Loading...
HomeMy WebLinkAboutAlt & Witzig Engineering, Inc/Eng/32,750/On-Call Environmental Services – Midtown on the Monon/1st Ave SW/Veteran’s Way Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COIT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 QQR0L ¢' A �; �'S • ✓AO AGREEMENT FOR PROFESSIONAL SERVICES THIS AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement") is hereby made and entered into by and between the City of Carmel, Indiana, acting by and through its Board of P,ublic Works and Safety (hereinafter "City"), and Alt&Witzig Consulting Services, LLC (hereinafter"Professional"). • RECITALS WHEREAS City owns and is responsible for the operation and maintenance of its property, personnel, public works and infrastructure; and WHEREAS, from time to time, City needs professional assistance in fulfilling its foregoing responsibilities; and WHEREAS, Professional is experienced in providing and desires to provide to City the professional services ("Services") referenced herein; and WHEREAS, City desires to engage Professional as an independent contractor for the purpose of providing to City the Services referenced herein; • NOW, THEREFORE, in consideration of the foregoing recitals and the covenants and conditions set forth herein, City and Professional mutually-agree as follows: SECTION 1 INCORPORATION OF RECITALS • The foregoing Recitals are hereby incorporated into this Agreement and made a part hereof. SECTION 2 SCOPE OF SERVICES 2.1 City desires to engage Professional as an independent contractor for the Services set forth in attached Exhibit A, incorporated herein by this reference. 2.2 Professional understands and agrees that City may, from time to time, request Professional to provide additional or modified Services to City. When City desires additional Services from Professional, the City shall notify Professional of such additional Services desired, as well as the time frame in which same are to be provided. Only after.City has approved Professional's time and cost estimate for the provision of such additional Services, has encumbered sufficient monies to pay for same, and has authorized Professional, in writing, to provide such additional Services, shall such Services be provided by Professional to City. A copy of the City's authorization documents for the purchase of additional Services shall be numbered and attached hereto in the order in which they are approved by City. 2.3 Time is of the essence of this Agreement. [S:1Contracts\ProESvcs&Goods Svcs\Engineering12017Wt&Witzig Consulting Services,LLC Professional Services Connact.doc:6/9201711:19 AM] 1 Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COIT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 • SECTION 3 CITY'S RESPONSIBILITIES 3.1 City shall provide such information as is reasonably necessary for Professional to understand the Services requested. 3.2 City shall provide all data required for provision of Services. Professional may assume that all data so provided is correct and complete. 3.3. City shall arrange for Professional to enter upon public and private property as reasonably required for Professional to perform the Services. 3.4 City shall designate payment of the Services from City budget appropriation number 2016 COIT Bond funds. 3.5 City shall designate the Mayor or his duly authorized representative to act on City's behalf on all matters regarding the Services. • SECTION 4 PROFESSIONAL'S RESPONSIBILITIES • 4.1 Professional shall perform the Services pursuant to the terms of this Agreement and within any applicable time and cost estimate. 4.2 Professional shall coordinate with City its performance of the Services. 4.3 Professional shall provide the Services by following and applying at all times reasonable and lawful standards as accepted in the industry. . SECTION 5 COMPENSATION 5.1 Professional estimates that the total price for the Services to be provided to City hereunder shall be no more than Thirty Two Thousand Seven Hundred Fifty Dollars ($32,750.00) (the "Estimate"). Professional shall submit an invoice to City no more than once every thirty (30) days for Services provided City during the time period encompassed by such invoice. Invoices shall be submitted on a form containing the same information as that contained on the Professional Services Invoice attached hereto as Exhibit B, incorporated herein by this reference. City shall pay Professional for all undisputed Services rendered and stated on such invoice within thirty five(35) days from the date of City's receipt of same. • 5.2 Professional agrees not to provide any Services to City that would cause the total cost of same to exceed the Estimate, without-City's prior written consent. • • tS:\Contr'ac151Prof.S\cs&Goods Svcs\Engineering12017Ali&Wilzig Consulting Services,LLC Professional Services Contract.doc:6/9201711:19 AM] 2 Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COLT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 • SECTION 6 TERM Unless otherwise terminated in accordance with the termination provisions set forth in Section 7.1 hereinbelow, this Agreement shall be in effect from the Effective Date through December 31, 2017, 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. SECTION 7 MISCELLANEOUS 7.1 Termination • 7.1.1 The obligation to provide all or any portion of the Services under this Agreement may be terminated by City or Professional,without cause, upon thirty(30) days' notice. 7.1.2 The obligation to provide all or any portion of the Services under this Agreement may be terminated by City, for cause, immediately upon Professional's receipt of City's"Notice To Cease Services." 7.1.3 In the event of full or partial Agreement termination, and as full and complete compensation hereunder, Professional shall be paid for all such Services rendered and expenses incurred as of • the date of termination that are not in dispute, except that such payment amount shall not exceed the Estimate. Disputed compensation amounts shall be resolved as allowed by law. 7.2 Binding Effect . City and Professional, and their respective officers, officials, agents, partners and successors in interest are bound to the other as to all Agreement terms, conditions and obligations. 7.3 No Third Party Beneficiaries Nothing contained herein shall be construed to give rights or benefits to anyone other than the parties hereto. 7.4 Relationship The relationship of the parties hereto shall be as provided for in this Agreement, and neither Professional nor any of its agents, employees or contractors are City employees. Professional shall have the sole responsibility to pay to or for its agents, employees and contractors all statutory, contractual and other benefits and/or obligations as they become due. Professional hereby warrants and indemnifies City for and from any and all costs, fees, expenses and/or damages incurred by.City as a result of any claim for wages, benefits or otherwise by any agent, employee or contractor of Professional regarding or related to the subject matter of this Agreement.This indemnification obligation shall survive the termination of this Agreement. [S:lConttacts'ProfSva&Goods Svcs\Engineeringl2017 Alt&Witzig Consulting Services,LLC Professional Services Contract.doc:6l9201711:19 AM] 3 Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COIT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 7.5 Insurance Professional shall procure and maintain with an insurer licensed to do business in the State of Indiana such insurance as is necessary for the protection of City and Professional from all claims under workers' compensation, occupational .disease and/or unemployment compensation acts, because of errors and omissions, because of bodily injury, including, but not limited to, the personal injury, sickness, disease, or death of any of Professional's employees, agents or contractors and/or because of 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 on attached Exhibit C. Such insurance policies shall not be canceled without thirty (30) days' prior written notice to City. 7.6 Liens Professional shall not cause or permit the filing of any lien on any of City's property. In the event such a lien is filed and Professional fails to remove it within ten (10) days after the date of filing, City shall have the right to pay or bond over such lien at Professional's sole cost and expense. 7.7 Default In the event Professional: (a) repudiates, breaches or defaults under any of the terms or conditions of this Agreement, including Professional's warranties; (b) fails to perform the Services as specified; (c) fails to make progress so as to endanger timely and proper completion of the Services and does not correct such failure or breach within five (5) business days after receipt of notice from City specifying same; or (d) becomes insolvent, files, or has filed against it, a petition for 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 terminate all or any part of this Agreement, without liability to Professional and to exercise any other rights or remedies available to it at law or in equity. 7.8 Government Compliance Professional agrees to comply with all laws, executive orders, rules and regulations applicable to Professional's performance of its obligations under this Agreement, all relevant provisions of which being hereby incorporated herein by this reference, to keep all of Professionals' required professional licenses and certifications valid and current, and to indemnify and hold harmless City from any and all losses, damages, costs, liabilities, damages, costs and attorney fees resulting from any failure by Professional to do so. This indemnification obligation shall survive the termination of this Agreement. 7.9 Indemnification -Professional shall indemnify and hold harmless City and its officers, officials, employees and agents from all losses, liabilities, claims,judgments and liens, including, but not limited to, all damages, costs, expenses and reasonable attorney fees arising out of any negligent act or omission of Professional and/or any of its employees, agents or contractors in the performance of this Agreement. This indemnification obligation shall survive the termination of this Agreement. I$:1COnnacts\rOfSvcs&Goods SvcslEngioeering120171Alt&Witzig Consoltmg Services,LLC Professional Services Contract.doc:6192017 11.19 AM] 4 Alt&Witzig Consulting Services,LLC Engineering-2017 • Appropriation:#2016 COIT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 7.10 Discrimination Prohibition Professional represents and warrants that it and each of its employees, agents and contractors shall comply with all existing and future laws prohibiting discrimination against any employee, applicant for employment and/or other person in the subcontracting of work and/or in the performance of any Services contemplated by this Agreement with respect to hire, tenure, terms, conditions or privileges of employment or any matter directly or indirectly related to employment, subcontracting or work performance hereunder because of race, religion, color, sex, handicap, national origin, ancestry, age, disabled veteran status or Vietnam era veteran status. This indemnification obligation shall survive the termination of this Agreement. 