HomeMy WebLinkAboutDon_Hinds_Ford,_Inc._Goods_and_Services DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
APPROVED
Don Hinds Ford,Inc. By Jon Oberlender at 3:27 pm,Dec 07,2020
Fire Department-2020
Appropriation# 102 44-650.01;P.O.#104492
Contract Not To Exceed$40,157.50
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
Don Hinds Ford, 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 102 44-650.01 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 Forty Thousand One Hundred Fifty Seven Dollars and Fifty Cents
($40,157.50) (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, 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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DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
Don Hinds Ford,Inc.
Fire Department-2020
Appropriation# 102 44-650.01;P.O.#104492
Contract Not To Exceed$40,157.50
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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DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
Don Hinds Ford,Inc.
Fire Department-2020
Appropriation# 102 44-650.01;P.O.#104492
Contract Not To Exceed$40,157.50
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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DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
Don Hinds Ford,Inc.
Fire Department-2020
Appropriation# 102 44-650.01;P.O.#104492
Contract Not To Exceed$40,157.50
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,
Two Civic Square Corporation Counsel
Carmel, Indiana 46032 Department of Law
One Civic Square
Carmel, Indiana 46032
If to Vendor: Don Hinds Ford, Inc.
12610 Ford Drive
Fishers, Indiana 46038
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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DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
Don Hinds Ford,Inc.
Fire Department-2020
Appropriation# 102 44-650.01;P.O.#104492
Contract Not To Exceed$40,157.50
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, 2021 and shall,
on the first day of each January thereafter, automatically renew for a period of one (1) calendar year, unless
otherwise agreed by the parties hereto.
23. HEADINGS
All heading and sections of this Agreement are inserted for convenience only and do not form a part of this
Agreement nor limit, expand or otherwise alter the meaning of any provision hereof.
24. BINDING EFFECT
The parties, and their respective officers, officials, agents, partners, successors, assigns and legal
representatives, are bound to the other with respect to all of the covenants, terms, warranties and obligations
set forth in Agreement.
25. NO THIRD PARTY BENEFICIARIES
This Agreement gives no rights or benefits to anyone other than City and Vendor.
26. 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.
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DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
Don Hinds Ford,Inc.
Fire Department-2020
Appropriation# 102 44-650.01; P.O.#104492
Contract Not To Exceed$40,157.50
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 Don Hinds Ford, Inc.
by and through its Board of Public
Works and Safety
By:
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am Jes lrainard, Presiding Officer o.%% `d Sign '
Date: 12/17/2020 ``Z
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Mary/lnn Burke, Member
Date: 12/17/2020 j. , . IhieeRe44-447c'
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l:O SoU a_ tson, Member FID/TIN: - O a 7&4
Date: 12/17/2020
Last Four of SSN if Sole Proprietor:
ATTEST:
Date: /l ,/,,otv
rDocuSignedl by:
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Sue Wolfgang, Clerk
Date: 12/17/2020 !!!
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DocuSign Envelope ID:D9A506C0-FCCC-4F7D-80F1-C7292938ADAE 5 rew "'
(revised 11/16/20 to add the optional to igate step)
Prepared by: Todd Gilkey
11/07/2020 Don Hinds Ford Inc 112610 Ford Drive Fishers Indiana 1460382892
2021 F-250 4x4 SD Crew Cab 6.75' box 160" WB SRW XLT (W2B)
Price Level: 115 I Quote ID: CarmeIW2b
As Configured Vehicle
Code Description MSRP
Base Vehicle
W2B Base Vehicle Price (W2B) $46,300.00
Packages
603A Order Code 603A N/C
Includes:
-Engine:6.2L 2-Valve SOHC EFI NA V8 Flex-Fuel
-Transmission:TorqShift-G 6-Spd Auto w/SelectShift
-GVWR:10,000 lb Payload Package
-Tires:LT275/65Rx18E BSW A/S
Spare may not be the same as road tire.
-Wheels:18"Sparkle Silver Painted Cast Aluminum
Includes bright hub covers/center ornaments.
