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Shiels Obletz Johnsen ~ C110030 q s l 33 ° 2 ) CITY OF TIGARD, OREGON PERSONAL SERVICES CONTRACT REAL ESTATE CONSULTING FLEXIBLE SERVICES THIS AGREEMENT made and entered into this 18th day of February 2010 by and between the City of Tigard, a municipal corporation of the State of Oregon, hereinafter called City, and Shiels Obletz Johnsen, Inc., hereinafter called Contractor. RECITALS WHEREAS City has need for the services of a company with a particular training, ability, knowledge, and experience possessed by Contractor, and WHEREAS City has determined that Contractor is qualified and capable of performing the professional services as City does hereinafter require, under those terms and conditions set forth, THEREFORE the Parties agree as follows: 1. SERVICES TO BE PROVIDED Contractor shall initiate services immediately upon receipt of City's notice to proceed, together with an executed copy of this Agreement. Contractor agrees to complete work that is detailed in Exhibit A and by this reference made a part hereof. 2. EFFECTIVE DATE AND DURATION This Agreement shall become effective upon the date of execution, and shall expire, unless otherwise terminated or extended, on June 30, 2010. All work under this Agreement shall be completed prior to the expiration of this Agreement. 3. COMPENSATION City agrees to pay Contractor on a time and materials basis not to exceed Thirty -five Thousand Dollars ($35,000) for performance of those services described herein, which payment shall be based upon the following applicable terms: A. Payment by City to Contractor for performance of services under this Agreement includes all expenses incurred by Contractor, with the exception of expenses, if any identified in this Agreement as separately reimbursable. B. Payment will be made in installments based on Contractor's invoice, subject to the approval of the City Manager, or designee, and not more frequently than monthly. Payment shall be made only for work actually completed as of the date of invoice. C. Payment by City shall release City from any further obligation for payment to Contractor, for services performed or expenses incurred as of the date of the invoice. Payment shall not be considered acceptance or approval of any work or waiver of any defects therein. D. Contractor shall make payments promptly, as due, to all persons supplying labor or materials for the prosecution of this work. City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services • F e • tf E. Contractor shall not permit any lien or claim to be filed or prosecuted against the City on any account of any labor or material furnished. F. Contractor shall pay to the Department of Revenue all sums withheld from employees pursuant to ORS 31 6.167. G. If Contractor fails, neglects or refuses to make prompt payment of any claim for labor or services furnished to Contractor or a subcontractor by any person as such claim becomes due, City's Finance Director may pay such claim and charge the amount of the payment against funds due or to become due the Contractor. The payment of the claim in this manner shall not relieve Contractor or their surety from obligation with respect to any unpaid claims. H. Contractor shall pay employees at least time and • a half pay for all overtime worked in excess of 40 hours in any one week except for individuals under the contract who are excluded under ORS 653.010 to 653.261 or under 29 USC sections 201 to 209 from receiving overtime. I. Contractor shall promptly, as due, make payment to any person, co- partnership, association or corporation, furnishing medical, surgical and hospital care or other needed care and attention incident to sickness or injury to the employees of Contractor or all sums which Contractor agrees to pay for such services and all moneys and sums which Contractor collected or deducted from the wages of employees pursuant to any law, contract or agreement for the purpose of providing or paying for such service. J. The City certifies that sufficient funds are available and authorized for expenditure to finance costs of this contract. 4. OWNERSHIP OF WORK PRODUCT City shall be the owner of and shall be entitled to possession of any and all work products of Contractor which result from this Agreement, including any computations, plans, correspondence or pertinent data and information gathered by or computed by Contractor prior to termination of this Agreement by Contractor or upon completion of the work pursuant to this Agreement. 5. ASSIGNMENT/DELEGATION Neither party shall assign, sublet or transfer any interest in or duty under this Agreement without the written consent of the other and no assignment shall be of any force or effect whatsoever unless and until the other party has so consented. If City agrees to assignment of tasks to a subcontract, Contractor shall be fully responsible for the acts or omissions of any subcontractors and of all • persons employed by them, and neither the approval by City of any subcontractor nor anything contained herein shall be deemed to create any contractual relation between the subcontractor and City. City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services 6. STATUS OF CONTRACTOR AS INDEPENDENT CONTRACTOR Contractor certifies that: A. Contractor acknowledges that for all purposes related to this Agreement, Contractor is and shall be deemed to be an independent contractor as defined by ORS 670.700 and not an employee of City, shall not be entitled to benefits of any kind to which an employee of City is entitled and shall be solely responsible for all payments and taxes required by law. Furthermore, in the event that Contractor is found by a court of law or any administrative agency to be an employee of City for any purpose, City shall be entitled to offset compensation due, or to demand repayment of any amounts paid to Contractor under the terms of this Agreement, to the full extent of any benefits or other remuneration Contractor receives (from City or third party) as a result of said finding and to the full extent of any payments that City is required to make (to Contractor or to a third party) as a result of said finding. B. The undersigned Contractor hereby represents that no employee of the City, or any partnership or corporation in which a City employee has an interest, has or will receive any remuneration of any description from Contractor, either directly or indirectly, in connection with the letting or performance of this Agreement, except as specifically declared in writing. If this payment is to be charged against Federal funds, Contractor certifies that he /she is not currently employed by the Federal Government and the amount charged does not exceed his or her normal charge for the type of service provided. Contractor and its employees, if any, are not active members of the Oregon Public Employees Retirement System and are not employed for a total of 600 hours or more in the calendar year by any public employer participating in the Retirement System. C. For Tigard based businesses, Contractor certifies that it currently has a City business license, or will obtain one prior to delivering services under this Agreement. D. Contractor is not an officer, employee, or agent of the City as those terms are used in ORS 30.265. 7. INDEMNIFICATION City has relied upon the professional ability and training of Contractor as a material inducement to enter into this Agreement. Contractor warrants that all its work will be performed in accordance with generally accepted professional practices and standards as well as the requirements of applicable federal, state and local laws, it being understood that acceptance of a contractor's work by City shall not operate as a waiver or release. Contractor agrees to indemnify and defend the City, its officers, agents and employees and hold them harmless from any and all liability, causes of action, claims, losses, damages, judgments or other costs or expenses including attorney's fees and witness costs and (at both trial and appeal level, whether or not a trial or appeal ever takes place) that may be asserted by any person or entity which in any way arise from, during or in connection with the performance of the work described in City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services this contract, except liability arising out of the sole negligence of the City and its employees. Such indemnification shall also cover claims brought against the City under state or federal worker's compensation laws. If any aspect of this indemnity shall be found to be illegal or invalid for any reason whatsoever, such illegality or invalidity shall not affect the validity of the remainder of this indemnification. 8. INSURANCE Contractor and its subcontractors shall maintain insurance acceptable to City in full force and effect throughout the term of this contract. Such insurance shall cover all risks arising directly or indirectly out of Contractor's activities or work hereunder, including the operations of its subcontractors of any tier. The policy or policies of insurance maintained by the Contractor and its subcontractor shall provide at least the following limits and coverages: A. Commercial General Liability Insurance Contractor shall obtain, at contractor's expense, and keep in effect during the term of this contract, Comprehensive General Liability Insurance covering Bodily Injury and Property Damage on an "occurrence" form (1996 ISO or equivalent). This coverage shall include Contractual Liability insurance for the indemnity provided under this contract. The following insurance will be carried: Coverage Limit General Aggregate 1,000,000 Products - Completed Operations Aggregate 1,000,000 Personal & Advertising Injury 1,000,000 Each Occurrence 1,000,000 Fire Damage (Any one fire) 50,000 Medical Expense (Any one person) 5,000 B. Commercial Automobile Insurance Contractor shall also obtain, at contractor's expense, and keep in effect during the term of the contract, Commercial Automobile Liability coverage including coverage for all owned, hired, and non -owned vehicles. The Combined Single Limit per occurrence shall not be less than $1,000,000. C. Workers' Compensation Insurance The contractor, its Subcontractors, if any, and all employers providing work, labor, or materials under this Contract that are subject employers under the Oregon Workers' Compensation Law shall comply with ORS 656.017, which requires them to provide workers' compensation coverage that satisfies Oregon law for all their subject workers. Out - of -state employers must provide Oregon workers' compensation coverage for their workers who work at a single location within Oregon for more than 30 days in a calendar year. Contractors who perform work without the assistance or labor of any employee need not obtain workers' compensation coverage. All non - exempt employers shall provide Employer's Liability Insurance with coverage limits of not less than $500,000 each accident. City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services D. Additional Insured Provision The Commercial General Liability Insurance and Commercial Automobile Insurance policies and other policies the City deems necessary shall include the City, its officers, directors, and employees as additional insureds with respect to this contract. E. Notice of Cancellation There shall be no cancellation, material change, exhaustion of aggregate limits or intent not to renew insurance coverage without 30 days written notice to the City. Any failure to comply with this provision will not affect the insurance coverage provided to the City. The 30 days notice of cancellation provision shall be physically endorsed on to the policy. F. Insurance Carrier Rating Coverages provided by the Contractor must be underwritten by an insurance company deemed acceptable by the City. The City reserves the right to reject all or any insurance carrier(s) with an unacceptable financial rating. G. Certificates of Insurance As evidence of the insurance coverage required by the contract, the Contractor shall furnish a Certificate of Insurance to the City. No contract shall be effected until the required certificates have been received and approved by the City. The certificate will specify and document all provisions within this contract. A renewal certificate will be sent to the above address 10 days prior to coverage expiration. H. Independent Contractor Status The service or services to be rendered under this contract are those of an independent contractor. Contractor is not an officer, employee or agent of the City as those terms are used in ORS 30.265. I. Primary Coverage Clarification The parties agree that Contractor's coverage shall be primary to the extent permitted by law. The parties further agree that other insurance maintained by the City is excess and not contributory insurance with the insurance required in this section. J. Cross - Liability Clause A cross - liability clause or separation of insureds clause will be included in all general liability, professional liability, pollution and errors and omissions policies required by this contract. Contractor's insurance policy shall contain provisions that such policies shall not be canceled or their limits of liability reduced without thirty (30) days prior notice to City. A copy of each insurance policy, certified as a true copy by an authorized representative of the issuing insurance company, or at the discretion of City, in lieu thereof, a certificate in form satisfactory to City certifying to the issuance of such insurance shall be forwarded to: Sean Farrelly, Redevelopment Project Manager City of Tigard Business Phone: 503- 718 -2420 13125 SW Hall Blvd. Business Fax: 503- 718 -2420 Tigard, Oregon 97223 Email Address: Sean @tigard - or.gov Such policies or certificates must be delivered prior to commencement of the work. City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services The procuring of such required insurance shall not be construed to limit contractor's liability hereunder. Notwithstanding said insurance, Contractor shall be obligated for the total amount of any damage, injury, or loss caused by negligence or neglect connected with this contract. 9. METHOD & PLACE OF SUBMITTING NOTICE, BILLS AND PAYMENTS All notices, bills and payments shall be made in writing and may be given by personal delivery, mail or by fax. Payments may be made by personal delivery, mail, or electronic transfer. The following addresses shall be used to transmit notices, bills, payments, and other information: City Contractor City of Tigard Company: Shiels Obletz Johnsen, Inc. Attn: Sean Farrelly Attn: Kim Knox 13125 SW Hall Blvd., Tigard, Oregon 97223 Address: 1140 SW 11 Suite 55; Portland, OR 97205 Phone: 503- 718 -2420 Phone: 503.242.0084 Fax: 503- 718 -2748 Fax: 503.299.6769 Email Address: Sean @tigard - or.gov Email Address: knox cr soipdx.com and when so addressed, shall be deemed given upon deposit in the United States mail, postage prepaid, or when so faxed, shall be deemed given upon successful fax. In all other instances, notices, bills and payments shall be deemed given at the time of actual delivery. Changes may be made in the names and addresses of the person to who notices, bills and payments are to be given by giving written notice pursuant to this paragraph. 10. MERGER This writing is intended both as a final expression of the Agreement between the parties with respect to the included terms and as a complete and exclusive statement of the terms of the Agreement. No modification of this Agreement shall be effective unless and until it is made in writing and signed by both parties. 11. PROFESSIONAL SERVICES The City requires that services provided pursuant to this agreement shall be provided to the City by a Contractor that does not represent clients,on matters contrary to City interests. Further, Contractor shall not engage services of an attorney and/or other professional who individually, or through members of his/her same firm, represents clients on matters contrary to City interests. Should the Contractor represent clients on matters contrary to City interests or engage the services on an attorney and /or other professional who individually, or through members of his /her same firm, represents clients on matters contrary to City interests, Contractor shall consult with the appropriate CITY representative regarding the conflict. After such consultation, the Contractor shall have 7 days to eliminate the conflict to the satisfaction of the City. If such conflict is not eliminated within the specified time period, the agreement may be terminated pursuant to Section 13 (B) (3) of this agreement. City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services • 12. TERMINATION WITHOUT CAUSE At any time and without cause, City shall have the right in its sole discretion, to terminate this Agreement by giving notice to Contractor. If City terminates the contract pursuant to this paragraph, it shall pay Contractor for services rendered to the date of termination. 13. TERMINATION WITH CAUSE A. City may terminate this Agreement 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: 1) If City funding from federal, state, local, or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services. This Agreement may be modified to accommodate a reduction in funds 2) 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 Agreement. 3) If any license or certificate required by law or regulation to be held by Contractor, its subcontractors, agents, and employees to provide the services required by this Agreement is for any reason denied, revoked, or not renewed. 4) If Contractor becomes insolvent, if voluntary or involuntary petition in bankruptcy is filed by or against Contractor, if a receiver or trustee is appointed for Contractor, or if there is an assignment for the benefit of creditors of Contractor. Any such termination of this agreement under paragraph (a) shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination. B. City, by written notice of default (including breach of contract) to Contractor, may terminate the whole or any part of this Agreement: 1) If Contractor fails to provide services called for by this agreement within the time specified herein or any extension thereof, or 2) If Contractor fails to perform any of the other provisions of this Agreement, or so fails to pursue the work as to endanger performance of this agreement in accordance with its terms, and after receipt of written notice from City, fails to correct such failures within ten (10) days or such other period as City may authorize. 3) if Contractor fails to eliminate a conflict as described in Section 11 of this agreement. The rights and remedies of City provided in the above clause related to defaults (including breach of contract) by Contractor shall not be exclusive and are in addition to any other rights and remedies provided by law or under this Agreement. If City terminates this Agreement under paragraph (b), Contractor shall be entitled to receive as full payment for all services satisfactorily rendered and expenses incurred, an amount which bears the same ratio to the total fees specified in this Agreement as the services satisfactorily rendered by Contractor bear to the total services otherwise required to be City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services performed for such total fee; provided, that there shall be deducted from such amount the amount of damages, if any, sustained by City due to breach of contract by Contractor. Damages for breach of contract shall be those allowed by Oregon law, reasonable and necessary attorney fees, and other costs of litigation at trial and upon appeal. 14. ACCESS TO RECORDS City shall have access to such books, documents, papers and records of Contractor as are directly pertinent to this Agreement for the purpose of making audit, examination, excerpts and transcripts. 15. FORCE MAJEURE Neither City nor Contractor shall be considered in default because of any delays in completion and responsibilities hereunder due to causes beyond the control and without fault or negligence on the part of the parties so disenabled, including but not restricted to, an act of God or of a public enemy, civil unrest, volcano, earthquake, fire, flood, epidemic, quarantine restriction, area -wide strike, freight embargo, unusually severe weather or delay of subcontractor or supplies due to such cause; provided that the parties so disenabled shall within ten (10) days from the beginning of such delay, notify the other party in writing of the cause of delay and its probable extent. Such notification shall not be the basis for a claim for additional compensation. Each party shall, however, make all reasonable efforts to remove or eliminate such a cause of delay or default and shall, upon cessation of the cause, diligently pursue performance of its obligation under the Agreement. 16. NON - WAIVER The failure of City to insist upon or enforce strict performance by Contractor of any of the terms of this Agreement or to exercise any rights hereunder should not be construed as a waiver or relinquishment to any extent of its rights to assert or rely upon such terms or rights on any future occasion. 17. NON - DISCRIMINATION Contractor agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statues, rules, and regulations. Contractor also shall comply with the Americans with Disabilities Act of 1990, ORS 659.425, and all regulations and administrative rules established pursuant to those laws. 18. ERRORS Contractor shall perform such additional work as may be necessary to correct errors in the work required under this Agreement without undue delays and without additional cost. 19. EXTRA (CHANGES) WORK Only Sean Farrelly, the Redevelopment Project Manager, may authorize extra (and /or change) work. Failure of Contractor to secure authorization for extra work shall constitute a waiver of all right to adjustment in the contract price or contract time due to such unauthorized extra work and Contractor thereafter shall be entitled to no compensation whatsoever for the performance of such work. City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services 20. ATTORNEY'S FEES • In case suit or action is instituted to enforce the provisions of this contract, the parties agree that the losing party shall pay such sum as the court may adjudge reasonable attorney fees and court costs, including attorney's fees and court costs on appeal. 21. GOVERNING LAW The provisions of this Agreement shall be construed in accordance with the provisions of the laws of the State of Oregon. Any action or suits involving any question arising under this Agreement must be brought in the appropriate court of the State of Oregon. 22. COMPLIANCE WITH STATE AND FEDERAL LAWS/RULES Contractor shall comply with all applicable federal, state and local laws, rules and regulations, including, but not limited to, the requirements concerning working hours, overtime, medical care, workers compensation insurance, health care payments, payments to employees and subcontractors and income tax withholding contained in ORS Chapter 279B, the provisions of which are hereby made a part of this agreement. 23. CONFLICT BETWEEN TERMS It is further expressly agreed by and between the parties hereto that should there be any conflict between the terms of this instrument in the proposal of the contract, this instrument shall control and nothing herein shall be considered as an acceptance of the said terms of said proposal conflicting herewith. 24. AUDIT Contractor shall maintain records to assure conformance with the terms and conditions of this Agreement, and to assure adequate performance and accurate expenditures within the contract period. Contractor agrees to permit City, the State of Oregon, the federal government, or their duly authorized representatives to audit all records pertaining to this Agreement to assure the accurate expenditure of funds. 25. SEVERABILITY In the event any provision or portion of this Agreement is held to be unenforceable or invalid by any court of competent jurisdiction, the validity of the remaining terms and provisions shall not be affected to the extent that it did not materially affect the intent of the parties when they entered into the agreement. 26. CONDITIONS OF SUPPLYING A PUBLIC AGENCY Where applicable, seller must make payment promptly as due to persons supplying Contractor labor or materials for the execution of the work provided by this order. Contractor must pay all contributions or amounts due from Contractor to the Industrial Accident Fund incurred in the performance of this order. Contractor., shall not permit any lien or claim to be filed or prosecuted against Buyer or any subdivision of City on account of any labor or material to be furnished. Contractor further agrees to pay to the Department of Revenue all sums withheld from employees pursuant to ORS 316.167. City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services 27. HOURS OF LABOR If labor is performed under this order, then no person shall be employed for more than eight (8) hours in any one day, or forty (40) hours in any one week, except in cases of necessity, or emergency or where the public policy absolutely requires it, and in such cases, except cases of contracts for personal services as defined in ORS 279A.055, the labor shall be paid at least time and a half for all overtime in excess of eight (8) hours a day and for all work performed on Saturday and on any legal holidays as specified in ORS 279C.540. In cases of contracts for personal services as defined in ORS 279A.055, any labor shall be paid at least time and a half for all hours worked in excess of forty (40) hours in any one week, except for those individuals excluded under ORS 653.010 to 653.260 or under 29 USC SS 201 -209. 28. MEDICAL CARE AND WORKERS' COMPENSATION Contractor shall promptly, as due, make payment to any person, co- partnership, association or corporation, furnishing medical, surgical and hospital care or other needed care and attention incident to sickness or injury, to the employees of such Contractor, of all sums which the Contractor agrees to pay for such services and all moneys and sums which the Contractor collected or deducted from the wages of the employees pursuant to any law, contractor agreement for the purpose of providing or paying for such service. 29. COMPLETE AGREEMENT This Agreement and attached exhibits constitutes the entire Agreement between the parties. No waiver, consent, modification, or change of terms of this Agreement 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 specific instances and for the specific purpose given. There are no understandings, agreements, or representations, oral or written, not specified herein regarding this Agreement. Contractor, by the signature of its authorized representative, hereby acknowledges that he has read this Agreement, understands it and agrees to be bound by its terms and conditions. IN WITNESS WHEREOF, City has caused this Agreement to be executed by its duly authorized undersigned officer and Contractor has executed this Agreement on the date hereinabove first written. CITY OF TIGA'' D 3/, / /o f By: Crairosser,CCity Manager Date CONTRA .1 •l' v (1 By Carte J acNichol, Shiels Obletz, Johnsen Date City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services • EXHIBIT A SERVICES To BE PROVIDED 1. SERVICES TO BE PROVIDED Specific assignments will be provided to Contractors through a work order agreement which will include a detailed description of the services to be rendered, the cost of such services, and a time period in which to complete the assigned tasks. Potential services to be provided by Contractor under this Agreement include, but are not limited to, the following: A. Provide project management services for development projects involving public- private partnerships B. Facilitate negotiations and outreach to private property owners and other stakeholders in the Urban Renewal Area C. Assist the City in offering publicly owned sites for development and evaluating development proposals D. Identify opportunities and constraints for redevelopment of key sites • E. Provide prospectuses for potential development projects, including recommendations for land uses, housing types, mix of uses, and projected rents F. Develop overview of development costs, ROI analysis, and financing options G. Identify potential project funding gaps, as well as financial incentives that could enhance project feasibility H. Perform development opportunity studies on designated sites that incorporate many of the above elements I. Present any necessary briefings on projects to Council /Development Agency, and citizen boards J. Participate in education and outreach programs as a speaker, panelist, or instructor 2. FEE SCHEDULE Schedule of Rates For this contract, hourly rates are as follows: Staff Hourly Rate Doug Obletz, Principal $200 Kim Knox, Project Manager $120 Francesca Gambetti, Project Manager $120 Lisa Selman, Project Manager $120 David Davies $120 City of Tigard Personal Service Agreement Real Estate Consulting Flexible Services 9 7 s 3(c- CITY OF TIGARD P 1 3 } CONTRACT SUMMARY FORM (THIS MUST ACCOMPANY EACH CONTRACT BEFORE AUTHORIZATION SIGNATURE CAN BE ACQUIRED) Title of Contract: Downtown Real Estate Consulting Flexible Contract #: (Assigned after execution) Services Contractor: Shiels Obletz Johnsen Total: $35,000 Brief Overview: Flexible services contract for real estate Consulting for Downtown Urban Renewal to include development opportunity studies, project management, negotiation, and reviews of development costs, ROI analysis, and financing options . Szc u-� Changes Made To _ 4,4d p '' f � , f a K d rive teV � i h� S i'r i Boilerplate Contract _ /� p �iL �,�:/l l:p ✓. T 1 344 A"' 1B.r's _Oe le f 04 LQ "W rec,i e - s/F Type of Contract: ❑ Purchase. Agreement, ' 1,Personal Service ® Construction ❑ Other Start Date: Z11 6 ,; 'End Date;:' 4 d LCRB' Award Date: Contract Manager: Sean Farrelly Extension: 2420 ` Deparirnent: L-D Quotes /Bids /Proposals: COMPANY AMOUNT / SCORE Shiels Obletz Johnsen- 1 Leland. Consulting Group 1.2C e b J ohnson Rid 2 �" ,.,,.A. 104.4. LW-0 - D;a ...ol- resarp . • ' Department Comments: Department Signature Date: 2. f i/ Purchasing Comments: Purchasing Signa Date: Cal i o bol Administration: Date: Certificate of Insurance Received? ❑ Yes ❑ No ❑ Self - Insured (Farm Received) Business Tax Current? ❑ Yes ❑ No Al 41 Contractor License Current? ❑ Yes ❑ No Federal TIN /1099 #: y" 3 _ j Z 3 '32 Bonds Required: ❑ Yes l2I Accounting String: Fund Division Account Total gi-l(;g000 3 0 o I 5- 1 III brit CCDA August 10, 2010 Shiels Obletz Johnsen Attn: Kim Knox . 1140 SW 11th Ave Portland, OR 97205 RE: City of Tigard Contract No.: P12281 CONTRACT NOTICE OF AWARD - EXTENSION Dear K-im: The City of Tigard /City Center Development Agency would like to extend your current contract for Real Estate Consulting Flexible Services through June 30, 2011. This extension period shall be governed by the specifications, pricing, and the terms and conditions set forth per the above referenced contract. In accordance with these conditions, the extension of the contract will not affect the compensation for services performed. The total amount of compensation will not exceed $35,000 (unless additional tasks are mutually agreed upon). Please acknowledge your acceptance of this extension by signing this document in the space provided below and returning it to: City of Tigard /CCDA Attn: Sean Farrelly 13125 SW Hall Blvd. Tigard, OR 97223 We will send a copy of the letter to you after it is signed by the Tigard designee. I /We hereby acknowledge acceptance of this Contract renewal, and agree to be bound by all requirements, terms, and conditions as set forth in the above referenced Contact. _,J Date: 8/l 1/ 1 J ,Shiels, Obletz Johnsen ----5/4/VV1 Date: �j/I �f I 0 ,City of Tigard , SAIF Corporation 2/10/2010 10:30:34 AM PAGE 1 /001 Fax Server OREGON WORKERS' COMPENSATION CERTIFICATE OF INSURANCE i f CERTIFICATE HOLDER: CITY OF TIGARD ATTN: SEAN FARRELLY 13125 SW HALL BLVD TIGARD, OR 97223 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 922992 10/01/2009 TO 10/01/2010 02/10/2010 INSURED: BROILER OF RECORD: SHIELS OBLETZ JOHNSEN INC 1140 SW 11TH AVE SUITE 500 PORTLAND, OR 97205 LIMITS OF LIABILITY: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Bodily Injury by Disease $500,000 policy limit D ESCRIPTION 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. AUTHORIZED REPRESENTATIVE J President and CEO tg SAIF CORPORATION 1 400 High St SE I Salem, OR 97312 I P: 900.25.8525 I www.salf.00m Form Request for Taxpayer Give form to the (Rev. October 2007) identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service Name (as shown on your income tax return) SiiIELS OBLETZ JOHNSEN, INC. ro Business name, If different from above a t6�r c Check appropriate box: ❑ IndivlduaVSole proprietor 0 Corporation ❑ Partnership Exempt �` ❑ Limited liability company. Enter the tax classification (D= disregarded entity, Cecorporation, Pepartnershlp) ® ❑ palms $ 2 ❑ Other (see instructions) s. C b' Address (number. street, and apt, or suite no.) Requesters name and address (optional) 1140 SW 11TH AVENUE SUITE 500 City, stale, and ZIP code PORTLAND OR 97205 List account number(s) here (optional) rn Par ' I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line t to avoid Social security number 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, or Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Emptoyer Identification number number to enter. 93 1253321 Part tl Certification Under penalties of perjury, I certify that: • t. 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 it 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, Iasi e is or er than interest and div'.end -, you are not required to sign the Certification, but you must provide your correct TIN. See the in+°ru.'ionsj•n pa.e • Sign r� Here u.s. person g signature of ''�t O Date 7 1 ? General instruction ' Definition of a U.S. person. or federal tax purposes, you are considered a U.S. person if you are: Section references are to the Int- • at Revenue Code unless @ An individual who is a U.S. citizen or U.S. resident alien, otherwise noted. is A partnership, corporation, company, or association created or Purpose of Form organized in the United States or under the laws of the United A person who is required to file an information return with the States, IRS must obtain your correct taxpayer identification number (TIN) a An estate (other than a foreign estate), or to report, for example, income paid to you, real estate e A domestic trust (as defined in Regulations section transactions, mortgage interest you paid, acquisition or 30t,770t -7). abandonment of secured property, cancellation of debt, or Special rules for partnerships. Partnerships that conduct a contributions you made to an IRA. trade or business in the United States are generally required to Use Form W -9 only if you are a U.S. person (including a pay a withholding tax on any foreign partners' share of income resident alien), to provide your correct TIN to the person from such business. Further, in certain cases where a Form W -9 requesting it (the requester) and, when applicable, to: has not been received, a partnership is required to presume that t. Certify that the TIN you are giving is correct (or you are a partner is a foreign person, and pay the withholding tax. waiting for a number to be issued), Therefore, if you are a U.S. person that is a partner in a 2. Certify that you are not subject to backup withholding, or partnership conducting a trade or business in the United States, provide Form W -9 to the partnership to establish your U.S. 3. Claim exemption from backup withholding if you are a U.S. status and avoid withholding on your share of partnership exempt payee. If applicable, you are also certifying that as a Income. U.S. person, your allocable share of any partnership income from The person who gives Form W -9 to the partnership for a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. on of partnership nrposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the p Note. If a requester gives you a form other than Form W -9 to conducting a trade or business in the United States is in the request your TIN, you must use the requester's form if it is following cases: substantially similar to this Form W -9. e The U.S. owner of a disregarded entity and not the entity, Cat. No. 1023tx Form W -S (Rev. 10 -2007) /'9ii ®RD CERTIFICATE OF LIABILITY INSURANCc OP ID $G DATE(MMIDD /YY) HIEL -1 , 10/28/10 • PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Alfred J. Davis Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 1776 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR `p ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Portland OR 97207 fECEl V . T ® INSURERS AFFORDING COVERAGE Phone :503- 226 -3801 Fax:503- 226 -0376 INSURED ' NOV Continental Casualty Company , -_- ®8 INSURER B: Continental Insurance Company Shiels Obletz Johnsen Inc INSURER C: • 1149 SW. 11th Avenue Ste 501 , 0 1St< MANAG uENITT Portland OR 97205 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MMIDDIYY) DATE (MM /DD /YY) GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY 4026531407 10/23/10 10/23/11 FIRE DAMAGE (Any one fire) $ 100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $5,000 X WA Stop Gap PERSONAL & ADV INJURY $ 1 , 000 , 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY PEA LOC Emp Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 $ ANY AUTO 4026531388 10/23/10 10/23/11 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ • 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 LIABILITY EACH OCCURRENCE $1,000,000 A X OCCUR CLAIMSMADE 4026531360 10/23/10 10/23/11 AGGREGATE $ 1,000,000 DEDUCTIBLE $ RETENTION $ WCSrATU- OlH- WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY E L. EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Re: All Operations City of Tigard, its officers, directors and employees are additional insured per attached G147167 -B99. CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CITYOF5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN `City of Tigard NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Sean Farrelly IMPOSE NO OBLIGATION OR LI Y OF ANY UPON THE INSURER, ITS AGENTS OR 13125 SW Hall Blvd Tigard OR 97223 REPRESENTATIV AUTHORIZEYJ ENTA N. Di so •Da a ACORD 25 -S (7/97) ©ACORD CORPORATION 1988 G- 147167 -B99 A (Ed. 12/06) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part. 1. ADDITIONAL INSURED — BLANKET VENDORS g. Products which, after distribution or WHO IS AN INSURED (Section II) is amended to sale by you, have been labeled or relabeled or used an a container, include as an additional insured any person or part organization (referred to below as vendor) with or ingredient of any other thing or whom you agreed, because of a written contract or substance bstannece e ient by or for the vendor; or agreement to provide insurance, but only with h. "Bodily injury" or "property damage" respect to "bodily injury" or "property damage" arising out of the sole negligence of the arising out of "your products" which are distributed vendor for its own acts or omission or or sold in the regular course of the vendor's those of its employees or anyone else business, subject to the following additional acting on its behalf. However, this exclusions: exclusion does not apply to: 1. The insurance afforded the vendor does not (1) The exceptions contained in apply to: Subparagraphs d. or f.; or a. "Bodily injury" or "property damage" for (2) Such inspections, adjustments. which the vendor is obligated to pay tests or servicing as the vendor has damages by reason of the assumption agreed to make or normally of liability in a contract or agreement. undertakes to make in the usual This exclusion does not apply to liability course of business, in connection for damages that the vendor would with the distribution or sale of the have in the absence of the contract or products. agreement; 2. This insurance does not apply to any b. Any express warranty unauthorized by insured person or organization, from whom you; you have acquired such products, or any c. Any physical or chemical change in the ingredient, part or container, entering into, product made intentionally by the accompanying or containing such products. vendor; 3. This provision 1. does not apply to any vendor included as an insured by an d. Repackaging, except when unpacked endorsement issued by us and made a part solely for the purpose of inspection, of this Coverage Part. demonstration, testing, or the substitution of parts under instructions 4. This provision 1. does not apply if "bodily from the manufacturer, and then injury" or "property damage" included within repackaged in the original container; the "products- completed operations hazard" is excluded either by the provisions of the e. Any failure to make such inspections, Coverage Part or by endorsement. adjustments, tests or servicing as the vendor has agreed to make or normally 2. MISCELLANEOUS ADDITIONAL INSUREDS undertakes to make in the usual course of business, in connection with the WHO IS AN INSURED (Section II) is amended to distribution or sale of the products; include as an insured any person or organization (called additional insured) described in paragraphs f. Demonstration, installation, servicing or 2.a. through 2.g. below whom you are required to repair operations, except such add as an additional insured on this policy under a operations performed at the vendor's written contract or agreement but the written premises in connection with the sale of contract or agreement must be: the product 1. Currently in effect or becoming effective during the term of this policy; and G- 147167 -B99 Page 1 of 6 (Ed. 12/06) G- 147167 -B99 , c (Ed. 12/06) 2. Executed prior to the "bodily injury," c. Managers or Lessors of Premises "property damage" or "personal injury and advertising injury," but A manager or lessor of premises but only with respect to liability arising out Only the following persons or organizations are of the ownership, maintenance or use additional insureds under this endorsement and of that specific part of the premises coverage provided to such additional insureds leased to you and subject to the is limited as provided herein: following additional exclusions: a. State or Political Subdivisions This insurance does not apply to: A state or political subdivision subject (1) Any "occurrence" which takes to the following provisions: place after you cease to be a (1) This insurance applies only with tenant in that premises; or respect to the following hazards for (2) Structural alterations, new which the state or political construction or demolition subdivision has issued a permit in operations performed by or on connection with premises you own, behalf of such additional insured. rent, or control and to which this insurance applies: d. Mortgagee, Assignee or Receiver (a) The existence, maintenance, A mortgagee, assignee or receiver but repair, construction, erection, only with respect to their liability as or removal of advertising signs, mortgagee, assignee, or receiver and awnings, canopies, cellar arising out of the ownership, entrances, coal holes, maintenance, or use of a premises by driveways, manholes, you. marquees, hoistaway openings, This insurance does not apply to sidewalk vaults, street banners, structural alterations, new construction or decorations and similar or demolition operations performed by exposures; or or for such additional insured. (b) The construction, erection, or e. Owners /Other Interests — Land is removal of elevators; or Leased (2) This insurance applies only with An owner or other interest from whom respect to operations performed by land has been leased by you but only you or on your behalf for which the with respect to liability arising out of the state or political subdivision has ownership, maintenance or use of that issued a permit. specific part of the land leased to you This insurance does not apply to "bodily and subject to the following additional injury," "property damage" or "personal exclusions: and advertising injury" arising out of This insurance does not apply to: operations performed for the state or municipality. (1) Any "occurrence" which takes place after you cease to lease that land; b. Controlling Interest or Any persons or organizations with a (2) Structural alterations, new controlling interest in you but only with construction or demolition respect to their liability arising out of: operations performed by or on (1) Their financial control of you; or behalf of such additional insured. (2) Premises they own, maintain or f. Co - owner of Insured Premises control while you lease or occupy A co -owner of a premises co -owned by these premises. you and covered under this insurance This insurance does not apply to but only with respect to the co- owners structural alterations, new construction liability as co-owner of such premises. and demolition operations performed g. Lessor of Equipment by or for such additional insured. Any person or organization from whom you lease equipment. Such person or G- 147167 -B99 Page 2 of 6 (Ed. 12/06) cFNA G- 147167 -B99 (Ed. 12/06) organization are insureds only with Coverage under this provision is afforded only until respect to their liability arising out of , the end of the policy period or the next anniversary the maintenance, operation or use by of this policy's effective date after you acquire or you of equipment leased to you by such form the organization, whichever is earlier. person or organization. A person's or 4. JOINT VENTURES / PARTNERSHIP / LIMITED organization's status as an insured LIABILITY COMPANY COVERAGE under this endorsement ends when their written contract or agreement with A. The following is added to Section II — Who Is you for such leased equipment ends. An Insured: With respect to the insurance afforded 4. You are an insured when you had an these additional insureds, the following interest in a joint venture, partnership or additional exclusions apply: limited liability company which terminated This insurance does not apply: or ended prior to or during this policy period but only to the extent of your interest in (1) To any "occurrence" which takes such joint venture, partnership or limited place after the equipment lease liability company. This coverage does not expires; or apply: (2) To "bodily injury," "property a. Prior to the termination date of any joint damage," or "personal and venture, partnership or limited liability advertising injury" arising out of the company; or sole negligence of such additional insured. b. If there is other valid and collectible insurance purchased specifically to Any insurance provided to an additional insured insure the partnership, joint venture or designated under paragraphs a. through g. limited liability company. above does not apply to "bodily injury" or B. The last paragraph of Section II — Who Is An "property damage" included within the "products- completed operations hazard." Insured is deleted and replaced by the following: As respects the coverage provided under this endorsement, Paragraph 4.b. SECTION IV — Except as provided in 4. above, no person or COMMERCIAL GENERAL LIABILITY organization is an insured with respect to the CONDITIONS is deleted and replaced with the conduct of any current or past partnership, joint following: venture or limited liability company that is not shown as a Named Insured in the Declarations. 4. Other Insurance 5. PARTNERSHIP OR JOINT VENTURES b. Excess Insurance Paragraph 'Lb. of Section II — Who Is An Insured This insurance is excess over: is deleted and replaced by the following: Any other insurance naming the b. A partnership (including a limited additional insured as an insured liability partnership) or joint venture whether primary, excess, contingent or you are an insured. Your members, on any other basis unless a written your partners, and their spouses are contract or agreement specifically also insureds, but only with respect to requires that this insurance be either the conduct of your business. primary or primary and noncontributing. 6. EMPLOYEES AS INSUREDS — HEALTH CARE Where required by written contract or SERVICES agreement, we will consider any other insurance maintained by the additional For other than a physician, paragraph 2.a(1)(d) of insured for injury or damage covered Section II — Who Is An Insured does not apply by this endorsement to be excess and with respect to professional health care services noncontributing with this insurance. provided in the course of employment by you. 3. NEWLY FORMED OR ACQUIRED 7. SUPPLEMENTARY PAYMENTS ORGANIZATIONS A. Under Section I — Supplementary Payments Paragraph 3.a. of Section II — Who Is An Insured — Coverages A and B, Paragraph 1.b., the limit is deleted and replaced by the following: of $250 shown for the cost of bail bonds is replaced by $2,500: G- 147167 -B99 Page 3 of 6 (Ed. 12/06) G- 147167 -B99 . c (Ed. 12/06) B. In Paragraph 1.d., the limit of $250 shown for 11. LEGAL LIABILITY — DAMAGE TO PREMISES daily loss of earnings is replaced by $1,000. A. Under Section I — Coverage A — Bodily Injury 8. MEDICAL PAYMENTS and Property Damage 2. Exclusions, A. Paragraph 7. Medical Expense Limit, of Exclusion j. is replaced by the following. Section III Limits of Insurance is deleted "Property damage" to: and replaced by the following: (1) Property you own, rent, or occupy, 7. Subject to 5. above (the Each Occurrence including any costs or expenses Limit), the Medical Expense Limit is the incurred by you, or any other most we will pay under Section — I — person, organization or entity, for Coverage C for all medical expenses repair, replacement, enhancement, because of "bodily injury" sustained by any restoration or maintenance of such one person. The Medical Expense Limit is property for any reason, including the greater of: prevention of injury to a person or (1) $15,000; or damage to another's property; (2) The amount shown in the (2) Premises you sell, give away or Declarations for Medical Expense abandon, if the "property damage" Limit. arises out of any part of those premises; B. This provision 8. (Medical Payments) does not (3) Property loaned to you; apply if Section I — Coverage C Medical Payments is excluded either by the provisions (4) Personal property in the care, of the Coverage Part or by endorsement. custody or control of the insured; C. Paragraph 1.a.(3)(2) of Section I — Coverage (5) That particular part of real property C — Medical Payments, is replaced by the on which you or any contractors or following: subcontractors working directly or indirectly on your behalf are The expenses are incurred and reported to us years of the date of the accident; per o if the within three y "property damage" arises out of and those operations; or 9. NON - OWNED WATERCRAFT (6) That particular part of any property Under Section I — Coverage A — Bodily Injury that must be restored, repaired or and Property Damage, Exclusion 2.g., replaced because "your work" was subparagraph (2) is deleted and replaced by the incorrectly performed on it. following. Paragraph (2) of this exclusion does (2) A watercraft you do not own that is: not apply if the premises are "your work" and were never occupied, rented (a) Less than 55 feet long; and or held for rental by you. (b) Not being used to carry Paragraphs (1), (3) and (4) of this persons or property for a exclusion do not apply to "property charge. damage" (other than damage by fire) to 10. NON -OWNED AIRCRAFT premises: Exclusion 2.g. of Section I — Coverage A — Bodily (1) rented to you; Injury and Property Damage, does not apply to an (2) temporarily occupied by you with aircraft you do not own, provided that: the permission of the owner, or 1. The pilot in command holds a currently (3) to the contents of premises rented effective certificate issued by the duly to you for a period of 7 or fewer constituted authority of the United States of consecutive days. America or Canada, designating that person as a commercial or airline transport A separate limit of insurance applies to pilot; Damage To Premises Rented To You as described in Section III — Limits Of 2. It is rented with a trained, paid crew; and Insurance. 3. It does not transport persons or cargo for a charge. G- 147167 -B99 Page 4 of 6 (Ed. 12/06) • G- 147167 -B99 C NA, (Ed. 12/06) - Barra; raphs (3), (4), (5) and (6) of this 12. BROAD KNOWLEDGE OF OCCURRENCE exclusi do not apply • to liability assumed under a sidetrack agreement. The is added to paragraph 2. of Section IV - Commercial General Liability Conditions - Paragraph 1W-of exclusion does Duties in The Event of ,Occurrence, Offense, not apply to "property damage" Claim or Suit: included in the , "products- completed oper ^:i6ns hazard." You must give us or our authorized representative notice of an "occurrence," offense, claim, • or "suit" B. Under Section I - Coverage A - Bodily Injury only when the "occurrence," offense, claim or "suit" and Property Damage the last paragraph of 2. is known to : Exclusions is deleted and replaced by the following. (1) You, if you are an individual; Exclusions c. through n. do not apply to (2) A partner, if you are a partnership; damage by fire to premises while rented to you (3) An executive officer or the or temporarily occupied by you with permission employee designated by you to of the owner or to the contents of premises give such notice, if you are a rented to yr.. for a period of 7 or fewer corporation; or consecutive says. (4) A manager, if you are a limited A separate i;mit of insurance applies to this liability company. coverage as lescribed in Section III - Limits Of Insurance. 13. NOTICE OF OCCURRENCE C. Paragraph 6.. Damage To Premises Rented The following is added to paragraph 2. of Section To You Unit. of Section III - Limits Of IV - Commercial General Liability Conditions - Insurance is replaced by the following: Duties in The Event of Occurrence, Offense Claim or Suit: - 6. Subject t 5. above,. (the Each Occurrence Limit), t11) Damage To Premises Rented To Your rights under this Coverage Part will not be You Limit is the most we will pay under prejudiced if you fail to give is notice of an Section - I - Coverage A for damages "occurrence," offense, claim or "suit" and that because of "property damage" to any one failure is solely due to your reasonable belief that premises while rented to you or temporarily the "bodily injury" or "property damage" is not occupied by you with the permission of the covered under this Coverage Part. However, you owner, including contents of such premises shall give written notice of this "occurrence," rented to you for a period of 7 or fewer offense, claim or "suit" to us as soon as you are consecutive days. The Damage To aware that this insurance may apply to such Premise Rented To You Limit is the "occurrence," offense claim or "suit." greater of: 14. UNINTENTIONAL FAILURE TO DISCLOSE a. $200.000; or HAZARDS • b. The Damage To Premises .Rented To Based on our reliance on your representations as to You Limit shown in the Declarations. existing hazards, if unintentionally you should fail to disclose all such hazards at the inception date of D. Paragraph 4.b.(1)(b) of Section IV - your policy, we will not deny coverage under this Commercial General Liability Conditions is Coverage Part because of such failure. deleted and replaced by the following: • 15. EXPANDED PERSONAL AND ADVERTISING (b) That is property insurance for INJURY premises rented to you or temporarily occupied by you with A. The following is added to Section V - the permission of the owner; or Definitions, the definition of "personal and advertising injury": E. This provision 11. (LEGAL LIABILITY - DAMAGE TO PREMISES) does not apply if h. Discrimination or humiliation that Damage To Premises Rented To You Liability results in injury to the feelings or under Section I - Coverage A is excluded reputation of a natural person, but only either by the provisions of the Coverage Part or if such discrimination or humiliation is: by endorsemPnt. (1) Not done intentionally by or at the direction of: (a) The insured; or G- 147167 -B99 Page 5 of 6 (Ed. 12/06) G- 147167 -B99 .NA (Ed. 12/06) (b) Any "executive officer," 16. BODILY INJURY director, stockholder, partner, member or manager (if you are Section V — Definitions, the definition of "bodily a limited liability company) of injury" is changed to read: the insured; and "Bodily injury" means bodily injury, sickness or (2) Not directly or indirectly related to disease sustained by a person, including death, the employment, prospective humiliation, shock, mental anguish or mental injury employment, past employment or by that person at any time which results as a termination of employment of any consequence of the bodily injury, sickness or person or persons by any insured. disease. B. Exclusions of Section I — Coverage B — 17. EXPECTED OR INTENDED INJURY Personal and Advertising Injury Liability is Exclusion a. of Section I — Coverage A — Bodily amended to include the following: Injury and Property Damage Liability is replaced p. Discrimination Relating To Room, by the following: Dwelling or Premises a. "Bodily injury" or "property damage" Caused by discrimination directly or expected or intended from the indirectly related to the sale, rental, lease or standpoint of the insured. This sub -lease or prospective sale, rental, lease exclusion does not apply to "bodily or sub -lease of any room, dwelling or injury" or "property damage" resulting premises by or at the direction of any from the use of reasonable force to insured. protect persons or property. q. Fines Or Penalties 18. LIBERALIZATION CLAUSE Fines or penalties levied or imposed by a If we adopt a change in our forms or rules which governmental entity because of would broaden coverage under this endorsement discrimination. without an additional premium charge, your policy will automatically provide the additional coverages C. This provision 15. (EXPANDED PERSONAL as of the date the revision is effective in your state. AND ADVERTISING INJURY COVERAGE) 19. PROPERTY DAMAGE — ELEVATORS does not apply to discrimination or humiliation committed in the states of New York or Ohio. With respect to Exclusions of Section I — Also, EXPANDED PERSONAL AND Coverage A, paragraphs (3), (4) and (6) of ADVERTISING INJURY COVERAGE does not Exclusion j. and Exclusion k. do not apply to the apply to policies issued in the states of New use of elevators. York or Ohio. The insurance afforded by this provision 19. is D. This provision 15. (EXPANDED PERSONAL excess over any valid and collectible property AND ADVERTISING INJURY COVERAGE) insurance (including any deductible) available to does not apply if Section I — Coverage B — the insured, and the Other Insurance Condition is • Personal And Advertising Injury Liability is changed accordingly. excluded either by the provisions of the Coverage Part or by endorsement. G- 147167 -B99 Page 6 of 6 (Ed. 12/06) Page 1 of 2 . t. sE arils Analysis s C to United States I Asia Pacific I Canada I Europe — � - About I Contact I Sitemap Ratings &:Analysis Continental Casualty Company g Print this page I Member Center » Home (a member of CNA Insurance Companies) _ „ - -- _ For ratings and product access » Best's Credit Ratings+ A.M. Best #: 002128 NAIC #: 20443 FEIN #: 3621145451 Assigned to Finan•ialStrength Rating Login J Siqn-up » Financial Strength I companies Ratings— Insurer that have, in • ; -- — A Excellent n Issuei'Credit Ratings lour opinion, • Address: 333 South Wabash Avenue, Floor 22 Find a Best's Credit Rating • » Debt Ratings an excellent ability to, meeYtheir C » Financiat.Strength Chicago, IL 60604 I ongoing insurance obligations. Enter a Company Name [IlEo Ratings —Bank UNITED STATES » Advanced Search • » Advanced Search ',About Best's Credit Ratings+ Phone: 312 - 822 - 5000 —� u Get a Credit Rating +- Fax: 312 822 - 6419 » Best's Special Reports' Web: www.cna.com rr per^° ten- I u •Add Best's Credit RatingsSearch t ilt E i Rated By A.M. Best To•Your Site Best's Ratings » BestMark for Secure -Rated • :Insurers , Financial Strength Ratings View Definitions Issuer, Credit Ratings View Definitions » Contact an Analyst View Rating Definitions u Awardsand,Recognitions Rating: A (Excellent) Long -Term: a Select one... • Affiliation Code: g (Group) Outlook: Stable Nevins- &.Research Financial Size Category: XV ($2 Billion or Action: Affirmed Products & Services , greater) Date: February 08, 2010 Industry Information . Outlook: Stable Corporate • Action: Affirmed Support'& Resources 8 Effective Date: February 08, 2010 • Conferences and Events v * Denotes Under Review Best's Ratings Reports and News - • - Visit our NewsRoom for the latest news and press releases for this company and its A.M. Best Group. =mot AMB Credit Report - Insurance Professional - includes Best's Financial Strength _F Rating and rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 07/16/2010 (represents the latest significant change). Historical Reports are available in AMB Credit Report - Insurance Professional Archive. r - 1 Best's Executive Summary Reports (Financial Overview) - available in three F I versions, these presentation style reports feature balance sheet, income statement, key financial performance tests including profitability, liquidity and reserve analysis. Data Status: 2010 Best's Statement File - P /C, US. Contains data compiled as of 11/3/2010 (Quality Cross Checked). • Single Company - five years of financial data specifically on this company. • Comparison - side -by -side financial analysis of this company with a peer group of up to five other companies you select. • Composite - evaluate this company's financials against a peer group composite. Report displays both the average and total composite of your selected peer group. ' AMB Credit Report - Business Professional - provides three years of key F financial data presented with colorful charts and tables. Each report also features the latest Best's Ratings, Rating Rationale and an excerpt from our Business Review commentary. Data Status: Contains data compiled as of 11/3/2010 (Quality Cross Checked). E Best's Key Rating Guide Presentation Report - includes Best's Financial ) Strength Rating and financial data as provided in Best's Key Rating Guide products. Data Status: 2009 Financial Data (Quality Cross Checked). Financial and Analytical, Products Best's Key Rating Guide - P /C, US & Canada Best's Statement File - P /C, US Best's Statement File - Global Best's Insurance Reports - P /C, US & Canada Best's State Line - P /C, US Best's Insurance Expense Exhibit (IEE) - P /C, US Best's Schedule F (Reinsurance) - P /C, US Best's Schedule D (Municipal Bonds) - US 11/8/2010 11/8/2010 Page 1 of 2 Ratings Analysis Center United ed States I Asia Pacific Canada I Europe About I Contact Sitemap Ratings & Analysis: is Continental Insurance Company Print this page Member Center » Home (a member of CNA Insurance Companies) For ratings and product access » Best's Credit Ratings + - 4 A.M. Best #: 002118 NAIC #: 35289 FEIN #: 135010440' Assigned to Fnangia1Strength Rating' i Login I Sign - up , » companies Ratings— Insurer that have, in A Excellent » Issuer CreditRatings' our opinion, { Address: 333 South Wabash Avenue, Floor 22 Find a Bests Credit Rating » Debt Ratings � an,excelient ability to meet their »`Financial Strength Chicago, IL 60604 !ongoing insurance obligations. Enter a Company Name ' lmo Ratings - Bank UNITED STATES - -- -- — — - -- — - -' » Advanced Search » Advanced Search { » About Best's Credit Ratings+ Phone 312- 822 -5000 •-» Get a Credit Rating +. Fax: 312 822 - 6419 » Best's Special Reports Web: www.cna.com r » Add Best's Credit Ratings Search .7 ''` )! et R ated By A.M. Best ToYourSite -, Best's Ratings ' » BestMark.forSecure - Rated Insurers Financial `Strength Ratings View Definitions (Issuer Credit Ratings View Definitions / ~ » Contact an Analyst - View Rating Definitions Rating: A (Excellent) Long -Term: a "J » Awards and,Recognitions Select one... Affiliation Code: g (Group) Outlook: Stable News & Research Financial Size Category: XV ($2 Billion or Action: Affirmed { Products & Services { � greater) Date: February 08, 2010 Industry Information • Outlook: Stable Corporate K Action: Affirmed Effective Date: February 08, 2010 Support & Resources m ! Conferences and.Events • i • Denotes Under Review Best's Ratings Reports and News Visit our NewsRoom for the latest news and press releases for this company and its A.M. Best Group. vitt AMB Credit Report - Insurance Professional - includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 07/16/2010 (represents the latest significant change). Historical Reports are available in AMB Credit Report - Insurance Professional Archive. Best's Executive Summary Reports (Financial Overview) - available in three versions, these presentation style reports feature balance sheet, income statement, key financial performance tests including profitability, liquidity and reserve analysis. Data Status: 2010 Best's Statement File - P /C, US. Contains data compiled as of 11/3/2010 (Quality Cross Checked). o Single Company - five years of financial data specifically on this company. • Comparison - side -by -side financial analysis of this company with a peer group of up to five other companies you select. • Composite - evaluate this company's financials against a peer group composite. Report displays both the average and total composite of your selected peer group. AMB Credit Report - Business Professional - provides three years of key financial data presented with colorful charts and tables. Each report also features the latest Best's Ratings, Rating Rationale and an excerpt from our Business Review commentary. Data Status: Contains data compiled as of 11/3/2010 (Quality Cross Checked). Best's Key Rating Guide Presentation Report - includes Best's Financial Strength Rating and financial data as provided in Best's Key Rating Guide products. Data Status: 2009 Financial Data (Quality Cross Checked). Financial and Analytical Products Best's Key Rating Guide - P /C, US & Canada Best's Statement File - P /C. US Best's Statement File - Global Best's Insurance Reports - P /C, US & Canada Best's State Line - P /C. US Best's Insurance Expense Exhibit (IEE) - P /C, US Best's Schedule F (Reinsurance) - P /C, US Best's Schedule D (Municipal Bonds) - US 11/8/2010 11/8/2010 LRI CERTIFICATE OF LIABILITY INSURANCE H IEL - 1 OPID BG DATE(MM /DD /YY) 10/28/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Alfred J. Davis Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 1776 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Portland OR 97207 Phone: 503- 226 -3801 Fax: 503- 226 -0376 INSURERS AFFORDING COVERAGE INSURED INSURER A: Admiral Insurance Company ,4 INSURER B Shiels Obletz Johnsen Inc INSURER C: 1149 SW 11th Avenue Ste 500 INSURER D' Portland OR 97205 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 TYPE OF INSURANCE POLICY NUMBER DATE (M Y YI E DATE (MM D YY) EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ CLAIMS MADE X ] OCCUR ��� ECEIVED MED EXP (Any one person) $ \,/ PERSONAL & ADV INJURY $ N 1 V ®� 2010 GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP /OP AGG $ POLICY JECT LOC AUTOMOBILE LIABILITY RISK ANAGEMENT COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WCSIAIU- OTH- WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E L DISEASE - POLICY LIMIT $ OTHER B A & E Professional E000001212502 11 /01 /10 11 /01 /11 Ea Claim 1,000,000 Claims Made Form Aggregate 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Professional Liability Deductible $10,000 Per Claim and Retroactive Date: 10/18/2000. 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 of this policy. CERTIFICATE HOLDER N ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CITYOT1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Tigard NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Sean Farrelly IMPOSE NO OBLIGATION OR L. = ` TY OF AN D UPON THE INSURER, ITS AGENTS OR 13125 SW Hall Blvd. Tigard OR 97223 REPRESENTATIV a AUTHORIZ - 7-ENT ■ N. Di•r s• - Da s• ACORD 25 -S (7/97) ©ACORD CORPORATION 1988 Page 1 of 2 p i at ngs Aiatysi.s C , , . • __ United States I Asia Pacific I Canada I Europe About ( Contact I Sitemap Ratings 8 Analysis Adm Insurance Company Print this page .c"T Member Center . » Home . ` (a member of W. R. Berkley Group) , ratings and product access j » Best's Credit Ratings + A.M. Best #: 003026 NAIC #: 24856 FEIN #: 222235730 Assigned to Financiaistrength Rating Login I Signign_up ` » Financial ` companies I Ratings— Insurer' that have, in A+ Superior . — » Issuer Credit Ratings our opinion, a Find a Best's Credit Rating » Debt Ratings Address:1255 Caldwell Road superior ability to meet their ongoing g Cherry Hill, NJ 08034 » Financial Strength m I insurance obligations. � Enter a Company Name [Co [ ] Ratings —Bank UNITED STATES -- - _ „gdvanced Search » Advanced Search • »About: Best's, Credit Ratings+ , Phone: 856- 429 -9200 » Get a Credit Rating + ' ' j Fax 856- 429 -8611 » Best's Special Reports Web: www.admiralins.com r � r » Add,Best's CreditRatingsSearch 4 %'l et Rated By A.M. Best To Your Site Best s Ratings . BestMark for Secure -Rated • - . .Insurers Financial: Strength Ratings View Definitions Issuer Credit Ratings' View Definitions' - - ° - View Rating Definitions » Contact an Analyst Rating: A+ (Superior) Long -Term: as- » Awards and Recognitions Select one... Financial Size Category: XIII ($1.25 Billion to Outlook: Stable 1 News & Research $1.5 Billion) Action: Affirmed Products:& Services Outlook: Stable Date: May 17, 2010 Industry Information, v ' Action: Affirmed Corporate e. Effective Date: May 17, 2010 Support & Resources v * Denotes Under Review Best's Ratings Conferences..and Events s Reports and News Visit our NewsRoom for the latest news and press releases for this company and its A.M. Best Group. 04e1 AMB Credit Report - Insurance Professional - includes Best's Financial Strength _- . i Rating and rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 07/16/2010 (represents the latest significant change). Historical Reports are available in AMB Credit Report - Insurance Professional Archive. F - 1 Best's Executive Summary Reports (Financial Overview) - available in three versions, these presentation style reports feature balance sheet, income statement, key financial performance tests including profitability, liquidity and reserve analysis. Data Status: 2010 Best's Statement File - P /C, US. Contains data compiled as of 11/3/2010 (Quality Cross Checked). • Single Company - five years of financial data specifically on this company. • Comparison - side -by -side financial analysis of this company with a peer group of up to five other companies you select. • Composite - evaluate this company's financials against a peer group composite. Report displays both the average and total composite of your selected peer group. -' AMB Credit Report - Business Professional - provides three years of key 1 financial data presented with colorful charts and tables. Each report also features the latest Best's Ratings, Rating Rationale and an excerpt from our Business Review commentary. Data Status: Contains data compiled as of 11/3/2010 (Quality Cross Checked). Best's Key Rating Guide Presentation Report - includes Best's Financial j- Strength Rating and financial data as provided in Best's Key Rating Guide products. Data Status: 2009 Financial Data (Quality Cross Checked). Financial and Analytical Products ' Best's Key Rating Guide - P /C, US & Canada Best's Statement File - P /C, US Best's Statement File - Global Best's Insurance Reports - P /C. US & Canada Best's State Line - P /C. US Best's Insurance Expense Exhibit (IEE) - P /C, US Best's Schedule F (Reinsurance) - P /C, US Best's Schedule D (Municipal Bonds) - US 11/8/2010 11/8/2010