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HomeMy WebLinkAboutBPW-03-05-14-04 -Acknowledging Contract Signed by Mayor - Majors Supply (Salt) RESOLUTION NO. BPW-03-05-14-04 RESOLUTION OF THE CITY OF CARMEL BOARD OF PUBLIC WORKS AND SAFETY ACKNOWLEDGING RECEIPT OF CONTRACT WHEREAS, pursuant to Indiana Code 36-1-4-7, the City of Carmel, Indiana ("City"), is authorized to enter into contracts: and WHEREAS, pursuant to Indiana Code 36-4-5-3, the City's mayor may enter into contracts on behalf of the City: and WHEREAS, pursuant to his authority under Indiana law, the City's mayor, the Honorable James C. Brainard,has caused to be signed the City contract attached hereto as Exhibit A (the"Contract"): and WHEREAS, Mayor Brainard now wishes to present the contract to the City's Board of Public Works and Safety for it to be publicly acknowledged, filed in the Clerk-Treasurer's Office, and made available to the public for review. NOW, THEREFORE, BE IT RESOLVED by the City of Cannel Board of Public Works and Safety as follows: 1. The foregoing Recitals are incorporated herein by this reference. 2. The receipt of the Contract is hereby acknowledged. 3. The Contract shall be promptly filed in the office of the Clerk-Treasurer and thereafter made available to the public for review. / SO RESOLVED this day of //70-r(-6 . 2014. • CITY OF CARMEL, INDIANA By and through its Board of Public Works and Safety BY: 2° (-4)i /i IXJe / James Brainard, Presiding Officer Date: 4/ - DJ Mary A i Bur Member Date: i— —I y Lori 5.'Wu�on'e Date: 3 /67/ / ATTEST. ) 1 ,' al Jj .24iN:24 Dana Cordray, IM A CI I. -Treasurer Date: \\Issvrapps1\sser data.adnin, Etlf4\My DkumeMS\RPW'Resolutions\2014\Acknowledge Majors Supply A Grounds Maintenance.doca2/25j j411:47 AM Majors Supply&Grounds Maintenance ' Street Department -2014 Appropriation#0042-365.00; P.O. #31854 Contract Not To Exceed $225.000.00 AGREEMENT FOR PURCHASE OF GOODS AND SERVICES THIS AGREEMENT FOR PURCHASE OF GOODS AND SERVICES ("Agreement") is hereby entered into by and between the City of Carmel, Indiana, acting by and through its Board of Public Works and Safety ("City"), and Majors Supply & Grounds Maintenance, an entity duly authorized to do business in the State of Indiana ("Vendor"). TERMS AND CONDITIONS 1. ACKNOWLEDGMENT, ACCEPTANCE: Vendor acknowledges that it has read and understands this Agreement, and agrees that its execution of same constitutes its acceptance of all of the Agreement's terms and conditions. 2. PERFORMANCE: City agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City budget appropriation number 0042-365.00 funds. Vendor agrees to provide the Goods and Services and to otherwise perform the requirements of this Agreement by applying at all times the highest technical and industry standards. 3. PRICE AND PAYMENT TERMS: 3.1 Vendor estimates that the total price for the Goods and Services to be provided to City hereunder shall be no more than Two Hundred Twenty Five Thousand Dollars ($225,000.00) (the "Estimate"). Vendor shall submit an invoice to City no more than once every thirty (30) days detailing the Goods and Services provided to City within such time period. City shall pay Vendor for such Goods and Services within sixty (60) days after the date of City's receipt of Vendor's invoice detailing same, so long as and to the extent such Goods and Services are not disputed, are in conformance with the specifications set forth in Exhibit A, are submitted on an invoice that contains the information contained on attached Exhibit B, and Vendor has otherwise performed and satisfied all the terms and conditions of this Agreement. 3.2 Vendor agrees not to provide any Goods and Services to City that would cause the total cost of the Goods and Services provided by Vendor to City hereunder to exceed the Estimate, unless City has previously agreed, in writing, to pay an amount in excess thereof. 