-Radio:AM/FM Stereo/MP3 Player
Includes 7 speakers.
-SiriusXM Radio
Includes a 6-month prepaid subscription and 1 I/P mounted center speaker. Services are not
available in Alaska and Hawaii. SiriusXM audio and data services each require a subscription sold
separately or as a package by SiriusXM Radio Inc.If you decide to continue service after your trial,
the subscription plan you choose will automatically renew thereafter and you will be charged
according to your chosen payment method at then-current rates.Fees and taxes apply. To cancel
you must call SiriusXM at 1-866-635-2349. See SiriusXM customer agreement for complete terms
at www.siriusxm.com.All fees and programming subject to change. SiriusXM and all related marks
and logos are trademarks of SiriusXM Radio Inc.
-SYNC 3 Communications&Entertainment System
Includes enhanced voice recognition, 8"LCD capacitive touch screen in center stack with swipe
capability,pinch-to-zoom capability included with available voice-activated touchscreen navigation
system, 4.2"productivity screen in IP cluster,AppLink, 911 Assist,Apple CarPlay and Android Auto
capability and 2 smart charging USB-C ports.
Powertrain
996 Engine: 6.2L 2-Valve SOHC EFI NA Included
V8 Flex-Fuel
44S Transmission: TorqShift-G 6-Spd Included
Auto w/SelectShift
X3E Electronic-Locking w/3.73 Axle Ratio $390.00
STDGV GVWR: 10,000 lb Payload Package Included
Wheels & Tires
TCH Tires: LT275/65Rx18E BSW A/S Included
Spare may not be the same as road tire.
648 Wheels: 18" Sparkle Silver Painted Included
Cast Aluminum
Includes bright hub covers/center ornaments.
Seats & Seat Trim
Prices and content availability as shown are subject to change and should be treated as estimates only.Actual base vehi:le,EXEH tE3' lion pricing
may vary from this estimate because of special local pricing,availability or pricing adjustments not reflected in the dealer's computer system.See
salesperson for the most current information. A
1
DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
Prepared by: Todd Gilkey
11/07/2020 Don Hinds Ford Inc 112610 Ford Drive Fishers Indiana 1460382892
2021 F-250 4x4 SD Crew Cab 6.75' box 160" WB SRW XLT (W2B)
Price Level: 115 I Quote ID: CarmeIW2b
As Configured Vehicle (cont'd)
Code Description MSRP
2 Cloth 40/Console/40 Front Seats $945.00
Includes 2-way adjustable driver/passenger headrests and driver's side manual lumbar.
Includes:
-Flow-Through Console
Includes 110V/400W outlet in rear.
Other Options
160WB 160"Wheelbase STD
17V XLT Value Package $1,480.00
Includes rear under-seat storage.
Includes:
-Autolock/Auto Unlock
-Halogen Fog Lamps
-8-Way Power Driver's Seat
-Reverse Sensing System
-SecuriCode Driver's Side Keyless Entry Keypad
47B Snow Plow/Camper Package $245.00
Requires Extra Extra Heavy-Duty Alternator(67E)when ordered with Upfitter
Switches (66S)and 110V/400W Outlet(43C).
Includes computer selected springs for snowplow application and heavy service front springs(1 up
upgrade above the spring computer selected as a consequence of options chosen. Not included if
maximum springs have been computer selected as standard equipment)and slide-in camper
certification.Note 1:Salesperson's Source Book or Ford RV Trailer Towing Guide should be
consulted for specific trailer towing or camper limits and corresponding required equipment, axle
ratios and model availability. Restrictions apply;see Supplemental Reference or Body Builders
Layout Book for details.Expect firmer ride when vehicle is not equipped with snowplow and/or
camper.Note 2:May result in deterioration of ride quality when vehicle is not equipped with
snowplow and/or camper.
