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Home My WebLink AboutTriCo Utility Reimbursement Agreement Obvd UTILITY REIMBURSEMENT AGREEMENT 96TH AND KEYSTONE PARKWAY ROAD IMPROVEMENTS NORTHWEST RAMP GRAVITY SEWER AND FORCEMAIN RELOCATION CITY OF CARMEL PROJECTO NNO. I 6-ENG-05 THIS AGREEMENT,made and entered into this ./ dayk 0 't , b$ y and between Clay Township Regional Waste District(hereinafter referred to as the 'Utility"),and the City of Carmel, by and through its Board of Public Works and Safety, (hereinafter referred to as the"City of Carmel"). WITNESSETH: WHEREAS, the City of Carmel desires to improve and/or maintain the condition of the above- referenced road and has determined the construction designated by the above project number (hereinafter referred to as the "Project") is necessary for the improvement and/or maintenance of the roadway; WHEREAS, the City of Carmel will advertise for bids for construction of the project, award the contract,supervise the construction of the Project; WHEREAS, the Project will require that certain adjustments, removals, alterations, and/or relocations of the existing facilities of the Utility will have to be made as shown on the plan marked Exhibit "A", which is attached hereto and incorporated by this reference; WHEREAS, it is in the interests of the Utility and the City of Carmel for the Utility to make the necessary adjustments, removals, alterations, and/or relocations of its existing facilities as shown on Exhibit "A" with the Utility's regular construction and maintenance forces, or by a contractor paid under a contract let by the Utility. NOW,THEREFORE, IN CONSIDERATION OF THE PREMISES AND THE MUTUAL AGREEMENTS AND COVENANT HEREIN CONTAINED (THE ADEQUACY OF WHICH CONSIDERATION AS TO EACH OF THE PARTIES TO THIS AGREEMENT IS HEREBY MUTUALLY ACKNOWLEDGED), AND OTHER GOOD AND VALUABLE CONSIDERATION, THE RECEIPT OF WHICH IS HEREBY ACKNOWLEDGED AND INTENDING TO BE LEGALLY BOUND, THE PARTIES HEREBY COVENANT AND AGREE AS FOLLOWS: SECTION I-DESCRIPTION OF WORK AND ITEMIZED COST ESTIMATE The Utility shall make the necessary adjustments, removals,alterations, and/or relocations to its existing facilities. The preliminary itemized cost estimate for this project is set forth in attached Exhibit "B", incorporated by reference. Exhibit"B" shall include an itemized estimate of all anticipated costs, including, but not limited to, materials, labor, equipment costs, preliminary and construction engineering costs, administrative costs, eligible property costs, and or contracted services. Each item shall be shown as a "per unit" cost. Professional services cannot be listed as a percentage of the total cost. City of Carmel must acquire right of way from the same property owners from which Utility must acquire easements. Utility's easements are necessary for Utility to complete the reimbursable portion of its relocation work,making all incurred costs necessary to acquire easements reimbursable by City of Carmel. Therefore,to improve efficiency of the project in terms of cost and time,the City of Carmel shall acquire easements on behalf of Utility as shown on Exhibit C. Easement documents shall be prepared by Utility and set forth in attached Exhibit"C". SECTION II-WORK COMMENCEMENT City of Carmel shall notify Utility in writing once it has secured all right of way and easements necessary for Utility's work. Utility shall then promptly commence with public bidding of its work.Utility will provide bid results to City of Carmel for review. The Utility shall not start work on the adjustments, removals,alterations,and/or relocations covered by this Agreement until written authorization has been given to the Utility by the City of Carmel. SECTION III—REIMBURSEMENT 33 % of the cost to design and prepare construction plans, specifications and preliminary itemized cost estimate for relocation of the Utility's facilities shall be borne by the City of Carmel. 