HomeMy WebLinkAbout246323 06/17/15 t1q
�`' "f CITY OF CARMEL, INDIANA VENDOR: 115100
® ONE CIVIC SQUARE DEBRA GRISHAM CHECK AMOUNT: $*****9,324.00*
:. ?� CARMEL, INDIANA 46032 922 E GREYHOUND PASS CHECK NUMBER: 246323
+, ,_ CARMEL IN 46032 CHECK DATE: 06117115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
106 5023990 5/15 1,274.00 OTHER EXPENSES
1081 4340000 5/15 56.00 LEGAL FEES
1091 4340000 5/15 238.00 LEGAL FEES
1125 4340000 5/15 7,756.00 LEGAL FEES
DEBRA M. GRISHAM, ATTORNEY AT LAW LLC
922 EAST GREYHOUND PASS
CARMEL, INDIANA 46032
Telephone: 317-690-1597
Email: dgrishamlaw@gmail.com
May 27, 2015
James Engledow, President Mark Westermeier, Director
Carmel/Clay Board of Parks and Recreation Carmel/Clay Department of Parks &
1411 E. 116'x' Street Recreation
Carmel, IN 46032 1411 E. 116'' Street
Carmel, IN 46032
Re: Notice of Change of Status
Dear Mr. Engledow and Mr. Westermeier,
Please accept this notification consistent with the Contractual Services Agreement by and
between the Carmel/Clay Board of Parks and Recreation and Debra M. Grisham, Attorney at
Law,that my status has changed from a sole practitioner to a limited liability company. I have
confirmed on this date that all steps have been completed to effect this change which included
application to, and acceptance by,the Indiana Secretary of State, my professional liability insurer
and the Indiana Board of Law Examiners.
I am happy to complete any forms necessary to facilitate payment to Debra M Grisham, Attorney
at Law LLC rather than to Debra M. Grisham individually. Toward that end, I am copying
Audrey Kostrzewa, Business Services Division,Manager.
It is and always has been my great honor to work with you both,the Park Board and the Park
Department staff. I believe in the quality of life that only a vibrant park and recreation system
can offer to a community. Like both of you and Carmel's elected and appointed officials, I
believe in the mission exemplified by the ever evolving Carmel Clay Park System and I am
humbled to have been chosen to work with you on it.
Thank you for your prompt attention to this matter.
Very truly yours,
Debra M. Grish , Attorney at Law, LLC
cc: Audrey Kostrzewa
Form W-9 Request for Taxpayer Give Form to the
(Rev.January 2011) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
Nie(as shown on your income tax return)
I C61ri)—, M, G-16,1,7 c�,)l
N Business name/disregarded entity name,if different from above
c- Check appropriate box for federal tax
c
O classification(required): ❑ Individual/sole proprietor ❑ C Corporation ❑S Corporation ❑ Partnership ❑Trust/estate
d c
0
v Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)d Exempt payee
o --------------------------------
C H
a C
V LJOther(see Instructions)10-
!E Address(number,street,and apt.or suite no.) Requester's name and address(optional
`,2 L C� c...-e i.
City tate,and ZIP code /
List account number(s)here(optional)
DOM Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line I Social security number
to avoid backup withholding.For individuals,this is your social security number However,fora
resident alien,sole proprietor,or disregarded entity,see the Part I instructions onn 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.
Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identification number
number to enter.
M47 - 3 � IM
Certification
Under penalties of perjury,I certify that:
1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and
2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding,and
3. 1 am a U.S.citizen or other U.S.person(defined below).
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividn s on your tax return.For real estate transactions,item 2 does not apply.For mortgage
interest paid,acquisition or abandonment of secured r erty,cancellation of debt,contributions to an individual retirement arrangement(IRA),and
generally,payments other than interest and dividends ou are not required to sign the certification,but you must provide your correct TIN.See the
instructions on page 4.
Sign Signature of
Here U.S.person► Date► M Z 7 (fol S
General Instructions Note.If a requester gives you a other than Form W-9 to request
Section references are to the Internal Revenue Code unless otherwise your TIN,you must use the requester's form if it is substantially similar
to this Form W-9.
noted.
Definition of a U.S.person.For federal tax purposes,you are
Purpose of Form considered a U.S.person if you are:
A person who is required to file an information return with the IRS must •An individual who is a U.S.citizen or U.S.resident alien,
obtain your correct taxpayer identification number(TIN)to report,for •A partnership,corporation,company,or association created or
example,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the United States,
you paid,acquisition or abandonment of secured property,cancellation .An estate(other than a foreign estate),or
of debt,or contributions you made to an IRA.
•A domestic trust(as defined in Regulations section 301.7701-7).
Use Form W-9 only if you are a U.S.person(including a resident
alien),to provide your correct TIN to the person requesting it(the Special rules for partnerships.Partnerships that conduct a trade or
requester)and,when applicable,to: business in the United States are generally required to pay a withholding
tax on any foreign partners'share of income from such business.
1.Certify that the TIN you are giving is correct(or you are waiting for a Further,in certain cases where a Form W-9 has not been received,a
number to be issued), partnership is required to presume that a partner is a foreign person,
2.Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a
3.Claim exemption from backup withholding if you are a U.S.exempt partner in a partnership conducting a trade or business in the United
payee.If applicable,you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S.
allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership income,
is not subject to the withholding tax on foreign partners'share of
effectively connected income.
Cat.No.10231X Form W-9(Rev.1-2011)
7JU 201
Professional Services Invoice -- -- ..
FOR SERVICES RENDERED Date: 6/1/2015
FROM 5/1/15 THROUGH 5/31/15 C--Ay -FW F
1215--L} 13,T—= It ao0
Provider: Debra M. Grisham, Attorney at Law LLC C ITY Q F CPc9NE7L—%q'�4.00
Address: 922 E Greyhound Pass Purchase LEaAl- gelROJIM5 IUPPIS
Carmel, IN 46032 Description
1115 +01- q-340000 = -1-751 ,00
Telephone: 317-690-1597 10(p - 50 a 3q q 0 = 19 00
Email: dgrishamlaw@gmail.com IDftJ-q°/- 4 3 000 0 = 5(0.00
Project Name: General Park Legal and Business Services l DriI ' `f 540 O = oR -38'00
Invoice NO: 5.15 Approval'IV Date-L4&t—
Hourly Rate: $140.00
Service Date Description of Service Hours Worked Amount Due
5/4/2015 Worked on the Matilda Haverstick Family Property 0.5 $70.00 10(,
("MHFP") acquisition including survey
engagement letter with CrossRoad Engineers.
Worked on coversheet for Gibraltar contract 0.4 $56.00 12.j
change order#5 regarding the Central Park Dog
Park Project (the "Dog Park").
Communications regarding Sunrise on the Monon 0.4 $56.00 1- 1
("SOM") matters including communications with
Hamilton Title regarding tax payments and
updated the file.
Worked on and met with M Klitzing and L Russell 1 $140.00 I t
regarding, maintenance personnel matters.
Communications to M Westermeier and M Klitzing 0.2 $28.00 1° t
regarding Park Member inquiry into the delegation
of authority.
Prepared for and attended Agenda and Project
Status meeting with Senior Management Staff. 2 $280.00 io
5/5/2015 Worked on SOM related matters including the tax 1.6 $224.00 i
exempt form and communications regarding the
same with the Hamilton County Auditor's Office.
Met with M Westermeier regarding maintenance 0.4 $56.00 lot
personnel matters.
1
Service Date Description of Service Hours Worked Amount Due
Communications regarding and completed the 1.5 $210.00 1 o c,
MHFP survey engagement letter with Crossroads
Engineers, obtained M Westermeier's signature
and distributed the same via electronic mail and
took steps to send originals via U.S. Mail.
Updated the file.
Reviewed Park Board member inquiry regarding 0.5 $70.00 Iu 1
delegation of authority and discussed the same
with M Westermeier and M Klitzing.
5/6/2015 Met with M Westermeier, M Klitzing and L Russell 0.7 $98.00 101
regarding maintenance personnel matters.