Includes:
-Rear Stabilizer Bar
67E 240 Amp Alternator (Required with upfitteir switclhes) $85.00
54F PowerScope Trailer Tow Mirrors $280.00
w/Heat
Includes power-folding with Auto fold,telescoping,power glass,turn signal,high intensity LED
security approach lamps and utility lighting system(LED side-mirror spotlights).
18D 6"Angular Chrome Extended $740.00
Running Boards
153 Front License Plate Bracket N/C
Standard in states requiring 2 license plates and optional to all others.
595 Halogen Fog Lamps Included
85S Tough Bed Spray-In Bedliner $595.00
Includes tailgate-guard,black box bed tie-down hooks and black bed attachment bolts.
PAINT Monotone Paint Application STD
43B Fixed Rear-Window w/Defrost $60.00
Prices and content availability as shown are subject to change and should be treated as estimates only.Actual base veh cle, on pricing
may vary from this estimate because of special local pricing,availability or pricing adjustments not reflected in the dealers c r fSee
salesperson for the most current information. 2
DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
L�Uxd.)
Prepared by: Todd Gilkey
11/07/2020 Don Hinds Ford Inc 1 12610 Ford Drive Fishers Indiana 1 460382892
2021 F-250 4x4 SD Crew Cab 6.75' box 160" WB SRW XLT (W2B)
Price Level: 115 I Quote ID: CarmeIW2b
As Configured Vehicle (cont'd)
Code Description MSRP
Includes:
-Privacy Glass
166 Carpet Delete -$50.00
Replaced with black flooring.
76S Remote Start System $250.00
76R Reverse Sensing System Included
66S Upfitter Switches (6) $165.00
Requires Extra Extra Heavy-Duty Alternator(67E)when ordered with
110V/400W Outlet(43C) and Snow Plow Pkg. (473)or Snow Plow/Camper
Pkg. (47B).
Located in overhead console.
585 Radio: AM/FM Stereo/MP3 Player Included
Includes 7 speakers.
Includes:
-SiriusXM Radio
Includes a 6-month prepaid subscription and 1 I/P mounted center speaker. Services are not
available in Alaska and Hawaii. SiriusXM audio and data services each require a subscription sold
separately or as a package by SiriusXM Radio Inc.If you decide to continue service after your trial,
the subscription plan you choose will automatically renew thereafter and you will be charged
according to your chosen payment method at then-current rates.Fees and taxes apply. To cancel
you must call SiriusXM at 1-866-635-2349. See SiriusXM customer agreement for complete terms
at www.siriusxm.com.All fees and programming subject to change. SiriusXM and all related marks
and logos are trademarks of SiriusXM Radio Inc.
-SYNC 3 Communications&Entertainment System
Includes enhanced voice recognition, 8"LCD capacitive touch screen in center stack with swipe
capability,pinch-to-zoom capability included with available voice-activated touchscreen navigation
system, 4.2"productivity screen in IP cluster,AppLink, 911 Assist,Apple CarPlay and Android Auto
capability and 2 smart charging USB-C ports.
- 110V/400W Outlet
Includes 1 in-dash mounted outlet.
79V COV Required N/A
C09 Priced DORA N/C
Emissions
425 50-State Emissions System STD
Interior Colors
2S_01 Medium Earth Gray N/C
Primary Colors
Z1 01 Oxford White V N/C
SUBTOTAL $51,485.00
Prices and content availability as shown are subject to change and should be treated as estimates only.Actual base vehii le,4 sa'.n .ricing
may vary from this estimate because of special local pricing,availability or pricing adjustments not reflected in the dealer co "' . -ee
salesperson for the most current information. A
DocuSign Envelope ID: D9A506CO-FCCC-4F7D-80F1-C7292938ADAE
Prepared by: Todd Gilkey
11/07/2020 Don Hinds Ford Inc 112610 Ford Drive Fishers Indiana 1460382892
2021 F-250 4x4 SD Crew Cab 6.75' box 160" WB SRW XLT (W2B)
Price Level: 115 I Quote ID: CarmeIW2b
As Configured Vehicle (cont'd)
Code Description MSRP
Destination Charge $1,695.00
TOTAL $53,180.00
Prices and content availability as shown are subject to change and should be treated as estimates only.Actual base ve iclecacituevalpr fion pricing
may vary from this estimate because of special local pricing,availability or pricing adjustments not reflected in the deale's c81ThebtrWeFn!Ser.
salesperson for the most current information.
