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HomeMy WebLinkAboutE&B Paving/Eng/1,471,824.33/136th Street and Carey Road Roundabout and Carey Road and Hawthorne Drive Roundabout – ConstructionE & B Paving, Inc. Engineering -2016 Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337 e Contract Not To Exceed $1,471,824.33AGREEMENT 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 'E & B Paving, 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. 2. PERFORMANCE: City agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City budget appropriation number 2016 General Obligation Bond, 94-650.04 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. 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 One Million. Four Hundred Seventy One Thousand Eight Hundred Twenty Four Dollars and Thirty -Three Cents ($1,471,824.33) (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 pursuant to or as part of that certain City of Carmel Engineering Department Bid Proposal Package for "Roundabout Improvements 136th Street and Carey Road/ Roundabout Improvements Carey Road and Hawthorne Drive" received by the City of Carmel Board of Public Works and Safety on or about August 17, 2016, 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 jX:1Contmcts\Prof.Svcs & Goods SvcslEngineering@016\E & B Paving. Inc. Goods & Services FORM -WITH E -Verify Langwige.doc:8/19/2016 2:29 PMS E & B Paving, Inc. Engineering - 2016 Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337 Contract Not To Exceed $1,471,824.33 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. 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. JXACon0aslProf.Svcs & Goods SvcslEngineering@016\E & B Paving Inc. Goods & Services FORM - WITH E -Verify language.doc:8/192016 2:29 PMJ 2 E & B Paving, Inc. Engineering - 2016 Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337 Contract Not To Exceed $1,471,824.33 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 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, JXAContmcts\ProLSvcs & Goods SvcAEnginceringl2016E & B Paving Inc. Goods & Services FORM - WITH E -Verify Language.doc:8/19/2016 2:29 PMJ E & B Paving, Inc. Engineering - 2016 Appropriation 2016 General Obligation Bond, 94-650.04; P.O. 934337 Contract Not To Exceed $1,471,824.33 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: E & B Paving, Inc. 17042 Middletown Avenue Noblesville, IN 46060 Telephone: 317-773-4132 ATTENTION: Mark E. Jones 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, as1ong 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. JXAContracts\Prof.Svcs @. Goods Svcs\Engin=ring@016\E & B PAng. I= Goods & Seim FORM - WITH E -Verify langaige.d=8/19/2016 2:29 PMj 4 E & B Paving, Inc. Engineering - 2016 Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337 Contract Not To Exceed $1,471,824.33 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. 1XAConuecls\ProMS & Goods Sves\Engineering120161E & B Paving, Inc. Goods & Senices FORM - WITH E -Verify Langwge.doc:8/17/2016 2:27 PM1 E & B Paving, Inc Lngineerin- - 2016 Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #31337 Contract Not To Exceed $1,471,824.33 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: James Brainard, Presiding Officer Date: - — Mary An�Aurke, M e / Date: �O Lori S. Watson be Date: / I E & B Paving, Inc. By: Authorized Slg ature , :�,�, 141; mark E. James Printed Name — Area �/� ....... Title Title��������if FID/TIN: 35-1139301 Last Four of SSN if Sole Proprietor: Date: X22, 20162016 {S',Ccmna\dic(Ars \ Gawis A';\\Ertinmrixg\!+�U,�Ti 8 D. Pr\'{n� Ili Gcv.1.fi S:na FGfC.I - 1YIT11 F.-Yai(,.'t augmc:4x a: ta':'�h•:.;'i PUS 6 I BIDDER'S ITEMIZED PROPOSAL ,AND DECLARATIONS City`of Carmel Instructions To Bidders.-. This form shall be utilized by.all Bidders. Except as othei-wise specifically provided, .:all Parts shall be fully and accurately f lied n and completed and notarized Project; Proposal For Construction of .Date. must 11, 2616 Roundabout Improvements 136th Street and Carey Road Roundabout Improvements Carey Road and.Hawthorne Drive .Part la: 1361f' Street and Carey Road Intersection ,Reconstructioii to a:Single:Iane Roundabortt. Part lb: 1360 Street and Keystone _Parkway Signal Metering. Installation Part :2; Carey. ,Road and Hawthorne Drive Intersection. Reconstruction to a Single Lane Roundabout To: City of Carmel, Indiana, Boatd of Puh&.:Works And Safety \\`���tis��irrr����� w ZI //������trttri�►��1\��`\\� Ey"X H T ru PART 2 BID PROPOSAL 2.1 Base Bid The undersigned Bidder proposes to furnish all necessary labor, machinery; tools, apparatus, materials, equipment, service and other necessary supplies,, and to perform and .fulfill all obligations 'incident thereto in strict accordance With and. within the time(s) provided by `the terms and conditions of the Contract Documents for the. above described Work:: and Project,"including any and all addenda thereto, for the Unit Prices applicable. to the Contract Items as stated :in ,Part 3 hereof, which Unit Prices; when multiplied by estimated uni ' t'quantities for such Contract Items, total one M�.11ica; Ftxar Hiux].red sev�ty end, Eight.RzCired. Twaty.-Ft u :and .'Thirty Three tears ($ ,1,471,824:33. ). The. Bidder acknowledges that evaluation of the lowest B,id shall be based on such price and further acknowledges; that the unit quantitieslisted in Part.3 of this Proposal are estimates solely for the purpose of Bid evaluation and Contract award, and are not to be: construed as exact: or binding: The. Bidder further understands that .all Work which may result on the Contract shall be compensated for on a; Unit. Price basis and that the OWNER and ENGINEER cannot and do not .guarantee the amount or quantity of any item. of Work to be performed or furnished under the Contract; -V C) SEAL J SEAL _ l L/rl! kliltt\1, PART3 CONTRACT ITEMS AND UNIT PRICES Part la: 136`" Street &Carey Road Intersection Reconstruction ,jxVIN(3 SEAL - Contract Item No. Description Estimated Unit Quantlty Unit.Ptice Item Total 0001 CONSTRUCTION ENGINEERING 1.00 IS $ 9,500.00 $ 9,500.00 90,02. INSPECTION HOLE, GREATER THAN.3 FT 2.00 EACH $ 623.00 S 1;250.006, 0003 INSPECTION HOLE, 31FT DEPTH OR.LESS 2.00 EACH $ 300.00 $ 600.00 0004 MOBILIZATION AND DEMOBILIZATION 1.00 LS $ 33,13 1 ;07 S. 33,131.07 0005 CLEARING RIGHT OF WAY 1.00 LS $ 14,000.00 $ 19,000.60 0006 HOUSES, AND BUILDINGS, REMOVE 1:00_ LS $ 14,000.00 $ 94,000.00 0607 EXCAVATION, COMMON 1555:00 CYS $ 49.00 $ 76,195.00 0008 TEMPORARY`INLETP.ROTECTION 14.00 EACH $ 85;00 $ 1,190.00 0009 TEMPORARY MULCH, 3.00 TON $ 1,000:00 $ 3,000.00 0010 TEMPORARY SILT FENCE 470.00 LFT $ 3.00 $ 1,410.00 0011 NO3 STONE 100.00 TON 24.00 S. 2,400;00, 0012 TEMPORARY GEOTEXTILE 235:00 'SYS $ 3`.00 $ 705.00 000 TEMPORARY:SEED MIXTURE 130.00 LBS $ 4.00 $ 520.00 6014 SUBGRADE TREATMENT, TYPE IB or.IC 2,183.00 SYS $ 25:50 $ 70,966.50 0015 STRUCTURAL BACKFILL, TYPE 1 147.00 CYS $ 48.00 $ 7;056.00 0.016 STRUCTURAL BACKFILL, TYPE 3 .84.00 CYS $ 48.00 $ 4,032.0.0 0017 COMPACTED AGGREGATE, NO. 53 257.00 TON $, 32.00 $ 8,224.00 0018 WIDENING WITH PCC BASE, 6.'IN 10.60 SYS 5 60:00 $ 600.00 0019 MILLING, ASPHALT, 1 1/2 IN: 321:00 SYS $ 10,00 $ 3,210:00 0020 HMA, SURFACE, TYPE B, 9.5 inin 37.00 TON $ 100:00 $.: 3,700.00' 0021 HMA, SURFACE, TYPE C, 9.5 iron 15,8.00 TON $ 1.13:00. S 17,854.00 0022 HMA; INTERMEDIATE, TYPE.B, 19.0. Imm 31:00 TON $ 90.00 $ 2,790.00 0023 HMA; INTERMEDIATE„TYPE C, 19.0 MM 554.00 TON $ 60:00 $ 33,240.00 0024 HMA, BASE, TYPE C, 25.0 nun 720:00 TON, S 60.00. $ 43,200.00. 0025 JOINT ADHESIVE,_SURFACE 436.00 LFT S. 0.10 $ 43.60 0026. JOINT ADHESIVE, INTERMEDIATE 392.00 LFT $ 0.15 $ 58.80 0027 LIQUID ASPHALT SEALANT 436:00 LFT $ 0.20 $ 87.20 0028 ASPHALT FOR TACK COAT 4.00 TON S. 350.00 $ 1,400.00 0029 DECORATIVE.CONCRETE PAVEMENT; TRUCK APRON, 7 IN 361.00 SYS $ 60.00 $ 21,660.00 0030 SIDEWALK, CONCRETEy4IN 8.00 SYS' $ 42.00 $, 336.00 6031 CURB RAMP; CONCRETE 24.00 SYS $ 140:00 $ 3,360.00. 0032 DETECTABLE WA. RNING SURFACES 5.00 SYS $ 90:00 $ 450.00 0033 IHAND RAIL, PEDESTRIAN 58.00 LFT $ 308:00 $ 17,864.00 0034 STRAIGHT CONCRETE CURB 108.06 M S 35:60 $ 3,780.00 0035 CENTERCURB,TYPE D, CONCRETE 15.00 LFT $ 90.00 $ 11350.00 0036 CURB AND'GUTTER.CONCRETE TYPE II 975.00 LFT $, 18.00 $ 17;550.00 0037 MODIFIED ROLL CURB 607.00 LFT $: 24:00 $ 14,568.00 0038 PCCP FOR APPROACHES, 6 IN 104,00 SYS $ 43.00 $ 4,472.06 0039 MAILBOX ASSEMBLY, SINGLE,'RESET 1:00 EACH S. 175:00. $ 1:75.00 0646. GEOTEXTILES 16.00 SYS $' 4.00 $ 64.00 0041 RIPRAP; REVETMENT 8.00 TON $. 80:00 $ 640.00. 0042: MOBILIZATION' AND:DEMOBILiZATION FOR 100 EACH $ 250.00 $ 500.00 0043 TOPSOIL 163.00 CYS $ 50.00, $ 8,150.00. DI/II T A- -3 u-f�S 0,044 SODDING, NURSERY 1,953.00 SYS $ 3.25 $ 6,347.25 0045 IRRIGATION CONTROLLER BOX 1.00 EACH $ 1,000:00: S 1,000.00 0046 FIELD OFFICE,.B 4.00 MO.S. $ 2,100.00 $. 8,400.00 0047 PIPE ENDSECTION; PRECAST CONCRETE, 151N 1:00 EACH $ 785.06 $ 785.00 0048 PIPE, CLASS III RCP, CIRCULAR 15 IN 16.00 LFT S 50.00 $ 800.00 0049 PIPE, CLASS.111 RCP; CIRCULAR 12 IN 501.061FT S $ 18,036.00 0050 CONCRETE ANCHOR, 12 IN 1.00` EACH $ 800.00 $ 800.00 0051 MANHOLE, J10 1:00 EACH S 41800.00. $ 4,800.00 0052 STORMWATER.BMP, 15 1.00•EACH $ 14,00.0.,00 $ 14,000.00 0053 INLET,.A2 1:00 EACH $ 1,750.00 $. 1,750.00- 00'54 INLET, J10 4.00 EACH $ 2,100.00 $ 8,400.00 0055 INLET, M10 2.00 EACH 2,100.OQ; $, 4,200.00 0056 MANHOLE, C4 1.00' EACH $ 2,800.00 $ 2,800.00 0057 MANHOLE, C2 1.00 EACH $ 2;900.00 $ 2,900.00 0058 MANHOLE, CIO 3.00 :EACH $ 3,100.00 S. 9;300.00 0059 AGGREGATE, FOR: DRAINAGE FILL 15.00CYS $ 47.00 `$ 705.00 0060. MODULAR,BLOCK WALL ERECTION .383.00. SFT $ 29.00 $ 11,107.00 0061 MODULAR BLOCK WALL WITH GROUND 383.00 SFC S 23.00 S. 8,809.00 0.062 CONSTRUCTI.ON SIGN; C 2:00 EACH $ 280.00 S 360.00 00.63 ROAD CLOSURE SIGN ASSEMBLY 10.00 EACH $ 170:00 S7 1,7.0.0.60 0064 DETOUR ROUTE MARKER ASSEMBLY, MULTIPLEROT JTFS 1.00 EACH $ 387.00 $ 337.00 0065 DETOUR ROUTE MARKER ASSEMBLY 31.00 EACH S 129.00 '$ 3,999.06 0066 CONSTRUCTION SIGN, A 7:00 EACH $ 195.00 $. 1,365.00 0067 CONSTRUCTION SIGN, B 33.00 EACH S 105.00, S 3,465`00 0068 MAINTAINING TRAFFIC 1.00 Ls. S. 1.1,945.68 S 11,945.68 0069 BARRICADE; III -A 168.06 'LFT S 10.00 1,680.00 0070 BARRICADE, III -B. 72.00 LFT $ 11.00 .S 792.00 0071 DECORATIVE STREET.S.IGN ASSEMBLY, DIRECTIONAL, INSTALLED 3.00 EACH $ 2,337.00 S 7,011.00 0072 SIGN POST, SQUARE, TYPE 2, REINFORCED 151.00 LFT $ 19.00 $ 2,869.00 0073 SIGN„ SHEET, WITHlLEGEND 0.080' 83:00 SFT $ 17.10 $' 1,419.30. 0074 SIGN; SHEET, WITH LEGEND 0.100 IN 12.0.0. SFT S 19.00 S, 228.00 0075 TRAFFIC SIGNAL AND EQUIPMENT, REMOVE -AND SALVAGE 1.06 EACH $ 1,465.00 $ 1,465.00 0076 CONDUIT; STEEL,. GALVANIZED, 2IN 92.00117T $ 26'.50 :S 2,438.00 0077 CONDUIT,.PVC, 4.1N, SCHEDULE 80 136.00 LFT $ 20.86 . S 2,828.80 0078 CONDUIT„PVC, 41N., SCHEDULE8,0 WITH 3-1.25 IN 136.00 LFT S 35:00 $. 4,760.00 0079 HANDHOLE, LIGHTING 2.00 EACH S 745.00' .$ 1,490.00 0080 LUMINAiRE,.LED, 152 WATT 4.00.EACH $ 3,702.00 S: 14,808:00 0081 LIGHTING FOUNDATION, CONCRETE, WITH GROUNDING, 30 IN k,96 IN 4:00 EACH S 1,057.00 $ 4,228:00 0082 LIGHT POLE; 30 FT E.M.H:, 8 FT MAST ARM, DECO MAP BASE 4.00 EACH $ 3,997.00 $ 15,988.00 0083 SERVICE -PO INT, II 1:00 EACH S 7,01.4.00 7,014.00 0084 CABLE,:POLE CIRCUIT THWN, NO 1.0 COPPER,STRANDFD. 11C, 590.00 .LFT $ 0.65 $ 383.50 00.85 CONNECTOR KIT, UNFUSED. 4.00 EACH $ 36.90• $ 147:60 0086 CONNECTORKIT,,FUSED 4,00'EACH S 39.60 .$ 158.40 0087 MULTIPLE.COMPRESSI011>�] ERPROOFED .� 10.00. -EACH S 11.20 $ 112:00 0088 INSULATION LINK, NOl� WATERPROOFED '; LC} =. 11.0.0 EACH S, 8.60 $; 94.60 0089 JINSULATIONIINK, WgEMOMIWAI I 8.00:EACH _ $ 11:30. 8 90A0, //,'1��tlitt?llll010\\\ r-Nfl-MIT A 0090 CABLE -DUCT MARKER 4:00 EACH $ 184:00 $ 736.00 0091 WIRE,:NO 10 COPPER, I/C 3,280.00 LFT $ 0.65 S 2,132.00 0092 TRANSVERSE MARKING THERMOPLASTIC CROSSWALK, WHITE 24 IN 70.00 LFT $ 10.00 $ 700:00 0093 LINE; THERMOPLASTIC, SOLID, WHITE, 4 IN 156.0.0 LFT $ 1.35 S 210.60 0094 TRANSVERSE MARKING, THERMOPLASTIC, YIELD, WAITE,24IN (SHARKS'TEETH) 48.00 LFT $ 26.00 S 1,248.04 0095 LINE, THERMOPLASTIC; DOTTED, WHITE, 8 IN (2 FT LINE, 2 FT GAP) 49,00 LFT S 6.00 S 294:00 0096 LINE, THERMOPLASTIC; SOLID, YELLOW; 4 IN 904.00 LFT $ 1.35 $ 1;220.40 0097 SNO.WPLOWABLE RAISED PAVEMENTMARKER 15.00 EACH $ 40.00 S 600.00 0098 2 IN..HDPE SDR1:1'.FORCE MAIN 251.00 LI=T S 38.00 $ :9,538.00 0099 2IN. CONNECTION FO , .i�lAXb114Ch11/ 2.00 EACH $. 360:00 S 600.00 6100 HYDRANT ASSEMI L 'vAND Y} • ' •� ; _ ADJUST TO GRA jv •; / �� 2.00 EACH $ 1,000.00 S 2000.00 0101 ADJUST VALVEE'O GJAA 3:00 EACH $ 85:00 S 253.00 � L Part` 1 a. To a1 $, 672,182.70 Subnutted:By. S B Inc. Signature:'MaE Area { Thr //j711111111�� Part 1b: 136" Street and Keystone Parkway Signal Metering Installation Contract Item No. Description Estimated Quantity Unit Unit Price Item Total 1.001 MOBILIZATION AND DEMOBILIZATION 1.00 LS $ 8,183.18 S 8,183.18 1002 ANCHOR PLATE FOR SIGNMO.UTING TO TRAFFIC BARRIER, DRILL AND EPDXY 1.00 EACH $ 305.00 $ 305.00 1003 CONTROLLER; RESET TIMING 1.00 LS S 6,552.00 $ 6,552.00 1004 MAINTAINING TRAFFIC 1;00 LS $ 5,54107 $, .5,541.07 1005 SIGN POST, SQUARE, TYPE 1, REINFORCED ANCHOR RASP 70.00 LFT $ 20.00. $ 1,400.00 1,006 SIGN, SHEET, WITH LEGEND 0.080" 20.00 SFT S 17:90 $ 358.00. 1007 HANDHOLE, SIGNAL, TYPE 1 2.00 EACH: $' 1,57200 $ 3,144.00 1,008 CONDUIT,.STEEL, GALVANIZED,.2 IN .140.00 LFT S 26.50 S 3;710.00 1009 SIGNAL PEDESTAL FOUNDATION, A Loo EACH S 893.00 $ :893.00; 1010 SIGNAL POLE,.PEDESTAL; 4FI' 1.00 EACH; $ 2,678:00 $ 2,618.00 10.1.1 SIGNAL POLE, PEDESTAL -15 FT 4.00 EACH $ 3,190.00 S 12,760.00 1012 RECEIVERTROCES.SOR 1.00 EACH $ 7096:00 $' 7,196.00 1013 WIRELESS MAGNETOMETER DETECTOR 12.00 EACH $ 789.00 $_ 9;468.00 1014 WIRELESS REPEATER 2.00 EACH $ 2;397:00 S 4,794.00 1095 TRAFFIC SIGNAL HEAD,' SECTION, 12IN;,LED (RED, 4.00 EACH S :1,416.00 S` .5,664.00 1016 SIGNAL SERVICE 1.00 EACH S 1,667;00 $ 1:,667,00 1017 SIGNAL CABLE; SERVICE, COPPER. 3C18GA 15.00 LFT $ 1.70 $ 25.50 10:18 SIGNAL CABLE; CONTROL, COPPER 7C/ 14GA 314.00 LFT $ 2.10 S 659.40 1019 CONTROLLER C ABINET FOUNDATION, P 1 1:00 EACH $, 1,536;00 $ 1,536.00 1020 LIGHTING FOUNDATION, CONCRETE, WITH GROUND , 30 IN X 30 INX. 96 IN 4:00 EACH $ 1,057.00 $' 4,228.00 1021 TRANSVERSE Iv1ARKING'MULTI-COMPONENT, STOP LINE, 24" 36.00. LFT S 50.00 $. 1,800.00 �...=mac 6V�•t �Ol' 1022 1 HMA PATCHING, TYPE D (UNDISTRIBUTED) 45.00 TON $ 125.00 $ 5,625.00 Part lb Total = $ $8,187.15 Submitted By: E Signature. ^ -.--%� E. I Area N13nac�r Part .1 c: Lantfsc'aping.cit :136th Street and Carey Road Roundabout. Contract Item No. Description Estimated 011niltitv Estimated Quantity Unit Unit Price Lfem.Total 1:100 EVERGREEN SHRUB, NO.SCONTAINER CONSTRUCTION ENGINEERING 16.00 EACH 5 42.00 S 672:00 1101 DECIDIOUS SHRUB, NO.3 CONTAINER 2002 15.00 EACH $ 41.00. $ 615.00 1102 ORNAMENTAL GRASS; NO 1 CONTAINER 26,133.48 48.00 EACH $ F$.00 $ 8.64.00 .1103 PERENNIAL; PLUG CONTAINER S 129.00 EACH $ 4.50 $ 580.50 1104 IRRIGATION SYSTEM 350.00 1:00 LS $ 11,593.4`1 $ 11,,593.41 1105 YIASONRY WALL S .4.5.00 LFT $ 392:67 S: 17,670:15 1106 DECORATIVE CONCRETE CYS 101.00 SYS $ 111.82 -$ 11,293:82 1108 SODDING, NURSERY ��� ' ,• // -100.00 Svs $ 0.01 $ (1,00) 1109 DE. CIDIOUS SHRUB, NO. `..Qj 'yAINER TEMPORARY CHECK DAM 14.00 EACH :$ 45.00 $ 630:00 1.110 HARDWOOD MULCH � � 2009 8.00; CVS $ 75.00 :$ 600.00 [tl-1'FREE AND SIiRUfi$ SOIITM[ 680.00 31.00 CYS $ 100.Q0 y 3,100.00 Part 2 a : Carey Road and Hawthorne Drive Intersection Reconstruction Pali I c Total = ? 47,617.88 Submitted By: E & IB , Signature: E. , Area Mmager Contract Item No. Description Estimated 011niltitv Unit. Unit Price Item Total 2001 CONSTRUCTION ENGINEERING 1.0 LS S 9,200.0.0 $ 9.,200.00 2002 MOBILIZATION AND DEMOBILIZATION 1..0 LS S 26,133.48 S 26,133.48 2003. CLEARING RIGHT OF WAY 1.0 LS $ 161000.00 S 16,000.00 20.04 HEADWALL, REMOVE 1.0 EACH $ 350.00 8 350.00 2005 EXCAVATION, COMMON 554.0 CYS. S 90:00 $ 49,860.00 200E BORROW 440.0 CYS S 1.00 $ '440.00 2007 SEDIMENT, REMOVE 5.0 CYS S5500 $ 275.00 2008 TEMPORARY CHECK DAM 12.0' TON S 65:00 S 780.00 2009 'TEMPORARY INLET. PROTECTION 8.0 EACH 'S 85.00 $ 680.00 2010 INLET FILTERS 8.0 EACH S 350.00 $ 21800.00 201,1. TEMPORARY MULCH 0.6 TON S 1,250.00 $ 750.00. 2012 TEMPORARY SILT FENCE 1,152.0. LFT $ 1.50 $ 1,728.0.0 2013. NO. 2, STONE 100.0 TON $. 25.00 S 2,500.00. 2014 TEMPORARY SEED MIXTURE 70:0 LBS S 7.00 $ 490.00 2015 SUBGRADETREATMENT,.TYPEIC .3,564.0 SYS S •20.00 S 71,280.00 2016 STRUCTURE BACKFILL, TYPE 1 104.1 CYS S. 50.00 $ . 5,205.00 2.01.7 COMPACTED AGGREGATE. NO. 53. 75.0 TON S 35.00 S. 2,625.00 2018: HMA, SURFACE; TYPE'C, 9.5mm 225.0 TON $ 83:00 S 18;675.00 2019 HMA,,INTERMEDIATE,.TYPE'C', 375,0 TON $ 60.0,0 S. 22,500.00 2020 HMA, BASE, TYPE'C',.25.0mm 1,027.0 TON S 50.00 $ 51;350.00 2021 HMA, INTERMEDIATE, TYPE'C OGi 19.0imn 419.0 TON $ 60.00 $ 25,140.00 2022 JOINT ADHESIVE, SURFACE 1,486.0 LFT S 0;10 S 148.60 2023 JOINT ADHESIVE;: INTERMEDIATE 1,486.0 LFI' S 0.15 $ 22290 2024 LIQUID ASPHALT: SEALANT 1,486.0 LFT S 0.20 S 297.20 E?�C R B 6 T )+t L�t 6, of '8� 2025 ASPHALT FOR TACK COAT 2.7 TON $ 350.00 $ 945.00 2026 DECORATIVE CONCRETE PAVEMENT, TRUCK APRON. 7 IN - 192:2 SYS $. 45.00 $ 8,649.00 2027 SIDEWALK, CONCRETE _141N.) 245.0 SYS. $ 37.00 $. 9,065.00 2028 CURB RAMP,.CONCRETE 175.0 SYS. $ 122.00 $ 2.1,350.00 202.9 IDETECTABLE WEARING. SURFACE 27.0 SYS $ 90.00 $ 2,430.00 2030 CURB, CONCRETE 138.0 LFT $ 30.00 $ 4,140.00 2031 CURB, TURNOUT 65 LFT $ 80.00' .S 520.0.0 2032 COMBINED CURB & GUTTER. CONCRETE; TYPEZ 1,094.6 LFT' $ 14.00 $ 15;316.00 2033 COMBINED CURB &':GUTTER; CONCRETE, TYPE III 243.0 LFT $ 40.50 $ 9,84L:50 2034 ROLLED CURB &GUTTER, CONCRETE, MODIFIED 482.0 LFT $ 15.00 $ 7,230,00 2035 RIPRAP, REVETMENT 4.2 TON $ 95.00 $ 399.00 2036 GEOTEXTILES 5:6 SYS $ 15.00 S 84.00 2037 MOB, & DEMOB: FOR SEEDING 2.0 EACH $ 250.00 S 500.00 2038 WATER 4.1 kGAL $ 1.00 3 4.10 2039 SODDING. 1,135.2 SYS $ 3;.50 S 3;973.20 1040 P4P-EKY-P-E'-rl,-`C-i1RG1J1- R -"N: m-.0 LF -T $ 8 2041 PIPE, RCP; CIRCULAR IN: 222.0 LFT` $ 37.00 $ 10;804,00 2042 PIPE END SECTION, DIAMETER 12 N. 1.0 EACH $ 750.00 S 750;00 2043 AGGRI:�-GA-T-1; I -BR-' NDE-RDR-A N8 49:1 Com$_ $ - $' U44 GE-OTC-i-T4U- FG1? n,_�„yD"E.oTXRArM" $�"�? zSa S $: - $ - 2045 INLET, J 10 4.0 EACH $ 2,100.00 $ 8,400:00 2046 INLET, M 10 2.0 EACH S. 2,1:00.00 S. 4,200.00 2047 MANHOLE; C4 3.0 EACH. $ .3,100.00 '$ 9,300.60 2048 CASTING, ADJUST TO GRADE- UNDISTRIBUTED 5.0 EACH $ 365.00• $ 1,825.00 2049 MAINTAINING TRAFFIC 1.0 LS $ 51000.06 $ 5,000,00 2050 SIGNPOST, SQUARE TYPE 1 REINFORCED ANCHOR 169.0 LFT $ 19.76 $ 3,329.30 2051 DECORATIVE STREET SIGNS, INSTALLED 4.0 EACH $ 2314.00 $' 9,256.00 .2052 SIGN,.SHEET, WITH LEGEND, 0.086 IN.' 49.2 SFT $ 17.30 $ 851.16 2053 SIGN, SHEET, WITH LEGEND, 0.100. IN. 75.0 SFT $ 19.00 $ 1,425.00 2054 CONDUIT,. STEEL, GALVANIZED, 2IN. 205.5 LFT $ 22.50 $ 4,623..75 2055 CONDUIT, PVC 4 IN.•SCHEDULE 80 3385 LFT $ 20.80 $ 71040.80 2056 CONDUIT, PVC 4 IN. SCHEDULE 80 WITH 3-1.25 IN. 338:5 LFT $ 34.40 'S: 11;644.40 2057 4=1C NO.4 Cu CONDUCTOR IN PLASTI.C'DUCT 502.5 LFT $ 11.50 '$ 51778;75 205.8 LIG14T POLE, ORNAMENTAL 30 FT. E.M H., 8 FT. MAST.ARM, DECO WRAP BASE 8.6 EACH $ 3,9.97.00 $ 31,976.00 1059 LIGHTINGTOUNDATION, CONCRETE, W f GROUNDING; 30 IN:X 96 IN. 8.0 EACH $ 1,057.00 $ 8,456.00 2060 LUMINAW,LED,.152WATT 8.0 EACH $ 3;7.02.00 :$ 29;616.00 2061 HANDHOLE, STREETLIGHTING 1.0 EACH $ 74,5.00 $ 745.00 2062 SERV. ICE' POINT, 7I; METERED 1.0 EACH $ 7,014.00 $, 7;014,00 2063 IRRIGATION CONTROLLER BOX 1.0 EACH $_ 1,000.00 :$ 1,000:00 .2064 TRANSVERSE MARKING, THERMOPLASTIC; CROSS! ggyjWiIkiilaIN. \, y .. J . 192.0 LFT S 10.00 $ 1,920:00 2065 LIN F HSR OPLA . , ,LID; WHITE,.4IN. : J 1;359:0 LFT $ 1.35: S 1;834;65 2066 LIfitE,fiHEROPLASTIC; _7ED, WHITE,"8 IN. 56:0 LFT $ 6.00' '$ 336.00 1111 U\0\\\� 2067 TRANSVERSE MARKING, THERMOPLASTIC, YIELD LINE, WHITE, 24 IN. 64.0 LFT $ 26:00 S 1,664.00 2068 LINE, THERMOPLASTIC; SOLID WHITE, 6 IN. 100.0 LFT 2.55 'S 255.00 2069 LINE, THERMOPLASTIC; SOLID,.YELLOW, 4 IN. 1,243.0 LFT $ 1.35 S 1,678.0.5 2670 LINE, THERMOPLASTIC, SOLID YELLOW; 8 IN. 208.0 LFT $ 3.40 $ 707.20 2071 SNOWPLOWABLE RAISED PVMT MARKING (BLUE) 2.0 EACH 'S 70.00. :$ 140.00 2072 CEN`I'ERCURB, TYPE D, CONCRETE 13:6 SYS $ .132,00 $ 1,795.20. 2073 HYDRANT ASSEMl3LY,.REMOVF/REPLACE.AND ADJUST 2.0 EACH $ 1'000 '.00 $ 2,00.0.00 2074 ADJUST VALVE TO:GRADE 4.0 EACH S .85.00 S 340.00 2075_ RECTANGULAR RAPID FL..ASHER BEACON NVf PUSH uvi-TON ACTIVATION 4.0 EACH $ 9;585:00 $ 38,340.00. 2076 CABLE, POLE CIRC.QIT, THWN, NO, I0, COPPER, STRANDED; 1:fC 400.0 LFT $ 0.65 $ 260:00 2077 CONNECTOR KIT, UNFUSED 4:0 EACH $ 36.90 'S 147;60 2078 CONNECTOR KIT, FUSED 4.0 EACH $ 19:60 :$ 158;40: 2079 MULTIPLE COMPRESSION FITTING, NON- W .1 EI PROOFED 18.0 EACH $ 1.1.20 $ 201.60 2080 INS ULATION:LIN ,;i t l l -':k ._ ¢-ED 8.0 EACH $ 8.60 $ 68.80 208.1 iNSULATIONL� ATGRPROb,. 8.0 EACH $ 1:1.30 $ 80.40 2082 A11I.1 ING, A$PLIAL'I' - 412.0 SYS $ 10.00_ _$ 4,120.00 OCAL 01;II IIIA\\ � Pala 2h:.Lnndscapin_ at. Carev Road and Hawthorne Deive Roundabout Part 2 Total.= $ 612;969.04 Submitted By:. E: &. B , ..?,ne. .Signature: E. , Area Mmager Contract Item No. Description Estimated Quuntity Unit Unit Price Item Total 2100 ORNAMENTAL TREE, 8 F'1'. HE, IGHT' 2.00 EACH 5375.00' $ 750.00 2101 EVERGREEN. SHRUB, NO. 3 CONTAINER 23:00 EACH 544.00 $ 1,012.00 2.102 DECIDIOUS SHRUB .N0.3 CONTAINER 26.00 EACH $47.00 $ 1,222.00 2I03 ORNAMENTALGRASS NO, -CONTAINER 86.00 EACH.I7.50 S 1;5,05:00 2104 PERENNIAL,NO: I CONTAINER 487.00 EACH $18:25 $ 8;887.75 .2105 IRRIGATIONSYSTE'M 1.00 LS, 58,490.64 $ 8,490.64 2106 MASONRY-R'ALL 31.00 LFT $459.67 $ 14,249.77 2107 DECIDIOUS SHRUB, NO: 1 CONTAINER 50.00 EACH $24.00 $ 1400.00 2108 PERENNIAL, PLUG CONTAINER 186.00 EACH $3.90 5 725.40 2109 HARDWOOD: MULCH 1-7.00 CYS $75.00 $ 2;025.00 2.110 TREE. AND SOIL. PLANTING 1}IIN 108.00 CYS 5100.00 S 10;800.00 Part 2b Total= Is 50;867:56 Submitted By: g PAVJ;�' Fbrk E. Alm,Mkt I `\ • \Z�' aA F-1 L'i A ilall►I �61 EXHIBIT B Invoice Name of Company: Address & Zip: Telephone No.: Fax No.: Project Name: Invoice No. Purchase Order No: Date: Signature Printed Name Goods Services Person Providing Goods/Services Date Goods/ Service Provided Goods/Services Provided (Describe each good/service separately and in detail) Cost Per Item Hourly Rate/ Hours Worked Total GRAND TOTAL Signature Printed Name EXHIBIT C INSURANCE COVERAGES Worker's Compensation & Disability Employer's Liability: Bodily Injury by Accident/Disease: Bodily Injury by Accident/Disease: Bodily Injury by Accident/Disease: Commercial General Liability: General Aggregate Limit (other than Products/Completed Operations): Products/Completed Operations: Personal & Advertising Injury Each Occurrence Limit: Statutory Limits $1,000,000 each employee $1,000,000 each accident $1,000,000 policy limit $6,000,000 $5,000,000 $5,000,000 Comprehensive Auto Liability (owned, hired and non -owned) Bodily Injury and Property Damage: $5,000,000 each occurrence Umbrella Excess Liability If a commercial umbrella liability policy is used to satisfy the minimum limits of liability requirements, the combined limits must equal these minimum limits of liability. EXHIBIT D AFI`IDAVIT Mark E. Jcnes beim first duly sworn, deposes and says that he/she is familiar with and has personal knowledge of the facts herein and, if called as a witness in this matter, could testify as follows: I am over eighteen (18) years, of age and ani competent to testify to the facts contained herein. 2. I am now, and at .ill tinies.rclevant herein have been employed by E & B PaviM, Inc.(the `'Employer'') in the position of Arm M-gg x 3. I am Iamiliar with the employment policies, practices, and procedures of the Employer and have the authority to .act on behalf of tine Employer. 4. The Employer is enrolled and participates in tine federal E -Verity program. Documentation of this enrollment and participation is attached and incorporated herein. The Employer does not knowingly employ any unauthorized aliens. 6. To the best of nay information said belief, the Employer does not currently employ any Unauthorized aliens. FURTHER AFFIANT.SAYETH NOT. EXECUTED on tlae ;22nd clay of _-- t 120 16. Printed: & Jam. I certify under -the penalties for perjury under the laws of the United States of America and the State of Indiana that the foregoing factual statements and aaepresentations are true and correct. Printed: Company ID Number: 426977 To be accepted as a participant in E -Verify, you should only sign the Employer's Section of the signature page. If you have any questions, contact E -Verify at 888-464-4218. Employer E&B Paving, Inc. hilli :Dockter ame (Please Type or Pring ElectrorOVOWftoed Title 0612812011 igneture o ate q � R � relB 0 Depart ent of Homela d Security —Verification Division SCIS Verification Division ame (Please Type or Print) lectronically Signed Title 6128/2011 lgnature Date Information Required for the E -Verify Program Information relating to your Company: Company Name: E&B Paving, Inc. Company Facility Address! 286 West 300 North Anderson, IN 46012 Company Alternate Address: County or Parish: MADISON Employer Identification Number:.. 5113930 Page 12 of 141 E -Verify MOU for Employer I Revislon Date 09/01/09 www.dhs.gov/E-Verify Company ID Number: 426977 North American Industry Phillip Dockter Classification Systems Code: 237 Administrator: (765) 643.- 0699 Number of Em to ees: 100 to 499. Number of Sites Verified for. Lori Hughes Are you verifying for more than I site? If yes, please provide the number of sites verified for n each State: • INDIANA 1 site(s) Information relating to the Program Administrator(s) for your Company on polity questions or operational problems: Name: Phillip Dockter Telephone Number; (765) 374 - 0350 Fax Number, (765) 643.- 0699 E-mail Address: phil.dockterf4_,ebpaving.com Name: Lori Hughes Telephone Number: (765) 643 - 5358 Fax Number;' (765) 643 - 0699 E-mail Address: teri.bughes@ebpaving.eom Name: Gayle $ehm Telephone Number. (765) 374 .0352 Fax Number. (765) 643 - 0699 E-mail Address: gayle.bebm@ebpaving.com Name: Sarah Shuter Telephone Number. (765) 374 - 0342 Fax Number: (765) 643 -0699 E-mail Address: sarah.shutee@ebpaving.com Page 13 of 14 1 E -Verify MOU for Employer I RevWon Date 09/01/09 Www.dhs.9ovJE-Verify City ofCarm l INDIANA RETAIL TAX EXEMPT CERTIFICATE NO. 003120155 002 0 Page 7 of 1 PURCHASE R NUMBER FEDERAL EXCISE TAX EXEMPT CORD; 3433 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES, A1P CARMEL, INDIANA 46032-2584 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. VENDOR NO. IDESCRIPTION 8/1912016 T0002120 Projects 16 -ENG -26 and 16 -ENG -09 E & B PAVING INC City Engineering's Office VENDOR 12600 STATE ROAD 38 E SHIP 1 Civic Square TO Carmel, IN 46032- NOBLESVILLE, IN 46060 - Kate Lustig PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 7691 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 2200 Fund: 0 General Obligation Bond Account., 94-650.04 1 Each 136th Street and Carey Road Roundabout Construction and 1,471,824.33 $1,471,824.33 Carey Road and Hawthorne Drive RAB Construct Sub Total $1,471,824.33 Send Invoice To: Jill Newport CrossRoad Engineers, P.C. 3417 Sherman Drive Beech Grove, IN 46107 G.O./Storm Water Bonds PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT PAYMENT $1,471,824.33 SHIPPING INSTRUCTIONS 'SHIP PREPAID. 'C.O.D. SHIPMENT CANNOT BE ACCEPTED. 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. AM 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 AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. ORDERED BY TITL CONTROL NO. 34337 CLERK -TREASURER