Updated the file.
Worked on matters in preparation for the 5-12- 0.9 $126.00 i a l
2015 Park Board meeting including the Attorney
report update and agenda item review.
Researched and otherwise worked on response to 1.3 $182.00 1 o I
Park Board member inquiry regarding delegation
of authority and met with J Engledow regarding
the same.
Communications with appraisers regarding the 0.8 $112.00 �d L
MHFP. Updated the file.
Communications regarding SOM property tax 1.4 $196.00 i a t
exemption matters and met with and obtained J
Engledow's signature and filed the property tax
exemption application with the Hamilton County
Assessor.
5/7/2015 Reviewed and updated Project List; general file 1 $140.00 lot
organization.
Continued work on response regarding the 1.6 $224.00 1v 1
delegation of authority inquiry.
Communications regarding SOM property tax 0.4 $56.00 id i
exemption filing with Hamilton County Assessor's
office.
Worked on maintenance personnel matters 1.9 $266.00
including research of applicable law regarding an
employee warning notice.
5/8/2015 Finished and distributed response regarding the 1.8 $252.00 I
delegation of authority inquiry.
Communications with appraisers regarding the 0.2 $28.00 1 v Co
MHFP.
Finished research of applicable law and 2 $280.00
suggested draft language regarding an employee
warning notice.
Worked on general file organization. 0.5 $70.00 1,)i
2
Service Date Description of Service Hours Worked Amount Due
5/11/2015 Prepared for and participated in conference call 2 $280.00 I o(.,
with Scheidt appraisers regarding the MHFP and
organized the file. Communications with
CrossRoads Engineering regarding survey
engagement documents, processed the same and
updated the file. Worked with CrossRoad's
insurance contact regarding the Certificate of
Insurance content. Distributed engagement and
corrected COI.
Worked on MHFP and general file organization. 1.5 $210.00 1,�
5/12/2015 Worked on Purchase Agreement Form. 2 $280.00 I
Worked on general file organization and filing. 1 $140.00
Prepared for and attended Regular Park Board 2 $280.00 Id
meeting.
5/13/2015 Received and reviewed CrossRoad Engineers 0.5 $70.00 1
Survey Engagement Documents with original
signatures and distributed to A Kostrzewa.
Communications with the title insurance company
regarding the MHFP title commitment and
underlying documents of record.
Finished Purchase Agreement form. 3 $420.00 t o I
5/14/2015 Met with M Westermeier regarding Park Board 0.5 $70.00 lot
governance matters.
Received and started review of MHFP title 1.5 $210.00 1 ,c,
commitment and underlying documents.
Communications with CrossRoad Engineers
regarding the same.
Reviewed status of Indiana legislation with 0.5 $70.00
potential impact to CCPR.
5/15/2015 Revised and researched records request and 1.2 $168.00 I ,
discussed the same with M Westermeier and A
Kostrzewa.
Communications with M Krosschell of The 0.8 $112.00 1 ZiT,y64
Schneider Corporation regarding the Central Park
West Commons Project ("CPWCP") timeline,
reviewed the proposed timeline against applicable
legal requirements, met with M Westermeier and
proposed an alternative timeline for the same.
Worked on SOM file organization and 2.7 $378.00 1
communications with the Department of
Community Services ("DOCS") and A Greenwood
regarding the Secondary Plat status;
communications with the Title Company regarding
document recording and return status.
3
Service Date Description of Service Hours Worked Amount Due
5/18/2015 Communications regarding the CPWCP bid 0.2 $28.00 I Li S-y aA
documents and timeframe.
Continued review of 2015 Indiana legislation 3 $420.00 to
pertinent to the Park Board including cell tower
siting and HEA 1019 regarding the Common
Construction Wage law. Discussed the same with
J Molitor.
Received and briefly reviewed SOM Plat and 1 $140.00 1j I
CCRs from DOCS and communications with M
Westermeier and A Greenwood regarding the
same.
