HomeMy WebLinkAboutHarding Group, LLC/Street/4,749,985.50/2019 Paving Harding Group,LLC
Street Department- 2019
Appropriation#2200 43-502.00,2201 43-502.00 Fund;P.O.#: 102827, 102834
Contract Not To Exceed$4,749,985.50 ‘ ROk
AGREEMENT FOR PURCHASE OF GOODS AND SERVICES v.
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
Harding Group, Inc., an entity duly authorized to do business in the State of Indiana ("Vendor").
TERMS AND CONDITIONS
1. 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 2200 43-502.00 and 2201 43-502.00 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.
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 Four Million Seven Hundred Forty Nine Thousand Nine Hundred Eighty Five
Dollars and Fifty Cents ($4,749,985.50) (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 pursuant to or as part of that certain City of Carmel Engineering
Department Bid Proposal Package for "2019 Paving Program" received by the City of Carmel Board of Public
Works and Safety on or about April 3, 2019, 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.
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.
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Harding Group,LLC
Street Department-2019
Appropriation#2200 43-502.00,2201 43-502.00 Fund;P.O.#: 102827, 102834
Contract Not To Exceed$4,749,985.50
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.
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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Harding Group,LLC
Street Department-2019
Appropriation#2200 43-502.00,2201 43-502.00 Fund;P.O.#: 102827, 102834
Contract Not To Exceed$4,749,985.50
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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Harding Group,LLC
Street Department-2019
Appropriation#2200 43-502.00,2201 43-502.00 Fund;P.O.#: 102827, 102834
Contract Not To Exceed$4,749,985.50
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 AND Douglas C. Haney,
Street Department Corporation Counsel
3400 W 131st Street Department of Law
Carmel, IN 46074 One Civic Square
Carmel, Indiana 46032
If to Vendor: Harding Group, LLC
2916 Kentucky Ave
Indianapolis, IN 46221
ATTENTION: Sean Rizer
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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Harding Group,LLC
Street Department-2019
Appropriation#2200 43-502.00,2201 43-502.00 Fund;P.O.#: 102827, 102834
Contract Not To Exceed$4,749,985.50
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, 2019 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. Upon renewal Vendor will submit to City revised pricing for work
performed after January 1, 2020 based upon raw material price increases. City reserves the right upon
written request to substantiate the price increase.
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. DEBARMENT AND SUSPENSION
24.1 The Vendor certifies by entering into this Agreement that neither it nor its principals nor any of its
subcontractors are presently debarred, suspended, proposed for debarment, declared ineligible or
voluntarily excluded from entering into this Agreement by any federal agency or by any department,
agency or political subdivision of the State of Indiana. The term "principal" for purposes of this
Agreement means an officer, director, owner, partner, key employee or other person with primary
management or supervisory responsibilities, or a person who has a critical influence on or
substantive control over the operations of the Vendor.
24.2 The Vendor certifies that it has verified the state and federal suspension and debarment status for all
subcontractors receiving funds under this Agreement and shall be solely responsible for any
recoupment, penalties or costs that might arise from use of a suspended or debarred subcontractor.
The Vendor shall immediately notify the City if any subcontractor becomes debarred or suspended,
and shall, at the City's request, take all steps required by the City to terminate its contractual
relationship with the subcontractor for work to be performed under this Agreement.
25. 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.
26. NO THIRD PARTY BENEFICIARIES
This Agreement gives no rights or benefits to anyone other than City and Vendor.
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Harding Group,LLC
Street Department-2019
Appropriation#2200 43-502.00,2201 43-502.00 Fund;P.O.#: 102827, 102834
Contract Not To Exceed$4,749,985.50
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.
This Agreement may only be modified by written amendment executed by both parties hereto, or their
successors in interest.
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Harding Group,LLC
Street Department-2019
Appropriation#2200 43-502.00,2201 43-502.00 Fund;P.O.#: 102827, 102834
Contract Not To Exceed$4,749,985.50
IN WITNESS WHEREOF,the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL, INDIANA Harding Group, LLC •
by and through its Board of Public
Works and Safety
By: By:
/\ ert-11)rtc2eVq
James Brainard, Presiding Officer Aut rued Signht r
Date:
(5:6.4N2 �
Printed Name
Mary An urke,Me r
Date:
Title
Lori S.Vllat ,Membe FID/TIN: 65—/ 95705
Date: ee/5 /7 •
Last Four of SSN if Sole Proprietor: /V
A T: Date: 5'a2 oZ f�'
,/foeCtiel
Christine S. Payley,Cler -Tre surer
Date: /�
Is^C.+ar<l w.efs GahSrs'Str«i120I941a.img Gm.�fa<Gcw I,awl St,irsJ..-5/15/:019 IVO q
7
2019 PAVING TOTAL
COST
TOTAL PRICE .‘,/, 799, Sys�o
Name 1A--d171 -7.- expCompany
THIS IS TO BE THE FIRST PAGE OF ENTIRE BID.
Exhibit ,n
PART 1
BIDDER INFORMATION
(Please Type or Print)
1.1 Bidder Name: Harding Group
1.2 Bidder Address: Street Address: 10151 Hague Road
City: Indianapolis State: IN Zip: 46256
Phone#: ( ) 317-849-9666 Fax#: ( ) 317-570-4317
1.3 Bidder is a/an[mark one]:
Individual Partnership Indiana Corporation;
Foreign(Out of State)Corporation; State: ;
Joint Venture x Other:LLC
1.4 [The following must be answered if the Bidder or any of its partners or joint
venture parties is a foreign corporation. Note: To do business in or with the City of
Cannel, Indiana,foreign corporations must register with the Secretary of the State of
Indiana as required by the Indiana General Corporation Act as stated therein and
expressed in the Attorney'General's Opinion #2, dated January 23, 1958.]
.1 Corporation Name: Harding Group
.2 Address: 10151 Hague Road, Indianapolis, IN 46256
.3 Date registered with State of Indiana: 12-2-94
.4 Indiana Registered Agent: R.J. McConnell
Name: D. Michael Harding
Address: 10151 Hague Road, Indianapolis, IN 46256
Exhibit ('
vr�
PART 2
BID PROPOSAL
2.1 Project Bid.
The undersigned Bidder proposes to furnish all necessary labor, machinery, tools,
apparatus, materials, equipment, service and other necessary supplies, and to perform
and fulfill all obligations incident thereto in strict accordance with and within the
time(s) provided by the terms and conditions of the Contract Documents for the
above described project, including any and all addenda thereto, for the total sum of
Four Million Seven Hundred Forty Nine Thousand Nine Hundred Eighty Five Dollars and 50 cents
Dollars ($4,749,985.50 ). The Bidder acknowledges that evaluation of
the lowest Bid shall be based on such price. The Bidder further understands that all
work which may result on the Contract shall be compensated for on a lump sum basis
and that the OWNER cannot and does not guarantee the amount or quantity of any
item of work to be performed or furnished under the Agreement.
Exhibit
A-
30 .
)1,-0-10-,7
BID TABULATION SHEET
Project Name: 2019 PAVING PROGRAM
Bid Date:April 3rd, 2019 TOTAL
Substantial Completion Date:August 13,2019 AMOUNT: $4,749,985.50
Final Completion Date:August 13,2019
ITEM# DESCRIPTION UNIT QUANTITY UNIT PRICE • AMOUNT
10 AET or AE 150 TAC GAL 27,747 $ 3.50 $ 97,114.50
