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HomeMy WebLinkAboutArctic Zone Iceplex, LLC dba Carmel Ice Skadium/CRED/$339,088/Ice Rink Services DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 AlNl1N cwla 1N14/11.,A,LLI,u/W a L.cu1111L1 1Nl, ols.aulwll Department of Community Relations-2020 APPROVED Appropriation#922 43-509.00; P.O.# 104248 By Jon Ober!ander at 8:43 am,Oct 26,2020 Contract Not To Exceed$339,088.00 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 Arctic Zone Iceplex, LLC d/b/a Carmel Ice Skadium, 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 922 43-509.00 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 Three Hundred Thirty Nine Thousand Eighty Eight Dollars ($339,088.00) (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. 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. [C:AUsecs\clivmgsronAppDataLocalIVlicxosofNWmdoosVlNetCacheAContentOutlook\562V7G6GAreric Zone Iceplex LLC dba Cannel Ice Skadrmn Goods and Ser ces.docl0/6/2020 12:01 PM] 1 DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 AlNl1N cwla 1N14/11.,A,LLI,u/W a L.cu1111L1 1Nli ols.aulwll Department of Community Relations-2020 Appropriation#922 43-509.00; P.O.# 104248 Contract Not To Exceed$339,088.00 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. [C:AUsecs\clivmgsronAppDataLocalIVlicxosofNWmdoosVlNetCacheAContentOutlook\562V7G6GAreric Zone Iceplex LLC dba Cannel Ice Skadrmn Goods and Ser ces.docl0/6/2020 12:01 PM] 2 DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 AlNl1N cwla 1N14/11.,A,LLI,u/W a L.cu1111L1 1Nli ols.aulwll Department of Community Relations-2020 Appropriation#922 43-509.00; P.O.# 104248 Contract Not To Exceed$339,088.00 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 [C:AUsecs\clivmgsronAppDataLocalIVlicxosofNWmdoosVlNetCacheAContentOutlook\562V7G6GAreric Zone Iceplex LLC dba Cannel Ice Skadrmn Goods and Ser ces.docl0/6/2020 12:01 PM] 3 DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 AlNl1N cwla 1N14/11.,A,LLI,u/W a L.cu1111L1 1Nli ols.aulwll Department of Community Relations-2020 Appropriation#922 43-509.00; P.O.# 104248 Contract Not To Exceed$339,088.00 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 AND Douglas C. Haney, One Civic Square Corporation Counsel Carmel, Indiana 46032 Department of Law One Civic Square Carmel, Indiana 46032 If to Vendor: Arctic Zone Iceplex, LLC d/b/a Carmel Ice Skadium 16616 Southpark Drive Westfield, Indiana 46074 Attn: Mike Aulby 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. [C:AUsecs\clivmgsronAppDataLocalIVlicxosofNWmdoosVlNetCacheAContentOutlook\562V7G6GAreric Zone Iceplex LLC dba Cannel Ice Skadrmn Goods and Ser ces.docl0/6/2020 12:01 PM] 4 DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 AlNl1N cwla 1N14/11.,A,LLI,u/W a L.cu1111L1 1Nli ols.aulwll Department of Community Relations-2020 Appropriation#922 43-509.00; P.O.# 104248 Contract Not To Exceed$339,088.00 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 August 31, 2023 and may be renewed by written agreement of both 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. DEBARMENT AND SUSPENSION 26.1 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. 26.2 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. [C:AUsecs\clivmgsronAppDataLocalIVlicxosofNWmdoosVlNetCacheAContentOutlook\562V7G6GAreric Zone Iceplex LLC dba Cannel Ice Skadrmn Goods and Ser ces.docl0/6/2020 12:01 PM] 5 DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 Arctic Zone Iceplex,LLC d/b/a Cannel Ice Skadium Department of Community Relations-2020 Appropriation#922 43-509.00;P.O.#104248 Contract Not To Exceed$339,088.00 27. IRAN CERTIFICATION - Pursuant to I.C. § 5-22-16.5, the Vendor shall,certify that, in signing this Agreement, it does not engage in investment activities within the Country of Iran. 28. 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. 