~xarnination, excerpts, and transcriptions, for three years aher final payments and all other pending matters related to this Aln~eel~nent are closed. 12. General Liability Insurance. The Contractor shall provide the City a Cea-tillcate of Insurance complying with flee standard contractor's minimum. coverage requirements of $1,000,000. combined single limit naming the City of Columbia Heights as an additional insured. Contractor's liability policy shall be so endorsed with a copy delivered to the City. 13. Data Privacy. The Contractor shall comply with Minnesota Stahrtes Chapter 13, The Minnesota Govei7lment Data Practices Act. The Contractor shall riot 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. IS. Covernln~ Law. The laws of the State of Minnesota shall control this Agreement. Executed as of the day and year first written above. CO"I'RAC"~Ok: '~ 5 1 /- ~ ~,,,~.. w 4 P 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. ~~ INSURANCE COMPANY NAME: .... .- (NOT the insurance agent) POLICY NO. OR SELF-INSURANCE PERMIT NO.: DATES OF COVERAGE: ~ ~. `" g _ ~ ~ t'R -OR- I am not required to have workers' compensation liability coverage because: I have no employees covered by the law. ~' ^ Other (specify): f`~t, ~"` I HAVE READ AND UNDERSTAND MY RIGHTS AND OBLIGATIONS WITH REGARD TO PUBLIC CONTRACTS AND WORKERS' COMPENSATION COVERAGE, AND I CERT Y THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT. ~ '~ d r' ,- Contractor (Signatu~ Minnesota Workers' Compensation Assigned disk Pian Standard Workers' Compensation and Employers' Liability Policy Contract Administrator: RTW Inc. R'i"w NCCI Carrier Cade: 39579 P.O. Bax 390901 Minneapolis, Minnesota 55439-0901 1-888-273-9709 ii~ir=uKnnA r ivN NAOE WCIP Renewal of Na. New Policy Number: MNAR-0000014692-1 Association File Number: 3223068 1. -The Insured Chad Johnson TaxID#: 412020361 DBA: Johnson's Outdoor Services UIC#: Exempt 5011 179th Ln NW Date of Mailing: 03/2012007 Ramsey, MN 55303 X Individual Partnership Other workplaces not shown above: SEE WC990601 Corporation 8 Other 2. -The policy period is from 12:01 a.m. 03/09/2007 to 12:01 a.m. 03/09/2008 at the insured's mailing address. 3. A. Workers' Compensation Insurance: Part One of the policy applies to Workers' Compensation Law of the state{s} listed here: MN 8. Employers' Liability Insurance: Part Two of the policy applies to work in each state listed in ITEM 3.A.: The limits of our liability under Part Two are: Bodily Injury by Accident $500,000 Each Accident Bodily Injury by Disease $500,000 Each Employee Bodily Injury by Disease $500,000 Policy Limit C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: D. This policy includes these endorsements and schedules: See POLICY FORM AND ENDORSEMENT SCHEDULE attached. 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All information below is subject to verification and change by audit. PREMIUM BASIS RATES CODE ENTRIES IN THIS ITEM, EXCEPT AS SPECIFICALLY ESTIMATED ESTIMATED PER $100 OR NO. PROVIDED ELSEWHERE IN THIS CONTRACT; DO NOT ANNUAL TOTAL ANNUAL REMUNERATION MODIFY ANY OF THE OTHER PROVISIONS OF THIS POLICY. PREMIUM REMUNERATION See Schedule Minimum Premium: Agency Name and Address Mark Klobuchar Agency 4940 Vking Dr Ste 304 Edina, MN 55345 DATE: 3/20J2007 Manual Premium Increased Employer Liability Limits Standard Premium Minimum Premium Adjustment Adjusted Standard Premium Foreign Terrorism Surchar e Estimated Annual Premium Total Cost 9807 1 0990 9740 ' 0900 0174 3 Premium Paid to Date __~_ SIGNATURE: -++~.rx.~,-.--- 1 1 Includes copvrioht material of the National Council on Compensation Insurance used with its permission. !~~a CERTIFICATE aF LIABILITY INSURANCE 12/12/2007) PRODUCER (763> 574-7447 FAX (763} 574-7504 The Insurance Mart 6875 Hi hwa 65 NE 9 Y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fridley, MN 55432 INSURERS AFFORDING COVERAGE NAIC # INSURED Chad ]ohnson & 7ennifer Castle INSURER A. OWnerS Insurance 32700 ®BA: ]Ohnson OutdOOr SerVlCeS INSURER B: Auto-Owners Insurance 18988 5011 179th Lane NW INSURER C. Ramsey. MN 55303 INSURERD INSURER E COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY TBD 12/10/2007 12/10/2008 EACH OCCURRENCE $ 1 ~ 000 ~ 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50 ~ 000 CLAIMS MADE a OCCUR MED EXP (Any one person) $ 5 ~ 000 A PERSONA.! & ADL' INJURY $ ], ~ ®OQ} ~ ®®~ GENERAL AGGREGATE $ 2 , 000 , OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2 ~ 000 ~ ~~~ POLICY PRO- LOC JECT AUT OMOBILE LIABILITY 474602 5400 11/30/2007 11/30/2008 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 500,000 ALL OWNED AUTOS BODILY INJURY B 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 AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ . $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT -"' $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE "-"-"'~ $ -- ~--"" If yes, describe under SPECIAL PROVISIONS below .~ E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS ABC Co 5011 179th Lane NW Ramsey, MN 55303 ACORD 25 (2001/081 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ]oseph Washleski ~-~ ©ACORD CORPORATION 1988 City of Columbia Heights Tall Grass and Weed Removal Program Exhibit A Description of Work Contractor will perform the following: (a) Contractor shall thoroughly familiarize themselves with City ordinances and State laws dealing with noxious weeds and long grass. (b) Contractor shall, within two business days, cut or remove weeds and long grass as instnicted by the City Weed Inspector or lZis representative. Removal of weeds and long grass includes trinvning along all fences, walls and structures, tl-imming around all trees and permanent objects, and the mulching or removal of all clippings. City of Columbia Heights Tall Grass and Weed Removal Program Exhibit B Contractor Information Johnson's Outdoor Services 5011 1.79`'' Lane NW Ramsey, MN 55303 (w) 763-757-1797 (Fax)763-757-0552 Contacts: Chad or Jenny Pricin $70.00 per hour with a minimum of one hour. Time over the initial bolo will be paid at quarter hour increments based on $70.00 per bolo.