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HomeMy WebLinkAboutIndianapolis Signworks, Inc/Eng/28,250/Reading Benches and UK Style Phone Booth LibraryIndianapolis Signworks, Inc. Engineering Department - 2017 Q�OVO Appropriation # 2016 COIT Bond Fund, P.O. #: 100728 �Q� Contract Not To Exceed $28,250.00 J,A 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 Indianapolis Signworks, Inc., an entity duly authorized to do business in the State of Indiana ("Vendor"). TERMS AND CONDITIONS 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 COIT Bond Fund 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 Vendor shall perform only those Services specifically detailed in the Notice. If the Vendor 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 Eight Thousand Two Hundred Fifty Dollars ($28,250.00) (the "Estimate"). Vendor shall submit an invoice to City no more than once every thirty (30) days detailing the Goods and Services provided to City within such time period. City shall pay Vendor for such Goods and Services within thirty-five (35) 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, 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. jSAConvaass\PmfSvcs & Goods Svcs\Engowering12017Undlanapolis Signworks, 1— Goods and SmicaAm 9/22/2017 10:59 AMS Indianapolis Signworks, Inc. Engineering Department - 2017 Appropriation # 2016 COIT Bond Fund, P.O. #: 100728 Contract Not To Exceed $28,250.00 5. TIME AND PERFORMANCE: This Agreement shall become effective as of the last date on which a party hereto executes same ("Effective Date"), and both parties shall thereafter perform their obligations hereunder in a timely manner, Time is of the essence of this Agreement. 6. DISCLOSURE AND WARNINGS: If requested by City, Vendor shall promptly furnish to City, in such form and detail as City may direct, a list of all chemicals, materials, substances and items used in or during the provision of the Goods and Services provided hereunder, including the quantity, quality and concentration thereof and any other information relating thereto. At the time of the delivery of the Goods and Services provided hereunder, Vendor agrees to furnish to City sufficient written warning and notice (including appropriate labels on containers and packing) of any hazardous material utilized in or that is a part of the Goods and Services. 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. 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. JSAConuacls\Pmf.Svcs & Goods Svcs\EnguWcnngk2017U dianapohs Sigovrodcs, Inc. Goods and Servi—doc:9/22/2017 10:59 AMS Indianapolis Signworks, Inc. Engineering Department - 2017 Appropriation # 2016 COIT Bond Fund, P.O. #: 100728 Contract Not To Exceed $28,250.00 10. GOVERNMENT COMPLIANCE: Vendor agrees to comply with all federal, state and local laws, executive orders, rules, regulations and codes which may be applicable to Vendor's performance of its obligations under this Agreement, and all relevant provisions thereof are incorporated herein by this reference. Vendor agrees to indemnify and hold harmless City from any loss, damage and/or liability resulting from any such violation of such laws, orders, rules, regulations and codes. This indemnification obligation shall survive the termination of this Agreement. 11. NONDISCRIMINATION: Vendor represents and warrants that it and all of its officers, employees, agents, contractors and subcontractors shall comply with all laws of the United States, the State of Indiana and City prohibiting discrimination against any employee, applicant for employment or other person in the provision of any Goods and Services provided by this Agreement with respect to their hire, tenure, terms, conditions and privileges of employment and any other matter related to their employment or subcontracting, because of race, religion, color, sex, handicap, national origin, ancestry, age, disabled veteran status and/or Vietnam era veteran status. 12. E -VERIFY: Pursuant to I.C. § 22-5-1.7 et seq., as the same may be amended from time to time, and as is incorporated herein by this reference (the "Indiana E -Verify Law"), Vendor is required to enroll in and verify the work eligibility status of its newly -hired employees using the E -Verify program, and to execute the Affidavit attached herein as Exhibit D, affirming that it is enrolled and participating in the E -verify program and does not knowingly employ unauthorized aliens. In support of the Affidavit, Vendor shall provide the City with documentation indicating that it has enrolled and is participating in the E -Verify program. Should Vendor subcontract for the performance of any work under and pursuant to this Agreement, it shall fully comply with the Indiana E -Verify Law as regards each such subcontractor. Should the Vendor or any subcontractor violate the Indiana E -Verify law, the City may require a cure of such violation and thereafter, if no timely cure is performed, terminate this Agreement in accordance with either the provisions hereof or those set forth in the Indiana E -Verify Law. The requirements of this paragraph shall not apply should the E - Verify program cease to exist. 13. NO IMPLIED WAIVER: The failure of either party to require performance by the other of any provision of this Agreement shall not affect the right of such party to require such performance at any time thereafter, nor shall the waiver by any party of a breach of any provision of this Agreement constitute a waiver of any succeeding breach of the same or any other provision hereof. 14. NON -ASSIGNMENT: Vendor shall not assign or pledge this Agreement, whether as collateral for a loan or otherwise, and shall not delegate its obligations under this Agreement without City's prior written consent. 15. RELATIONSHIP OF PARTIES: The relationship of the parties hereto shall be as provided for in this Agreement, and neither Vendor nor any of its officers, employees, contractors, subcontractors and agents are employees of City. The contract price set forth herein shall be the full and maximum compensation and monies required of City to be paid to Vendor under or pursuant to this Agreement jSACoovacls\Prof.SvcsR Goods Svcs\Engi= ingl201Tlndianapolis Signworks. Inc. Goods and Scni—dac:9/22/2017 10:58 AMS Indianapolis Signworks, Inc. Engineering Department - 2017 Appropriation # 2016 COIT Bond Fund, P.O. #: 100728 Contract Not To Exceed $28,250.00 16. GOVERNING LAW; LAWSUITS: This Agreement is to be construed in accordance with and governed by the laws of the State of Indiana, except for its conflict of laws provisions. The parties agree that, in the event a lawsuit is filed hereunder, they waive their right to a jury trial, agree to file any such lawsuit in an appropriate court in Hamilton County, Indiana only, and agree that such court is the appropriate venue for and has jurisdiction over same. 17. SEVERABILITY: If any term of this Agreement is invalid or unenforceable under any statute, regulation, ordinance, executive order or other rule of law, such term shall be deemed reformed or deleted, but only to the extent necessary to comply with same, and the remaining provisions of this Agreement shall remain in full force and effect. 18. NOTICE: Any notice provided for in this Agreement will be sufficient if it is in writing and is delivered by postage prepaid U.S. certified mail, return receipt requested, to the party to be notified at the address specified herein: If to City: City of Carmel One Civic Square Carmel, Indiana 46032 If to Vendor: Indianapolis Signworks, Inc. 5349 West 86th Street Indianapolis, IN 46268 ATTENTION: Brittany Patterson AND Douglas C. Haney, Corporation Counsel Department of Law One Civic Square Carmel, Indiana 46032 Notwithstanding the above, notice of termination under paragraph 19 hereinbelow shall be effective if given orally, as long as written notice is then provided as set forth hereinabove within five (5) business days from the date of such oral notice. 19. TERMINATION: 19.1 Notwithstanding anything to the contrary contained in this Agreement, City may, upon notice to Vendor, immediately terminate this Agreement for cause, in the event of a default hereunder by Vendor and/or if sufficient funds are not appropriated or encumbered to pay for the Goods and Services to be provided hereunder. In the event of such termination, Vendor shall be entitled to receive only payment for the undisputed invoice amount representing conforming Goods and Services delivered as of the date of termination, except that such payment amount shall not exceed the Estimate amount in effect at the time of termination, unless the parties have previously agreed in writing to a greater amount. 19.2 City may terminate this Agreement at any time upon thirty (30) days prior notice to Vendor. In the event of such termination, Vendor shall be entitled to receive only payment for the undisputed invoice amount of conforming Goods and Services delivered as of the date of termination, except that such payment amount shall not exceed the Estimate amount in effect at the time of termination, unless the parties have previously agreed in writing to a greater amount. 19.3 The City may terminate this Agreement pursuant to Paragraph 11 hereof, as appropriate. (SACon=U\Prof.Svcs & Goods Svcs\Enginttnng12017Vndimpohs Sig—rks. Inc. Goods and S—icns.doc:9/22/2017 10:58 AMI 4 Indianapolis Signworks, Inc. Engineering Department - 2017 Appropriation # 2016 COIT Bond Fund, P.O. #: 100728 Contract Not To Exceed $28,250.00 20. REPRESENTATIONS AND WARRANTIES The parties represent and warrant that they are authorized to enter into this Agreement and that the persons executing this Agreement have the authority to bind the party which they represent. 