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HomeMy WebLinkAboutPaperless Packet for BPW 11.3.21Board of Public Works and Safety Meeting Agenda Wednesday, November 3rd, 2021 – 10:00 a.m. Council Chambers City Hall, One Civic Square MEETING CALLED TO ORDER 1. MINUTES a. Minutes from the October 20, 2021, Regular Meeting 2. BID/QUOTE OPENINGS AND AWARDS a. Bid Opening for Construction of the Carmel Data Center; Timothy Renick, Director of Information and Communication Systems b. Bid Opening for 2022 Rock Salt; John Duffy, Director of the Department of Utilities 3. PERFORMANCE BOND RELEASE APPROVAL REQUESTS a. Resolution BPW 11-03-21-02; Salsbery Brothers Shop Building; Erosion Control; Salsbery Brothers b. Resolution BPW 11-03-21-03; The Ridge at Legacy, Section 5; Erosion Control; Falcon Nest II c. Resolution BPW 11-03-21-04; Amenity Area at the Legacy; Erosion Control; Falcon Nest II 4. CONTRACTS a. Resolution BPW 11-03-21-01; A Resolution of the City of Carmel Board of Public Works and Safety Acknowledging Agreement Between City and Vendor; Americans for the Arts; ($9,000.00); Arts and Economic Prosperity 6; James Brainard, Mayor b. Request for Purchase of Goods and Services; Maddox Industrial Group; ($4,524.75); Water Treatment Filters 7 and 8; CO #4202; John Duffy, Director of the Department of Utilities c. Request for Purchase of Goods and Services; CC & T Construction, Inc.; ($105,688.00); Resurfacing; Terry Killen, Street Commissioner d. Request for Purchase of Goods and Services; Indy Woodworks; ($2,321.96); Tables for Winter Pavilion; Nancy Heck, Director of the Department of Community Relations e. Request for Purchase of Goods and Services; Gradex, Inc.; (-$228,050.73); 16-ENG-49 North Rangeline Road Reconstruction; CO #7; Jeremy Kashman, City Engineer f. Request for Purchase of Goods and Services; Skillsoft Corporation; ($5,802.97); Software and Training; Additional Services Amendment; Timothy Renick, Director of Information and Communication Systems 5. REQUEST TO USE CITY STREETS/PROPERTY a. Request to Use Civic Square Gazebo; Giving Hope Diwali Event; November 5th, 2021; 5:00 PM – 10:00 PM; Joshika Sathyamathan b. Request to Use Civic Square Gazebo; Gold Star Memorial Ceremony; November 8th, 2021; 11:00 AM – 3:00 PM; Melanie Brewer, City of Carmel c. Request to Acknowledge Mayor’s Approval to Use City Hall Parking Lot; Bike Carmel Bicycle Donation Event; October 30th, 2021; 9:30 AM – 2:30 PM; Kevin Whited, City of Carmel d. Request to Use / Close City Streets; Tuxedo Brothers Gluhwein Gallop 5K Run/Walk; December 4th, 2021; 10:00 AM – 12:00 PM; Don Carr e. Request to Use Midtown Plaza and Stage; Holiday Porchfest, Amended; December 11th, 2021; 12:00 PM – 5:00 PM; Sondra Schwieterman 6. OTHER a. Request for Dedication and Deed of Public Rights –of-Way; The Signature at Carmel LLC; Jeremy Kashman, City Engineer b. Request for Grant of Perpetual Storm Water Quality Management Easement; EFN Crossroads Property, LLC; 4250 E. 96th Street; Jeremy Kashman, City Engineer c. Request for Waiver of BPW Resolution No. 04-28-17-01 / Lane Restrictions; 12575 River Road, 12602 Double Eagle Dr, 13023 Fletcher Trace; Duke Energy d. Request for Lane Restrictions / Open Pavement Cut; Smoky Row and Monon Trail; Terracon Consultants e. Request for Lane Restrictions / Sidewalk Closure / Pavement Cut; Proscenium II; Timothy Hill, NOVO f. Request for Construction Entrance; 10026 Spring Mill Road; Nichole Loomis, Hoss Homes g. Request for Consent to Encroach and Variance; 1077 3rd Ave SW; 1077 3rd Ave SW, LLC h. Request for Consent to Encroach and Variance; 13556 Silver Spur; Mark and Kelly Brotherton 7. ADJOURNMENT Board of Public Works and Safety Meeting 1 Minutes 2 Wednesday, October 20, 2021 – 10:00 a.m. 3 Council Chambers City Hall, One Civic Square 4 5 MEETING CALLED TO ORDER6 7 Mayor Brainard called the meeting to order at 10:01 AM 8 9 MEMBERS PRESENT10 11 Mayor James Brainard, Board Members Lori Watson and Mary Ann Burke, and Deputy Clerk Jennifer Stites 12 were present. 13 14 MINUTES15 16 Minutes from the October 6, 2021 Regular Meeting. Board Member Burke moved to approve. Board Member 17 Watson seconded. Request approved 2-0. Mayor Brainard abstained. 18 19 PERFORMANCE RELEASE/REDUCTION APPROVAL REQUESTS20 21 Resolution BPW 10-20-21-02; Copper Run; Erosion Control; Board Member Burke moved to approve. Board 22 Member Watson seconded. Request approved 3-0. 23 24 Resolution BPW 10-20-21-03; Woods of Shelborne; Erosion Control; Board Member Burke moved to approve. 25 Board Member Watson seconded. Request approved 3-0. 26 27 Resolution BPW 10-20-21-04; Indianapolis Rehab Institute; Right of Way; Board Member Burke moved to 28 approve. Board Member Watson seconded. Request approved 3-0. 29 30 Resolution BPW 10-20-21-05; Camden Walk 2B; Erosion Control; Board Member Burke moved to approve. 31 Board Member Watson seconded. Request approved 3-0. 32 33 CONTRACTS34 35 Resolution BPW 10-20-21-01; A Resolution of the City of Carmel Board of Public Works and Safety 36 Acknowledging Agreement Between City and Vendor; Envoy Construction Services, LLC.; ($1,276,500.00); 37 Agreement for Professional Services; Board Member Burke moved to approve. Board Member Watson 38 seconded. Request approved 3-0. 39 40 Request for Purchase of Goods and Services; Canon Solutions America, Inc; ($6,000.00); Copier Lease; 41 Additional Services Amendment; Board Member Burke moved to approve. Board Member Watson seconded. 42 Request approved 3-0. 43 44 Request for Purchase of Goods and Services; Fredericks, Inc; ($25,410.00); Roof for Fire Station #41; 45 Additional Services Amendment #2; Board Member Burke moved to approve. Board Member Watson seconded. 46 Request approved 3-0. 47 48 Request for Purchase of Goods and Services; Ellis OD, LLC; ($5,000.00); Professional Services – Department 49 Organizational Workshops; Board Member Burke moved to approve. Board Member Watson seconded. Request 50 approved 3-0. 51 52 Request for Purchase of Goods and Services; MEG & Associates, LLC; ($2,500.00); Media and Public 53 Relations; Additional Services Amendment #3; Board Member Burke moved to approve. Board Member Watson 54 seconded. Request approved 3-0. 55 56 REQUEST TO USE CITY STREETS/PROPERTY57 58 Request to Use/Close City Streets and Use the Monon and Main Plaza; Art of Wine Festival; May 21st, 2022; 59 9:00 AM – 11:00 PM; Board Member Burke moved to approve. Board Member Watson seconded. Request 60 approved 3-0.61 62 Request to Use Veterans Memorial Plaza; CPD Traffic Control for the City of Carmel Veterans Day Ceremony; 63 November 10th, 2021; 11:00 AM – 2:00 PM; Board Member Burke moved to approve. Board Member Watson 64 seconded. Request approved 3-0.65 66 Request to Have a Fireworks Display; Celebration for Diwali; November 6th, 2021; 6:30 PM – 9:30 PM; 67 Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. 68 69 Request to Have a Fireworks Display; Celebration for Diwali; November 6th, 2021; 8:00 PM – 9:00 PM; 70 Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0.71 72 Request to Acknowledge Mayor’s Approval to Use/Close City Streets; Midtown’s Got Talent; October 8th, 73 2021; 3:00 PM – 8:00 PM; Board Member Burke moved to approve. Board Member Watson seconded. Request 74 approved 3-0.75 76 Request to Use Civic Square Gazebo; Proposal; October 29th, 2021; 1:00 PM – 11:00 PM; Board Member 77 Burke moved to approve. Board Member Watson seconded. Request approved 3-0.78 79 Request to Use/Close City Streets; Carmel PorchFest; September 18th, 2022; 9:00 AM – 7:00 PM; Board 80 Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. 81 82 Request to Use Civic Square Gazebo; Fall Music Recital; October 24th (October 30th for a Rain Make-up 83 Date), 2021; 12:00 PM – 7:00 PM; Board Member Burke moved to approve. Board Member Watson seconded. 84 Request approved 3-0.85 86 Request to Use Tarkington Theatre & Veteran’s Plaza; City of Carmel Veterans Day Ceremony; November 87 10th, 2021; 11:00 AM – 2:00 PM; Board Member Burke moved to approve. Board Member Watson seconded. 88 Request approved 3-0.89 90 OTHER91 92 Request for New Curb Cut; Carmel Total Fitness – 820 City Center Drive; Board Member Burke moved to 93 approve. Board Member Watson seconded. Request approved 3-0.94 95 Request for New Curb Cut; Napleton Auxiliary Parking Lot – 4240 E. 96th Street; Board Member Burke moved 96 to approve. Board Member Watson seconded. Request approved 3-0. 97 98 Request for Lane Restriction/Open Cut; 202 Woodland Lane; Board Member Burke moved to approve. Board 99 Member Watson seconded. Request approved 3-0.100 101 Request for Storm Water Technical Standards Waiver; Islamic Life Center Carmel – 7299 E. 146th Street; 102 Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0.103 104 Request for Consent to Encroach; 30 Shoshone Drive; Board Member Burke moved to approve. Board Member 105 Watson seconded. Request approved 3-0.106 107 Request for Variance; 30 Shoshone Drive; Board Member Burke moved to approve. Board Member Watson 108 seconded. Request approved 3-0.109 110 Request for Replat; Carmel Science & Tech Lot 14; Board Member Burke moved to approve. Board Member 111 Watson seconded. Request approved 3-0.112 113 Resolution BPW 10-20-21-06; A Resolution of the City of Carmel, Indiana Board of Public Works and Safety 114 Regarding the Release of Temporary Highway Easement; Carmel Dr./ Penn St. Roundabout Project; Board 115 Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. 116 117 Request for Release of Temporary Highway Easement; Carmel Dr. / Penn St. Roundabout Project; Board 118 Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. 119 120 ADD-ONS121 122 Request for Secondary Plat; Hamilton Crossing East; Board Member Burke moved to add one add-on item onto 123 the agenda. Board Member Watson seconded. Add-on approved 3-0; Board Member Burke moved to approve 124 request. Board Member Watson seconded. Request approved 3-0. 125 126 ADJOURNMENT127 128 Mayor Brainard adjourned the meeting at 10:05 a.m. 129 130 131 APPROVED: ____________________________________ 132 Sue Wolfgang – City Clerk 133 134 _____________________________________ 135 Mayor James Brainard 136 ATTEST: 137 138 __________________________________ 139 Sue Wolfgang – City Clerk 140 RESOLUTION NO. BPW 11-03-21-01 RESOLUTION OF THE CITY OF CARMEL BOARD OF PUBLIC WORKS AND SAFETY ACKNOWLEDGING AGREEMENT BETWEEN CITY AND VENDOR WHEREAS, pursuant to Indiana Code 36-1-4-7, the City of Carmel, Indiana (“City”), is authorized to enter into contracts; and WHEREAS, pursuant to Indiana Code 36-4-5-3, the City’smayor may enter into contracts on behalf ofthe City; and WHEREAS, pursuant to his authority under Indiana law, the City’smayor, the Honorable James C. Brainard, has caused to be signed the Agreement attached hereto as Exhibit A (the “Contract”); and WHEREAS, Mayor Brainard now wishes to present the contract to the City’sBoard of Public Works and Safety for it to be publicly acknowledged, filed in the Clerk’sOffice, and made available to the public for review. NOW, THEREFORE, BE IT RESOLVED by the City of Carmel Board of Public Works and Safety as follows: 1. The foregoing Recitals are incorporated herein by this reference. 2. The receipt ofthe Contract is hereby acknowledged. 3. The Contract shall be promptly filed in the office of the Clerk and thereafter made available to the public for review. SO RESOLVED this day of , 2021. CITY OF CARMEL, INDIANA By and through its Board of Public Works and Safety BY: James Brainard, Presiding Officer Date: Mary Ann Burke, Member Date: Lori S. Watson, Member Date: ATTEST: Sue Wolfgang, Clerk Date: C:\\Users\\clivingston\\AppData\\Local\\Microsoft\\Windows\\INetCache\\Content.Outlook\\562V7G6G\\11-03-21-01AEP 6Contract Resolution.docx10/25/20213:11PM October 20, 2021 CzTfshfzHsfdivlijobu3;11qn-Pdu36-3132 CzTfshfzHsfdivlijobu21;17bn-Pdu37-3132 CC & T Construction, Inc. Street Department - 2021 Appropriation # 2201 176 44-628.06; P.O. #105629 Contract Not To Exceed $105,688.00 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:\\Users\\clivingston\\Desktop\\Contract Templates\\CC & T Construction, Inc. Goods and Services.doc:10/25/2021 11:53 AM\] 2 CC & T Construction, Inc. Street Department - 2021 Appropriation # 2201 176 44-628.06; P.O. #105629 Contract Not To Exceed $105,688.00 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:\\Users\\clivingston\\Desktop\\Contract Templates\\CC & T Construction, Inc. Goods and Services.doc:10/25/2021 11:53 AM\] 3 CC & T Construction, Inc. Street Department - 2021 Appropriation # 2201 176 44-628.06; P.O. #105629 Contract Not To Exceed $105,688.00 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 City of Carmel Street Department Department of Law st3400W. 131 Street One Civic Square Carmel, Indiana 46074 Carmel, Indiana 46032 If to Vendor: CC & T Construction, Inc. 5051 Prospect Street Indianapolis, Indiana 46203 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:\\Users\\clivingston\\Desktop\\Contract Templates\\CC & T Construction, Inc. Goods and Services.doc:10/25/2021 11:53 AM\] 4 CC & T Construction, Inc. Street Department - 2021 Appropriation # 2201 176 44-628.06; P.O. #105629 Contract Not To Exceed $105,688.00 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 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. C:\\Users\\clivingston\\Desktop\\Contract Templates\\CC & T Construction, Inc. Goods and Services.doc:10/25/2021 11:53 AM\] 5 EXHIBIT B Invoice Date: Name of Company: Address & Zip: Telephone No.: Fax No.: Project Name: Invoice No. Purchase Order No: Goods Services Person Providing Goods/Services Date Goods/ Service Provided Goods/Services Provided Describe each good/service separately and in detail) Cost Per Item Hourly Rate/ Hours Worked Total GRAND TOTAL Signature Printed Name 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 Page 1 of 1INDIANARETAILTAXEXEMPT CERTIFICATE NO. 003120155 0020PURCHASE ORDER NUMBERCityofCarmel FEDERAL EXCISE TAXEXEMPT 105629 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES, A/PONECIVICSQUARE VOUCHER, DELIVERY MEMO, PACKING SLIPS, CARMEL, INDIANA 46032-2584 SHIPPING LABELS AND ANY CORRESPONDENCE FORM APPROVED BYSTATE BOARD OFACCOUNTS FOR CITY OFCARMEL - 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 10/19/2021033150 CC & T CONSTRUCTION INC Street Department VENDORSHIP5051PROSPECTST 3400 W. 131st Street TO Carmel, IN 