20 9.5 Type B Surface TON 27,490 $ 67.00 $ 1,841,830.00
30 Type C Surface TON 14,952 $ 69.25 $ 1,035,426.00
40 Fiber additive for 5,340 tons of Type C Surface 0 $ -
50 Bad spots cut/removed(Plunge milling 6"depth) Sq. Yd. 2,000 $ 45.80 $ 91,600.00
60 Milling/Perimeter Milling Sq. Yd. 462,450 $ 0.97 $ 448,576.50
70 Blue Reflectors EA. 285 $ 64.00 $ 18,240.00
80 4"Broken Yellow Line L.F. 434 $ 0.50 $ 217.00
90 4"Solid white Line L.F. 44,104 $ 0.50 $ 22,052.00
100 4"Yellow Crosshatch L.F. 0 $ -
110 8"Solid Yellow L.F. 1,515 $ 3.25 $ 4,923.75
120 6"Solid White Line L.F. 1,025 $ 1.60 $ 1,640.00
130 8"Solid White Line L.F. 208 $ 3.25 $ 676.00
140 4"Solid Yellow Line L.F. 123,750 $ 0.50 $ 61,875.00
150 12"X 18"Yellow Line L.F. 127 $ 8.75 $ 1,111.25
160 18"X 27"yellow Line L.F. 79 $ 13.00 $ 1,027.00
170 4" Broken White Line L.F. 2,982 $ 0.50 $ 1,491.00
180 24"Yield Line L.F. 0 $ -
190 Shark Teeth EA. 0 $ -
200 Carmel Access Bikeway(CAB)Inlays EA. 0 $ -
210 6"White Crosswalk L.F. 2,604 $ 2.00 $ 5,208.00
220 24"White Stopbars L.F. 1,572 $ 5.50 $ 8,646.00
230 Lane Indicator Arrows EA. 38 $ 108.00 $ 4,104.00
240 "Only's" EA. 26 $ 216.00 $ 5,616.00
250 24"White Piano Keys L.F. 1,936 $ 6.00 $ 11,616.00
260 Roundabout Arrows EA. 0 $ -
270 "School" EA. 0 $ -
280 White"letters"PED-XING EA. 2 $ 541.00 $ 1,082.00
290 8"Solid White Line L.F. 0 $ -
300 6"Solid White Line L.F. 0 $ -
310 12"Yellow Crosshatch L.F. 407 $ 3.25 $ 1,322.75
320 4"Blue Crosshatch L.F. 141 $ 5.50 $ 775.50
330 8"Yellow Crosshatch L.F. . 34 $ 3.00 $ 102.00
340 24"Yellow Crosshatch L.F. 0 $ -
350 8"White Crosshatch L.F. 0 $ -
Exhibit_____A____
•
360 12"White Crosshatch L.F. 0 $
370 4"White Crosshatch L.F. 202 $ 2.00 $ 404.00
380 Combination Arrow EA. 28 $ 270.00 $ 7,560.00
390 4"x2'White Dash L.F. 63 $ 2.25 $ 141.75
400 6"x2'White Dash L.F. 202 $ 5.00 $ 1,010.00
410 8"x 24"White Dash LF 156 $ 6.50 $ 1,014.00
420 12"x 24"White Dash LF 178 $ 9.00 $ 1,602.00
430 4"White Parking stall L.F. 3,271 $ 5.50 $ 17,990.50
440 12"White Parking"T" L.F. 12 $ 11.00 $ 132.00
450 4"Blue Parking stall L.F. 140 $ 5.50 $ 770.00
460 Handi cap Symbol EA. 2 $ 270.50 $ 541.00
470 Bike Path Arrow EA. 0 $ -
480 Bike Path Symbol EA. 0 $ -
490 PCCP Patching, Full Depth, Minimum 10", Modified SYS 0 $ -
500 Decorative Concrete Border, 18"Width LFT 0 $ -
510 PCCP Decorative Paver Base w/Multi-colored Pavers SYS 0 $ -
520 Compacted Aggregate Base,#53,6"Street Panel Base TON 650 $ 48.70 $ 31,655.00
530 Loops EA. 8 $ 811.50 $ 6,492.00
540 Maintenance of Traffic LS 0 $ -
550 _Section Corner or Monuments, Undistributed EA. 0 $ -
560 Concrete Curb Replacement(Roll Curb) L.F. 9,000 $ 59.50 $ 535,500.00
570 Chairback Curb L.F. 1,000 $ 64.90 $ 64,900.00
580 Street Panels Sq.Yd. 4,500 $ 67.00 $ 301,500.00
590 Calcium 1% per Cu.Yd. Cu.Yd. 1 $ 4.50 $ 4.50
600 High Early 1%Cu.Yd. Cu.Yd. 1 $ 6.50 $ 6.50
610 ADA Ramp EA. 55 $ 1,298.00 $ 71,390.00
620 4'Wide Sidewalk LFT 1,000 $ 34.60 $ 34,600.00
630 Greater than 4'Wide Sidewalk Sq.Yd. 100 $ 65.00 $ 6,500.00
640
650 _
660
TOTALS $4,749,985.50 ,
Exhibit
4
EXHIBIT B
Invoice
Date:
Name of Company:
Address &Zip:
Telephone No.:
Fax No.:
Project Name:
Invoice No.