21. ADDITIONAL GOODS AND SERVICES Vendor understands and agrees that City may, from time to time, request Vendor to provide additional goods and services to City. When City desires additional goods and services from Vendor, the City shall notify Vendor of such additional goods and services desired, as well as the time frame in which same are to be provided. Only after City has approved Vendor's time and cost estimate for the provision of such additional goods and services, has encumbered sufficient monies to pay for same, and has authorized Vendor, in writing, to provide such additional goods and services, shall such goods and services be provided by Vendor to City. A copy of the City's authorization documents for the purchase of additional goods and services shall be numbered and attached hereto in the order in which they are approved by City. 22. TERM Unless otherwise terminated in accordance with the termination provisions set forth in Paragraph 19 hereinabove, this Agreement shall be in effect from the Effective Date through December 31, 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. 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. IC 5-16-13. The provisions of IC 5-16-13 are hereby incorporated into this Agreement by reference. 29. 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. IS..\Contmas\Pro(Sva & Goods Svcs\EnAnxnng\2017dndianapohs Sign—ks. Inc. Goods and Smices.dac:9/22/2017 10:58 AMS Indianapolis Signworks, Inc. Engineering Department - 2017 Appropriation # 2016 COIT Bond Fund, P.O. 4: 100728 Contract Not To Exceed $28,250.00 This Agreement may only be modified by written amendment executed by both parties hereto, or their successors in interest. 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: o�-�� & f� V James Brainard, Presiding Officer Ann Date: Lori S.atson ' embe I Date: / O 7y / / 7 IX:Y..,xaeYt..f ti.ca s ru�wl. 1.csU np.mrn.pL�� l i J�elwul,Jr, vpnw.rA: hw 4 �,h ..I%.Tr —a. �:4.•_017 W 1! AAI) 6 Indianapolis Signworks, Inc. By: AuthorizeS nature '6 � V CA N?MAt� Printed Name mus m> tZT C . � Title FID/TIN: 35 — 20 21 S -3f 9 Last Four of SSN if Sole Proprietor: Date: 9 12 -:� < Indianapolis Signworks, Inc. 5349 West 86th Street, Indianapolis, Indiana, 46268 Quote 2224 Phone Booth/Reading Benches ORDERED BY City of Carmel # ITEM SHIPPING ADDRESS City of Carmel SALES REP INFO QUOTE DATE Steve Gruca 09/13/2017 Project Manager QUOTE EXPIRY DATE sgruca@indianapolissignworks.com 10/13/2017 317408-4962 TERMS 50/50 1 UK Style Phone Booth UK Style Phone Booth Fabricated as a book share. Painted one standard color red to match. The fabrication is one off and will be completed per to be developed shop drawings. 2 Reading Bench - Fabrication and Installation Approximately 3' H x 5'W x TD, Aluminum structure, Graphics to be produced on the various facades of each book will be produced by an artist and painted on the structure. Pricing for Budgeting Purposes, final pricing based on final designs and specifications. Installation subject to site conditions and final location information. 3 Installation & Delivery Installation of Phone Booth and Reading Benches onto client supplied level concrete pad using standard concrete anchors, electrical by others. Installation location must be accessible by truck and access available for a 30' crane as well. Installation to be done during normal business hours. Any need for traffic management during delivery to be provided by city. City will acquire permission from neighboring parking for delivery if needed. Any changes in planned scope, including but not limited to, equipment usage, site conditions, site preparations, or traffic management plans, will be considered a scope change. PAYMENT METHOD CONTACT INFO Kate Lustig klustig@carmel.in.gov QTY UOM UNIT PRICE TOTAL (EXCL. TAX) 1.0 Unit $10,750.00 $10,750.00 2.0 Unit $6,500.00 $13,000.00 1.0 Unit $4,500.00 $4,500.00 'EXHIBIT - L / 0lr PRINTED ON 2017-09-21 16:17:14 -0400 BY SG CREATED BY SG 1/2 QUOTE 2224, CITY OF CARMEL, 09/13/2017 Please make all checks payable to: S/gnworks. This Proposal may be withdrawn if not accepted within 30 days. By signing, Client accepts the Proposal for the Project and agrees Setup: $0 to these terms and any addendums, exhibits, and attachments. There is a required deposit as specified and the balance is due in full on the day of installation unless prior and mutually agreed arrangements were made, in writing. In either case, interest will Shipping: $0 incur 1.75% per month beginning on the installation date. All products, services, signs, artwork, concepts, and sketches remain the exclusive property of Signworks, Inc. until purchased. The Client acknowledges that the Design Work and other documents prepared Subtotal: $28,250.00 by the Company for this Project are instruments of professional services for use solely with respect to this Project and, unless otherwise provided, the Company shall be deemed the author of these documents and shall retain all common law, statutory, and Sales Tax (0%): $0 other reserved rights, including the copyright Any additional uses will require separate pricing. The Company will grant the Client a limited license to use the documents for completion of the current Project and for information and reference in connection with the Total: $28,250.00 Client's use and occupancy of the completed Project. The Company's Design Work and other documents shall not be used by the Client, or others on other projects or for additions to this Project, except by agreement in writing with the Company. The rights granted to Client are for usage of the Final Works in their original form only. Client may not crop, distort, manipulate, reconfigure, mimic, animate, edit, extract portions, intentionally alter the color of the Final Works, or otherwise create derivative works based on the Final Works. Upon completion of the Services, and expressly conditioned upon full payment of all fees and costs due, the Company grants to Client limited usage rights in the Final Works as set forth above. The Company retains all proprietary rights, including property ownership, intellectual property rights and Copyrights, in and to all Preliminary Works and Working Files, and Client shall return all Preliminary Works and Working Files in Client's possession upon request. The Company retains property ownership in any original artwork comprising Final Works. The Client agrees to pay all costs of collection in the event of default of payment and/or schedule of payments, including reasonable attorney fees and other collection costs. Client agrees to provide any existing art or logo files necessary for the construction of the requested Project and Services. Prices include standard time to manufacture and/or perform the scope of work under normal conditions utilizing standard materials and methods. Actual production time could differ depending on final order quantity, time submitted or other conditions. Please order and/or Schedule as far in advance as possible. A Rush Fee shall be incurred based on Client needs. The Client agrees that the Company shall not be liable for any delays in the delivery of products and services caused by any act outside the direct control of the Company including but not limited to; acts of God; adverse weather conditions, fire, tornado, wind, rain, strikes, lockouts and other labor difficulties; government controls, procedures or requirements; acts of suppliers of material or labor; acts or defaults of developers; acts or defaults of the Client. Such delays shall not serve as cause to cancel, amend or diminish any of the requirements of the Client under the terms of this Proposal. The Company does not guarantee a firth completion date and under no circumstances shall the Company be held liable in any manner for such delays or be obligated to provide or compensate the Client for said delays. The Client is responsible for any contingent signage arrangements, payments and storage space that may be needed as a result of any delays. Pricing is based on the Entire Combined Scope presented and are quantity dependent. Set up charges, if applicable, unless specified, are not included. Client requests for additional services such as storage, removal, proofs, plotting, engineering, wind load calculations, design, revisions, overnight shipping, and/or powder coating, will be billed depending on the Scope of Work. Any changes made during the shop drawing, submittal, or engineering phase may result in additional charges. Client will be billed on a time and material basis for any changes in scope. This includes the project not being ready when our team members are scheduled to be on site. Additional Reimbursable Travel Charges will be incurred if there are additional client requested, client required, and/or unplanned or irregular trips due to circumstances beyond our control. In the event that we are contracted to install sign products, and undisclosed, unknown, unforeseen, or unusual digging and/or mounting, installing, fastening, or hanging conditions are encountered, this contract is binding; however, an additional cost based on labor and materials, may be added to the above cost estimate. Sign and/or Graphic removal is considered a change in scope unless specifically itemized and provided. Client acknowledges and understands that any amount on this quotation for Permits and for Sales, Use or Privilege Taxes is merely an estimate and is subject to change at any time without notice. Sales, Use and Privilege Taxes will be calculated and charged based on the sale, installation, and delivery of the goods and services as determined by any applicable governing authorities or jurisdiction. Client