46074- INDIANAPOLIS, IN 46203 - Terry Killen(317) 733-2001 PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 60329 QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION Department:Fund: 2201176ARP COVID LOCAL FIS REC Account: 44-628.06 1EachResurfacing$105,688.00$105,688.00 Sub Total 105,688.00 Send Invoice To: Street Department 3400 W. 131st Street Carmel, IN 46074- 317) 733-2001 PLEASE INVOICE INDUPLICATE DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT 105,688.00PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE ASHIPPINGINSTRUCTIONSPARTOFTHEVOUCHERANDEVERYINVOICEANDVOUCHERHASTHEPROPERSWORN 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 LABEL THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 ORDERED BYANDACTSAMENDATORYTHEREOFANDSUPPLEMENTTHERETO. Terry KillenJames Crider TITLECommissionerDirector ofAdministration CONTROL NO. 105629 CONTROLLER CzTfshfzHsfdivlijobu2;35qn-Pdu38-3132 Tim Schnizlein d/b/aIndy Woodworks Department of Community Relations - 2021 Appropriation #43-509.00 Ice Rink Fund 922; P.O. #105634 Contract Not To Exceed $2,321.96 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. INDEMNIFICATION: 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. 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, S:\\Contracts\\Prof.Svcs & Goods Svcs\\Community Relations\\2021\\Tim Schnizlein dba Indy Woodworks Goods and Services.doc:10/27/2021 9:30 AM\] 2 Tim Schnizlein d/b/aIndy Woodworks Department of Community Relations - 2021 Appropriation #43-509.00 Ice Rink Fund 922; P.O. #105634 Contract Not To Exceed $2,321.96 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 C, 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 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. S:\\Contracts\\Prof.Svcs & Goods Svcs\\Community Relations\\2021\\Tim Schnizlein dba Indy Woodworks Goods and Services.doc:10/27/2021 9:30 AM\] 3 Tim Schnizlein d/b/aIndy Woodworks Department of Community Relations - 2021 Appropriation #43-509.00 Ice Rink Fund 922; P.O. #105634 Contract Not To Exceed $2,321.96 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 Jon Oberlander, One Civic Square Interim Corporation Counsel Carmel, Indiana 46032 Department of Law One Civic Square Carmel, Indiana 46032 If to Vendor: Tim Schnizlein d/b/a Indy Woodworks 1125 N. Hartman Dr. Indianapolis, Indiana 46219 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. 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 S:\\Contracts\\Prof.Svcs & Goods Svcs\\Community Relations\\2021\\Tim Schnizlein dba Indy Woodworks Goods and Services.doc:10/27/2021 9:30 AM\] 4 Tim Schnizlein d/b/aIndy Woodworks Department of Community Relations - 2021 Appropriation #43-509.00 Ice Rink Fund 922; P.O. #105634 Contract Not To Exceed $2,321.96 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. 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. 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. S:\\Contracts\\Prof.Svcs & Goods Svcs\\Community Relations\\2021\\Tim Schnizlein dba Indy Woodworks Goods and Services.doc:10/27/2021 9:30 AM\] 5 Timothy Schnizlein Owner 4297 10/27/2021 Indy Woodworks PROJECT ESTIMATE1125NHartmanDr. Indianapolis, IN 46219 317-426-6066 Prepared by: Tim Schnizlein Project Description: Project Manager Christmas Tree Tables x4 PARTS/MATERIAL/SERVICES TOTALITEMNAMEITEMDESCRIPTIONUNITSPRICE / UNIT 502.40Lumber1x10x10' Pine16$ 31.40 150.161x10x6' Pine8$ 18.77 63.42SparUrethane2$ 31.71 30.98GoldenPecanStain1$ 30.98 PARTS/MATERIAL$ 746.96 LABOUR TOTALTASKNAMETASKDESCRIPTIONHOURSPRICE / HOUR 855.00MillingCuttingandmanufacturingallparts19$ 45.00 270.00JointingPreparingsurfacesandjointsforattachment6$ 45.00 180.00AssemblyFinalassemblyofproject4$ 45.00 270.00FinishStain/Finish6$ 45.00 LABOUR$ 1,575.00 2,321.96PROJECTDESCRIPTION: SUBTOTAL Four slide together christmas tree tables. Stained to match barrell tables. 