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. IN WITNESS WHEREOF,the parties hereto have made and executed this Agreement as follows: CITY OF CARMEL, INDIANA Arctic Zone Iceplex,LLC d/b/a Carmel Ice Skadium by and through its Board of Public Works and Safety By: By: Not Present �c -- (24-41-&r.' James Brainard, Presiding Officer Authorize Signature Date: I/q/yqY /y DocuBignetl /' J4 a✓ci A'r�:Htl,L �k t4C, Elkar le WA.15100, Printed Name Mary Ann Burke, Member Date: 11/4/2020 UnouSignetl bY: Title ton Ulatsau Lori' .c7letson, Member FID/TIN: 3 c- 2.1 V 5'V'73 Date: 11/4/2020 Last Four of SSN if Sole Proprietor: ATTEST: Date: /OA'5/l40 nocu8ionetl by. Sue Wolfgang, Clerk Date: 11/4/2020 [C:\t7serslelivingstonkAppDntiAtocnllMicroso11Windows\INotCneholContent.Gutlookl562V7G6G1Ascuc Zone lcepiax LLC ddba Cannel leco Skednun Goods and Pelvises.doe:l0/6/2020 12:01 PM] oocuoign Envelope ID: 1a602746-7B42wo�9838-n38o50FAC89 fil ilh ICEPLEX 1040 3rd Ave. S.VV. Carmel, IN 46032 317.844.8889 Exhibit March 2O20—Juh/2021(Year 1) Due toCOVlD-19 and the cancellation ofthe 2020-2021 Ice at Carter Green ice rink season,the first year pYthe three-year contract will Include: Management Fees: � Carmel ice Skadiurn would receive a monthly Consulting Fee of$500 for 13 months($6,500.00 Total) � Carmel Ice Skadlum would be reimbursed for Skate Maintenance: cleaning and sharpening of skates during the 2U2O-2D21 cancelled season ($4,8OO.8OTmta|): o Sharpening Fee: 18O employee hours x$20.OU per hour($3,280.00Total) o Cleaning Fee: 16U employee hours x$10.O0 per hour,($1,8OU.0&Total) Estimated Expenses: ° Carmel Ice Ska6|um would he reimbursed for the cost of the Skate Sharpening Machine:sharpening stones ($1,2U0.00)1, sharpener filters($S0)and shipping($5o).($1,3n0.ODTotal) Carmel Ice Skmdium would assist in the Olympia ice Cleaning Machine operation.The Carmel UcoSkmdium would run the Olympia ice cleaning machine for m week |n the Fall mf2U2U and the Spring of2O21 tu identify any mechanical issues and to keep the machine in operating order while not in use during the cancelled 2020-2021 Ice at Carter Green season.This will take place at the Carmel ice Skadium during their normal operation hours.All costs for maintenance and upkeep of the Olympia Ice Cleaning Machine will be the responsibility of the City of Carmel.The cost of delivery and pick up of machine to be covered bv Carmel Street Department ������U��U�� u~��nnn��nn �� ��N �� ��� �� � N ��N ��� ^ ^ DocuSign Envelope ID: 18602746-7642-4CF0-9838-7738D50FAC89 10111 !CEPLEX 1040 3rd Ave. S.W. Carmel, IN 46032 317.844.8889 August 2021—August 2023(Years 2&3) Management Fees: • Fee is charged per rink season (2021/22 and 2022/23). ($44,000.00 per year) • Carmel Ice Skadium would receive 25%of all Private Ice Rental ($1,110.00 approx.*) • Carmel Ice Skadium would receive 10%of the revenue for Skate Rental ($10,070.00 approx.*) and Admissions Sales($28,000.00 approx.*).There would be no percentage received from the concessions. *Fees based on average past sales from previous Ice at Center Green seasons Estimated Rink Expenses: • Arctic Zone dba Carmel Ice Skadium would be reimbursed for all direct and actual expenses paid by Carmel Ice Skadium to unrelated third parties to operate ice rink,which yearly expenses are estimated below. • Office supplies ($250.00) • Staffing($60,000.00 based on staffing needs and days &hours of operation) • Employee Uniforms ($750.00, Large winter type coats, lighter weight jacket, shirts, hats, scarves, gloves. Jacket would be kept for use at rink only, all other items are employee specific.) • Safety Equipment($500.00) • Insurance($2,500.00) • Purchase of Skater Wristbands ($3,700.00) • Inventory for concessions($3,000.00 per month, December 26th—March 1st) • Concession Stand Equipment($1,000.00) • Olympia Ice Cleaning Machine blades and sharpening ($250.00 per blade; $500.00 total) • Olympia Ice Cleaning Machine Fuel Cost ($3,364.00, based on estimated usage and current cost of propane) EXHIBIT A (2 of 5) DocuSign Envelope ID:8602746-7B42-4CF0-9838:7738D5OFAC89 ICEPLEX 1040 3rd Ave. S.W. Carmel, IN 46032 317.844.8889 Management Fee(Year 1) Consulting Fee $6,500.00 Skate Maintenance $4,800.00 Total $11,300.00(Year 1) Estimated Expenses(Year 1) Skate Sharpening Machine $1,300.00 Olympia Ice Cleaning Machine Operation Transport costs to &from Ice Skadium covered by Carmel St. Dept. Total $1,300.00(Year 1) Total Estimated Costs(Year 1): Management Fees $11,300.00 Estimated Expenses $1,300.00 TOTAL $12,600.00(Year 1) EXHIBIT A (3 of 5) DocuSign Envelope ID: 18602746-7642-4CF0-9838-7738D50FAC89 ICEPLEX 1040 3rd Ave. S.W. Carmel, IN 46032 317,844,8889 Management Fees(Years 2&3) Fee $44,000.00 Private Ice Rental $1,110.00 (approx.)* Skate Rental $10,070.00(approx.)* Admission Sales $28,000.00(approx.)