Midwest Constructors; P.O. 31784; $236,510 Sponsor: Councilor Seidensticker
RESOLUTION CC-08-18-14-01
A RESOLUTION OF THE COMMON COUNCIL OF THE CITY OF CARMEL,
INDIANA,APPROVING CARMEL REDEVELOPMENT COMMISSION GOODS AND
SERVICES CONTRACT WITH MIDWEST CONSTRUCTORS
WHEREAS, THE City of Carmel Common Council ("Council") created by ordinance
the Carmel Redevelopment Commission ("CRC"); and
WHEREAS, by subsequent ordinance, the Council requires the CRC to seeks its
approval, by simple majority vote, of all professional services contracts that exceed Twenty-Five
Thousand Dollars ($25,000.00) in a calendar year(the"Threshold Amount"); and
WHEREAS, the CRC now desires to enter into the goods and services contract with
Midwest Constructors, the same being attached hereto as Exhibit A, which contract (the "Goods
and Services Contract") is in an amount that exceeds the Threshold Amount; and
WHEREAS, the CRC has presented the Goods and Services Contract to the Council and
has requested approval of the same.
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of
Carmel, Indiana, as follows:
Section 1. The foregoing Recitals are incorporated herein by this reference.
Section 2. The Contract should be and the same is hereby APPROVED by the Common
Council of the City of Carmel, Indiana.
11.1 ESOLVED by the Common Council of the City of Carmel, Indiana, this I day of , 2014,by a vote of Ihe 5 ayes and G nays.
This Resolution was prepared by Douglas C.Haney,Carmel City Attorney,on 8/8/14 at 11:30 a.m. No subsequent
revision to this Resolution has been reviewed by Mr.Haney for legal sufficiency or otherwise.
Sponsor: Councilor Seidensticker
OMMON COUNCIL FOR THE CITY F CARMEL
1.siding Officer Kevin D. Rider
ttL/L.h.
W. Eric id nsticker,Preslin Pro Tempore Carol Schleif
PR..csc
ald E. Carter Richard L. Sharp
4 4/ 1.31—
S e Fi Luci Snyder
ATTES •
,mi ein_d_Aa.
Diana L. Cordray, IAMC, Clerk-Treasurer
Presented by me to the Mayor of the City of Carmel, Indiana this IR day of ,
2014, at 6•'SS P .M.
4, , u
0
Diana L. Cordray, IAMC, Clerk-Treasurer
Approved by me, the Mayor of the City of Carmel, Indiana, this 18 day of ati gt)-4-41—
2014, at 6.575 .M.
ietfrkft,„
s Brainard,Mayor
ATTEST:A
Diana L. Cordray, IAMC, Clerk-Trcl asurer
Resolution No.CC-08-18-14-01
Page Two of Two Pages
This Resolution was prepared by Douglas C.,Haney,Carmel City Attorney,on 8/8/14 at 11:30 a.m. No subsequent
revision to this Resolution has been reviewed by Mr.Haney for legal sufficiency or otherwise.
08/08/2014 10:00 3175712484 CARMEL LAW DEPARTMET PAGE 02112
Midwest Can x ctara,LLC
CRC-20I4
Appmpriatien N902-4460807; P.O.#31784
Contract Not To Exceed$236,510.00
„ h�
1IAO ;
AGR FAIFALEtaeOgil CES
THIS AGREEMENT FOR PURCHASE OF GOODS AND SERVICES ("Agreement") Is
hereby entered Into by and between the City of Carmel Redevelopment Commission ("CRC"),
and, an entity duly authorized to do business in the State of Indiana and Midwest Constructors,
LLC (Vendee).
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;
CRC agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using CRC
budget appropriation number 902-4460807 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 CRC hereunder
shall be no more than Two Hundred Thirty Six Thousand Five Hundred Ten Dollars($236,510.00)
(the 'Estimate"). Vendor shall submit an invoice to CRC no more than once every thirty(30) days
detailing the Goods and Services provided to CRC within such time period. CRC shall pay Vendor
for such Goods and Services within thirty five(35) days after the date of CRC'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 Fxt i , are submitted on an Invoice that
contains the information contained on attached Exhibit S,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 CRC that would cause the total cost of the
Goods and Services provided by Vendor to CRC hereunder to exceed the Estimate,unless CRC 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 CRC and/or by Vendor to and accepted by CRC pursuant to or as part of that certain City
of Carmel Redevelopment Department Bid Proposal Package for"CRC Streetscape"received by the
City of Carmel Redevelopment Commission on or about July 16, 2014, 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 CRC's
intended use and expressly warrants that the Goods and Services provided to CRC pursuant to this
Agreement have been selected by Vendor based upon CRC's stated use and are fit and sufficient for
their particular purpose.
•
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@8/@8/2 014 10:@0 3175712484 CARMEL LAW DEPARTMET PAGE 08/12
Midwest Constructors,LLC
CRC..2014
Appropriations#902-4460807; PD.#31784
contract Not To Exceed$236.510.00
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,
8. DISCLOSURE AND WARNINGS:
If requested by CRC,Vendor shall promptly furnish to CRC,in such form and detail as CRC may direct,a fist
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 CRC suffloient written warning and notice(including appropriate labels on containers and packing)
of any hazardous material utilized In or that is a part of the Goads and Services.
7. LIENS:
Vendor shall not cause or permit the filing of any lien on any property of CRC or the City of Carmel,Indiana
("City'). In the event any such lien is filed and Vendor falls to remove such lien within ten(10)days after the
filing thereof, by payment or bonding, CRC shall have the right to pay such lien or obtain such bond, all at
Vendor°s sole cost and expense.
S. 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)falls to provide the Goods and Services as specified herein;
(a)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 CRC 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, CRC 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 CRC 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 CRC,the
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 Vendors 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 Q. Vendor shall
cause its insurers to name CRC and City as additional Insureds on all such insurance policies,shall promptly
provide CRC and 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 CRC and City. vendor shall indemnify
and hold harmless CRC and City from and against any and all liabilities, claims, demands or expanses
(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 Vendee provision of Goods and Services pursuant to or under
this Agreement or Vendor's use of CRC or City property.
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08/08/2814 10:00 3175712484 CARMEL LAW DEPARTMET PAGE 04/12
Midwest Const uetprs,LLC
CRC-20/4
Appropriation#902-4460807; P.O.#31784
Contract Not To Exceed$236,510.00
Vendor further agrees to Indemnify, defend and hold harmless CRC and City,and their respective officers,
officials, agents and employees from all claims and suits of whatever type, Including, but not limited to, all
court costs, attorney fees, end 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
CRC 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 CRC prohibiting
discrimination against any employee,applicant for employment or other person in the provision of any Goods
and Services provided by this Agreement with respect to their•hire,tenure,terms,conditions and privileges of
employment and any other matter related to their employment or subcontracting, because of race, religion, .
color, sex, handicap, national origin, ancestry, age, disabled veteran status and/or Vietnam era veteran
status.
12. E-VERIFY
Pursuant to LC.§22-5-1.7 at 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-Verlfy program, and to execute the Affidavit
attached herein as Exhibit U,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 CRC 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 Verify law,the CRC may require a cure of such violation and thereafter,if
no timely cure is performed, terminate this Agreement in accordance with either the previsions 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 strati not assign or pledge this Agreement,whether as collateral for a loan or otherwise,and shall not
delegate its obligations under this Agreement without CRC's prior written consent.
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08/08/2014 10:00 3175712484 CARMEL LAW AEPARTMET PAGE 05/12
Midwest Conft actors,LLC
CRC-2014
Appropriation#902.4460807; P.O.#317M
Contract Not To Exceed$236,510.00
1$. HELATiONSHJP 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 CRC.The contract price
set forth herein shall be the full and maximum compensation and monies required of CRC 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.
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 CRC: Carmel Redevelopment Commission AND Douglas C. Haney,City Attorney
30 West Main St.,Ste.220 Department of Law
Carmel, Indiana 46032 One Civic Square
ATTENTION: Coale Meyer Carmel, Indiana 46032
If to Vendor: Midwest Constructors,LLC
2916 Bluff Road,Suite C •
Indianapolis,IN 46225
Telephone:317-784-8400
E•Mail:jstreater @midwestconstructorelic.com
ATTENTION: Neal Burnett
Notwithstanding the above, notice of termination under paragraph 19 herelnbelow 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.
10. TERMINATION:
19.1 Notwithstanding anything to the contrary contained in this Agreement, CRC 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 far 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 Goads 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.
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06/08/2014 10;00 3175712484 CARMEL LAW DEPARTMEf PAGE 06/12
Midwest Col straetoi,LLC
CRC-20.14
Appropriation#902-4460807; P.t3.#31784
ConhgCt Not To Exceed 5236,510.00
19.2 CRC 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 CRC 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 CRC may, from time to time, request Vendor to provide additional
goods and services to CRC.When CRC desires additional goods and services from Vendor,the CRC shall
notify Vendor of such additional goods and services desired,as well as the time frame in which earns are to
be provided. Only after CRC 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 CRC. A copy of the CRC'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 CRC.
22. TERM
Unless otherwise terminated in accordance with the termination provisions set forth in Paragraph 19
hereinebove,this Agreement shall be in effect from the Effective Date through December 31,2014 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. THIRD PARTY BENEFICIARIES
Except as provided In paragraphs 7 and 9 hereof,this Agreement gives no rights or benefits to anyone other
than CRC and Vendor,
26, IRAN CERTIFICATION: Pursuant to I.C.§5-22-16.5,the Vendor shall certify that, in signing this document,
It does not engage in investment activities within the Country of Iran.
(^.eta nthatnmermrxwa cnabSTMCITAkhvwnaMPlattil=fa•CRC-moot SCI®,demsnalu4s PM
08/0812014 1.0;00 3115712484 CARS LMW utrmm t''t`
Midwest Constructors,LLC
CRC-2014
Appropriation#902-4460801; P.O.#31784
Contract Not To Exceed$236,510,00
27. 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,
28, ENTIRE AGREEMENT:
This Agreement, together with any exhibits attached hereto or referenced herein, constitutes the entire
agreement between Vendor and CRC 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 W1T IESS WHERIUUP,the parties hereto have made and executed this Agreement as follows:
CUIVIEL REDEVELOPM1(rNT Midwest Constructors,LLC
COMMISSION
BY:
BY: r' ,I16
j V�illiatzt Hammer;President Au orized Signature
Cato: ',fed Name:
Titie:
FIDITIN:... 11=-- 1fJLJ
Last Four of SSN if Sole Proprietor:
Date: far J Ig'
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08/09/2014 10:e0 3175712484 CARMEL. LAW DEPARTMET rmut no,is
DJDDEWS IZEIVILUD PROZOSAL
I �ECLA1 ATY0�11S
City of Carmel
•
instrigtions?,bidders:
This form shall be utilized by all Bidders. kept as otherwise specifically provided, all Parts
shall be fully and accurately filled in and completed and notarized.
Project: OI206/01209 Parcel 7C-4,Parcel 7G9
Proposal For Construction of city Of Carmet CRC Streetscape Bid
The she work far the addition of sidewalks, utilities, and
landscapbig. The work shall include demolition,
earlhww*, landscaping, utlldy installation, and paring
required to complete the indicated work
Date: o7/1 4
To city of Caramel,Indiana,Redevelopment Commission
•
EXHIBIT A
1
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08/08/2014 10:00 3175712434 CARMEL LAW DEPARTMET PAGE OW 12
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2 1F3ntrIV1`/A PItLTW Siii 7 warm
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4 .1401,41WN1sT" ' , 11121111111E111$ ..., . 9,otaao
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gm$.10$.1.K CONtse'1,tl,4 Na. Ell 4,201 2 =96A4
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1$ 2 TAnr21sANOiR I 0!m 2 1O0.a9
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WM 92V4+4.2220.6amn WEI MN 4 10311e1) 2 1120.00
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•
EXHIBIT A
2 n4 ?
08/0812014 10:00 8175712484 CARMEL LAW DEPARTMET PAGE 10/12
EDIT B
invoice
Date:
Name of Company:
Address&Zip:
Telephone No.:
Fax No.:
Project Name:
Invoke No.
Purchase Order No: _
Dods 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
88/08/2014 10:00 3175712484 CARMEL LAW DEPARTMET PAGE 11/12
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 agate: $500,000
Maximum deductible: $ 10,000
•
08/08/2014 10:00 3175712484 CARMEL. LAW DEPARTMET PAGE 12/12
EDIT B
•4,11?'1HDAVIT
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 lbllows:
1. I sin over eighteen(la)years of age and am competent to testify to the facta contained
hers,
2. I am now and at all times relevant herein have been Employed by
NA 1 1• (the"Employe'")
in the position of R'F.5a,
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 )Ernployer is enrolled and participates in the federal E-Very program and has
provided documentation of such enrollment and participation to the City of Carmel,
Indiana.
5, The Company does not knowingly employ any=authorized aliens.
FURTHER AFFIANT SAYETH NOT. .tp.RY
( vt■
EXECUTED on the day oi� 2b * SEAL
` Johnson County
\tn, Expires 02.12.214x,'
- �.�
P: ted: Y 1 i, f
1 certify under the penalties for perjury under the laws of the United States of,America and the State of
Indiana that the foregoing tactual statements and taxmen : •n : true and coneot.
ted: ! '
r .32 Employment Elig ibility a l ,, x i %. 0
--Asram".1"------"--""1-------
Company Information
Company Name: Midwest Form Constructors LLC ',`'' —
Doing Business As(UBA)Name: Midwest Constructors LLC
DUNS Number:
Physical Location: Mailing Address:
Address 1: 2916 Bluff Road Address 1:
• Address 2: Suite D Address 2:
City: Indianapolis City:
State: IN State:
Zip Code: 46225 Zip Code:
County; MARION
Additional Information:
Employer identification Number: 203303507
Total Number of Employees: 100 to 499
Parent Organization:
Administrator
How did you hear about E-Verlfy?
Other Marketing Channel:
Organization Designation:
Employer Category: None of these categories apply
NAICS Code: 236-CONSTRUCTION or BUILDINGS (236) NtiAtivid
Hiring Sites: 4i fj_a;t
INDIANA 1
E-Verify Users: llgit t1
Last First M.I. Phone E-mail
Name Name
Vasi Kim (317)784 6400 kvasi @midwestoonetructorsiic.com MOU Signatory ONLY
Vasi Kim (317)784-6400 kvasi @midwestconstructorsllc.com
I certify that the information provided for this registration is correct. I am aware that Federal
law provides for imprisonment and/or fines for knowing false statements or other fraudulent
conduct In connection with this registration. I am aware that providing any false Information
may be grounds for terminating participation in E Verify.
t I agree
City 0 INDIANA RETAIL TAX EXEMPT PAGE
of Carmel CERTIFICATE NO.003120155 002 0
Y PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT /-] p
35-60000972 J /d Jq
J
ONE CIVIC SQUARE 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
1
11 "� 4 (10151-rUle h , ( /�
VENDOR �I V Vv �� r�, �L C TO 30�W AA S�, J���C' 22V
2_ 916 fluff Road , 5�;fe D Cctr 2./4� �fI;43
14�i �� n olis ) IA( 14622f e 1, /
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
I 10�7 S+rw/ ioh work 236, 5/d. °°
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Pikr(d 76 't itd 76
t ¢` 7
,P 6 4'114; i1 !
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Send Invoice To: (/?(.:
30 I!. 1l d i�1 51-., S)(41i-t, 22 0 _1.. -
(6,rrnCI) Dr 0032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
9 02. 1 M 2 0 7 PAYMENT
• NP 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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE ISAN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. 0€514)-12-1 ORDERED BY / •
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ik , / I
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•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 1 L / • P 1.1 " L J
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. f
CLERK-TREASURER
DOCUMENT CONTROL NO. 4 VENDOR COPY