4. WARRANTY: Vendor expressly warrants that the Goods and Services covered by this Agreement will conform to those certain specifications, descriptions and/or quotations regarding same as were provided to Vendor by City and/or by Vendor to and accepted by City, all of which documents are incorporated herein by reference, and that the Goods and Services will be delivered in a timely, good and workmanlike manner and free from defect. Vendor acknowledges that it knows of City's intended use and expressly warrants that the Goods and Services provided to City pursuant to this Agreement have been selected by Vendor based upon City's stated use and are fit and sufficient for their particular purpose. I\LLs..ap,vlWm6fn-ntlnvnLLAN\trrcJC LL'rolScS( dS..'&rt«,1EO11N1apa Supply&Grw&%bi.ly.ntt c.. &S -.. d ZI�OU'I J'8 a&.\IJ Majors Supply &Grounds Maintenance Street Department - 2014 Appropriation#0042-365.00: P.O. #31354 Contract Not To Exceed $225,000.00 5. TIME AND PERFORMANCE: This Agreement shall become effective as of the last date on which a party hereto executes same ("Effective Date"), and both parties shall thereafter perform their obligations hereunder in a timely manner. Time is of the essence of this Agreement. 6. DISCLOSURE AND WARNINGS: If requested by City, Vendor shall promptly furnish to City, in such form and detail as City may direct, a list of all chemicals, materials, substances and items used in or during the provision of the Goods and Services provided hereunder, including the quantity, quality and concentration thereof and any other information relating thereto. At the time of the delivery of the Goods and Services provided hereunder, Vendor agrees to furnish to City sufficient written warning and notice (including appropriate labels on containers and packing) of any hazardous material utilized in or that is a part of the Goods and Services. 7. LIENS: Vendor shall not cause or permit the filing of any lien on any of City's property. In the event any such lien is filed and Vendor fails to remove such lien within ten (10) days after the filing thereof, by payment or bonding, City shall have the right to pay such lien or obtain such bond, all at Vendor's sole cost and expense. 8. DEFAULT: In the event Vendor: (a) repudiates, breaches or defaults under any of the terms or conditions of this Agreement, including Vendor's warranties; (b) fails to provide the Goods and Services as specified herein; (c) fails to make progress so as to endanger timely and proper provision of the Goods and Services and does not correct such failure or breach within five (5) business days (or such shorter period of time as is commercially reasonable under the circumstances) after receipt of notice from City specifying such failure or breach; or (d) becomes insolvent, is placed into receivership, makes a general assignment for the benefit of creditors or dissolves, each such event constituting an event of default hereunder, City shall have the right to (1) terminate all or any parts of this Agreement, without liability to Vendor; and (2) exercise all other rights and remedies available to City at law and/or in equity. 9. INSURANCE AND INDEMNIFICATION: _ Vendor shall procure and maintain in full force and effect during the term of this Agreement, with an insurer licensed to do business in the State of Indiana, such insurance as is necessary for the protection of City and Vendor from all claims for damages under any workers' compensation, occupational disease and/or unemployment compensation act; for bodily injuries including, but not limited to, personal injury, sickness, disease or death of or to any of Vendor's agents, officers, employees, contractors and subcontractors; and, for any injury to or destruction of property, including, but not limited to, any loss of use resulting therefrom. The coverage amounts shall be no less than those amounts set forth in attached Exhibit C. Vendor shall cause its insurers to name City as an additional insured on all such insurance policies, shall promptly provide City, upon request, with copies of all such policies, and shall provide that such insurance policies shall not be canceled without thirty (30) days prior notice to City. Vendor shall indemnify and hold harmless City from and against any and all liabilities, claims, demands or expenses (including, but not limited to, reasonable attorney fees) for injury, death and/or damages to any person or property arising from or in connection with Vendor's provision of Goods and Services pursuant to or under this Agreement or Vendor's use of City property. Wsa.aa�r.lWv,Lau.a.Am.VANl tu.aW'...v......]...h...WS.....re...... ..........S.....n.nL..... ........RSt,,,a,k...1/I WNIII9 8AMI Majors Supply&Grounds Maintenance Street Department- 2014 Appropriation#0042-365.00: P.O. #31854 Contract Not To Exceed $225.000.00 Vendor further agrees to indemnify, defend and hold harmless City and its officers, officials, agents and employees from all claims and suits of whatever type, including, but not limited to, all court costs, attorney fees, and other expenses, caused by any act or omission of Vendor and/or of any of Vendor's agents, officers, employees, contractors or subcontractors in the performance of this Agreement. These indemnification obligations shall survive the termination of this Agreement. 10. GOVERNMENT COMPLIANCE: Vendor agrees to comply with all federal, state and local laws, executive orders, rules, regulations and codes which may be applicable to Vendor's performance of its obligations under this Agreement, and all relevant provisions thereof are incorporated herein by this reference. Vendor agrees to indemnify and hold harmless City from any loss, damage and/or liability resulting from any such violation of such laws, orders, rules, regulations and codes. This indemnification obligation shall survive the termination of this Agreement. 11. NONDISCRIMINATION: Vendor represents and warrants that it and all of its officers, employees, agents, contractors and subcontractors shall comply with all laws of the United States, the State of Indiana and City prohibiting discrimination against any employee, applicant for employment or other person in the provision of any Goods and Services provided by this Agreement with respect to their hire, tenure, terms, conditions and privileges of employment and any other matter related to their employment or subcontracting, because of race, religion, color, sex, handicap, national origin, ancestry, age, disabled veteran status and/or Vietnam era veteran status. 12. E-VERIFY Pursuant to I.C. § 22-5-1.7 et seq., as the same may be amended from time to time, and as is incorporated herein by this reference (the "Indiana E-Verify Law"), Vendor is required to enroll in and verify the work eligibility status of its newly-hired employees using the E-Verify program, and to execute the Affidavit attached herein as Exhibit D, affirming that it is enrolled and participating in the E-verify program and does not knowingly employ unauthorized aliens. In support of the Affidavit, Vendor shall provide the City with documentation indicating that it has enrolled and is participating in the E-Verify program. Should Vendor subcontract for the performance of any work under and pursuant to this Agreement, it shall fully comply with the Indiana E-Verify Law as regards each such subcontractor. Should the Vendor or any subcontractor violate the Indiana E-Verify law, the City may require a cure of such violation and thereafter, if no timely cure is performed, terminate this Agreement in accordance with either the provisions hereof or those set forth in the Indiana E-Verify Law. The requirements of this paragraph shall not apply should the E- Verify program cease to exist. 13. NO IMPLIED WAIVER: The failure of either party to require performance by the other of any provision of this Agreement shall not affect the right of such party to require such performance at any time thereafter, nor shall the waiver by any party of a breach of any provision of this Agreement constitute a waiver of any succeeding breach of the same or any other provision hereof. 14. NON-ASSIGNMENT: Vendor shall not assign or pledge this Agreement, whether as collateral for a loan or otherwise, and shall not delegate its obligations under this Agreement without City's prior written consent. puss..avi^I4u ermm-aennnv,AxM1.nur(,mrssuM'ma.a h<' ,L.S d-,,,dUowo6x s xnppi,m cmuod.M,,i. ,fl-r d m sonmwac 3nwlou 9S Mp Majors Supply&Grounds Maintenance Street Department-2014 Appropriation#0042-365.00: P.O.#31854 Contract Not To Exceed $225.000.00 15. RELATIONSHIP OF PARTIES: The relationship of the parties hereto shall be as provided for in this Agreement, and neither Vendor nor any of its officers, employees, contractors, subcontractors and agents are employees of City. The contract price set forth herein shall be the full and maximum compensation and monies required of City to be paid to Vendor under or pursuant to this Agreement. 16. GOVERNING LAW; LAWSUITS: This Agreement is to be construed in accordance with and governed by the laws of the State of Indiana, except for its conflict of laws provisions. The parties agree that, in the event a lawsuit is filed hereunder, they waive their right to a jury trial, agree to file any such lawsuit in an appropriate court in Hamilton County, Indiana only, and agree that such court is the appropriate venue for and has jurisdiction over same. 17. SEVERABILITY: If any term of this Agreement is invalid or unenforceable under any statute, regulation, ordinance, executive order or other rule of law, such term shall be deemed reformed or deleted, but only to the extent necessary to comply with same, and the remaining provisions of this Agreement shall remain in full force and effect. 18. NOTICE: Any notice provided for in this Agreement will be sufficient if it is in writing and is delivered by postage prepaid U.S. certified mail, return receipt requested, to the party to be notified at the address specified herein: If to City: City of Carmel AND Douglas C. Haney, City Attorney One Civic Square Department of Law Carmel, Indiana 46032 One Civic Square Attention: Dave Huffman Carmel, Indiana 46032 If to Vendor: Majors Supply & Grounds Maintenance 6393 Hamilton Lebanon Road Monroe, OH 45050 Telephone: 513-539-8212 ATTENTION: Michael Majors Notwithstanding the above, notice of termination under paragraph 19 hereinbelow shall be effective if given orally, as long as written notice is then provided as set forth hereinabove within five (5) business days from the date of such oral notice. 19. TERMINATION: 19.1 Notwithstanding anything to the contrary contained in this Agreement, City may, upon notice to Vendor, immediately terminate this Agreement for cause, in the event of a default hereunder by Vendor and/or if sufficient funds are not appropriated or encumbered to pay for the Goods and Services to be provided hereunder. In the event of such termination, Vendor shall be entitled to receive only payment for the undisputed invoice amount representing conforming Goods and Services delivered as of the date of termination, except that such payment amount shall not exceed the Estimate amount in effect at the time of termination, unless the parties have previously agreed in writing to a greater amount. \I'.npn utr bla-aMVn L\M'\aMW!'mimttNTOfAV SC akSm\Slrta'i 41114U1aj S.,pplYS'Gemna i\laini�va-GUda S Snai(..d :YI8/'-IIIJ YS8.U11 Majors Supply Sc Grounds Maintenance • Street Department-2014 Appropriation#0042-365.00: P.O. #31854 Contract Not To Exceed $225.000.00 19.2 City may terminate this Agreement at any time upon thirty (30) days prior notice to Vendor. In the event of such termination, Vendor shall be entitled to receive only payment for the undisputed invoice amount of conforming Goods and Services delivered as of the date of termination, except that such payment amount shall not exceed the Estimate amount in effect at the time of termination, unless the parties have previously agreed in writing to a greater amount. 19.3 The City may terminate this Agreement pursuant to Paragraph 11 hereof, as appropriate. 20. REPRESENTATIONS AND WARRANTIES The parties represent and warrant that they are authorized to enter into this Agreement and that the persons executing this Agreement have the authority to bind the party which they represent. 21. ADDITIONAL GOODS AND SERVICES Vendor understands and agrees that City may, from time to time, request Vendor to provide additional goods and services to City. When City desires additional goods and services from Vendor, the City shall notify Vendor of such additional goods and services desired, as well as the time frame in which same are to be provided. Only after City has approved Vendor's time and cost estimate for the provision of such additional goods and services, has encumbered sufficient monies to pay for same, and has authorized Vendor, in writing, to provide such additional goods and services, shall such goods and services be provided by Vendor to City. A copy of the City's authorization documents for the purchase of additional goods and services shall be numbered and attached hereto in the order in which they are approved by City. 22. TERM Unless otherwise terminated in accordance with the termination provisions set forth in Paragraph 19 hereinabove, this Agreement shall be in effect from the Effective Date through December 31, 2014 and shall, on the first day of each January thereafter, automatically renew for a period of one (1) calendar year, unless otherwise agreed by the parties hereto. 23. HEADINGS All heading and sections of this Agreement are inserted for convenience only and do not form a part of this Agreement nor limit, expand or otherwise alter the meaning of any provision hereof. 24. BINDING EFFECT The parties, and their respective officers, officials, agents, partners, successors, assigns and legal representatives, are bound to the other with respect to all of the covenants, terms, warranties and obligations set forth in Agreement. 25, NO THIRD PARTY BENEFICIARIES This Agreement gives no rights or benefits to anyone other than City and Vendor. 26. IRAN CERTIFICATION: Pursuant to I.C. § 5-22-16.5, the Vendor shall certify that, in signing this document, it does not engage in investment activities within the Country of Iran. �1\ICSm.rPPxIW VrEria rLrvnY.Ax\rftaM['un,rensWWSaoS[.rrtls trcr\Gn't,\.`tIIlNlaNa S"ITIJS Cr.nnrir Mair,ii aa -<nadrk Smimdr�:/IPJ2IJ RjR A\II ' Feb-18-2314 05 24 PM US Sank 1234557890 1/4 Majors Supply&Grounds Maintenance Street Department-2014 Appropriation#0042-365.00: P.O.#31854 Contract Not To Exceed$225,000.00 27. ADVICE OF COUNSEL: The parties warrant that they have read this Agreement and understand it have had the opportunity to obtain legal advice and assistance of counsel throughout the negotiation of this Agreement, and enter into same freely,voluntarily,and without any duress,undue influence or coercion. 28. ENTIRE AGREEMENT: This Agreement, together with any exhibits attached hereto or referenced herein, constitutes the entire agreement between Vendor and City with respect to the subject matter hereof,and supersedes all prior oral or written representations and agreements regarding same. Notwithstanding any other term or condition set forth herein,but subject to paragraph 16 hereof,to the extent any term or condition contained In any exhibit attached to this Agreement or In any document referenced herein conflicts with any term or condition contained in this Agreement, the term or condition contained In this Agreement than govern and prevail. This Agreement may only be modified by written amendment executed by both parties hereto, or their successors In interest. IN WITNESS WHEREOF,the parties hereto have made and executed this Agreement as follows: CITY OF CARMEL.INDIANA Majors Supply&Grounds Maintenance by and through its Board of Public Works and Safety By: By: g ,Presiding # ..r Authorized Signature Data: i 2jarT G. /19.9,03,Cr Printed Name Mary Ann Burke,Member Date: fl'.YER _ Title Lori