HomeMy WebLinkAboutIntegrity Fire Protection, LLC/Fire/1,190/Service AgreementIntegrity Fire Protection, LLC
Fere Department - 2017
Appropriation # 43-501.00; P.O. # 100826
Contract Not To Exceed $1,190.00 QQ�
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 Integrity Fire Protection, LLC 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.
PERFORMANCE:
City agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City
budget appropriation number 43-501.00 funds. Vendor agrees to provide the Goods and Services and to
otherwise perform the requirements of this Agreement by applying at all times the highest technical and
industry standards. Vendor will not perform any of the Services detailed in Exhibit A prior to obtaining a
written Notice to Proceed from the City. Upon receiving a Notice to Proceed, the Vender shall perform only
those Services specifically detailed in the Notice. If the Vender desires clarification of the scope of any
Notice to Proceed, the Vendor shall obtain such clarification from the City in writing, prior to performing the
service set forth in the Notice to Proceed. Any services performed without the City's prior express written
authorization will not be compensated.
3. PRICE AND PAYMENT TERMS:
3.1 Vendor estimates that the total price for the Goods and Services to be provided to City hereunder
shall be no more than One Thousand One Hundred Ninety Dollars ($1,190.00) (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.
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Integrity Fire Protection, LLC
Fire Department - 2017
Appropriation # 43-501.00; P.O. #100826
Contract Not To Exceed $1,190.00
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.
DISCLOSURE AND WARNINGS:
If requested by City, Vendor shall promptly furnish to City, in such form and detail as City may direct, a list of
all chemicals, materials, substances and items used in or during the provision of the Goods and Services
provided hereunder, including the quantity, quality and concentration thereof and any other information
relating thereto. At the time of the delivery of the Goods and Services provided hereunder, Vendor agrees to
furnish to City sufficient written warning and notice (including appropriate labels on containers and packing)
of any hazardous material utilized in or that is a part of the Goods and Services.
7. LIENS:
Vendor shall not cause or permit the filing of any lien on any of City's property. In the event any such lien is
filed and Vendor fails to remove such lien within ten (10) days after the filing thereof, by payment or bonding,
City shall have the right to pay such lien or obtain such bond, all at Vendor's sole cost and expense.
8. DEFAULT:
In the event Vendor: (a) repudiates, breaches or defaults under any of the terms or conditions of this
Agreement, including Vendor's warranties; (b) fails to provide the Goods and Services as specified herein;
(c) fails to make progress so as to endanger timely and proper provision of the Goods and Services and does
not correct such failure or breach within five (5) business days (or such shorter period of time as is
commercially reasonable under the circumstances) after receipt of notice from City specifying such failure or
breach; or (d) becomes insolvent, is placed into receivership, makes a general assignment for the benefit of
creditors or dissolves, each such event constituting an event of default hereunder, City shall have the right to
(1) terminate all or any parts of this Agreement, without liability to Vendor; and (2) exercise all other rights
and remedies available to City at law and/or in equity.
9. INSURANCE AND INDEMNIFICATION:
Vendor shall procure and maintain in full force and effect during the term of this Agreement, with an insurer
licensed to do business in the State of Indiana, such insurance as is necessary for the protection of City and
Vendor from all claims for damages under any workers' compensation, occupational disease and/or
unemployment compensation act; for bodily injuries including, but not limited to, personal injury, sickness,
disease or death of or to any of Vendor's agents, officers, employees, contractors and subcontractors; and,
for any injury to or destruction of property, including, but not limited to, any loss of use resulting therefrom.
The coverage amounts shall be no less than those amounts set forth in attached Exhibit C. Vendor shall
cause its insurers to name City as an additional insured on all such insurance policies, shall promptly provide
City, upon request, with copies of all such policies, and shall provide that such insurance policies shall not be
canceled without thirty (30) days prior notice to City. Vendor shall indemnify and hold harmless City from and
against any and all liabilities, claims, demands or expenses (including, but not limited to, reasonable attorney
fees) for injury, death and/or damages to any person or property arising from or in connection with Vendor's
provision of Goods and Services pursuant to or under this Agreement or Vendor's use of City property.
Vendor further agrees to indemnify, defend and hold harmless City and its officers, officials, agents and
employees from all claims and suits of whatever type, including, but not limited to, all court costs, attorney
fees, and other expenses, caused by any act or omission of Vendor and/or of any of Vendor's agents,
officers, employees, contractors or subcontractors in the performance of this Agreement. These
indemnification obligations shall survive the termination of this Agreement.
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Integrity Fire Protection, LLC
Fire Department - 2017,
Appropriation # 43-501.00; P.O. #100826
Contract Not To Exceed $1,190.00
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
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Integrity Fire Protection, LLC
Fire Department - 2017
Appropriation # 43-501.00; P.O. #100826
Contract Not To Exceed $1,190.00
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
Fire Department
Two Civic Square
Carmel, IN 46032
If to Vendor: Integrity Fire Protection, LLC
11722 Allisonville Road
Suite 103-317
Fishers, IN 46038
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.
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Integrity Fire Protection, LLC:
,Fire Department - 2017
Appropriation # 43-501.00; P.O. # 100826
Contract Not To Exceed $1,190.00
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. ENTIRE AGREEMENT:
This Agreement, together with any exhibits attached hereto or referenced herein, constitutes the entire
agreement between Vendor and City with respect to the subject matter hereof, and supersedes all prior oral
or written representations and agreements regarding same. Notwithstanding any other term or condition set
forth herein, but subject to paragraph 16 hereof, to the extent any term or condition contained in any exhibit
attached to this Agreement or in any document referenced herein conflicts with any term or condition
contained in this Agreement, the term or condition contained in this Agreement shall govern and prevail.
This Agreement may only be modified by written amendment executed by both parties hereto, or their
successors in interest.
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Integrity Fire Protection. LLC
Fire Department - 2017
Appropriation #s 43-50L(N): P.O. itI00826
Contract Not To Exceed $1.190.00
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
By:
/z
James Brainard, Presiding Officer
Date: //- / — 7- A
Mary Ann�urke, M�
Date: _
Lon S.also , ember
Date: I
ATT
Christine S. autgy, perk -Tr rer
Date: i///9�
1♦1...1 t:.J ♦I..V'-1" 0.1 lLMnn 1-.,1-- 111 I:.S W Yl—d. I.r!1•.11' V— V41
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Integrity Fire FintvAing, LLC
By: II
Authorized Signature
1 _ (
fz—
Printed Name
V �(- ( Rest I?ErvZT
Title
FID/TIN: q 1- -5—1 101 y
Last Four of SSN if Sole Proprietor:
Date: 1O =�./ OI
INTEGRHY
FIRE PROTECTION, LLC.
QUALITY • SAFETY - SYNERGY
Service Agreement Proposal
Integrity Fire Protection, LLC
11722 Allisonville Road
Suite 103-317
Fishers, IN 46038
Fire Station 43
Fire Station 44
Fire Training Facility
Carmel Fire Department
2 Civic Square
Carmel, IN 46032
Integrity Fire Protection will provide services as shown below. Terms of this service agreement are contained
within this document.
Fire Sprinkler
Annual (November) — Wet System, Domestic and Fire Backflows, Control Valves, Monitoring Devices
Waterflow Devices, Sprinkler System Walkthrough, Main Drain
Station 43 - $350.00
Station 44 - $490.00
Training Facility - $350.00
Semi -Annual — N/A
Quarterly — N/A
Fire Alarm
N/A
1 of 4
The annual fee for the above listed items is $1,190.00. Equipment and breakdown on page 2.
Customer Initials
11722 Allisonville Road Ste. 103-317, Fishers, IN 46038 p: (317) 361-9770 e: info@intearitvfirellc.com w: intearityfirelic.com
"EXHIBIT
--,A—.
/�y
INTEGRITY
FIRE PROTECTION, LLC
QUALITY • SAFETY • SYNERGY
List of equipment included in this service agreement
Station 43
1 Wet System
1 DC Backflow — Fire Sprinkler
1 RPZ Backflow — Domestic
2 Monitoring Devices
1 Waterflow Device
Visual inspection of common areas throughout facility
Station 44
2 Wet Systems
1 DC Backflow — Fire Sprinkler
1 RPZ Backflow — Domestic
2 Monitoring Devices
1 Waterflow Device
Visual inspection of common areas throughout facility
Station 44
1 Wet Systems
1 DC Backflow — Fire Sprinkler
1 RPZ Backflow — Domestic
2 Monitoring Devices
1 Waterflow Device
Visual inspection of common areas throughout facility
Period of Agreement
The services of this agreement shall begin on the date of acceptance and signing. And shall be in place for a (3)
three-year period.
This service agreement proposal will remain valid for thirty (30) days and is subject for review upon expiration.
Integrity Fire Protection
Name:
Date:
Title:
Signature:
2 of 4
Carmel Fire Department
Owner:
Date:
Title:
Signature:
11722 Allisonville Road Ste. 103-317, Fishers, IN 46038 p: (317) 361-9770 e: info@intearityfirellc.com w: inteRi0firelic.corn
8EXH8rr
20R
INTEGRnY
FIRE PROTECTION, LLC
QUALITY • SAFETY • SYNERGY
Service Agreement Terms and Conditions
1. This proposal includes and is limited to the inspection and testing of the existing fire protection
equipment. This proposal does not include any maintenance, deficiency work, repairs, or system
alterations.
2. Integrity Fire Protection, LLC will record and complete a detailed report based on findings and
observations of the inspection. Any deficiencies, maintenance, or repairs that are found during the
inspection will be included in the detailed report to the owner. Any and all corrective actions and
replacement parts will be addressed outside of this proposal.
3. Any additional equipment that is found on premise is not included in this proposal and subject to review.
A new proposal and agreement will be created to include additional devices.
4. Owner must provide any and all equipment (lift, PPE, etc.) necessary beyond a 12' ladder to allow
Integrity Fire Protection to complete service and inspection. If additional equipment is necessary owner
must communicate with Integrity Fire Protection (in writing) 48 hours in advance and agree to cover any
and all costs associated with rentals. If Integrity Fire Protection cannot complete work associated with
this agreement due to lack of equipment, owner agrees to cover additional hourly fees.
5. Integrity Fire Protection will communicate with building owner for day(s) of inspection. If Integrity Fire
Protection cannot gain access to the premises, all devices, or specific areas for an unreasonable amount
of time, the owner shall be responsible to cover additional hourly fees.
6. Integrity Fire Protection shall not be held liable for any personal injury or property damage directly
associated with correct inspection and testing actions. Inspections and testing require draining, flushing,
electrical signals, etc. Integrity Fire Protection cannot verify the integrity of existing systems. The owner
agrees to pay for any labor or material associated with damages resulting from proper inspections and
system testing.
7. The system(s) owner understands and agrees that maintenance is dictated by NFPA 25.
8. Payment is due in full within 10 days of receiving invoice. Integrity Fire Protection may assess an interest
charge of one half percent (1.5%) per month that the owner does not submit payment.
9. Building owner has the complete power and authority to enter into this Agreement and that this
Agreement constitutes a valid and legally binding agreement enforceable against Contractor.
3 of 4
Customer Initials
11722 Allisonville Road Ste. 103-317, Fishers, IN 46038 p: (317) 361-9770 e: info@intearityfirellc.com w: inteRritvfirelic.com
.EXHIBIT
� y
INTEGRnY
FIRE PROTECTION, LLC
QUALITY • SAFETY • SYNERGY
10. Building owner has the complete power and authority to enter into this Agreement and that this
Agreement constitutes a valid and legally binding agreement enforceable against Contractor.
11. This agreement may be terminated by either party upon written notice if owner or Integrity Fire
Protection defaults on its obligation under this agreement.
12. This Agreement shall be governed by and interpreted according to the laws of the State of IN, applicable
to agreements to be wholly performed therein, with jurisdiction exclusive to the Federal and State
courts located in IN, and the parties hereto irrevocably consent to the jurisdiction of such courts.