0% TAX TOTAL 2,321.96 EXHIBIT B Invoice Date: Name ofCompany: Address & Zip: Telephone No.: FaxNo.: Project Name: Invoice No. Purchase Order No: Services Person Providing Date Services ProvidedHourly Total ServicesService (Describe each good/service Rate/ Provided separately and in detail)Hours Worked GRAND TOTAL Signature Printed Name Page 1 of 1INDIANARETAILTAXEXEMPT PURCHASE ORDER NUMBERCERTIFICATENO. 003120155 002 0CityofCarmel FEDERAL EXCISE TAX EXEMPT 105634 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES, A/PONECIVICSQUARE VOUCHER, DELIVERY MEMO, PACKING SLIPS, CARMEL, INDIANA 46032-2584 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 TABLES FOR PAVILION10/20/2021376104 INDY WOODWORKS Human Resources VENDORSHIP1125NHARTMANDR 1 Civic Square TO Carmel, IN 46032- INDIANAPOLIS, IN 46219 - PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 60364 QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION Department:Fund: 922922Ice Rink Fund Account: 43-509.00 Each1TABLES FOR WINTER PAVILION$2,321.96$2,321.96 Sub Total 2,321.96 Send Invoice To: Human Resources 1 Civic Square Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT 2,321.96PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE ASHIPPINGINSTRUCTIONSPARTOFTHEVOUCHERANDEVERYINVOICEANDVOUCHERHASTHEPROPERSWORN SHIP PREPAID. AFFIDAVIT ATTACHED. IHEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN C.O.D. SHIPMENT CANNOT BE ACCEPTED.THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 ORDERED BYANDACTSAMENDATORYTHEREOFANDSUPPLEMENTTHERETO. Nancy Heck TITLEDirector CONTROL NO. 105634 CONTROLLER CzTfshfzHsfdivlijobu:;61bn-Pdu38-3132 CzTfshfzHsfdivlijobu:;31bn-Pdu38-3132 ---- PM JS 10/27/21 BPW 11/3/21 REVIEWED VIA EMAIL CPD BICKEL 10/25/21 OK CFD SUTTON 10/25/21 OK CRED BREWER/HECK 10/27/21 ---- PM JS 10/27/21 BPW 11/3/21 CRED BREWER/HECK 10-27-21 CPD BICKEL 10-20-21 CFD SUTTON 10-20-21 REVIEWED VIA EMAIL CITY OF CARMEL, INDIANA INFORMATION SPECIAL EVENT / FACILITY USE REQUEST FORM Contact Person Email Phone Number: Cell Number: Address Name/Organization: Organization Type: Residency/Location: Event/Use Purpose: Event Date End Date Number of People Expected: Set-Up Start time Tear Down End Time CONTACT INFORMATION: Kevin Carmel: Whited kwhited@carmel.in.gov 3178197208 City Carmel State / Province / Region IN Postal / Zip Code 46032 Country United States Street Address 30 West Main Street Address Line 2 Economic Development/Carmel Utilitie City of Carmel, Bike Carmel Do you reside or are you located within the Carmel city limits? Yes No Bicycle donation event co-hosted by the City (Bike Carmel) and Freewheelin Community Bikes 10/30/2021 10/30/2021 50 09:30:00 AM 02:30:00 PM JS 10/27/21 BPW 11/3/21 MAYOR APPROVED 10/22/21 CFD SUTTON 10/22/21 CPD BICKEL 10/22/21RETRO APPROVAL REVIEWED VIA EMAIL Event Start time:Event end time: Rehearsal Rehearsal Date: Rehearsal Start Time: Rehearsal End Time: Fees? Description of Event: FACILITY (S) REQUESTS: VENDORS: 10:00:00 AM 02:00:00 PM NA Will a Fee be charged for this event? If yes please describe in narrative below. YES NO Provide a brief description of event This is a drive-up and drop-off event where members of the community can donate new and used bicycles to Freewheelin Community Bikes, a nonprofit that has various programs to help kids build and repair bicycles at the