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HomeMy WebLinkAboutCarmel Kitchen Specialists/Fire/34,135/Cabinets & Countertops for Station 46Carmel Kitchen Specialists, Inc.,, Fire Department - 2016 Appropriation #43-501.00; P.O. #24812 �pV Contract Not To Exceed $34,135.00 �e�p AGREEMENT FOR PURCHASE OF GOODS AND SERVICES �Ao 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 Carmel Kitchen Specialists, Inc. 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. 3. Q PERFORMANCE: City agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City budget appropriation number 43-501.00 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. Vendor will not perform any of the Services detailed in Exhibit A prior to obtaining a written Notice to Proceed from the City: Upon receiving a Notice to Proceed, the Vender shall perform only those Services specifically detailed in the Notice. If the Vender desires clarification of the scope 'of any Notice to Proceed, the Vendor shall obtain such clarification from the City in writing, prior to performing the service set forth in the Notice to Proceed. Any services performed without the City's prior express written authorization will not be compensated. 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 Thirty Four Thousand One Hundred Thirty Five Dollars ($34,135.00) (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 sefforth 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. 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. [S:\ContrnctsTrof.Sv & Goods Svcs\Fire Dcpt@016\Carme1 Kitchen Specialists, Inc. Goods && Services FORM - WITH ENcrify Linguagc.dac:5/6/2016 3:00 FfviJ Carmel Kitchen Specialists, Inc. Fire Department - 2016 Appropriation #43-501.00; P.O. #24812 Contract Not To Exceed $34,135.00 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. 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. 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) become's 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. 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. [S:\Cont,,,as\PmLSva & Goals S,.%Firc Dcpt\2016\Cs—c1 Kitchcn Spccinlists, Ina Gook & Scrvim FOR,bf - NffH ENcrify L ngtmgadoc:5/62016 3:00 PM] Carmel Kitchen Specialists, Inc. Fire Department - 2016 Appropriation #43-501.00; P.O. #24812 Contract Not To Exceed $34,135.00 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. 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 [SACrn 1racWPwf.Sv & Goads Sv \Firc Dept@016\Cm 1 Kitchen Spreialim& h, . Goals & S—iccs FORM - WITH E -Verify L nguagc-dao:5/62016 3:00 PM] Carmel Kitchen Specialists, Inc. Fire Department - 2016 Appropriation #43-501.00; P.O. #24812 Contract Not To Exceed $34,135.00 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 One Civic Square Carmel, Indiana 46032 If to Vendor: Carmel Kitchen Specialist, Inc. 606 Station Drive Carmel, Indiana 46032 ATTENTION: Jenny Collins AND Douglas C. Haney, Corporation Counsel Department of Law One Civic Square Carmel, Indiana 46032 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. 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. [SAContracts\Prof.Svcc & Goods SvcsTirc DcpA20l6\Cmmc1 Kitchen S,>ccialists, Inc. Goals & Scrvim FORM -WITH E-Vcrify I_nguagcdoc:5/62016 3:00 PM] 4 Carmel Kitchen Specialists, Inc. Fire Department - 2016 Appropriation #43-501.00; P.O. #24812 Contract Not To Exceed $34,135.00 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, 2016 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. 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 shall govern and prevail. This Agreement may only be modified by written amendment executed by both parties hereto, or their successors in interest. 1SXo11tr=1s\ProLSvcs & Goads Svcs\Firo Dcpl@0l6\C—A Kitchen Spcci;disls. Ina Goads & Scrvica FORM - N M E-Wrify Lvigaag.A=5/62016 3:00 PNU l.$MICI NItc1lC11:gw.vialust.", If)(;. Fire. Department - 201 G Appropriation #43-60 L00; P.O. 424812 Contract Not To Exceed .`d34.135.00 IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as follows: CITY OF CARMEL, INDIANA by and through its Board of Public Works and Safety By: vlee- ames Brainard, Presid'n Officer ilala ry.� /P—/ h Mary A�( Burke, Met Date:X? LoriWats , Me ber Date: ' f s h to ATTEST: .hristi.nc S. paul�y�, � lt�surer Date: Carmel Kitchen Specialists, Inc. By: 7ized Sic nature ;;E� e Prin d Name 7if -IdeA' Title L,// FID/TIN: i=� / f9�// Last Four of SSN if Sole Proprietor-, Date:�y/So !-�'`G+*.�Imn:V1r.(.S�a X.•iia.h Sv�at[i�: r3r7N1Y,Q16`C—.1 Yi1441tl151-win, I—Cr.A S8c:reFsrn IR}ItTI-%V(rfi Fr`JCII(y'Iana npc:,A :�ViMR�IG;I;i$l;.1; 6 x/u6rt si latz`7 606 STATION DRIVE •.CARMEL, INDIANA 46032 •317.844.3975 • 317.848.5938 - FAX SALES CONTRACT Date: May 3, 2016 Name of Purchaser(s): City of Carmel Street Address: 2 Civic Square City, State & Zip Code: Carmel, IN 46032 Telephone Number(s): 317-571-2622 CARMEL KITCHEN SPECIALISTS, INC. of Carmel Indiana, agree to furnish the merchandise and/or services shown and described on the drawing/letter dated May 3, 2016 , and shall do everything required by this agreement and the aforementioned letter. The Purchaser shall pay CARMEL KITCHEN SPECIALISTS, INC. for the performance of this contract at the time herein stated and in current funds. Purchase Price: $34,135.00 Plus Sales Tax: N/A Total Purchase w/Tax: $34,135.00 Schedule of Pa, ments: Upon execution of this Contract (representing approximately 40% of total purchase price): N/A Upon delivery of the merchandise and/or equipment (1st Delivery): $22,180.00 Upon delivery of the merchandise and/or equipment (2nd Delivery): $8,280.00 Upon completion of the work: $3,675.00 The merchandise and/or equipment outlined above is to be placed in the premises at: Address: 540 West 136th Street, Carmel IN Property Owner(s): Carmel Fire Station 46 Note: This Contract does not include the construction or connections of any wiring, plumbing, plastering, painting or any other alteration work of any kind, except as specifically mentioned in the attached letter. Any work requested by the Purchaser which is not included in this Contract, will be charged extra on a time and material basis. This Contract is subject to the further terms and conditions shown on the reverse side hereof. QYJIM-a 6e&�E F4 Carm tc en Specia fists, Inc. 2rmel, Indiana Accepted by Purchaser Accepted by Purchaser Date Terns and Conditions a avicI 1. This Contract, when accepted and signed by you and approved by a duly authorized official of this company, shall constitute the contract between us. it being understood that it covers all agreements between us and that no agent, representative or officer of either of us has made any statements or agreement, verbal or written, modifying, adding to, or changing the terms and conditions set forth herein. Any changes in the work which involve a change in the contract sum shall be agreed to in writing and a copy signed by both parties shall be attached to each copy of this agreement. 2. All orders, deliveries and/or installations are subject to delays due to strikes, fire, flood, shortage of material, delays in transit, government priority or regulations, or causes beyond the control of Carmel Kitchen Specialists, Inc. 3. No installation, plumbing, electrical, flooring, decorating or other construction work is to be provided unless specifically set forth herein. In the event Seller is to install, it is understood that the price agreed upon herein does not include possible expense entailed in coping with hidden or unknown contingencies found at the job site. In the event such. contingencies arise and the Selleris required to furnish labor or materials or otherwise perform work not provided for or contemplated by the Seller, the actual costs plus 20% thereof will be paid for by the Purchaser. Contingencies include but are not limited to inability to reuse existing water, vent and waste pipes, ''air shafts, ducts, grilles, louvers and registers, the relocation of concealed pipes, risers, wiring or conduits, the presence of which cannot be determined until the work has started: or imperfections, rotting or decay in the structure or parts thereof necessitating replacement. 4. CARMEL KITCHEN SPECIALISTS, INC., AND their sub -contractors carry public liability insurance. 5. The Purchaser agrees that the kitchen units and accessories, even though installed, are and shall remain the property of CARMEL KITCHEN SPECIALISTS, INC., until fully paid for, and are subject to removal by them as their property, regardless of the sale, lease or transfer of the premises in which they are installed, if the Purchaser should at any time be in default for payment or partial payment, according to the terms of this Contract. b. Delays in payment shall be subject to interest charges of 1 1/2% per month. If the Seller is required to engage the services of a collection agency or an attorney to enforce collection, the Purchaser agrees to pay 25% of any unpaid amounts as a reasonable collection fee. 7. This agreement involves special design and custom built articles and is not subject to cancellation by the Purchaser for any reason. 8. Any unresolved controversy or claim arising from or under this Contract shall be settled by arbitration and judgment upon the award rendered may be entered in any court of competent jurisdiction. The arbitration shall be held under the rules of the American Arbitration Association. E�r�I�G,tr� gdF y 606 Station Drive • Carmel, Indiana 46032 0 317-844-3975 + 317-84.8-5938 — Fax www.earnieMtehensi2eciali:sts.com. May 3, 2016 Estimate submitted for: Denise Snyder Carmel Fire Headquarters City of Carmel 2 Civic Square Carmel, IN 46032 317-571-2622 dsnyder@catmel.in.gov Job Site: Carmel Fire Station 46 Attn: Tony Collins 540 West 136th Street Carmel, IN 46032 Estimate submitted by: �Ww Agb�' S- - envy C ` ins, Designer Carmel Kitchen Specialists, Inc. is pleased to have this opportunity to provide this Revised Estimate for City of Carmel Fire Station 46. Pricing remains current for 60 days and is based on specifications given to Carmel Kitchen Specialists, Inc. Kitchen Cabinetry: Dynasty by Omega Cabinetry, Holton Classic overlay doorstyle in Alder wlKodiak stain..........................................................................$21,690.00 Note: Pricing includes the following: ➢ 3/ " plywood construction ➢ Soft close doors & drawers ➢ Dovetail full extension drawer boxes Six (6) slide out trays w/soft close ➢ Deep drawer stacks to the right & left of range ➢ Double trash pull out Hardware: Amerock Kane Collection in Brushed Nickel .............................................$490.00 Countertops: Stainless steel countertops on perimeter ................................................... $8,280.00 City of Carmel — Carmel Fire Station 46 Estimate - Revised May 3, 2016 Page 2�� y Subtotal........................................................................................................................... $30,460.00 Sales Tax (Exempt from Sales Tax — Need to provide Tax Exempt Certificate) ................... N/A Tear out & disposal of existing cabinetry............................................................................$825.00 Installation of new cabinetry & countertops..................................................................... $2,850.00 Total............................................................................................................................... 4 Q¢ Amount due at merchandise delivery — cabinetry & hardware.......................................$22,180.00 Amount due at merchandise delivery - countertops.........................................................$8,280.00 Amount due upon completion of installation....................................................................$3,675.00 Note: > Installation does not include plumbing or electrical work. Carmel Kitchens would be happy to contract these services for you. The plumbing or electrical bill will be increased 20% to cover this service by Carmel Kitchens and will be invoiced separately. Thank you! Customer Signature/Date EXHIBIT B Invoice Name of Company: Address & Zip: Telephone No.: Fax No.: Project Name: Invoice No. Purchase Order No: Date: i Goods Services Person Providing Date Goods/Services Provided Cost Per Hourly Total Goods/Services Goods/ (Describe each good/service Item Date/ Service separately and in detail) Hours Provided Worked GRAND TOTAL Signature Printed Name EXHIBIT C INSURANCE COVERAGES Worlcer's Compensation i& Disability Statutory Limits Employer's Liability: Bodily Injury by Accident/Disease: ' $100,000 each employee Bodily Injuiy by Accident/Disease: $250,000 each accident Bodily Injury by Accident/Disease: $500,000 policy limit Property damage, contractual liability, products -completed operjations: General Aggregate Limit (other than Products/Comple'ted Operations): $500,000 Products/Completed Operations: $500,000 Personal & Advertising Injury Policy Limit: $500,000 Each OccurrenceLimit: $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: Injury and property damage: Policy Limit: Umbrella Excess Liability Each occurrence and aggregate: Maximum deductible: $500,000 each accident $500,000 each accident $500,000 $500,000 $ 10,000 EXHIBTT D AFFIIDA V.IT being first duly sworn, deposes and says that he/she is familiar with an has personal knowledge of the :facts herein and, if called as a witness in this aiatter, could testify as follows: 1. I am over eighteen (18) years of age and iiia competent to testify to the facts -contained herein. ?_ in the position of 1 plover") 3. 1 am familiar with the employment policies, practices, and procedures of the Employer and have the authority to act on behalf of tate Employer. 4. The Employer is enrolled and participares in the federal E -Verify pro tate. Documentation of this enrollment and participation is attached and incorporated herein. 5. The Employer does not knowingly employ any unauthorized aliens. 6. To the best of my inforniation and belief, the Employer does not: currently e.rnploy ,any unauthorized aliens. 7. FURTHER AFFIANT SAYETH NOT. EXE CUTEDon theday Of .1 certify uxider the penalties :far perjury under the laws of the United States of Anier..i.ca and the State of Indiana. that the foregoing factual statements and representations are true and correct. jar r 1 CARM-1 OP ID: DC 14 ® CERTIFICATE OF LIABILITY INSURANCE D 06 30/201 YY) 0 613 012 01 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER nee, Inc.lnc. P. 0. Box 80865 8445 Keystone Crossing Ste 200 Indianapolis, IN 46240 James H. Conner CONTACT James H. Conner FAX x317-808-7711 A/C No): 317-808-7700 M ADDRESS: INSURERS AFFORDING COVERAGE NAIC p INSURER A: Allied Property and Casual 42579 INsuRrD Carmel Kitchen Speciallsts,inc R $ R Properties 606 Station Drive INSURER B:AMCOInsurance Company INSURER C INSURER D : Carmel, IN 46032 INSURER E : MED EXP (Any one person) $ 5,00 INSURER F: PERSONAL &ADV INJURY $ 1,000,00 COVERAGEb CERTIFICATE NLIMRFR' 0C1lICInKf NI IIIAMCD• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT,.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EF MM/DDIYYYY) POLICY EXP (MMIDDNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR GLP07184591344 - 07/09/2015 07/0912016 ' EACH OCCURRENCE S 1,000,00 DAMAGE T?5 RENTED PREMISES fEaocCurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL &ADV INJURY $ 1,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY E JECT F LOC OTHER: GENERAL AGGREGATE S 2,000,00 PRODUCTS -COMP/OPAGG S 2,000,00 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BAPC7184591344 07/09/2015 07/09/2016 COMBINED SINGLE LIMIT Ea accident)$ 1,000,00 BODILY INJURY (Per person) S BODILY INJURY Pereccidenl) S PROPERTY DAMAGE Per accide t S S B X UMBRELLA LIAR EXCESSLIAB X OCCUR CLAIMS -MADE CAA7184691344 07/09/2015 07109/2016 EACH OCCURRENCE S 1,000,00 AGGREGATE 5 1,000,00 DED I X I RETENTION $ 0 S B WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICEMMEMBEREXCLUDE07 E If yes, d ory In NHI If yes, describe under and DESCRIPTION OF OPERATIONS below NIA WCA7184591344 07/0912015 07109/2016 OTH• X STATUTE ER E.L,EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE S 500,00 E.L. DISEASE - POLICY LIMIT $ 500,00 A A PROPERTY EQUIP FLOATER CPAA7184691344 CIMP7184691344 07/09/2015 07/09/2015 07/09/2016 07/09/2016 BLDGICONT ON FILE EQUIPMENT ON FILE DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Fax: 571-2426 ___' ¢ nvwGr% L/i1V liCL LA I IUr4 CARMEL1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF CARMEL THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Community Services Department Phyllis Morrissey AUTHORIZED REPRESENTATIVE One Civic Square �f- CAAMEL, IN 46032 1 ©1988.2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ® ity Of (Carmel I INDIANA RETAIL TAX EXEMPT CERTIFICATE NO. 003120155 002 0 Page 1 of 1 PURCHASE ORDER NUMBER c«c+dddl FEDERAL EXCISE TAX EXEMPT r-� L4S 2 ONE CIVIC SQUARE' 35-6000972 ..... ......................._...............-_......._..................... THIS NUMBER MUST APPEAR ON INVOICES, AIP CARMEL, INDIANA 46032-2584 :---......_._._ .......... _.._......... ......__._......_......._................. _......_._..........._.. _..__._......__...__DEPARTMENT ........................_... __.._.........._...._ACCOUNT..._......._._.........._............_.... VOUCHER, DELIVERY MEMO, PACKING SLIPS, ;FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997 SHIPPING LABELS AND ANY CORRESPONDENCE PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. 1 VENDOR NO. PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN DESCRIPTION 4/15/2016 1 I 00350490 CARMEL KITCHEN SPECIALISTS INC. Carmel Fire i VENDOR 606 STATION DRIVE SHIP 2 Civic Square TO Carmel, IN 46032 - CARMEL, IN 46032 - PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 4069 QUANTITY! UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 1120 1 Each Send Invoice To: Carmel Fire Account: 43-501.00 Fund: 101 General Fund 'New Cabinets & Countertops for Station 46 $34,135.00 $34,135.00 Sub Total $34,135.00 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 AND ACTS AMENDATORY THEREOF AND SUPPLEMENTTHERETO. ORDERED BY TITLE CONTROL NO. 24812 CLERK -TREASURER Denise Snyder \ > Steve Engelking Budget & Accreditation Manager Administration 2 Civic Square r Carmel, IN 46032 - PLEASE INVOICE IN DUPLICATE :---......_._._ .......... _.._......... ......__._......_......._................. _......_._..........._.. _..__._......__...__DEPARTMENT ........................_... __.._.........._...._ACCOUNT..._......._._.........._............_.... - -- - ------ - - -..................._......_PROJECT.._._....._..-........... ._..L ..... ----PROJECTACCOUNT.................._..........._.._.._.._AMOUNT...__....._......... PAYMENT $34,135.00 SHIPPING INSTRUCTIONS A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN 'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN 'C.O.D. SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 AND ACTS AMENDATORY THEREOF AND SUPPLEMENTTHERETO. ORDERED BY TITLE CONTROL NO. 24812 CLERK -TREASURER Denise Snyder \ > Steve Engelking Budget & Accreditation Manager Administration Company ID Number: 968215 Approved by: Employer 'Carmel Kitchen Specialists, -Inc: Name (Please Type or Print)Title Richard Reed `.-- Signature Date Electronically Signed - 05/03/2016 Departmentof ;Homeland Security ='Verification Division Name (Please Type Print) Title . `USCIS Verification Division ` Signature- "" ; .. ;" Date Electronically -Signed 05/03/2016 Page 13 of 17 E -Verify MOU for Employers I Revision Date 06/01/13 Company ID Number: 968215 Information, Required for the E -Verify Program Information relating to your Company: Company Name Carmel Kitchen Specialists, Inc. Company Facility Address 606 Station Drive Carmel, IN 46032 Company Alternate Address County or Parish HAMILTON Employer Identification Number 351346643 North American Industry Classification Systems Code 238 Parent Company Number of Employees 10 to 19 Number of Sites Verified for 1 - Page 14 of 17 E -Verify MOU for Employers I Revision Date 06/01/13 r Company ID Number: 968215 Are you verifying for more than I site? If yes, please provide the number of sites verified for in eachState: INDIANA 1 site(s) Page 15 of 17 E -Verify MOU for Employers I Revision Date 06/01/13 Company ID Number: 968215 Information relating to the Program Administrator(s) for your Company on policy questions or operational problems: Name Richard J Reed Phone Number (317) 844 - 3975 Fax Number (317) 848 - 5938 Email Address mlwilliams@carmelkitchenspecialists.com Page 16 of 17 E -Verify MOU for Employers I Revision Date 06/01/13