5/19/2015 Discussed with A Kostrzewa, a subpoena 0.4 $56.00 I
regarding a former CCPR employee and
calendared for follow-up with L Russell. Created
file.
Continued review of SOM Plat and CCRs from 1.8 $252.00 1d
DOCS and communications with M Westermeier,
DOCS and A Greenwood regarding the same.
Started review of batherload research and 0.5 $70.00 lo-11
discussed the same with M Westermeier.
Communications with Travelers Adjuster 0.8 $112.00 1 v$
regarding Tort Claim JSESEE2S7919 and Tort
Claim PWMCCE1 E2841 matters and discussed
the same with M Westermeier. Updated the files.
5/20/2015 Completed review of batherload research and 0.8 $112.00 10�
updated the file regarding the same.
Worked on SOM matters including review of the 2.4 $336.00 1 ,
CCR draft and the Secondary Plat against
existing Access Easement, Use and Maintenance
Agreement and notes. Communications to
DOCS, A Greenwood and M Westermeier
regarding the same.
5/21/2015 Continued work on SOM CCR draft and 1.8 $252.00 to l
Secondary Plat review and multiple
communications with A Greenwood regarding the
same.
Received and prepared to review the CPWCP bid 0.7 $98.00 IL�r-y3Qs
documents.
5/22/2015 Communications with A Greenwood regarding 0.2 $28.00 I u(
SOM matters.
Communications regarding the MHFP. 0.2 $28.00 1 a
5/26/2015 Continued work on SOM CCR draft and 2.2 $308.00 a
Secondary Plat review. Communications with
DOCS regarding the same.
4
Service Date Description of Service Hours Worked Amount Due
5/27/2105 Continued work on SOM CCR draft and 2.1 $294.00 Id t
Secondary Plat review.
5/28/2015 Continued work on SOM CCR draft and 3.1 $434.00 I l
Secondary Plat review and met with M
Westermeier and M Klitzing regarding the same.
Met with A Greenwood and M Westermeier
regarding the SOM Secondary Plat and attending
documents, identified issues and assigned tasks.
Met with M Westermeier regarding various park 0.6 $84.00 l d(
projects including the Dog Park, Founders Park
Lighting Project, CPWCP and personnel and
accessibilty matters.
Communications regarding possible CCPR 0.4 $56.00 e t
employee for domestic dispute testimony.
5/29/2015 Worked on SOM matters and communications 3.3 $462.00 o t
with title company personnel and A Greenwood
regarding the same.
Communications regarding possible CCPR 0.4 $56.00 I l
employee for domestic dispute testimony.
Followed up on records request for former CCPR 0.2 $28.00
employee.
Communications regarding MHFP. 0.4 $56.00 �dC
Nature of Services FEE
Totals 68.7 $9,618.00✓
Signature: Deirra/M. Grohavw CITY 0 F CAROAEL_
Ph-/ oV\,--y
CLAY nvJnsot �ct4.1)0
pay C)
s
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Debra M Grisham, Terms
Attorney at Law LLC Date Due
922 East Greyhound Pasws
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
6/1/15 5.15 Legal services May'15 $ 7,756.00
6/1/15 5.15 Legal services May'15 $ 1,274.00
6/1/15 5.15 Legal services May'15 $ 56.00
6/1/15 5.15 Legal services May'15 $ 238.00
not mai
Total $ 9,324.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
120
Clerk-Treasurer
Voucher No. Warrant No.
Debra M Grisham, Allowed 20
Attorney at Law LLC
922 East Greyhound Pasws
Carmel, IN 46032 In Sum of$
$ 9,324.00
ON ACCOUNT OF APPROPRIATION FOR
101 General/106 Impact/108 ESE/109 MCC
PO#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
1125 5.15 4340000 $ 7,756.00 1 hereby certify that the attached invoice(s), or
106 5.15 5023990 $ 1,274.00 bill(s)is(are)true and correct and that the
1081-99 5.15 4340000 $ 56.00 materials or services itemized thereon for
1091 5.15 4340000 $ 238.00 which charge is made were ordered and
received except
June 11, 2015
Signature
$ 9,324.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund