HomeMy WebLinkAboutMammoth, Inc./ENG/$195,887.55/Replace & Rehab Brookshire Bridges1.
2.
lVlanrnroth. lnc.
Engirreering Delraflnrenl - 2020
Appropriation #41-628.7 I 201 0 Bond Fund: P.O. #104080
Contract Not To Exceed $ 195.{t87.55
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, lndiana, acting by and through its Board of Public Works and Safety (.City"), and
Mammoth, lnc., an entity duly authorized to do business in the State of lndiana ("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 44-628.71 2010 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. lf 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 authorrzaiion will not be compensated.
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 Hundred Ninety Five Thousand Eight Hundred Eighty Seven Dollars and
Fifty Five Cents ($195,887.55) (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 0n 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 sarne 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 "Project 19-02', Replacement and Rehabilitation of a Bridge in
Brookshire Golf Club" received by the City of Carmel Board of Public Works and Safety on or about July 1,
2020,a\irof which documents are incorporated herein by reference, and thatthe Goods and Services will be
delivered in a timely, g00d 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.
3.
By Jon Oberlander at 4:00 pm, Jul 08, 2020
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Mamnroth, Inc.
Engineering Depafiment - 2020
Appropriation t*44-628.7 1 20 I 0 Bond Fund; P. O. # I 04080
Contract Not To Exceed $ 195,887.55
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:
lf 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 noiice (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. ln 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:
ln 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 lndiana, 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 hoid 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 shallsurvive the termination of this Agreement.
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Mamnroth. Inc.
Engineering Departrnent - 2020
Appropriation #44-628.7i 2010 BondFuid; P.O. #10'1080
Contmct Not To Exceed $ 195.887.-55
10. GOVERNMENTCOMPLIANCE:
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 andlor liability resulting from any such violation of such laws, orders, rules,
regulations and codes. This indemnification obligation shallsurvive 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 lndiana 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 LC. S 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 "lndiana E-Verily 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. ln 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 lndiana E-Verify Law as regards each such subcontractor. Should the Vendor or any
subcontractor violate the lndiana 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 lndiana 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 collateralfor a loan or othenruise, 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
[C:lusrtivingffidplht.lkanT6rp,MeJlmdl lnc. (tusadS6'k6_l&tHJ:Mffih,lnc 6odsadSwiees.dc:6:29,-2020 I lS4 AM]
3
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Mamr.noth, Inc.
Errgineering Depamrnent - 2020
Appropriation #44-628.1 I 2010 Bond Fund; P.O. #l 04080
Contract Not To Exceed $ 195.887.55
16. GOVERNINGLAW;LAWSUITS:
This Agreement is to be construed in accordance with and governed by the laws of the State of lndiana,
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,
lndiana only, and agree that such court is the appropriate venue for and has jurisdiction over same.
17, SEVERABILITY:
lf 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
prepaid U.S. certified mail, return receipt requested, to the party to
herein:
lf to City:City of Carmel
One Civic Square
Carmel, lndiana 46A32
writing and is delivered by postage
be notified at the address specified
Douglas C. Haney,
Corporation Counsel
Department of Law
One Civic Square
Carmel, lndiana 46032
AND
lf to Vendor:Mammoth, lnc.
1000 W Broadway Skeet
Fortville, lndiana 46040
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. ln 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. ln 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 pariies have previously agreed in writing to a greater amount.
19.3 The City may terminate this Agreement pursuant to Paragraph 1 t hereof, as appropriate.
lc:luffidi\ing$m1ApDaE.iffil\T€mpwa,mtl,hc.C(qLrildSmic6 184]411M6@h,ltrcCmdiddS€nis.d@:6,29:2020lln4AMl
4
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Mantmoth, lnc.
Engineering Departnrent - :020
Appropriatior'r #44-628.71 20l0 Bond Fund; P.O. # 104080
Contr-act Not To Exceeci S 19,5.887.55
2A. REPRESENTATIONSANDWARRANTIES
The parties represent and warrant that they are aulhorized to enter into this Agreement and that the persons
executing this Agreement have the authority to bind the party which they represent.
21. ADDITIONAL GOODS AND SERVICES
Vendor understands and agrees that City may, from time to time, request Vendor to provide additional goods
and services to Ci$. 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 othenrvise 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, 2020 and shall,
on the first day of each January thereafter, automatically renew for a period of one (1) calendar year, unless
othenruise 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 othenrvise 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. 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.
27. rC 5-16-13.
The provisions of lC 5-16-13 are hereby incorporated into this Agreement by reference.
28. DEBARMENT AND SUSPENSION
28.1 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 lndiana. 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.
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Marnnroth, Inc.
Eneineering Deparrnrent - 2020
Appropriation #44-628.7 I 20 I 0 Bond Fund: P.O. # I 040t10
Contract Not To Exceccl $ I 9-5.887.5-5
28.2 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 0r 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.
29, IRAN CERTIFICATION.
Pursuant to LC. $ 5-22-16.5, the Vendor shall certify that, in signing this Agreement, it does not engage in
investment activities within the Country of lran.
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.
lN 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:
Mammoth, lnc.
James Brainard, Presiding Officer
Date:
Mary Ann Burke, Member
Date:
Lori S. Watson, Member
Date:
ATTEST:
Sue Wolfgang, Clerk
Date:
lci\Us\tliyinSll6iAffDgEllr€l\Tilpwallmrh, lnc. Goods ed Swis-l E,4f4SiMamsdh, lnc. {kDds and S6.ics.doc:6r29,:020 I 104 AM]
6
Ss.fa^ -T. 6-a,
Printed Name
?l,nt/ir,*f
Title
FrDffrN: trl-t{t173}l
Last Four of SSN if Sole Proprietor:
Date:-l-6-eo
3szr
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
7/15/2020
7/15/2020
7/15/2020
7/15/2020
BIDDOIT'S ITEMIZED PROPOSAL
AND DECLAI{ATIONS
City of Carrnel
.ilnu:l iqfi s fo IJi ddefs, :
'l'his.fitrm shall lte ulilized h.1, ull Birlders. Excepl u1;6lhent,ise .tpecilirully Ttxtt,idetl, ull l'arts.shull
bc ./illlv' trnd uccurulelv.filled in und compleled ancl nolnrized.
Project:I{cplacctncnt:tnrl ltchabilitatiorr of a l}r'irlgc irr
llrooksh irc (Jolf Clrr h
Proposal For C<xstnrctinn of :
Constructiorr of I Pcrlestrian
Approach Work
: .lnne l4th 2t120
('il"r' ol'(liu'lttcl" lrrrlialta, lioal'rl ol"l'rrhlic \Yorks irrrrl Sll'cty
liridge;Associaterl
Date
To:
EXFIIBITVcnion 201&08-l I
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
PABT-I
BI.PP{,I{ IFqAEMATION
ryri$)
I.l BiddrrName: klarnmntl:. lnc.
1.2 Bidder Address; $trset Address: 1000 w Braadrvay St'
City; F?jtvllle S1gte: lI - Zip: ,16.Q{Q
phone:317-q*-3224 Fax: 317-56$-4559
X.3 Ilidder is alan fmark one]
Individual Partnership X l*diana Corporation
Foreign (Out of State) Corporation; $tate:
Joint Venture 0thsr
1.4 {Tlrefoltot*,ing mu*t be ansryeyed if tlze l}idder or ctny a.f its p*rt*ers ar.join{ venture parties
is aJ'areign coryscr*ti*n" N*tt: To clo basiness in or with the City aJ'Carmel, Indiana,
Jbreign corporatians must register with the Secret*ry af the Str,te af Indian* *r rerptired
by tke lxdiona {}enerul Corpore$i*n A* tts ststed lherein and expressed in the Attorney
Gener*l's {)pinion #2, d$ted Januftnt 23, 1958,}
.l Corporation Name:
.2 Address:
.3 Date registered with State of Indiana:
.4 Indiana Begistered Agent:
Name:
Addrcss:
E)$TIBIT
A(2of5)Version ?{) l6-08-,i I
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Slick, Laurie
From:
Sent:
To:
Subject;
patrick.du ll @ mammothg roup.net
Thursday, June 25, 2A2O 1:28 PM
Slick, Laurie
Bid Submissir:n Error
rrir This is an EXTERilAt email. Please exerclse caution and tlo Not open attachments or click linls from
unknown $nders or unerpected email. **t*
Good afternoon Laurie. To confirm with our earlier conversation, Mammoth, lnc acknowledges the (520.00) math error
with our bid submission and agrees upon the final contract amount of 5L95,887.55. Thank you and we apologize for the
confusion.
Patrick Dull
Onsite Project Manager
Mammoth, lnc-
317-629-8140 Mobile
317-853-1260 Fax
www.MammethGroup.net
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
I'ARl.2
lill) PI{.()l}osAl,
2.1 Base Bid'lhe undersigned Bidder proposes to lurnish all necessary labor, machinery, tools,
apparatus, materials, equipment, service and other necessary supplies, and to perl'orm and
fulfill all obligations incident thereto in strict accordance with and within the time(s)
provided by the terms and conditions ol'the Contract Documen(s flor the above described
Work and Project, including any and all addenda thercto, fhr the Unit Prices applicable to
thc Contract ltems as stated in Part 3 hereol, rvhich lJnit Prices, when nrultiplied by
eslimated unit quantities for such Contract ltems, total ottttZ tlaN npFJ? nttFl{-
Fltrr THL\t'<nNarEt6tf ftuitt?Fl>9t{.^l)o/lars($Jg5*trd7 7_j.'I'heBidder
acknowledgcs that cvaluation ol'thc loudtt%"dshall be biised on-such price and lurther
acknowledges that thc unit quantities listed in Parl 3 of this Proposal are estimates solely
for the purpose ol'Bid evaluation arrd Contract award, and are not to be construed as exact
or binding. The Bidder further understands that all Work which may result on the Contract
shall be compensated fr:r on a Unit Price basis and that the OWNER and ENGINBER
cannot and do not guarantce the amount or quantity of any itenr of Work to be performed
or lumished under the Contract.
EX#tilBtT
(4 of 5
Vcnion 2016-08-ll
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Contract
Item lrio
Description Estimated
Quantity
Units L.lnit Price Total Prtce
1 05-06845 Construction Enqineerinq 1 LS tfl jt;,It",.}{,.
1 10-01001
Mobrlization and
Demobilization 1 IQ ltfi ofi ///6ffi
202-5.1330 Present Structure, Rernove 1 LS qesn 4$T4t
203-i)2000 Excavation, Conrnron 800 CYS {q5 . frr 3,9{r't.
243-512?3 Excavatior.r, Waterway 20 96 CYS tq?.1j 1, { }i,'l
205-08s94 Filter Sock 148.00 tFT ?"58 trt*l"s
205-03371 Sedinrent Remove 400 CYS alo.*tto"@
206-51 230
Excavation. Foundation,
Unclassified 86.00 \.T.)to,s(6q ?q.tt
211-A9265 Structure Eackfili, Type 2 41 56 CYS lt.ntl 3(,\. a(,
303-01 180 Compacied Aqqreqate No 53 17 83 TON ll{".?t l.o?).1?
HMA lnlermediate, Type B,
12.5mm 16 7$TON 3a?.,i6 5,5sD.o'?
406-05521 Asphait for Tack Coat 76 32 SYS ;t,6?-i . {,80, at{
616-05688 Rrorap. Class 1 1) 11 TON ?r.t,6 ?6 "17,\l616-12246 Geotextile for Riprap Type 1A 80 1'1 SYS lo,t{4 9To,Sf
702-51015 Concrete, B. Footings 13 60 CYS 5{o, -t tl fl,o?a.tf
702-92857 Concrete, C, Substructure 17.40 CYS rttl.i.&5-(1.q rS.6
703-06029
Reinforcing Bars, Epoxy
Coated 2892 00 I.BS I58 \'56fi,'lh
Dewalerinq {See TS51)'1 0 t('J.ll?--7' ,-? ;1.
Pre-Engineered Pedestrian
Bricloe (See TS49)1.0 le Yr)r'tqw ?orta>
Temp Construction Access
{See T$53)10 LS 7,7e zTod
TOIAt /15,frt1.f)
[,AIUI
c()lr"f liA(r'u -u:Ms AN I) tJ N l'r I't*tI C ris
E)${IBIT
A(5of5)
lrt&t,Stl
\'i l\ir)ii 11i1a1 ilS- i I
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
E.XHIBIT B
Invoice
Date:
N*tne of Company:
Address {t Zip:
TelephoneNa.:
FaxNo";
Project Name:
Invoice No.
Purchase Order No:
GoodslServices Provided
{Descrihe eac}r gnnd/service
separateh' anrl in detail)
Person Pror,iding
GoodslServices
GRAND TOTAL
Signature
Printed Name
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
EXHIBIT C
INSURANCE COVERAGES
Worker's Compensation & Disability Statutory Limits
Employer's Liability:
Bodily Iryury by Accident/Disease: $1,000,000 each employee
Bodily Injury by Accident/Disease: $1,000,000 each accident
Bodily Io:u.y 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 lrjury and Property Darnage: $5,000,000 each occurrence
Umbrella Excess LiabilitY
If a commercial umbrella liability policy is used to satisff the minimum limits of liability
requirements, the combined limits rnust equal these minimunr limits of liability'
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
EXHIBIT D
AF FIDAVIT
being first duly sworn, deposes and says that
knowledge of tlie facts herein and, if called as a witness in this
matter, could testify as follows:
l. I am over eighteen ( l8) years of age and am competent to testify to the facts contained
herein.
I am nolw and at all times relevant herein have been employed by
[fur,,no\ f^.. (the "Employer")
in the position of Vc=i[o,t f
I am familiar with the employrnent policies, practices, and procedures of the Employer and
have the authority to act on behalf of the Employer.
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.
2.
1J.
4.
5.
ay
EXECUTED on the o day of
I cerlify under the penalties for perjury r.rnder the
Indiana that the foregoing fachlal statements and
laws of the United States of America and the State of
representations are true and correct.
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590
Cf,ty of Carmel INOIANA RETAIL TAX EXEMPT
CERTTFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
Page 1 of 1
PURCHASE ORDER NUMBER
1 04080
THIS NUMSER UUSI APPEAR ON $IVOICES,
'fPVOUCHER, OEIIVERY rvlEMO, PACKING SLIPS.
SHIPPING I.AEEIS AND AI'IY CORRESPOH}ENC€
DESCRIPTION
;, ONE CtVtC SqUARE 3s"6000972
. CARMEL, |NDIANA 46032-2584
IFORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL " 1997
;PURCHAS€ ORDER DATE ttArE RE00iiED REQUISITION NO VENDOR NO
6t25t2020 374808
MAMMOTH I}IC
VE"A]OOR lOOO W BROADWAY ST SH/P
TO
City EnEineering's Office
1 Civic Square
Carmel, lN 46032-
Kate LustigFORTVTLLE, tN 45040 -
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
Project 19-02: Brookshire Golf Course
OUANTITY UNIT OF MEASURE
Department:
Account:
Each
Depadment: 2200 Fund: O
Account: U-628.71
1 Each
DESCRIPTION
2010 Bond Fund
Replacement & Rehabilitation of Bridges in Brookshire Golf
Club - Construction
UNIT PRICE EXTENSION
Sub Tolal
$195,887.5s
Sub Total
$195,887.55
I
Send lnvoice To:
Jill Newport
CrossRoad Engineers, P.C.
3417 Sherman Drive
Beech Grove, lN 46107
I newport @ crossroadengineers.com
DEPARTMENT i
3I{IPPIilG INSIRUCTE}IS
'SHIP PREPAIO
.C O O SHIPMEI{T CANNOT BE ACCEPTED
.PURCHASE OfiDER iIUMBER MUST APPEAR ON ALL SHIPPING ISSE
.THIS ORDEB }SSUEO IN COMPUANCE WIH CHAPIER 99. ACTS 194
AND ACTS ASIEI.IOATORY IHEREOF ANO $UPPLEMENT THEREIO
coNTRorNo. 104080
$195,887.55
PAYMENT $195,887.55
'&P VOUCHER CAIINOI BE APPROVE0 FOR PAYMENT UNLESS IHE P O. NUMBER lS iriA0€ A
PARI OF THE VOUCI.iER ANO EVERY I}$AC€ AND VOUCHER HAS THE PROPER SWOM
AFFIDAVIT ATIACHED t HEREBY C€RIIFY IHAT THERE lS AN UliOBLlCa(I€O BAIANCE lH
IHIS APPROPRIATION SUFFIOENT IO PAY FOR IHE ABOVE OROER
.rc:--/..*-n(*?t
\i\i,tiliiJfri
/
I
,
I
1L
\
ORDERED BY
TITLE
CONTROLLER
Jeremy K6shman
Director
James Crider
Director of Administration
.l'- n f,fkfi L] l-/**\\ '---- *
/' \J,/'-
J-
fl! * -\-
"'#&h"'.\-\ ^r \'r.a \\.,
\
FREIGHT
Fund
I
" ''.. 'f lV r : ; J'" {".3 }tu---"'' - 1 :t:' ' '-: j'':- '
PLEASE INVOICE II{ DUPLICATE:: ::f::-4,r,"qs-'---i
DocuSign Envelope ID: 983A2733-FB76-403C-9632-32509CF3D590