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
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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
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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.
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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