S.Watson',Member FID/TIN: Date? 3/h /1 + r Last Four of SSN if Sole Proprietor. ATTEST: Dar fwd. Kier .20i5z ■ 41 . (04. D':na Cordray,IAMC C rk- asurer sate: ? /y ,y��p,.spy..yet pVS✓tm1`3M 11"41,.. i..i,AMP)bgra Omni.M *.t WA a sm..d.ciendraw IA Abu ® . ; 16913 e o' " 1 J,O R S' PNrim Deakr 3;, " SUP PLY & (GROUNDS MAINT1 NANCE ' Mulches • Top-Soil• Seeds.. Fertilizer Straw • Salt alt 'Mowing • Mulching • Seeding Landscaping • Y. , r. Livestock/Pei Food `,, 6393 Hamilton Lebanon Rd. (513) 539-8212r ; Monroe,:Ohio 45050 www.majorssupply.com:;. SOLD TO: �; r ,t a DATE ja 20 � ADDRESS: "00 ��e5 130s ee C" '° AI'me, i•-r:.:1' :.t<y%c�!iw yl"O"/ `*' PHONE SOLD eY CASH 46 D CHARGE OM ACCT , MDSE.REID PAID OUT cR'.�ry1 CODE QTY:" DESCRIPTION PRICE " , AMOUNT �� a COO ° ' Bulk CALL S ?' " ' ka ,_ 6/y<% ry a A(kx F .p ". - 4 0-• i r Tall r a ,mot '� v e w uM> � es fi p•It .am- 9 es r•& ?a. 'SCk�i sa tip^ �, t ��. � 9 3.! W 4' L' w $ K 8Y y d t .t 4 4 r ; 1 1 tlq"rt° " - a. ° �9� �p c w yJn a 9a , ti r•y 'W fi B 'SY tY W�6")TA t if`e " .. k nr 1 - fi. ,.. •k '1 4 F=''� S - r "' (P' • *fit We ere not responsible,'` ," ,, �� , K• "� ' r for eny4rtellvery;past Curb. 4 � l , ,,s,* " ,r ,, ', 25%.Restocking charge onrany.delivered item returned �, S ,, rein T , _ , 9r 4 ay„'as llbfOf�l.,�, (F� O Ys. n m. c from this mvetcp,r ?"17.1•1:• ,44.4•"-' a t '".::.,�""- �qeh a -:.,9� r ar we` ' ,�. `"".: Tox"r .� e� s § Si y.� . ` 34 finer S a , a ,}` � .,+.� iF rte•• arT �Hr�u! aL ° .• �'k k * 'y �ode)• _ •x W "'TOTAL DUE � � ,.. ��"� t• ti C +r, *�, $ & o a `�y . L u ,, f i s8.m ' 1ti 1044404 44 .r•);14:2 it,fix 's 4 y+ry flv -;',41-1,4.;,.-.4,40`-lt.,,- �t o-�N'x i `x r €'9' ,.. �b�. a 4 *r ..,'- �^sMH .'n �`."Var. 4 ±, dkt1 ,�' ,"" �'�! > d t't +"},1.6• " W'.'�•yT;$sL '141-'4-4-4---- : ,� .. City of Carmel 003129155002° PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 31854 3540000972 ONE CIVIC SQUARE TARS MAHER MUST APPEAR ON NYVMEx Al CARMEL,INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SUPS FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 6IfPPNO '�met CORRESPONDENCE PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 2117/2014 - Major Supply 8 Grounds'Maintenance Street Department 9ero0R SHOP 3400 W.131st Street TO 8393 Hamilton Lebanon Road Cannel,IN 48074 Monroe,OH 45050 . (317)733-2001 ccommazo BLAME/ CONTRACT PAYMENT TERMS FREIGHT QUANTITY 'UNIT OF;ADMIRE( DESCRIPTION I UNIT PRICE I EOHYSON Account 0042.365.00 - 1 Each Salt - - I $225,000.00 $225,000;00 Sub Total: $225,000.00 !I 9F OF.-C4414.4,alw. :w LL ma D t QA 9 `a Send Invoice To �lTe. c® , Street Department 3400 W.131st Street Carmel,IN 48074- PLEASE INVOICE IN DUPLICATE DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT Carmel Street Deperbnent .. - PAYMENT - • $225,000.00 • AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UMESS THE P.O. NURSER IS MADE A PART OF TIE VOUCHER MOO EVERY INVOICE MID VOUCHER - PROPER SWORE AFFIDAVITATTM:HED. SHIPPING INSTRUCTIONS • IHEREBY ar' •.REIS AN UweuwIEDBMANCEN •sHP REFMD. mos AP"•,y - ro PAY/FOR TIE MJYE ORDER •COD.BH.PMENF9 CANNOT BE ACCEPTED_ t0Q adr.. -'_T •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY II • ✓A yV I SHIPPING LASU. • •THIS ORDER ISSUED IN COMPLIANCE YATH CHAPTER W.ACTS I94 TITLE AND ACTS AMENDATORY THEREOF MO SUPPLEMENT THERETO. CLERK-TREASURER ' D OCUMENT CONTROL No.318 54 A.P.V.COPY-SIGH AND RETURN TO CLERK'S OFFICE ; / A . A tet L/ • EXHIBIT B Invoice Date: Name of Coinpany: Address &Zip: Telephone No.: Fax No.: Project Name: Invoice No. Purchase Order No: Goods Services Person Providing Date Goods/Services Provided Cost Per Hourly Total Goods/Services Goods/ (Describe each good/service Item Rate/ Service separately and in detail) Hours Provided Worked GRAND TOTAL Signature Printed Name EXHIBIT C INSURANCE COVERAGES Worker's Compensation & Disability Statutory Limits Employer's Liability: Bodily Injury by Accident/Disease: $100,000 each employee Bodily Injury by Accident/Disease: $250,000 each