end of the program, they get to keep. Last year we had roughly ~75 bicycles donated. Attach additional pages if needed-SEE BELOW image.png 167.84KB ADDITIONAL PAGES OF DESCRIPTION OF THE EVENT CITY FACILITY (S) REQUESTED: Mark all that apply CARTER GREEN CIVIC SQUARE FOUNTAIN AREA CIVIC SQUARE GAZEBO JAPANESE GARDEN MONON & MAIN PLAZA MIDTOWN PLAZA - Events must be free and open to the public. REFLECTING POOL - Please note that Veteran's Plaza is NOT available for rent. Other City Hall Parking Lot SPECIAL REQUESTS: Mark all that apply ELECTRICITY FOUNTAIN RESTROOM - FOUNTAIN/GAZEBO JAMES BUILDING RESTROOMS (CARTER GREEN) *Extra fees apply N/A Other VENDORS: Mark all that apply SEE CITY OF CARMEL FACILITY USE POLICY VENDORS PRESENT FOOD SERVED ALCOHOL SERVED - Please see Section M under “General Terms and Conditions” in the special event policy handbook. N/A CITY SERVICES NEEDED: Neighborhood Name/Streets to be closed UPLOAD MAP Type of Closure: Further Info for type of closure CITY SERVICES NEEDED: Mark all that apply SEE CITY OF CARMEL FACILITY USE POLICY EMERGENCY MEDICAL SERVICES (EMS) TRAFFIC CONTROL ONSITE SECURITY BARRICADES NO PARKING SIGNS (PICK UP AT CARMEL POLICE DEPARTMENT) N/A Please note the number of NO PARKING SIGNS needed EVENT SET UP: Mark all that apply SEE CITY OF CARMEL FACILITY USE POLICY Stage Size of Stage Tent(s) – If you are requesting Midtown Plaza, the exclusive vendor for tent rental is A-Classic Party Rentals (317-251-7368). Size of Tent (s) Bounce House N/A Other Name of Merchants(s) doing the setup Phone Number of Merchant(s) doing set up: STREET(S) REQUESTED: SEE CITY OF CARMEL FACILITY USE POLICY Include addresses as appropriate An easy to read, color map of the area is required with submission. Rolling closure Total closure Lane restrictions - explain below Other - explain below N/A Explain lane restrictions needed and other needed below: SECURITY DEPOSIT AND FEE: A refundable Security Deposit in the amount of $100 for any applicant located or residing within Carmel city limits or a non-refundable event fee in the amount of $150 for any applicant located or residing outside of Carmel city limits must be received prior to application review or processing. Payment may be made online using a credit or debit card at www.govpaynow.com PLC #A0026j, calling the Govpay call center at 1-888-604-7888 (give them PLC#) or in the form of a certified check or money order made payable to the City of Carmel. (Mail to: Carmel City hall, Attn: Lobby Desk, 1 Civic Square, Carmel, IN 46032) The Carmel Board of Public Works and Safety reserves the right, in its sole discretion, to deny any facility use request and/or revoke any previsously granted request to use a City facility for any lawful reason. DISCLAIMER: ACKNOWLEDGEMENT AND AGREEMENT Mayor's Office ACKNOWLEDGEMENT AND AGREEMENT TO COMPLY WITH CITY FACILITY USE POLICY I have read and understand the City of Carmel, Indiana ("City") Facility Use Policy and agree to be bound by all the terms and conditions set forth therein. I will leave the City facility I use in the same condition that it was immediately prior to my use thereof. I agree to pay for any damage, repair or clean-up costs incurred by the City as a result of my use of a City facility. I hereby certify that I, and the organization I represent, if applicable, agree to be bound by the City's Facility Use Policy and by any addition conditions or restrictions placed upon my/our use of a City facility by the Board. I understand that the Board has the right to deny, alter or revoke my request for the use of a City facility for any lawful reason. I and/or my organization also agree to indemnify and hold harmless the City of Carmel and all of its directors, officers, employees, agents and affiliates from any claims of whatever nature (whether foreseeable or not) arising from or in connection with this Application for any damages, costs or expenses incurred directly or indirectly as a result of my/our use of the City-owned facility and/or property. * GO TO SUBMIT TAB AND CLICK ON SUBMIT Kevin W Whited, City of Carmel Name of Organization/Applicant Signature of Authorized Agent/Applicant Kevin W Whited, Transportation Development Coordinator Printed Name and Title (If applicable) Address of Organization/Applicant 10/21/2021 Date CITY OF CARMEL USE ONLY Approved this ______day of _______________, 20 CITY OF CARMEL, INDIANA By and Through its Board of Public Works and Safety ___________________________________ James Brainard, Presiding Officer Date: ______________________________ ___________________________________ Mary Ann Burke, Member Date: ______________________________ ___________________________________ Lori Watson, Member Date: ______________________________ ATTEST: _____________________ Sue Wolfgang, City Clerk ________________ Date Special Conditions:__________________________________________________________________ APPLICATION CHECKLIST (for use by City of Carmel) Checklist Applicable permit or approval copies received Application completed in full Event narrative description included Maps attached, if applicable Vendor list attached, if applicable Security deposit or event fee received Certificate of Insurance received Communication plan to residents and/or businesses and/or copy of email correspondence to affected parties received HOA approval received Hamilton County Health Department Hamilton County Sheriff City of Carmel Fire Marshal City of Carmel Police Department Carmel Clay Parks & Recreation SUBMIT Drop-down Single Line Checkbox Checkbox Drop-down choice 1 choice 2 choice 3 choice 1 choice 2 choice 3 10/27/21 AMENDED REQUEST AMENDMENT OK BREWER/HECK 10-27-21 AMENDMENT OK 10-25-21 AMENDMENT OK 10-25-21 ADDED REQUEST ADDED REQUEST ADDED REQUEST CzKpoPcfsmboefsbu21;22bn-Pdu38-3132 City of Carmel BOARD OFPUBLIC WORKS & SAFETY ACCEPTANCE OFDEDICATION & DEED OFPUBLIC RIGHTS-OF-WAY WHEREAS,theCitybelieves thatsaidfee simple conveyance ofthePropertyisdesirable, necessaryand intheCity'sbestinterests; and NOW THEREFORE, theCity, byandthrough itsBoard ofPublic Works andSafety, hereby accepts saidDedication andDeed, andorders thattheDedication andDeed of Public Rights-of-Way described herein berecorded intheRecorder'sOffice ofHamilton County, Indiana, andthatthe Property be, andthe samehereby is, declared open anddedicated tothe City. SOORDERED:CITY OFCARMEL BOARD OFPUBLIC WORKS &SAFETY James Brainard, Presiding Officer Date: MaryAnnBurke, Member Date: LoriWatson, Member Date: ATTEST: SueWolfgang, Clerk Date: TATE OF INDIANA ) S SS: COUNTY OF HAMILTON ) Before me, aNotary Public in and for said County and State, personally appeared JAMES BRAINARD, MARY ANN BURKE and LORI WATSON, by me known, and by me known to be the Members of the City of Carmel Board of Public Works and Safety, and SUE WOLFGANG, Clerk of THE CITY OF CARMEL, who acknowledged the execution of the foregoing Dedication and Deed of Public Rights-of-Way on behalf of the City of Carmel, Indiana. Witness my hand and Notarial Seal this day of , 20 . NOTARY PUBLIC My Commission No./Expiration: Printed Name My County of Residence: FYIJCJUB FYIJCJUB FYIJCJUB CzKpoPcfsmboefsbu2;2:qn-Pdu37-3132 FYIJCJUB 2PG3 FYIJCJUB 3PG3