7.11 E-Verify Pursuant to I.C. § 22-5-1.7 et seq., Professional shall enroll in and verify the work eligibility status of all of its newly-hired employees using the E-Verify program, if it has not already done so as of the date of this Agreement. Professional is further required to execute the attached Affidavit, herein referred to as Exhibit D, which is an Affidavit affirming that: (i) Professional is enrolled and is participating in the E-verify program, and (ii) Professional does not knowingly employ any unauthorized aliens. This Addendum incorporates by reference, and in its entirety, attached Exhibit D. In support of the Affidavit, Professional shall provide the City with documentation that it has enrolled and is participating in the E-Verify program. This Agreement shall not take effect until said Affidavit is signed by Professional and delivered to the City's authorized representative. Should Professional subcontract for the performance of any work under this Addendum, the Professional shall require any subcontractor(s) to certify by affidavit that: (i) the subcontractor does not knowingly employ or contract with any unauthorized aliens, and (ii) the subcontractor has enrolled and is participating in the E-verify program. Professional shall maintain a copy of such certification for the duration of the term of any subcontract. Professional shall also deliver a copy of the certification to the City within seven (7) days of the effective date of the subcontract. If Professional, or any subcontractor of Professional, knowingly employs or contracts with any unauthorized aliens, or retains an employee or contract with a person that the Professional or subcontractor • subsequently learns is an unauthorized alien, Professional shall terminate the employment of or contract with the unauthorized alien within thirty (30) days ("Cure Period"). Should the Professional or any subcontractor of Professional fail to cure within the Cure Period, the City has the right to terminate this Agreement without consequence. The E-Verify requirements of this Agreement will not apply, should the E-Verify program cease to exist. 7.12 Severability If any provision of this Agreement is held to be invalid, illegal or unenforceable by a court of competent jurisdiction, that provision shall be stricken, and all other provisions of this Agreement that can operate independently of same shall continue in full force and effect. Svcs&Goods Svcs\Eogineering\2017Wt&Wilzig Consulting Services,LLC Professional Services Contract.doc:6/92017 11:19 AM] 5 • • Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COLT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 • 7.13 Notice Any notice, invoice, order or other correspondence required or allowed to be sent pursuant to this Agreement shall be written and either hand-delivered or sent by prepaid U.S. certified mail, return receipt requested, addressed to the parties as follows: CITY: • City of Carmel Douglas C. Haney Department of Engineering Corporation Counsel One Civic Square One Civic Square Carmel, Indiana 46032 Carmel, Indiana 46032 ATTENTION: Jeremy Kashman PROFESSIONAL: Alt&Witzig Consulting Services, LLC 4105 West 99th Street Carmel, IN 46032 ATTENTION: David Herring dherring@altwitzig.com Notwithstanding the above, City may orally provide to Professional any notice required or permitted by this Agreement, provided that such notice shall also then be sent as required by this paragraph within ten (10) business days from the date of such oral notice. 7.14 Effective Date The effective date ("Effective Date") of this Agreement shall be the date on which the last of the parties hereto executes same. 7.15 Governing Law; Lawsuits This Agreement shall be governed by and construed in accordance with the laws of the State of Indiana, except for its conflict of laws provisions, as well as by all.ordinances and codes of the City of Carmel, Indiana. The parties agree that, in the event a lawsuit is filed hereunder, they waive any right to a jury trial they may have, agree to file such lawsuit in an appropriate court in Hamilton County, Indiana only, and agree that such court is the appropriate venue for and has jurisdiction over same. • 7.16 Waiver • Any delay or inaction on the part of either party in exercising or pursuing its.rights and/or remedies hereunder or under law shall not operate to waive any such rights and/or remedies nor in any way affect the rights of such party to require such performance at any time thereafter. • 7.17 Non-Assignment ]S:\Contracts\Prof$ves&Goods Svcs\Engineering\2017Wt&Witzig Consulting Services,LLC Professional Services Contract.doc:6/92017 11:19 AM] 6 Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COIT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 Professional shall not assign or pledge this Agreement nor delegate its obligations hereunder without City's prior written consent. 