* *Fees based on average past sales from previous Ice at Center Green seasons Total $83,180.00 Annual(Years 2 &3) Estimated Rink Expenses(Years 2&3) • Office Supplies $250.00 • Staffing $60,000.00 • Employee Uniforms $750.00 • Safety Equipment $500.00 • Insurance $2,500.00 • Skater Wristbands $3,700.00 • Inventory(Concessions) $7,500.00 • Concession Stand Equipment $1,000.00 • Olympia Ice Cleaning Machine $500.00 • Olympia Ice Cleaning Machine $3,364.00 Total $80,064.00 Annual(Years 2&3) Total Estimated Costs (Years 2&3): Management Fees $83,180.00 Annual/$166,360.00(Years 2&3 Combined) Estimated Rink Expenses $80,064.00 Annual/$160,128.00(Years 2&3 Combined) TOTAL $163,244.00 Annual (Years 2&3) $326,488.00(Years 2&3 Combined) EXHIBIT A (4 of 5) DocuSign Envelope ID 18602746-7642-4CF0-9838-7738D50FAC89 ICEPLEX 1040 3rd Ave. S.W. Carmel, IN 46032 317.844.8889 Total Estimated Costs(Years 1,2, &3) Management Fee $177,660.00 Estimated Expenses $161,428.00 TOTAL $339,088.00(Years 1, 2&3 Combined) EXHIBIT A (5 of 5) DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 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 DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 EXHIBIT C INSURANCE COVERAGES Worker's Compensation & Disability Statutory Limits Employer's Liability: Bodily Injury by Accident/Disease: $100,000 each employee Bodily Injury by Accident/Disease: $250,000 each accident Bodily Injury by Accident/Disease: $500,000 policy limit Property damage, contractual liability, products-completed operations: General Aggregate Limit (other than Products/Completed Operations): $500,000 Products/Completed Operations: $500,000 Personal & Advertising Injury Policy Limit: $500,000 Each Occurrence Limit: $250,000 Fire Damage (any one fire): $250,000 Medical Expense Limit(any one person): $ 50,000 Comprehensive Auto Liability(owned, hired and non-owned) Bodily Single Limit: $500,000 each accident Injury and property damage: $500,000 each accident Policy Limit: $500,000 Umbrella Excess Liability Each occurrence and aggregate: $500,000 Maximum deductible: $ 10,000 DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 FIDT. being first duty sworn;deposes and says that he/she is 'amthar u th and has,personal.kn.owled e of'the t is herein and,,if carted as:a Witness in this matter,cwld testy as follows-; .la. I am:over eighteen tl 8).years of.age and am competent to testify-to the facts contained hxein, 2 t,aixy ow and atalltime4 rele/^ant herein have boon employed by , {t e-"Employer) in the position of ©'-"" 3 I out with the emPloymentpolieiesx practices and procedures oftbe Employer and. have the authority to act on behalf crfthe Employer:, 4., The Employer is enrolled and participates in the federal „E.-Verify program and has prow ded documentation of such enrollment and parti ipation to the Cry of Ca eI2; h a4a a.., The Company does not knowingly employ any utnatthorized aliens.: E R7flif li, AFETAIS' SA`YETH NOT., EXECUTED on the 7- '- day,o f 6- ‘ ,� 20 zo, . 6-7 r....e....--.. ,,,,.......8._ .l?:sated:' ,92/,��. Az 87 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 tale and,correct;. ram— Printed; .. . .__. DocuSign Envelope ID: 18602746-7B42-4CF0-9838-7738D50FAC89 Pa e 1 of 1 INDIANA RETAIL TAX EXEMPT 9 City of Ciririiie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 10424. 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 9/1/2020 355765 ARCTIC ZONE ICE RINK SERVICES ARCTIC ZONE LLC Human Resources VENDOR 1040 3RD AVE SW SHIP 1 Civic Square TO Carmel, IN 46032— CARMEL, IN 46032— PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 49491 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 922 Fund: 922 Ice Rink Fund Account: 43-509.00 1 Each ARCTIC ZONE ICE RINK SERVICES $12,600.00 $12,600.00 Sub Total $12,600.00 ��Q Y ry � 11 .. I����(o'���J jf(i F r1 1�111�1�111� ly, �%�t f !D/ �111J l�J,t,)4"; % UPl '.111011�(1d7�1 it i.'111��111iffi 1�111ifi.1 Send Invoice To: IIiil � ?r pk%n , Human Resources ill 141184 ' 1 Civic Square Carmel, IN 46032— PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT $12,600.00 SHIPPING INSTRUCTIONS *A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE 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. *THIS E SSUE NUMBER MUST APPEAR H ALL SHIPPING 99, NG LABEL _� 1 /4/c 'c-- C� a *THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 u/ AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY D Nancy Heck James Crider TITLE Director Director of Administration CONTROL NO. 104248 CONTROLLER