4
DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
( .)
Prepared by: Todd Gilkey
11/07/2020 Don Hinds Ford Inc 1 12610 Ford Drive Fishers Indiana 1 460382892
2021 F-250 4x4 SD Crew Cab 6.75' box 160" WB SRW XLT (W2B)
Price Level: 115 I Quote ID: CarmeIW2b
Pricing Summary - Single Vehicle
MSRP
Vehicle Pricing
Base Vehicle Price $46,300.00
Options & Colors $5,185.00
Upfitting $0.00
Destination Charge $1,695.00
Subtotal $53,180.00
Pre-Tax Adjustments
Code Description
Government Indiana Gov't price Concession -$7,500.00
Government price Concession for F350 Crew cab, 4wd,pick-up.
Dealer Discount Dealer's discount -$5,874.00
2021 Gov't price Concession for F250 Crew Cab, 4wd,pick-up
Subtotal $39,806.00
Post-Tax Adjustments
Code Description
Tire Tax State Tire Tax $1.50
Indiana State Tire Tax, on all new vehicles sold.
$39,807.50
Tailgate Step 350.00
Total sale price $ 40,157.50
*** Plus sales tax, if not exempt
Customer Signature Acceptance Date
Prices and content availability as shown are subject to change and should be treated as estimates only.Actual base vehicl , . .s .ption pricing
may vary from this estimate because of special local pricing,availability or pricing adjustments not reflected in the dealer's ILT. • t- s e Se e
salesperson for the most current information. /�
/�+� 5
DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
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: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE
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: D9A506CO-FCCC-4F7D-80F1-C7292938ADAE
EXHIBIT D
AFFIDAVIT
John Colglazier ,being first duly sworn, deposes and says that
he/she is familiar with and has personal knowledge of the facts herein and, if called as a witness in this
matter, could testify as follows:
1. I am over eighteen(18) years of age and am competent to testify to the facts contained
herein.
2. I am now and at all times relevant herein have been employed by
Don Hinds Ford (the"Employer")
in the position of General Manager
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 and has
provided documentation of such enrollment and participation to the City of Carmel,
Indiana.
5. The Company does not knowingly employ any unauthorized aliens.
FURTHER AFFIANT SAYETH NOT.
EXECUTED on the 7th day of December , 20 20
411",
Printed: '4°Y---..4.:14,1 2.
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.
) „
- ... ...
4 CYNTHIA A KIGGINS Printed: ,N.
SEAL
4 Notary Public, State of Indiana o'
My Commission Expires July 08, 2021
DocuSign Envelope ID: D9A506C0-FCCC-4F7D-80F1-C7292938ADAE Page 1 of 1
INDIANA RETAIL TAX EXEMPT 9
City ®f Cinririni el CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
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
11/17/2020 00352042 2021 F250 4 x 4
DON HINDS FORD Fire Department
VENDOR 12610 FORD DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032-
FISHERS, IN 46038-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
51521
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-650.01
1 Each 2021 F-250 4 x 4 SD Crew Cab 6.75' Box 160"WB SRW XLT $40,157.50 $40,157.50
(W2B)
Sub Total $40,157.50
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Send Invoice To: 1 ',111�1011111Il�llllllOII11II11II11111111f111I-411111lJJllJJJ,11111111I111k, / l
Fire Department f/ /
2 Civic Square �11�1 ,J�`` "y/I p. elr � 1 '1/ip a p�F'%/
Carmel, IN 46032- 1�,�1 $ l a 11 ,
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $40,157.50
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.
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 "� "t40.-4, „• ,
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder James Crider
TITLE Accreditation/Budget Administrator Director of Administration
CONTROL NO. 104492 CONTROLLER