Purchase Order No:
Goods Services
Person Providing Date Goods/Services Provided Cost Per Hourly Total
Goods/Services Goods/ (Describe each good/service Item Rate/
Service separately and in detail) Hours
Provided Worked
GRAND TOTAL
Signature
Printed Name
EXHIBIT C
INSURANCE COVERAGES
Worker's Compensation&Disability Statutory Limits
Employer's Liability:
Bodily Injury by Accident/Disease: $1,000,000 each employee
Bodily Injury by Accident/Disease: $1,000,000 each accident
Bodily Injury by Accident/Disease: $1,000,000 policy limit
Commercial General Liability:
General Aggregate Limit(other than
Products/Completed Operations): $6,000,000
Products/Completed Operations: $5,000,000
Personal &Advertising Injury
Each Occurrence Limit: $5,000,000
Comprehensive Auto Liability(owned,hired and non-owned)
Bodily Injury and Property Damage: $5,000,000 each occurrence
Umbrella Excess Liability
If a commercial umbrella liability policy is used to satisfy the minimum limits of liability
requirements, the combined limits must equal these minimum limits of liability.
EXHIBIT D
AFFIDAVIT .
-3\0tYlnOr\ CaVYN �� 1 ,being first duly sworn,deposes and says that
he/she is familiar with and has persoI 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 an, i ow nd at all times.-eleQ ant•herein have been employed by
�(1� �- (the"Employer")
in the position of 1—\v iY1A\ V-e__<DUCC-to S .(_ S
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.Documentation
of this enrollment and participation is attached and incorporated herein.
5. The Employer does not knowingly employ any unauthorized aliens.
• 6. To the best of my information and belief, the Employer does not currently employ any
unauthorized aliens.
7. FURTHER AFFIANT SAYETH NOT.
EXECUTED on the O day of 1�,Q \1 ,20 \ :1
Priatecl: 4:11.YVI Ct\ CAYY\sc) Ur' `1
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:
C O INDIANA RETAIL TAX EXEMPT Page1 of 1
All y of
f Carmel CERTIFICATE NO. O 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102834
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AN
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
4/24/2019 00350164
P4rel,yrq 6rof SMR Street Department
VENDOR 7.7/6 /Lrg4,ucj 4 r_ SHIP 3400 W.131st Street
TO Carmel,IN 46074-
INDIANAPOLIS,IN 46266-- yy(D 2.Z1 S/7/L (317)733-2001
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
35694
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2201 Fund:2201 Motor Vehicle Highway FND
Account: 43-502.00
1 Each 2019 Resurfacing $62,000.00 $62,000.00
Sub Total $62,000.00
•
•
Send Invoice To:
Street Department
3400 W.131st Street
Carmel,IN 46074-
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT i ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $62,000.00
SHIPPING INSTRUCTIONS 'ARVOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.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.0.0.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 ci ,t
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dave Huffman James Crider
TITLE Director Administration
CONTROL NO. 1 02834 CLERK-TREASURER
•
INDIANA
TAIL
EXEMPT Page 1 of
Clay
of Carmel
CERTIFICA EENO0031015 002 0 PURCHASE ORDERNUMBER
FEDERAL EXCISE TAX EXEMPT 1 02827
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SUPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
4/23/2019 00350164 2019 Paving-Street Department
u4' ��n� is wP City Engineering's Office
VENDOR 29/(o 14,41.,cibtc} SHIP 1 Civic Square
TO Carmel,IN 46032-
INDIANAPOLIS,IN 4625C- '/ 2ZI SI�'t/[- Kate Lustig
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
35672
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE r EXTENSION
Department: 2200 Fund: 202 Local Road &Street Fund
Account: 43-502.00
1 Each 2019 Paving-Street Department 4,688,755.80 $4,688,755.80
Sub Total $4,688,755.80
•
•
•
•
Send Invoice To: •
City Engineering's Office •
Kate Lustig
1 Civic Square •
•
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT — PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $4,688,755.80
SHIPPING INSTRUCTIONS •AlP VOUCHER CANNOT BEAPPROVED FOR PAYMENT UNLESS THE P.O.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.O.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jeremy Kashman James Crider
TITLE Director Administration
CONTROL NO. 102827 CLERK-TREASURER