7.18 Entire Agreement This Agreement contains the entire agreement of and between the parties hereto with respect to the subject matter hereof, and no prior agreement, understanding or representation pertaining to such subject matter, ' written or oral, shall be effective for any purpose. No provision of this Agreement may be amended, added to or subtracted from except by an agreement in writing signed by both parties hereto and/or their respective successors in interest. To the extent any provision contained in this Agreement conflicts with any provision contained in any exhibit attached hereto, the provision contained in this Agreement shall prevail. 7.19 Representation and Warranties Each party hereto represents and warrants that it is authorized to enter into this Agreement and that any person or entity executing this Agreement on behalf of such party has the authority to bind such party or the party which they represent, as the case may be. 7.20 Headings, All headings 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. 7.21 Advice of Counsel The parties warrant that they have read this Agreement and fully understand it, have had an opportunity to obtain the advice and assistance of counsel throughout the negotiation of same, and enter into same freely, voluntarily, and without any duress, undue influence or coercion. 7.22 Copyright City acknowledges that various materials which may be used and/or generated by Professional in performance of Services, including forms, job description formats, comprehensive position questionnaire, compensation and classification plan and reports are copyrighted. City agrees that all ownership rights and copyrights thereto lie with Professional, and City will use them solely for and on behalf of its own operations. City agrees that it will take appropriate action with its employees to satisfy its obligations with respect to use, copying, protection and security of Professional's property. 7.23 Personnel Professional represents that it has, or will secure at its own expense, all personnel required in performing the services under this agreement. Such personnel shall not be employees of or have any contractual relationship with City. All of the services required hereunder will be performed by Professional or under his supervision and all personnel engaged in the work shall be fully qualified to perform such services. [S:1Contracts\Prof Sws&Goods SvcslEngineering12017tAlt&Wilzig Consulting Services,LLC Professional Services Contract.doc:6/9f201711.19 AM] 7 Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COIT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 • 7.24 Records and Inspections Professional shall maintain full and accurate records with respect to all matters covered under this agreement for three (3) years after the expiration or early termination of this Agreement. City shall have free access at all proper times to such records and the right to examine and audit the same and to make transcripts there from, and to inspect all program data, documents, proceedings and activities. 7.25 Accomplishment of Project Professional shall commence, carry on, and complete the project with all practicable dispatch,'in a sound economical and efficient manner, in accordance with the provisions thereof and all applicable laws. In accomplishing the project, Professional shall take such steps as are appropriate to ensure that the work involved is properly coordinated with related work being carried on within City's organization. 7.26 Iran Certification Pursuant to I.C. § 5-22-16.5, the Professional shall certify that, in signing this Agreement, it does not engage in investment activities within the Country of Iran. 7.27 Access to Public Records Act • Professional understands and agrees that any"public record", as that term is defined in Indiana Code 5-14-3- 2(m), as amended, that is related to the subject matter of this Agreement, whether the same is in the possession or control of the Professional or the City, shall be subject to release under and pursuant to the provisions of Indiana's Access to Public Records Act, as codified in Indiana Code 5-14-3-1, et seq., as amended. • • • (remainder of page intentionally left blank) • ]S:\Contracls\ProfSvcs&Goods Svcangineering\2017Wt&Witzig Consulting Services,LLC Professional Services Contract.doc:6/92017 11:19 AM] • Alt&Witzig Consulting Services,LLC Engineering-2017 Appropriation:#2016 COLT Bond Fund;P.O. 100499 Contract Not To Exceed$32,750.00 IN WITNESS WHEREOF,the parties hereto have made and executed this Agreement as follows: CITY OF CARMEL, INDIANA ALT&WITZIG CONSULTING SERVICS, LLC by and through its Board of Public Works and Safety BY BY: No--- Pros James Brainard, Presiding Officer Authorized Signat Date: . t Printed Name: 6.:4 r} gert'r.1 Title . prmse.eryr Mary An Burke,M m gr Date; c! FID/TiN: ZO D,51 yg?Z , Last Four of SSN if Sole Proprietor: Lori S.Watson , ber Date,_:06 / 13./1-_./ . :: . Date: 4 ATTEST: gifiaan:ief"Lay- Christine §. Pauley, Clerk-Treasurer Date: o — {sU5ML•.y.PndSxs k ..aUengmrrnn02017b\li R Wiirig Caualling Ranrrc.1 J„C•Vrofessinnal tie%¢w Cunvaddb.,W712U17 I I,10 AM l 9 Atig 4 Alt & Witzig Consulting Services 4105 West 99th Street• Carmel, Indiana 46032 V (317) 875-7000• Fax(317) 876-3705 June 8, 2017 Crossroad Engineers, PC 3417 Sherman Drive Beech Grove, Indiana 46107 Attn: Mr. Curtis Holcom RE: Further Site Investigation Midtown on the Monon 1st Avenue SW/Veterans Way Cannel, Indiana 46032 Alt&Witzig Proposal No.: 1706E004 Dear Mr. Holcum: In compliance with your recent request, Alt & Witzig Consulting Services (A&W) submits the following proposal for the performance of a Further Site Investigation (FSI) at the above- referenced Site. The purpose of the FSI is to further delineate potential chlorinated volatile organic compound (cVOC) contamination identified beneath the roadway during previous investigations. These results will be used to assist in determining waste characterization for disposal purposes during proposed utility trench excavations. Based on information obtained from previous investigations, A&W proposes the following scope of work. Scope of Work: Prior to field activities A&W will: • Prepare a Site-specific Health and Safety Plan (HASP) for the investigation in accordance with current Occupational Safety and Health Association(OSHA)requirements. • Coordinate the clearing of public underground utilities owned by local utility companies. Thus, the boring locations will be cleared of all underground utilities to the best of the environmental contractors' knowledge. It is understood that A&W will not be held responsible, financially or otherwise, for any property damage incurred during any and all field activities associated with this subsurface investigation due to faulty or improper utility locate. Field Activities • Complete up to eight(8) soil borings along the area of 1S`Avenue SW and Veterans Way in the area of concern for the Soil Management Plan (SMP) being prepared for the utility excavation Offices: Cincinnati•Dayton.Ohio Indianapolis•Evansville•Fort Wayne•Lafayette•South Bend,Indiana *EnvironmentalSen'ices• °EXHIBIT • work. The total depth of the borings will be based on the depth of the proposed utility corridors between 10 to 12 feet below ground surface(bgs). • During drilling activities, soils will be continuously sampled using a Geoprobe® sampling device. Soil samples will be field classified and screened with a MicroVac flame-ionization detector(FED)to detect the presence of total VOCs. • Soil samples will be collected utilizing US EPA 5035 sampling methodologies. • Two (2) to four(4) soil samples from each of the soil borings will be collected for laboratory analysis of likely potential contaminants. Up to 24 soil samples will be collected in total. Soil samples will be collected based on the following factors: o One(1) soil sample will be collected from the soil horizon that exhibits the highest level of contamination(i.e. PID reading, staining,odor);or o If no contamination is observed, one (1) soil sample will be collected from approximately 4-6 feet bgs and one(1) sample will be collected from 8-10 feet bgs. • Up to 24 soil samples collected from the Site will be analyzed for the following likely potential contaminants: • cVOCs utilizing EPA method SW846-8260. • In addition, three (3) of the 24 soil samples will be analyzed for waste characterization purposes for the following likely potential contaminants: • 1,4-Dioxane utilizing EPA method SW846-8260SIM; and, • Toxicity Characteristic Leaching Procedure (TCLP) cVOCs utilizing EPA method SW846-1311/8260. Report Preparation A&W will prepare a report documenting our field methodology and findings. The report will contain tables, figures and laboratory results. The report will also include any recommendations based upon the findings of this investigation. This information will be utilized to complete the Site Soil Management Plan (SMP) and will be utilized to get landfill approval and prevent the need for stockpiling soils on-Site. A&W will provide field staff for screening and manifest management during utility excavations and Project Management services for landfill approval, field coordination and end of project Summary Letter at the following Time &Materials Rates. Estimated Costs and Schedule: We request written authorization before any work can be performed on a project. For your convenience, please return a photocopy of this entire proposal with an appropriate authorization signature. We estimate the cost for the scope of work as discussed above based on the following fees and services. Based on the uncertainties of the utility installation process and the potential need for special disposal, the Field and Engineering costs will be billed on a Time and Materials basis with a not to exceed cost estimate below. FSI-Midtown on the Monon Cannel,Indiana A&W Proposal No.: 1706E004 2 "EXHIBIT • 20-E3 Tasks Estimated Cost Drilling Services $ 2,365.00 Includes mob, operator&sampling equipment(Fixed Rate) Field Scientist $ 19,873.00 Includes field scientist,field screening&sample collection(Time&Material) Laboratory Services $ 2,082.00 Includes lab analysis of soil samples for potential contaminants Engineering Services $ 8,430.00 Includes project management&report preparation(Time&Material) Not To Exceed Total Cost Estimate: $32,750.00 The above Engineering Services will be provided a the following rates: A&W will provide field staff for screening and manifest management during utility excavations and Project Management services for landfill approval, field coordination and end of project Summary Letter at the following Time&Materials Rates. Field Staff $ 70.00/hour Equipment&Materials $ 200/day Includes field screening equipment, supplies and materials Project Management $ 80.00/hour An environmental investigation as described above would be based on the following fees. If during the course of the investigation, unusual conditions are encountered, (i.e.; heaving sand, bedrock, rough fill, reinforced concrete or excessively thick concrete, etc.) the client will be notified and the price will be adjusted accordingly. All costs assume that normal conditions will be encountered and that any delays, obstructions or other limitations will result in additional expense. We guarantee not to exceed the scope of work proposed for this project without your prior approval. Standard turnaround for laboratory services is seven (7) to 10 business days. Rush laboratory services can be obtained at a surcharge of 100% mark-up for 24-hour return, 70% mark-up for 2-day return, 45%mark up for 3-day return and 20%mark-up for 4-day return. Upon authorization to proceed, fieldwork will be scheduled after the date of our authorization to proceed. Upon receipt of laboratory results, we will contact you with a verbal summary of our fmdings. One(1) electronic copy of our investigative report will be submitted within two(2)weeks of our receipt of laboratory results. Thank you for this opportunity to offer our services. If you have questions or require additional information, please contact us at your convenience. We look forward to working with you on this and future projects. FSI-Midtown on the Monon Cannel,Indiana A&W Proposal No.: 1706E004 3 "EXHIBIT EXHIBIT B Invoice Date: Name of Company: Address &Zip: Telephone No.: Fax No.: Project Name: Invoice No. Purchase Order No: Goods Services Person Providing Date Goods/Services Provided Cost Per Hourly Total Goods/Services Goods/ (Describe each good/service Item Rate/ Service separately and in detail) Hours Provided Worked GRAND TOTAL Signature Printed Name EXHIBIT C INSURANCE COVERAGES Worker's Compensation &Disability Statutory Limits Employer's Liability: Bodily Injury by Accident/Disease: $100,000 each employee Bodily Injury by Accident/Disease: $250,000 each accident Bodily Injury by Accident/Disease: $500,000 policy limit Property damage, contractual liability, products-completed operations: General Aggregate Limit(other than Products/Completed Operations): $500,000 Products/Completed Operations: $500,000 Personal &Advertising Injury Policy Limit: $500,000 Each Occurrence Limit: $250,000 Fire Damage (any one fire): $250,000 Medical Expense Limit(any one person): $ 50,000 Comprehensive Auto Liability (owned, hired and non-owned) Bodily Single Limit: $500,000 each accident Injury and property damage: $500,000 each accident Policy Limit: $500,000 Umbrella Excess Liability Each occurrence and aggregate: $500,000 Maximum deductible: $ 10,000 EXHIBIT D AFFIDAVIT: 1)tv�; w U rZ; ,being first duly sworn, deposes and says that he/she is familiar with and Bias 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 41/ ci- a, fl,Y (the "Employer") . ', p ri / in the position of . V ; 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 . r 3 day of \-)V.4e. , 201?. Printed:. "_,_•;y/ A- I certify under the penalties for penury 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. Printed: t42 C //-r . INDIANA RETAIL TAX EXEMPT Page 1 of I Chitof Ia1r]nnIe1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER • FEDERAL EXCISE TAX EXEMPT 100499 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP 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. DESCRIPTION 6/8/2017 00352600 Project 17-ENG-01;Contract Date 06.21.17 ALT&WITZIG ENGINEERING,INC City Engineering's Office VENDOR 4105 W 99TH ST SHIP 1 Civic Square TO Carmel,IN 46032- CARMEL, IN 46032- Kate Lustig PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 16093 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 2200 Fund: 0 COIT Bond Fund Account: 94-650.04 1 Each On-Call Environmental Services-Midtown on the Monon/lst $32,750.00 $32,750.00 Ave SW/Veteran's Way Sub Total $32,750.00 ",:itci,—''''e'e''''.'"'———%st 0 F C:'''''''Ail illeitvN N k‘,,, 7 00 *E i1 k .w.°y J. -Its a Send Invoice To: „;., R ' Skip Tennancour 1 �: American Structurepoint,Inc. `k 8425 Wicklow Way v. '' i; Brownsburg, IN 46112 2016 COIT Bond * :ti .. .: , PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT 1 PROJECT ACCOUNT r - AMOUNT J PAYMENT $32,750.00 SHIPPING INSTRUCTIONS 'NP 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 , cEEE `----7 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY --- Jeremy Kashman Douglas Haney TITLE Director Corporation Counsel CONTROL NO. 1 00499 CLERK-TREASURER