13. This Agreement may not be assigned or transferred by either party without the express written consent
of the other party which consent may be withheld in the discretion of the consenting party. Subject to
the foregoing, this Agreement shall be binding upon and ensure to the benefit of the parties and their
respective heirs, administrators, executors, successors and permitted assigns. Nothing herein, express
or implied, is intended to confer upon any person, other than the parties and their respective heirs,
administrators, executors, successors and permitted assigns, any rights, remedies, obligations or
liabilities under or by reason of this Agreement.
14. This Agreement constitutes the entire agreement between the parties and supersedes all prior
agreements, representations, warranties, statements, promises, information, arrangements and
understandings, whether oral or written, express or implied, with respect to the subject matter hereof.
The parties further acknowledge and agree that, in entering into this Agreement, they have not in any
way relied, and will not in any way rely upon any oral or written agreements, representations,
warranties, statements, promises, information, arrangements or understandings, express or implied, not
specifically set forth in this Agreement or in such schedules, documents or instruments.
15. Each provision of this Agreement is intended to be severable. If any provision hereof is illegal or invalid,
such illegality or invalidity shall not affect the validity of the remainder hereof.
4of4
Customer Initials
11722 Allisonville Road Ste. 103-317, Fishers, IN 46038 p: (317) 361-9770 e: info@integrityfirellc.com w: i to rit firellc.com
"EXHIBIT 10
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
it 1C.11 r -J AA'� %-.-,+f-r-- . being first duly sworn, deposes and says that
he/she is familiar with and has personal knowledge of the facts herein and, if called as a witness in this
matter, could testify as follows:
I am over eighteen (18) years of age and am competent to testify to the facts contained
herein.
2. 1 am now and at all times relevant herein have been employed by
_t r, mV- C,Z-i-r i TPV-&i-gLTIo tJ (the "Employer')
in the position of rVk6;e-iy&-WT
I am familiar with the employment policies, practices, and procedures of the Employer and
have the authority to act on behalf of the Employer.
d. 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.
The Company does not knowingly employ any unauthorized aliens.
FURTHER AFFIANT SAYETH NOT.
EXECUTED on the 27 =ciao• of _ (�G-r��E � 20 1 -1.
Printed:A ts-nr-4 1JA'`4n�-r`
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:
INDIANA RETAIL TAX EXEMPT Page 1 Of 1
i
Cityof Carmel - - PURCHASE CFEDERAL EXCISE TAXEXEMPT
PURCHAISEoOoRQDER� UMBER
ONE CIVIC SQUARE 35-6000972 _ THIS NUMBER MUST APPEAR ON INVOICES, A/P
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 I DATE REQUIRED li REQUISITION NO.
10/19/2017
INTEGRITY FIRE PROTECTION, LLC
VENDOR 11722 ALLISONVILLE ROAD
SUITE 103-317
FISHERS, IN 46038 -
PURCHASE ID 1 BLANKET CONTRACT
19977 ---_ --
QUANTITY UNIT OF MEASURE I
Department: 1120 Fund: 101 General Fund
Account: 43-501.00
VENDOR NO. DESCRIPTION
372005 Annual PM of Fire Sprinklers
Fire Department
SHIP 2 Civic Square
TO Carmel, IN 46032-
PAYMENTTERMS
6i -SCP PION
1
Each
Annual Inspection of West System, Backflows, Control
Valves, Monitoring Devices, Waterflow Devices
1
Each
Sprinkler System Walkthrough, Main Drains
1
Each
Station 43
1
Each
Station 44
1
Each
Training Facility
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032 -
CAA
PLEASE INVOICE IN DUPLICATE
FREIGHT
UNii PRICE EXl PNSION
$0.00 $0.00
$0.00
$350.00
$490.00
$350.00
Sub Total
$0.00
$350.00
$490.00
$350.00
$1,190.00
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $1,190.00
SHIPPING INSTRUCTIONS A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER ISMADE 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
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY - - --- - -- - --- - - - --- --
Denise Snyder
TITLE Budget & Accreditation Manager
CONTROL NO. 100826 CLERK -TREASURER