accepts responsibility for and shall pay all Sales, Use, Privilege or other Third Party expenses, imposed on, in connection with, or measured by the transaction contemplated by this quotation in addition to the prices set forth on this document. Permit acquisitions, fines or fees attributable or applicable to this job are not included, nor are estimates guaranteed, and remain the responsibility of the Client. Client acknowledges and understands that all Products and Services provided are sold subject to the terms of the Express Limited Warranty Agreement, no other warranty or guarantee express or implied is applicable. We will provide a Certificate of Insurance upon request. The Company shall have the right to document, photograph or otherwise record all completed designs or installations of the Work, and to reproduce, publish and display such documentation, photographs, or records for promotional purposes, recognition of creative excellence or professional advancement, and to be credited with authorship of the Deliverables in connection with such uses. We price each project based upon acceptance of our standard terms and contract, if you submit your own contract to us we will review to make a determination of acceptance, however there may be a price increase. „ Downpayment (50.0 %) $14,125.00 "EXHIBIT SIGNATURE. 2of3 DATE: PRINTED ON 2017-09-21 16:17:14.0400 BY SG CREATED BY SG 212 r rr •y{ �/• pt jt+moi; '�' .! ,Yll'•' -, _91Y's� 1 .. iy�lj• ^ . ` t,t •''�-• ' "•'P ` R ti,%s` �, iG * ray. r r r y� .1, 1. I' .j,[1W0\,I r . Viii a'S`•,1 .!• 'K t� +a' AsIR;:!i►>rll ,, 1K°. h �i•� .•aA'. Y' ' L \: y1' .,. y�,� ,.t ,.1• *lir s 1;w .. , UL ..i I, �i ,r. �, x; ;r. • ..��rL. Y ,t F �f1A � � l 'Eqp � � , r•ti r i V11. "i .r.+�.� SIGNWORD All artwork ons uteri l r simil rhes with ut property of Slgnworke, Inc. umll purchased, Any ws of this motorial or slmllmllles without the aulhonistfOn o161gnworks, Ir1a, i9 forbkden. COPYRIGHT Slgnworke 2017 • Images and concepts will be billable artwork 11 used without authorization. Ypct�Sigwvorks atn Renderings are conceptual any. Not to scala. 317'8728722 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: Property damage, contractual liability, products -completed operations: General Aggregate Limit (other than Products/Completed Operations): Products/Completed Operations: Personal & Advertising Injury Policy Limit: Each Occurrence Limit: Fire Damage (any one fire): Medical Expense Limit (any one person): Statutory Limits $100,000 each employee $250,000 each accident $500,000 policy limit $500,000 $500,000 $500,000 $250,000 $250,000 $ 50,000 Comprehensive Auto Liability (owned, hired and non -owned) Bodily Single Limit: Injury and property damage: Policy Limit: Umbrella Excess Liability Each occurrence and aggregate: Maximum deductible: $500,000 each accident $500,000 each accident $500,000 $500,000 $ 10,000 EXHIBIT D AFFIDAVIT Amb 4 (_ft` , being first duly sworn, deposes and says that he/she is familiar with A 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 S,S (the "Employer") in the position of�i 4--Q- r-,�7 - 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 2 `7 day of 4Lrr- - , 20L7. Printed:—U �� 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. - Printed: ��`'���'6 ityINDIANA RETAIL TAX EXEMPT Page 1 of 1CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 100728 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ONINVOICES, AIP CARMEL, INDIANA 46032-2584 VOUCHER DELIVERY MEMO, PACKING SUPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997 I SHIPPING LABELS AND ANY CORRESPONDENCE PURCHASE ORDER DATE I DATE REQUIRED REQUISITION NO. VENDOR NO. 9113/2017 369739 INDIANAPOLIS SIGNWORKS, INC VENDOR 5349 WEST 86TH STREET INDIANAPOLIS, IN 46268 - PURCHASE ID BLANKET CONTRACT 18972 QUANTITY UNIT OF MEASURE DESCRIPTION DESCRIPTION Project 16 -ENG -22; Quote 2224 City Engineering's Office SNIP 1 Civic Square TO Carmel, IN 46032 - Kate Lustig Department: 2200 Fund: 0 COIT Bond Fund Account: 94-650.04 1 Each Reading Benches and UK Style Phone Booth Library for Monon Trail Send Invoice To: Skip Tennancour American Structurepoint, Inc. 8425 Wicklow Way Brownsburg, IN 46112 2016 COIT Bond -N OF A. FREIGHT UNIT PRICE I EXTENSION $28,250.00 $28,250.00 Sub Total $28,250.00 PLEASE INVOICE IN DUPLICATE ACCOUNT _ PROJECT I PROJECT ACCOUNT AMOUNT PAYMENT $28,250.00 SHIPPING INSTRUCTIONS'AIPVOUCHERCANNOT BEAPPROVED FOR PAYMENT UNLESS THEP.O. NUMBERISMADEA PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN 'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBUGATED 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 oo 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945��- AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY — Jeremy Kashman James Crider TITLE Director Administration CONTROL NO 100728 CLERK -TREASURER