accident Bodily Injury by Accident/Disease: $500,000 policy limit Property damage, contractual liability, products-completed operations: General Aggregate Limit (other than Products/Completed Operations): $500,000 Products/Completed Operations: $500,000 Personal & Advertising Injury Policy Limit: $500,000 Each Occurrence Limit: $250,000 Fire Damage (any one fire): $250,000 Medical Expense Limit(any one person): $ 50,000 Comprehensive Auto Liability (owned, hired and non-owned) Bodily Single Limit: $500,000 each accident Injury and property damage: $500,000 each accident Policy Limit: $500,000 Umbrella Excess Liability Each occurrence and aggregate: $500,000 Maximum deductible: $ 10,000 Feb 18 14 08:55a Abacus Tax Service Inc 513 539 9924 p.1 • ivv E-Verifv Affidavit Pursuant to Indiana Code 22-5-1.7-11, the Contractor entering into a contrast With the City is required to enroll in and verify the work eligibility status of all its newly hired employees through the E-Verify program. The Contractor is not required to verify the work eligibility status of all its newly hired employees through the E-Verify program if the E-Verify program no longer exists. The undersigned, on behalf of the Contractor, being first duly sworn, deposes d states that the Contractor does not knowingly employ an unauthorized alien. The undersigned tiller affirms that, prior to entering into its contract with the City, the undersigned Contractor will enroll in and agrees to verify the work eligibility status of all its newly hired employees through the E1 Verify program. 1 • (Contractor): 411 v/.S iNTEifFXjsa ' 14'C By(Written Signature): . ,--Z-1:. J �,,, � (Printed Name): '��� j ////l' ,-MS " _ (Title): AgfieJy cNT G;YYLir important-,Votary Signature and Seat Required in the Space Below STATE OF r s s: COUNTY OF r.-t9, , � I Subscribed and sworn to before me this J1- day of -e-iini 20 /1 J ,fit v� My commission expires: 5110e11,,pl,, /5• ,Zpll (Signed) Residing in L/3 u t ,,._, County, State of ` � tl 111th ,`,,111$i AL y.4,. • • 41 = L!af=.Garrey '..,*= Public.Slate a Ohio j - _-`. My Co-vnisan:sal December es�em� 15.2716 • t•p cij i itOf to` e' • I ' Feb 191410'.21a Abacus Tax Service Inc 513 539 9924 p.1 Request Access to BSO Services Confirmation :7ttps::/secure.ssa.goy/acu!IRESWeb/secigenericTarget.do?targetFor... Social Security Online Business Services Online www.socialsecurity.gov Main Menu I Contact Us (popup)I BSO Information(popup) I Keyboard Navigation(popup) DENNIS MAJORS :,og Out AGN Request Access to BSO Services Confirmation Manage Account • View/Edit Account Info • Change Password • Disable Account Manage Services • View/Edit Services • Request New Services • View?ending Services • Enter Activation Codes Manage Employer Information • Add)Uodate Employer information • Remove Employer Information Your request for access to the services and tasks listed below was received on February 19, 2014. Report Wages to Social Security You may begin to use this service immediately. To do that, select"BSO Main Menu" below. Then, on the BSO Main Menu page, select "Report Wages to Social Security." • 1 oft 2119.20149:44 AM Feb 191410.21a Abacus Tax Service Inc 513 539 9924 p.2 R.ecuest Access to BSO Services Confinnaton https:;/secure.ssa.gov/acuJ1RESWeb'sec/genericTarget.do?targetFor... View Wage Report Name 1 SSN Errors An activation code has been sent by first class mail to the address we have on record for you (MONROE, OH). Once you have received the activation code and activated this service, you may view 'Mew Wage Report Name/SSN Errors"from the Wage Reporting menu. Social Security Number Verification Service An activation code has been sent by first class mail to the address we have on record for you (MONROE, OH). Once you have received the code and activated this service, you may access "Social Security Number Verification Service" from the BSO Main Menu page. Please print this page for your records, Print Main (Menu www.socialsecurity.gov 2 of 2/19/2014 9:44 AM