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Home My WebLink About187563 07/08/2010 CITY OF CARMEL, INDIANA VENDOR: 359715 Page 1 of 1 ONE CIVIC SQUARE EAGLE RIDGE CIVIL ENG SVS LLC CHECK AMOUNT: $593.77 CARMEL, INDIANA 46032 1321 LAUREL OAK DR AVON IN 46123 CHECK NUMBER: 187563 CHECK DATE: 7/8/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 211 4462200 027 -08 31.05 SIDEWALK IMPROVEMENTS 211 R4462200 19821 027 -08 562.72 AUMAN /NEWARK IMRPO ST Invoice Date Invoice IFIALCG 11 IF, RI ]E> CT'\7T7-, TE.T%TC,1W'F. 6/26/2010 027-08 1321 Laurel Oak Drive Avon, IN 46123 Project Bill To: City of Carmel 027 Auman Newark Neighbrhd ]mprvmnts David Littlejohn Dept. of Community Services One Civic Square P.O. No. Terms Carmel, IN 46032 19921 Net 60 Item Description Quantity Unit Rate Markup Amount Engineering Services Brock Ridgway, P.E. 1,5 Hours 105.00 157.50 CADD Services Robert Allen 0 Hours 55.00 0.00 Survey Services Topo Survey Topographic Surve 0 LumpSum 20,475.00 0.00 Project Mileage Project Mileage 120 Miles 0.50 60.00 Project Misc. Expenses Printing of Bid Sets I Direct Cost 364,72 364.72 Reimbursable Expense Permits Permit Fees 0 100.00 0.00 Project Misc. Expenses UPS Shipping I Direct Cost 11.55 11.55 1 Total $593.77 INVOICING SUMMARY: Sub Witted by: Previously Invoiced: Total To Date: $40,763.78 $41,357.55 Br R- gway, Manager Invoice Date Invoice 8103 East US Highway 36 Avon IN 46123 5117/2010 30382 317 272 -4798 or 317 -272 -4300 FAX 317 -272 -4388 managerCa a vonreprographics. com www. theupsstorelocaL com /4266 Eagle Ridge Civil Eng Serv. LLC. 1321 Laurel Oak Drive Avon IN 46123 P.O. No. Terms Order By NOW OFFERING LARGE FORMAT COLOR SCANNING Carmel Spec Printing Net 30 Brock Ridgeway Quantity Description Rate Amount 532 1 IX17 Copies 19 28 sets 0.11 58.52 4,880 4889 copies 0.05 244.00 225 Colored Paper 0.04 9.00 19 Comb Binding/ 19 combs 2.80 53.20 oz� Thank you for your Business UPS Reprographics Center To tal $364.72 Signator represents that the reproduction of the above described material does not violate any copyright laws and the signator agrees to indemnify and hold THE UPS STORE REPROGRAPHICS CENTER harmless against all claims for any alleged copyright infrigement. UPS Store is not responsible for consequential damages Signature Late Charges of 1.5% per month, equal to 18% annual on unpaid balances after 30 days. In the event that legal action is required to collect an unpaid balance that is due, all court costs and reasonable attorney fees will apply. The UPS Store Staff Delivery Service Invoice O Invoice date June 19, 2010 Invoice number 0000132F33250 T. Shipper number 132F33 Page 3 of 3 Outbound UPS Shipping Document Pickup ZIP Billed Date Tracking Number Service Code Zone Weight Charge 06 /17 1 Z132F333710002240 2nd Day Air Commercial 46032 202 3 10.50 Fuel Surcharge 1.05 Total 1 1.55 1st ref: 1503 -027 Sender BROCK RIDGWAY Receiver: DAVID LITTLE JOHN EAGLE RIDGE CIVIL EN CITY OF CARMEL DEPT INDIANAPOLIS IN 4626$ CARMEL IN 46032 Total UPS Shipping Document 1 Package(s) 11.55 Total Outbound 1 Package(s) 11.55 1 ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE 06 11 -2010_ PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USAA INSURANCE AGENCY INC /PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 812846 P:(888)242-1430 F (8 7 7) 9 0 5 04 5 7 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 33015 SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED INSURER A: Hart f Ord Casualty Ins Co EAGLE RIDGE CIVIL ENGINEERING INSURER B: Hartford Ins Co of the Midwest SERVICES, LLC INSURER C: 1321 LAUREL OAK DR INSURER D: AVON IN 46123 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH P AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA CLAIM ICY LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMFDD/YYE I P DATE IMM /OD/YYN LIMITS 1 GENERAL LIABILITY EACH OCCURRENCE S2 A n COlvl(CiERCIAL cE aEr AL LIABILITY 65 SBM RZ2256 0 7 12 10 07/12/11 FIRE DAMAGE (Any ane Ive) I $300,000 CLAIMS MADE I X I OCCUR VIED EXP (Any one person) 0 U U X General Liab PERSONAL ADV INJURY 52 000 0 GENERAL AGGREGATE $4 0 0 0, 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMPIOP AGG I s4 ,000,0001 POLICY F I PRO ECT X LOG J AUTOMOBILE LIABILITY A ANY AUTO 65 SBM RZ2256 07/12/10 07/12/11I COMBINEDSINGLELIMI7 000, 000 (Ea accidentl ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accidentl PROPERTY DAMAGE (Per accidenO GARAGE LIABILITY AUTO ONLY EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $1, 0 0 0 00 0 A X I OCCUR a CLAIMSMADE 65 SBM RZ2256 07/12/10 07/12/11 AGGREGATE $1, 000, 000 DEDUCTIBLE X RETENTION $10, 000 TDRY LIMITS ER WORKERS COMPENSATION AND X WC D IMIT B EMPLOYERS' LIABILITY 65 WEC RT2 5 8 2 0 01/02/11 E.L. EACH ACCIDENT $500,000 E.L. DISEASE EA EMPLOYEE $5 0 0 000 E.L. DISEASE PO LIMIT s500 0 0 0 OTHER DESCRIPTION OF OPERATIONS ILOCATIONSIVEH ICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Those usual to the Insured's Operations. City Carmel, Indiana is an Additional Insured per the Business Liability Coverage form SS0008, attached to this CERTIFICATE HOLDER X I ADDITIONAL INSURED INSURER LETTER: CANCELLATION SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON PAYMENT) TO THE CERTIFICATE City f Carmel, Indiana HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO y OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1 Civic Sq. REPRESENTATIVES. Carmel, IN 46032 AUTHORI D RE S�TIVE ACORD 25 -S 171971 C ACORD CORPORATION 1988 USAA INSURANCE AGENCY INC /PHS PO BOX 33015 SAN ANTONIO TX, 76265 12024 EAGLE RIDGE CIVIL ENGINEERING SERVICES, LLC. 1321 LAUREL OAK DR AVON IN 46123 m N a E m ACORD 25 -S (7197) Prescribed by State Board of Accounts City Farm No. 201 (Rev. 1995 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Eagle Ridge Civil Engineering Services, LLC Purchase Order No. 1321 Laurel Oak Drive Terms Avon, IN 46123 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 06/26/10 027 -08 Auman Newark Neighbrhd Improvements $593.77 I W 59 2 7 7- Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Eagle Ridge Civil Engineering Service I IN SUM OF 1321 Laurel Oak Drive Avon, IN 46123 $593.77 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members PQ# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice {s or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except LZ 20 �r Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund