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HomeMy WebLinkAbout2016-27132016 -2713 AGREEMENT O. SERVICES THIS AGREEMENT is made on the _ �Z da y of ri ,between the CITY OF COLUMBIA HEIGHTS ( "City "), whose business address is 825 41't Avenue NE, Columbia Heights, NIN 55421, and DuAll Services Inc. ( "Contractor "), whose business address is 636 — 39h Avenue NE, Columbia Heights, MN 55421. 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 compensation 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's A and B, attached and made a part of this Agreement. The Contractor shall, in the execution of services, confonn to all applicable federal, state, and local 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 B, attached and made a part of this Agreement. 5. Method of Payment. The Contractor 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 Contractor except to compensate Contractor for 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. 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, 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 any 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. 11. 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 final payments and all 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 $1,000,000. 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 Statutes 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. r Attest: City Clerk MKOAA MAO 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: A I am not required to have workers' compensation liability coverage because: ❑ 1 have no employees covered by the law. ❑ Other (specify): 1 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. Contractor (Signature) 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 instructed by the Fire Department or his representative. Removal of weeds and long grass includes trimming along all fences, walls and structures, trimming around all trees and permanent objects, and the mulching or removal of all clippings. (c) Digital photo's shall be taken on every property prior to cutting and after cutting and shall be sent to the fire department upon completion and also retained by contractor. City of Columbia Heights Snow Removal 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 snow removal. (b) Contractor shall, within two business days, to remove snow from requested areas by City staff. (c) Digital photo's shall be taken on every property prior to removal and after removal and shall be sent to the fire department upon completion and also retained by contractor. City of Columbia Heights Tall Grass and Weed Removal Program Exhibit B DuAll Services, Inc. 636-3 9th avenue NE Columbia Heights, MN 55421 dterruqyez@duallservices.com Contacts: David Contractor Information Pricing $45 for first hour. Time over the initial hour will be paid at $11.25 for quarter hour increments. City of Columbia Heights Snow Removal Program Exhibit B DuAll Services, Inc. 636-3 9th Avenue NE Columbia Heights, MN 55421 dterriquez@duallservices.com Contacts: David Contractor Information Pricing $45 for first hour. Time over the initial hour will be paid at $11.25 for quarter hour increments. Form request for Taxpayer Social security number Give Form to the (Rev. December oft 20eas Department Identification Number and Certification requester. Do not rnal Rev rue Service Internal Revenue Service send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. OLLM 5ey-6 t\i m m m 2 Business name /disregarded entity name, if different from above Employer identification number CL ° u 3 Check appropriate box for federal tax class floation; check only one of the following seven boxes: ❑ IndividuaVsoie proprietor or P p ❑ C Corporation 9 S Corporation ❑ Partnership ❑ Trust/estate 4 Exemptions (codes apply only to certain entities, not individuals; see a o y� 2 single- member LLC ❑ Limited liability company. Enter the tax classification (C =C corporation, S =S corporation, P =partnership) 01 instructions on page 3): Exempt payee code (if any) o c Note. For a single- member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single- member owner, Exemption from FATCA reporting p`, " U ❑ Other (see instructions ► ) code ('rf any) !Applies to accounts mainlalned outside the U.S.) .5 a 5 Address (number, street, d apt or suite no.) {{ -3 A t u� Requester's name and address (optional) CO xo m 6 City, state and ZIP ode ��33 .� ..((� /� C�Ium iQ t��..t_5hf5I,j P d dN 66 f LI i List account number(s) here (optional) ca.t+oy c ucnuuliquVlI Imulnuier I, I RIM) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. For individuals, this is generally your social security number ( page However, fo thra resident alien, sole proprietor, ar disregarded entity, see the Part I instructions on page 3. For oer _ m _ entities, it is your employer identification number (EIN). If you do not have a number, see Now to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for or Employer identification number guidelines on whose number to enter. r r—, —, - -� — — OMMUMMENIM 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. 1 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. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. 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 pane 3. rl Signature of , 6 /� Here U.S. person ► 4A_44_. —� W V_ P pate ► General Instructions Section references are to the Internal Revenue Code unless othenuise noted. Future developments. Information about developments affecting Form W -9 (such as legislation enacted after we release it) is at www.irs.gov1tw9. Purpose of Form An individual or entity (Form W -9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (MN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: • Form 1099 -INT (interest earned or paid) • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099 -MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099 -8 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099 -S (proceeds from real estate transactions) • Form 1099 -K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098 -E (student loan interest), 1098 -T (tuition) • Form 1099 -C (canceled debt) • Form 1099 -A (acquisition or abandonment of secured property) Use Form W -9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W -9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or - 3. Claim exemption from backup withholding if you are a U.S, exempt 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, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Cat. No. 10231X Form W -9 (Rev. 12 -2014) AC r ® CERTIFICATE LIABILITY INSURANCE DATE(MM /DD/YYYY) 4/13/2016 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, Inc. 3600 American Boulevard West Suite 500 CONTACT NAME: Janelle Harms PHONE 952- 358 7500 FAX N . 952- 358 -7501 E-MAIL .Janelle_Harms9a jg com Bloomington MN 55431 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Westfield Insurance Company 24112 $1,000,000 INSURED INSURERB:American Select Insurance Company 19992 DuAll Service Contractors 636 NE 39th Avenue INSURER C: $10,000 GEN'L %< Minneapolis, MN 55421 INSURER D: AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OPAGG INSURER E: INSURER F: A AUTOMOBILE X COVERAGES CERTIFICATE NUMBER. 604663680 RFVICIr)N NI IMRF:P- 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR TRA5316576 6/30/2015 6/30/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $500,000 MED EXP (Any one person) $10,000 GEN'L %< PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OPAGG $2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO AUT OWNED SCHEDULED HIRED AUTOS NON -OWNED AUTOS TRA5316576 6/30/2015 6/30/2016 SINGLE L Eacdent $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE TRA5316576 6/30/2015 6/30/2016 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WCP5316838 6/30/2015 6/3012016 X STATUTE OERH E.L. EACH ACCIDENT s500,000 E.L. DISEASE - EA EMPLOYE $500,000 E.L. DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 7 Llli�l: i� \�9 City of Columbia Heights 590 40th Avenue NE Columbia Heights MN 55421 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD