HomeMy WebLinkAboutNorth Mechanical Services, Inc/DOA/24,108/Automation System Upgrade.North Mechanical Services, Inc.
Department of Administration - 2016 AMMWO By
Appropriation #1208-509; P.O. #33918 ®a
Contract Not To Exceed $24,108.00-���
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AGREEMENT FOR PURCHASE OF GOODS AND SERVICES
THIS AGREEMENT FOR PURCHASE OF GOODS AND SERVICES ("Agreement") is
hereby entered into by and between the City of Carmel, Indiana, acting by and through its Board
of Public Works and Safety ("City"), and North Mechanical Services, 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 1208.509 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 Twenty -Four Thousand One Hundred Eight Dollars ($24,108:00) (the
°Estimate'. Vendor shall submit an invoice to City no more than once every thirty (30) days detailing
the Goods and Services provided to Citywithin 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 are submitted on -an invoice that contains the information
contained on attached Exhibit B, and Vendor has otherwise performed and satisfied all the terms
and conditions of this Agreement.
3.2 Vendor agrees not to provide any Goods and Services to City that would cause the total cost of the
Goods and Services provided by Vendor to City hereunder to exceed the Estimate, unless City has
previously agreed, in writing, to pay an amount in excess thereof.
4. WARRANTY:
Vendor expressly warrants that the Goods and Services covered by this Agreement will conform to
those certain specifications, descriptions and/or quotations regarding same as were provided to
Vendor by City and/or by Vendor to and accepted by City, all of which documents are incorporated
herein by reference, and that the Goods and Services will be delivered in a timely, good and
workmanlike manner and free from defect. Vendor acknowledges that it knows of City's intended use
and expressly warrants that the Goods and Services provided to City pursuant to this Agreement
have been selected by Vendor based upon City's stated use and are fit and sufficient for their
particular purpose.
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North Mechanical Services, Inc.
Department of Administration - 2016
Appropriation. #12.08-509; P.O. #33918
Contract Not To Exceed $24,108.00
5. TIME AND PERFORMANCE:
This Agreement shall become effective as of the last date on which a party hereto executes same rEffective
Datel, and both parties thereafter perform their obligations hereunder in a timely manner. Tme 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, Vendoragrees to
furnish to City sufficient written waning 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,
B. 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) falls 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 onto 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 . 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 shail'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.
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North Mechanical Services, Inc.
Department of Administration - 2016
Appropriation #1208-509; P.O.433918
Contract. Not To Exceed $24,108.00
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.pdvileges 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. NOWASSIGNMENT:
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
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3
North Mechanical Services, Inc.
Department of Administration - 2016
Appropriation #1208-509; P.O. #33918
Contract Not To Exceed $24,108.00
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
wawe: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 necessaryto
comply with same, and the remaining provisions of this Agreement shall remain in full force and effect.
18. NOTICE:
Any notice provided for in this Agreement will be sufficient if it is in writing and is delivered by postage
prepaid U.S. certified mail, return receipt requested, to the party to be notified at the address specified
herein:
If to City: City of Carmel AND Douglas C. Haney,
Carmel, Indiana 46032 Department of Law
One Civic Square
Carmel, Indiana 46032
If to Vendor: North Mechanical Services, Inc.
2127 North Emerson Avenue
Indianapolis, IN 46218
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.
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4
North Mechanical Services, Inc.
Department of Administration - 2016
'Appropriation #1208-509; P.O. #33918
Contract Not To Exceed -$2,4,108.00
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 Vendors time and cost. estimate for the provision of such additional
goods and services, has encumbered sufficient monies to pay for some, 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 govem and prevail.
This Agreement may only be modified by written amendment executed by both parties hereto, or their
successors in interest.
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North Mechanical Services, Inc.
Department of Administration - 2016
Appropriation #1208-509; P.O. #33918
Contract Not To Exceed $24,108.00
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:
N
James Brainard, Presiding Officer
Lori,S. Wat
Datta: 7
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NORTH MECHANICAL SERVICES, INC.
By:
Ne
Authorized Si
Printed Name
000
FIDfrIN:
Last Four of SSN if Sole Proprietor:
Date:
NORTH: MECHANICAL
SERVICES, INC.
Mechanical:— Plumbing.. Controls — Engineering
TO:
Carmel Energy Center
FOR; I
Automation System Upgrade
QUOTE:
SP -1607
LOCATION:
Carmel, IN
DATE:
7-19-16
ATTN:
John Duffy
PHONE:
(317) 571-2451
PAGE(s):
2
We are pleased to provide a price for your Energy Center Server upgrade.
Scope of Work:
1. Provide and install new Honeywell Web Enabled Building Solution DACE.
a. Integration of existing building systems as they are now:
is Fire Station Distech.
Il. Police Station Distech.
iii. Town Hall Distech.
iv. BTU meter points over IP.
v. Includes (3) year maintenance for DACE software.
vi. Includes local wiring as needed to connect to power and existing network.
2. Provide and install Niagara 4 server software.
a. Replaces existing graphic server.
b. Includes new computer and setup for user interface in the mechanical room.
c. Includes programming for graphic user Interface panels, similar to the existing system.
TOTALINVESTMENT...........................................................................................................24,108.00
Clarifications;
♦ Work to be performed during normal working hours;
Taxes are excluded;
o, Anything not mentioned aboveis excluded;
♦ This quotation subject to management approval;
♦ Standard terms and conditions apply;
Safety and your complete Satisfaction are our focus. Thank you for this opportunity.
If you have any questions, please call. Thank you, This quotation Is accepted by:
Date
Al May 317-610-2627
HonesyweH
niagara4
Quotation subject to negotiation after 30 days
This document Is confidential and contains proprietary and Intellectual property of North Mechanical Services, Inc. No Information contained hereto maybe discussed or shared
with other parties that may assist other contractors, bidders, vendors, subcontractor or competitors to garner advantage.
Ior2
EXHIBIT
NORTH: MECHANICAL
SERVICESJNC..
Mechanical - Plumbing Controls - Engineering
GEN94ALTERMS AND CONDITIONS FORSERVICES
1. Applicabillty.
(a) These terms and conditions for services (these "Terms") are the only terms that govern the provision of services and any provision of
goods by NORTH MECHANICAL SERVICES, INC. ("Service Provider") to the customer which accepted the accompanying Quotation ("Customer").
(b) The accompanying Quotation (the "Quotation") and these Terms (collectively, this "Agreement") comprise the entire agreement
between the parties, and supersede all prior or contemporaneous understandings, agreements, negotiations, representations and warranties, and communications,
both written and oral. In the event of any conflict between these Terms and the Quotation, these Terms shall govern unless the Quotation expressly states that the
terms and conditions of the Quotation shall control.
(c) These Terms prevail over any of Customer's general terms and conditions regardless whether or when Customer has submitted Its
request for proposal, order, or such terms. Provision of services to Customer does not constitute acceptance of any of Customer's terms and conditions and does not
serve to modify or amend these Terms.
2. Services. Service Provider shall provide the goods and services to Customer as described In the Quotation (collectively, the "Services") In
accordance with these Terms.
3. , Customer's Obligations. Customer shall; (I) cooperate with Service Provider in all matters relating to the Services and provide such access to
Customer's premises, and such office accommodation and other facilities as may reasonably be requested by Service Provider, for the purposes of performing the
Services; and (11) respond promptly to any Service Provider request to provide direction, information, approvals, authorizations or decisions that are reasonably
necessary for Service Provider to perform Services in accordance with the requirements of this Agreement.
4. Customer's'Acts or Onrisslons. If Service Provider's performance of Its obligations under this Agreement is prevented or delayed by any act or
omission of Customer or its agents, subcontractors, consultants or employees, Service Provider shall not be deemed in breach of Its obligations under this Agreement
or otherwise liable for any costs, charges or losses sustained or incurred by Customer, in each case, to the extent arising directly or indirectly from such prevention or
delay.
S. Payment Terms: Interest an Late Payments.
(a) . Service Provider shall Issue Invoices to Customer and Customer shall pay all invoiced amounts due to Service Provider within 30 days
after Customer's receipt of such invoice. All payments hereunder shall be In US dollars and made by check or wire transfer.
(b) in the event payments are not received by Service -Provider within 30 days after becoming due, Service Provider may: (1) charge interest
on any such unpaid amounts at a rate of 1.5%, per month or, if lower, the maximum amount permitted under applicable law, from the date such payment was due until
the date paid; and (ii) suspend performance for all Services until payment has been made in full.
6. Taxes. Customer shall be responsible for all sales, use and excise taxes, and any other similar taxes, duties and charges of any kind Imposed by
any federal, state or local governmental entity on any amounts payable by Customer hereunder.
7. Confidential Information. All non-public, confidential or proprietary Information of Service Provider, including, but not limited to, trade secrets,
technology, information periatning to business operations*and strategles; and information pertaining to customers, pricing, and marketing (collectively, "Confidential
Information"), disclosed by Service Provider to Customer, whether disclosed orally or disclosed or accessed in written, electronic or other form or media, and whether
or not marked, designated or otherwise Identified as "confidential," in connection with the provision of the Services and this Agreement Is confidential, and shall not
be disclosed or copied by Customer without the prior written consent of the Service Provider. Servlce'Provider shall be entitled to injunctive relief for any violation of
this Section.
8. Representation and Warranty. Service Provider represents and warrants to Customer that it shall perform the Services using personnel of
required skill, experience and.qualincations and In a professional and workmanlike manner In: accordance with generally recognized Industry standards for similar
services and shall devote adequate resources to meet Its obligations under this Agreement. EXCEPT FOR THE WARRANTY SET FORTH ABOVE, SERVICE PROVIDER MAKES
NO WARRANTY WHATSOEVER WITH RESPECT TO THE SERVICES, INCLUDING ANY (A) WARRANTY OF MERCHANTABILITY; OR (8) WARRANTY OF FITNESS FOR A
PARTICULAR PURPOSE; OR (C) WARRANTY OF TITLE; OR (D) WARRANTY AGAINST INFRINGEMENT OF INTELLECTUAL PROPERTY RIGHTS OF A THIRD PARTY; WHETHER
EXPRESS OR IMPLIED BY LAW, COURSE OF DEALING, COURSE OF PERFORMANCE, USAGE OF TRADE OR OTHERWISE.
9. . Umitation of liability. IN NO EVENTSHALL SERVICE PROVIDER BE LIABLE TO CUSTOMER OR TO ANY THIRD PARTY FOR ANY LOSS OF USE, REVENUE
OR PROFITOR LOSS OF DATA OR DIMINUTION IN VALUE, OR FOR ANY CONSEQUENTIAL; INCIDENTAL, INDIRECT, EXEMPLARY, SPECIALOR PUNITIVE DAMAGES WHETHER
ARISING OUT OF BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE) OR OTHERWISE, REGARDLESS OF WHETHER SUCH DAMAGE WAS FORESEEABLE AND
WHETHER OR NOT SUCH PARTY HAS'BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, AND NOTWITHSTANDING THE FAILURE OF ANY AGREED OR OTHER
REMEDY OF ITS ESSENTIAL PURPOSE.
10. Force Maleure. The Service Provider shall not be liable or responsible to Customer, nor be deemed to have defaulted or breached this Agreement,
for any failure or delay In fulfilling or performing any term of this Agreement when and to the extent such failure or delay Is caused by or results from acts or
circumstances beyond the reasonable control of Service Provider including, without limitation, acts of God, flood, fire, earthquake, explosion, governmental actions:.
war, Invaslon or hostilities (whether war is declared or not), terrorist threats or acts, riot, or other civil unrest, national emergency, revolution, insurrection, epidemic,
lock -outs, strikes or other labor disputes (whether or not relating to either party's workforce), or restraints or delays affecting carriers or inability or delay In obtaining;;
supplies of adequate or suitable materials, materials or telecommunication breakdown or power outage.
11. Governing Law. All matters arising out of or relating to this Agreement are governed by and construed in accordance with the internal laws of the
State of Indiana without giving effect to any choice or conflict of law provision or rule that would cause the application of the laws of any jurisdiction other than those
of the State of Indiana.
12. Submissionjo Jurisdiction. Any legal suit, action or proceeding arising out of or relating to this Agreement shall be instituted in the federal courts
of, the United States of America or the courts of the State of Indiana in each case located in the City of Indianapolis and County of Marion, and each party Irrevocably
submits to the exclusive jurisdiction of such courts in any such suit, action or proceeding.
Z Of Z
EXHIBIT
20-�Z
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 Statutory Limits
Employer's Liability:
Bodily Injury by Accident/Disease:
$100,000 each employee
Bodily Injury by Accident/Disease:
$250,000 each accident
Bodily Injury by Accident/Disease:
$500,000 policy limit
Property damage, contractual liability,
products -completed operations:
General Aggregate Limit (other than
Products/Completed Operations): $500,000
Products/Completed Operations: $500,000
Personal & Advertising Injury
Policy Limit: $500,000
Each Occurrence Limit: $250,000
Fire Damage (any one fire): $250,000
Medical Expense Limit (any one person): $ 50,00,0
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
EXHIBIT D
AFFIDAVIT
being 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:
1. I am over eighteen (18) years of age and am competent to testify to the facts contained
herein.
2. I am now and at all times relevant herein have been employed by
(the `Employer')
in the position of
3. I am familiar with the employment policies, practices, and procedures of the Employer and
have the authority to act on behalf of the Employer.
4. The Employer is enrolled and participates in the federal E -Verify program and has
provided documentation of 'such enrollment and participation to the City of Carmel,
Indiana.
5. The Company does not knowingly employ any unauthorized aliens.
FURTHER AFFIANT SAYETH NOT.
EXECUTED on the i 5 day of GL 20.
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 representations are true and correct.
WA r�� �W-74
Printe d:�/
Clause and Affidavit to be, added to Contract
For.Services-to be>provided'to
CITY OF CARAMEL; .INDIANA
(as required by Indiana SEA..590, effective" July i, 2011)
VERIFICATION OF WORK ELIGIBIIiITY STATUS
(hereinafter called
"Contractor") underst _ ds and agrees that it is required to enroll in and verify the work
eligibility status of all employees hired after the date of this- contract through the E -Verify
program. This requirement shall be waived if the E-Verify.program ceases to exist. For the
Purposes of this paragraph, the "E -Verify program" means -the. electronic verification of work
authorization program ofthe Illegal Immigration Reform and Immigration Responsibility Act
of 196 {P.L. 104=208), Division C, Title IV; s..403(a), as amended, operated by the United
States D.epaitiuent of .Sec
Homeland urlty or a successor :work authorization program
designated' by the United States Department of Homeland Security or other federal agency
authorized to verify the work authorization status of newly hired employees under the
Immigration Reform and Control Act of 1986 (P.L..99-603).
2.- An authorized representative of the Contractor has signed the affidavit below concerning
the empioyment of unauthorized aliens.
AFFIDAVIT CONCERNING•EMPLOYMENT
OF UNAUTHORIZED ALIENS
I, am a duly authorized'°officer of Aloke 1
(hereinafter called "Contractor") and I hereby certify that as of the date of Jthis Affidavit,
Contractordoes not employ, any "unauthorized aliens" as that term is defined in 8 U.S.C.
1324a=(h)(3).
I AFFIRM UNDERTHE PENALTIES FOR PERJURY THAT THE FOREGOING
REPRESENTATIONS ARE TRUE.
Dated: 84546 ILL
Signature
Printed; Name
&U S..1324a(h)(3) Defnition of unauthorized aBen'
As useflnCthis sectior, the term "unauthorized alien" meanswith respect to the employment
of an alien.at a partimilar time, that the alien is not at that time either
(A),An. alien:lawfuliy admitted for permanent residence, or
'Authorized to be so employed by this chapter or by the Attorney General.