33%of the cost to provide testing and inspection services for relocation of the Utility's facilities shall be borne by the City of Carmel. The estimated cost of relocation work, excluding professional services, easement acquisition, testing and inspection, is$223,400.The estimated cost of reimbursable relocation work is$75,850 and the estimated cost of non-reimbursable relocation work is$147,550, See Exhibit"Jr for an itemized estimate of all anticipated costs, including but not limited to, materials, labor, and equipment costs. The cost of relocation of the Utility's facilities shall equal the amount paid to the contractor based upon the actual units of work performed at the unit prices set out in the contractor's itemized proposal or in change orders. SECTION IV - MATERIAL ALTERATIONS DUE TO CHANGED AND UNFORESEEN CIRCUMSTANCES The Utility shall modify its facilities in accordance with the plans, specifications, and estimates shown in Exhibits"A"and`B". No work shall be performed by the Utility beyond the scope contemplated by Exhibits"A"and`B"without prior written authorization by the City of Carmel. In the event there are changes in the scope of work, extra work, or major change in the planned work covered by the approved agreement, plans, and estimate, the Utility shall inform the City of Carmel as soon as practical upon discovery. The Utility shall also notify the City of Carmel of any material alterations due to unforeseen circumstances as soon as practical upon discovery. Such notification shall consist of a letter, telephone call,or other electronic communication confirmed by letter to the address of the City of Cannel listed on page I of this Agreement. Notification shall include sufficient information to indicate the nature of the changed or unforeseen circumstances, the location of the changed or unforeseen circumstances, and the impact of the changed or unforeseen circumstances upon the Utility's relocation efforts, cost of the relocation, the time necessary to complete the relocation and the extent of relocation. SECTION V-STANDARD PAYMENT METHOD/PROGRESS BILLING The Utility may, once the Utility has accumulated $1,000 of expenses, submit one request for payment per calendar month for work covered by this Agreement. The Utility shall attach an itemization of costs incurred with each request for payment. This itemization of costs shall appear in the same form and manner as the preliminary estimate as shown on Exhibit"B". The City of Carmel will reimburse the Utility for any item of worth of expense involved if performed at the written direction of the City of Carmel. The Utility will be reimbursed for its actual costs of the work described in Exhibit "A" upon presentation of itemized bills to the City of Carmel from the Utility. Progress payments made by the City of Cannel to the Utility shall not exceed 97 percent of the estimated cost of the completed work. Reimbursement for progress billings shall be paid within 60 days of receipt. Partial payment shall not abrogate the City of Carmel's or the State's right to dispute in good faith the Utility's claim for compensation. Such good faith disputes shall be resolved upon presentation of the Utility's final request for payment and the resolution of any audit performed in accordance with Section IX of this Agreement. SECTION VI—LUMP-SUM PAYMENT METHOD The Utility may elect to petition the City of Carmel for payment of its expenses by lump sum. Such petition shall include Exhibits "A" and `B"along with a detailed explanation requesting payment by lump sum and showing how all individuals will be best served by this payment method. The City of Carmel may make payment to the Utility by lump sum if the total cost for the adjustments, removals, alterations, and/or relocations do not exceed $25,000. Lump-sum payments in excess of $25,000 will be made only if in the best interests of the public. If a lump-sum payment is approved, the Utility shall submit one request for payment no later than 90 days after the work is completed. No amount in excess of the agreed amount in Exhibit `B"shall be reimbursed. SECTION VII-FINAL BILL The Utility shall present its final itemized bill accompanied by an itemized cumulative invoice within 90 days of completion of its work. All documents required to substantiate any claims for payment shall be submitted with this final itemized bill. Such supporting documentation shall include, but shall not be limited to, copies of material invoices, time sheets, vendor and/or contractor invoices, and other such documents as may be deemed by the State to support such invoice. Upon receipt of a final bill,the Utility shall be reimbursed for such items of project work, expense, and retainage within 90 days after the resolution and issuance of any audit performed in accordance with Section IX. SECTION VIII-RECORDS The Utility accounts and the accounts and records of any contractor or subcontractor involved in carrying out the proposed work shall be kept in such manner that they may be readily audited and actual costs determined, and such accounts shall be available for audit by auditors of the the City of Carmel for a period of not less than three years from the date final payment has been received by the Utility. SECTION IX-DISCRIMINATION Pursuant to IC 22-9-1-10, the Utility, its Contractor and subcontractors, if any, shall not discriminate against any employee or applicant for employment, to be employed in the performance of this contract, with respect to hire, tenure, terms, conditions or privileges of employment, or any matter directly or indirectly related to employment, because of race, color, religion, sex, disability, national origin, or ancestry. Breach of this covenant may be regarded as a material breach of contract. SECTION X-GENERAL LIABILITY PROVISIONS The Utility for itself, its employees, agents, and representatives, shall indemnify, protect,and save harmless the City of Carmel from and against any and all legal liabilities and other expenses,claims,costs, losses, suits or judgments for damages, or injuries to or death of persons or damage to or destruction of property (hereafter "Claim"), arising out of intentional tortuous acts or whether due in whole or in part to the negligent acts or omissions of the Utility, its employees or agents or contractors, in relation to or in connection with any work performed or to be performed pursuant to this Agreement, provided, however, where City of Carmel has been found liable by a court, tribunal, or governing body entitled to make such a determination for intentional tortious acts and/or negligence with respect to the occurrence or occurrences giving rise to the Claim, the Utility shall have no duty to indemnity, protect, or save harmless the City of Carmel. SECTION XI-PENALTIES/INTERESTS/ATTORNEY'S FEES The City of Carmel will in good faith perform its required obligations hereunder and does not agree to pay any penalties, liquidated damages, interest.,and/or attorneys fees,except as required by Indiana Law, in part,IC 5-17-5-I et seq. SECTION XII-GOVERNING LAWS This contract shall be construed in accordance with and governed by the laws of the state of Indiana and suit, if any,must be brought in the state of Indiana. SECTION XIII-BINDING UPON SUCCESSORS OR ASSIGNS This Agreement shall be binding upon the parties and their successors and assigns. SECTION XIV-NON COLLUSION AFFIDAVIT The Utility shall execute a Non-Collusion Affidavit, notarized with a seal, which is attached hereto and incorporated by reference. If the Utility is a governmental entity, the execution of a Non-Collusion Affidavit shall not be required. SECTION XV-DRUG-FREE WORKPLACE (A)The Utility is a public entity and maintains a drug free workplace. Utility's contractors will be required to comply with IC-36-1-12-24. IN WITNESS HEREOF, the parties hereto separately and severally have caused this instrument to be executed in their respective names by and through their duly authorized officers. THE UTILITY: ATT U Tsu ►Ttonal (Utilit Name) (SeeremmthIlt141tS+-Signature) (Signature of fficer) (SaaFetaurp+s Name,Printed or Typed) - g:44..4nfi1/9 IkAirovateir INI•A rem L0a1►c rns (Officer's Name,Printed or Typed) (Officer's Posi ion) ACKNOWLEDGEMENT State of.County of IBC\YYI I. I 1 0 SS Before me,the undersigned Notary Public in and for said County and State, personally appeared Anarekii WI. 1 � D .,--iK1 (Names and offices of sinners of Utility) (Name of Utility) {�� an acknowledged the execution of the foregoing contract on this "1 day of \yIC4 1i/, 20 Witness my hand and seal the said last day. My Commission Expires 10" fit''T d 7n!C; f e�Cti �iU .4.4.4 (Signature) Esefila (Printed Typed)(Notary Public) •' MARGUERITE ANNE CREDIFORD SFAl County of Res:Hamilton My Comm.Expires 10-6-2022 4 r nt4' Comm.No.658943 CITY OF CARMEL, by and through its Board of Public Works and Safety BY: ATT r i (It) (_Y4f gke/L M e idA- (T(T ped or Printed Name) (Typed or Printed Name) Na7a.- f72n / Afu 7 8 wk. iiiAtil at. (Typed or Printed an ) t y-i 5, (A.) -50r) (Typed or Printed Name) ►roc-'-kga, r— ACKNO WLEDGEMENT State of Indiana,County of Q.yW11 NI)r i ,SS Mali#WIJ Zia egr Loki s wTs<7rloo Before me,the undersigned Notary Public in and for said County and State,personally appeared CI4V-461-/Of S liktLCP and acknowledged the execution of the foregoing contract on this day of.G�1-4,0J- ( ,20 t g My Commission Expires dJi( ` ` "i'a-z-V-ielt . _ (Signature) DIANNE WALTHALL 'D/MNNE Rif 47 4L _ Soil (Seal) Notary Public•State of Indiana (Printed or Typed)(Notary Public) Hamilton County My Commission s Mar 16,2024 f r i :J 0 V Q U , V CC I I. r • J COfa I, ' • ,. o Z O W - °�f COw < QzU goo 04 --I Cjw o O w°C o C5 0 § 0 � zW o Q 0 g- -C >- _ ._, cc (00) Q Z F- z - O < F- ci) >-- Q0 z 0 ' .•./1 1,N Fri .‘ il. 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J J 0,l!J Jm - JYu u ? v, J WWW u .O' 0 W W l7J y cc C N ) .c N 3 0 2 'a Q o h o w o > o o a r} p Y O v V J W LA. z v 0 z 0 z a r to w z QH 17: Z O c m 3 E Z Z N w v O Z z W [Y .. w PWm m � � � J > m �n W O W W Q 5 tD Q V c 0 V z W O Z � X W W 0 I-Q 0 to ()) C702w = g C7 J N Q Z Q W W U 0 Li W V) Z to < >- Z F- J W 0 OON >- � z >- Q2 ' ZW a - vv U - � XX � i- D F_ O -) � z0U rJ• - R 22 ¢Q ¢ a 2 ¢ V o u 01 J J u) , wa_ aa.. a0Qvv) Za zZwoO z m w 2 2 2 W a cz ui z J m z z Oo2I- HHFw- amWa0ta- toOU022 to 0 h Op r. th c/ ., h )h 0) .- U) O O 000 O N 00)) 0j 00 0) NC W 00) h 00) 0) e00c�)) .v- N V' U) F O O O O r r- 0 0 00) O CD 00) O v- 0Ni 0 1 O C) 0 0 0 0 0 Ul to to N 0 U) 0 CD CV T N N N N h h ti h h fD t` h t` h h 2 o_ O O 8 0 0 0 tNo to to to o N tNo to to ON O 0 r-I r-I N N N N N N N N N tD h N N n h w O z c-I N r) v U) to N co Q1 ti rh-I • Exhibit fB Exhibit ' DESCRIPTION Part of the West Half of the Southeast Quarter of Section 7, Township 17 North, Range 4 East located in Hamilton County, Indiana described as follows: Commencing at the Southeast Corner of Lighthouse Tabernacle, Inc. recorded as Book 209, Page 98 in the Office of the Hamilton County Recorder; thence South 89 degrees 40 minutes 00 seconds West along the south line of said Lighthouse Tabernacle, Inc. 10.58 feet to the western right-of-way of Keystone Avenue per INDOT Project Number 16-ENG-05 also being the Point of Beginning of the herein described parcel; thence continuing South 89 degrees 40 minutes 00 seconds West along said south line 20.00 feet; thence North 00 degrees 31 minutes 37 seconds East 423.57 feet; thence North 89 degrees 30 minutes 00 seconds East 26.00 feet to the aforesaid right-of-way; the next three courses follow said right-of-way; 1) thence South 00 degrees 30 minutes 00 seconds East 154.99 feet; 2) thence South 89 degrees 27 minutes 38 seocnds West 8.77 feet; 3) thence South 00 degrees 31 minutes 37 seconds West 268.61 feet to the Point fo Beginning containing 9,616 Square Feet (0.22 Acre) more or less. Subject to all easements, restrictions and rights-of-way. Exhibit SEE EXHIBIT "B" lb CIO ........_, ..„ . , . , _�X 1 Olt � � Nip t � 98th STREET 26.00' N 89'30'00" E V w_ w W3 LIGHTHOUSE 1/1 rn•o z o (O. e}M O H TABERNACLE, INC. "'•o N_m U1 BOOK 209, PAGE 98 Y W I El /' (� Z 8.77' 7 S 89'27'38" W rcl 268.61' 9,616 S.F. S 00'31'37" W 0.22± ACRE V KEYSTONE AVENUE RIGHT—OF—WAY S.E. CORNER TABERNACLE,LIGHTHOUSEINC. n o PER `� BOOK 209, PAGE 98 U 20.00' 10.58' S 89'40'00" W S 89'40'00" W x [—IPOINT OF 0 BEGINNING Z z I Exhibit C.:.. Exhi3i ? ?AV DESCRIPTION Part of the West Half of the Southeast Quarter of Section 7, Township 17 North, Range 4 East located in Hamilton County, Indiana described as follows: Commencing at the Southeast Corner of Lighthouse Tabernacle, Inc. recorded as Book 267, Page 383 in the Office of the Hamilton County Recorder; thence South 89 degrees 40 minutes 00 seconds West along the south line of said Lighthouse Tabernacle, Inc. 19.41 feet to the western right-of-way of Keystone Avenue per INDOT Project Number 16-ENG-05 also being the Point of Beginning of the herein described parcel; thence continuing South 89 degrees 40 minutes 00 seconds West along said south line 20.05 feet; thence North 03 degrees 38 minutes 56 seconds East 150.35 feet to the north line of said Lighthouse Tabernacle, Inc.; thence North 89 degrees 40 minutes 00 seconds East 20.05 feet to said right-of-way; thence South 03 degrees 38 minutes 56 seconds West along said right-of-way 150.35 feet to the Point fo Beginning containing 3,007 Square Feet(0.07 Acre) more or less. Subject to all easements, restrictions and rights-of-way. SEE EXHIBIT "B" Exhibit_,_______ 3 '(0 Exhibit P P :; P P O 20.05' N 89'40'O0" E w 150.35' S 03'38'56" W LIGHTHOUSE o o� - TABERNACLE, INC. - � BOOK 267, PAGE 383 0A 3,007 S.F. 0.07± ACRE KEYSTONE AVENUE RIGHT-OF-WAY 20.05' S.E. CORNER S 89'40'00" W LIGHTHOUSE TABERNACLE, INC. PER BOOK 267, PAGE 383 POINT OF 19.41' BEGINNING S 89'40'00" W 0 u ai H x O z Exhibit_C 1-4 — -1 Q v c u DESCRIPTION Part of the West Half of the Southeast Quarter of Section 7, Township 17 North, Range 4 East located in Hamilton County, Indiana described as follows: Commencing at the Northeast Corner of The Tom Wood Irrevocable Trust recorded as Instrument Number 9407773 in the Office of the Hamilton County Recorder; thence South 89 degrees 40 minutes 00 seconds West along the north line of the aforesaid Instrument 19.41 feet to the western right-of-way of Keystone Avenue per INDOT Project Number 16-ENG-05 also being the Point of Beginning of the herein described parcel; thence South 02 degrees 41 minutes 00 seconds West along said right-of-way 62.60 feet; thence North 89 degrees 57 minutes 08 seconds West 20.02 feet; thence North 02 degrees 41 minutes 00 seconds East 62.47 feet to the aforesaid north line; thence North 89 degrees 40 minutes 00 seconds East 20.02 feet to the Point fo Beginning containing 1,251 Square Feet(0.03 Acre) more or less. Subject to all easements, restrictions and rights-of-way. SEE EXHIBIT "B" Exhibi t 6- ‹„,c) x � 0 t I � 8 10.41' S 89^40'00^ W N.E. CORNER THE TOM WOOD IRREVOCABLE POINT OF BEGINNING REAL ESTATE TRUST PER |NSTR. #9407773 20.02' N 89'40'00" E 62.47' ---- ~ N ' " E E--q ; O2.8O' . . 5 O��41UO VY 1 �51 SF.~^ 0.03:t ACRE ,- � 20.02' . '. KEYSTONE AVENUE N O3`57OD YV RIGHT-OF-WAY THE TOM WOOD IRREVOCABLE REAL ESTATE TRUST |NSTR. #9407773 ---_ --- � 1� �� ATTACHMENT 2 EXCLUSIVE SANITARY SEWER EASEMENT THIS INDENTURE WITNESSETH that: Lighthouse Tabernacle, Inc., of Hamilton County, State of Indiana (hereinafter called "Grantor"), for and in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt of which is hereby acknowledged, does hereby grant, sell and convey to the Clay Township Regional Waste District, a regional sewer district duly organized and existing under the laws of the State of Indiana, (hereinafter called "Grantee"), a permanent exclusive easement and right-of-way to construct, operate, control, maintain, reconstruct, change the size of, repair and remove a pipeline and related or appurtenances to be used for the transmission of sewage along, under, through and across the Grantor land in Hamilton County, State of Indiana, which easement is more particularly described as follows, to-wit: SEE ATTACHED EXHIBIT A and B Grantee will level the ground and reseed any areas that might be disturbed as a result of the construction of the sewer line, or appurtenances or as a result of any maintenance repairs that may be made to said sewer line or appurtenances hereafter. It is further agreed that any damage to any private drive, pipe, tile, fences or other property of the Grantor (other than trees, shrubs and ground cover) occasioned by the construction of said sewer line shall be repaired or replaced by the Grantee in as good or better condition as the same presently exists. Grantee shall have the right of ingress and egress over and across the easements granted for purposes described herein. Whenever necessary or convenient, Grantee may haul across the easements granted herein such pipe and other materials as may be needed in the construction or maintenance of its pipeline. Grantor shall have the right to fully use and enjoy the strip of land granted as a permanent easement except for such use as may impair, impede or unreasonably interfere with the exercise by Grantee of the rights granted herein. Grantor shall not construct or permit to be constructed any house, structure or obstruction on or over or interfering with the construction, maintenance, or operation of any pipeline or appurtenance constructed pursuant to this instrument. Grantor further agrees that Grantor shall not change the grade of any such pipeline. The grants, covenants and stipulations hereof shall extend to and be binding upon the respective heirs, successors and assigns of the parties. Grantor covenants that Grantor is the owner of and has the right, title and capacity to grant the easement granted herein. Executed this day of , 20 , by Grantor. Signed Printed Exhibit STATE OF ) ss: COUNTY OF Before me,a Notary Public, in and for said County and State,personally appeared , who acknowledged the execution of the foregoing Exclusive Sanitary Sewer Easement, and who, having been duly sworn, stated that any representations contained therein are true. Witness my hand and Notarial Seal this day of , 20 . Notary Public Printed: My Commission Expires: I affirm under the penalties for perjury, that I have taken reasonable care to redact each social security number in the document, unless required by law. (name) Exhibit 10 f to ATTACHMENT 2 EXCLUSIVE SANITARY SEWER EASEMENT THIS INDENTURE WITNESSETH that: The Tom Wood Irrevocable Real Estate Trust, of Hamilton County, State of Indiana (hereinafter called "Grantor"), for and in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt of which is hereby acknowledged, does hereby grant, sell and convey to the Clay Township Regional Waste District, a regional sewer district duly organized and existing under the laws of the State of Indiana, (hereinafter called "Grantee"), a permanent exclusive easement and right-of-way to construct, operate, control, maintain, reconstruct, change the size of, repair and remove a pipeline and related or appurtenances to be used for the transmission of sewage along, under, through and across the Grantor land in Hamilton County, State of Indiana, which easement is more particularly described as follows, to-wit: SEE ATTACHED EXHIBIT A and B Grantee will level the ground and reseed any areas that might be disturbed as a result of the construction of the sewer line, or appurtenances or as a result of any maintenance repairs that may be made to said sewer line or appurtenances hereafter. It is further agreed that any damage to any private drive, pipe, tile, fences or other property of the Grantor (other than trees, shrubs and ground cover) occasioned by the construction of said sewer line shall be repaired or replaced by the Grantee in as good or better condition as the same presently exists. Grantee shall have the right of ingress and egress over and across the easements granted for purposes described herein. Whenever necessary or convenient, Grantee may haul across the easements granted herein such pipe and other materials as may be needed in the construction or maintenance of its pipeline. Grantor shall have the right to fully use and enjoy the strip of land granted as a permanent easement except for such use as may impair, impede or unreasonably interfere with the exercise by Grantee of the rights granted herein. Grantor shall not construct or permit to be constructed any house, structure, or obstruction on or over or interfering with the construction, maintenance, or operation of any pipeline or appurtenance constructed pursuant to this instrument. Grantor further agrees that Grantor shall not change the grade of any such pipeline. The grants, covenants and stipulations hereof shall extend to and be binding upon the respective heirs, successors and assigns of the parties. Grantor covenants that Grantor is the owner of and has the right, title and capacity to grant the easement granted herein. Executed this day of , 20_, by Grantor. Signed Printed Exhibit C go-0 0 STATE OF ) ss: COUNTY OF ) Before me,a Notary Public, in and for said County and State, personally appeared , who acknowledged the execution of the foregoing Exclusive Sanitary Sewer Easement, and who, having been duly sworn, stated that any representations contained therein are true. Witness my hand and Notarial Seal this day of , 20 . Notary Public Printed: My Commission Expires: I affirm under the penalties for perjury, that I have taken reasonable care to redact each social security number in the document, unless required by law (name) Exhibit 6_- 16 0f'c 4 INDIANA RETAIL TAX EXEMPT Page 1 of 1 �it sy a Larrnel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 1 01 953 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL. INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO VENDOR NO DESCRIPTION 9/17/2018 372570 Project 16-ENG-05; Utility Reimbursement Agreement TRICO REGIONAL SEWER UTILITY City Engineering's Office VENDOR P.O. BOX 40638 SHIP 1 Civic Square TO Carmel, IN 46032- INDIANAPOLIS, IN 46240--0638 Kate Lustig PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT . 29356 QUANTITY UNIT OF MEASURE DESCRIPTION 1 UNIT PRICE EXTENSION Department: 2200 Fund: 0 COIT Bond Fund Account: 44-628.71 1 Each 96th Street and Keystone Parkway-Northwest Ramp Gravity $109,908.12 $109,908.12 Sewer and Forcemain Reloc. Sub Total $109,908.12 -/'''';14. 0 F all h---N '/ i �1 = \ ! 1 1 N. `a A , ;, \ ,; ..., Send Invoice To: `, ` Skip Tennancour r," ` American Structurepoint, Inc. ,•,_ h 8425 Wicklow Way -_-a— Brownsburg, IN 46112 d P1r 2016 COIT Bond PLEASE INVOICE IN DUPLICATE I DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT PAYMENT $109,908.12 SHIPPING INSTRUCTIONS *NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P0. NUMBER IS MADE A *SHIP PREPAID. PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN 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 f' cc c._-O C �76 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY Jeremy Kashman James Crider TITLE Director Administration CONTROL NO. 101953 CLERK-TREASURER