Shade Trees Unlimited/DOCS/Addl Serv 1/40000/TreesShade Trees Unlimited
DOCS Department - 2015
Appropriation #44-624.00; P.O. #32739
Contract Not To Exceed $40.000.00
ADDITIONAL SERVICES AMENDMENT TO
AGREEMENT FOR PURCHASE OF GOODS AND SERVICES
THIS AMENDMENT TO THE GOODS AND SERVICES AGREEMENT ("Agreement") entered into by and
between the City of Carmel and Shade Trees Unlimited (the "Vendor"), as City Contract dated March 5, 2014 shall
amend the terms of the Agreement by adding the additional services to be provided by Vendor consistent with the
Scope of Work attached hereto and incorporated herein as Exhibit "A". Furthermore, the terms of the Agreement
shall be amended to include the E -verify requirement as stated in Indiana Code § 22-5-1.7 et seq., which is attached
hereto and incorporated herein as Exhibit "B" as well as the required E -verify Affidavit, attached hereto and
incorporated herein as Exhibit "C". Also, pursuant to I.C. § 5-22-16.5, Vendor shall certify that in signing this
document, it does not engage in investment activities within the Country of Iran. The terms and conditions of the
Agreement shall not otherwise be affected by this Additional Services Amendment and shall remain in full force and
effect.
IN WITNESS WHEREOF, the parties hereto have made and executed this Amendment as follows:
CITY OF CARMEL, INDIANA Shade Trees Unlimited
by and through its Board of Public
Works and Safety
By:
O4 12r�
mes Brainard, Presiding Officer
Date: e -- /5 ' /
Mary Ann
Date:
Lori S. Watson
Date: i
ATTEST:
Diana Cordray, IAMC, — erk-Treasurer
Date: 7 —15-5
IS,CmuanWraSn. Or. SmNOCSMI NNYI Sm Mm' C.Nh\J\YllYA115I E151 PSII
Authorized
e
ej4)2r
Tim/ So4 -
Printed N
kip e
Title
FID/TIN: 317' g_6.J7 8 I
Last Four of SSN
if Sole Proprietor:
Date: e D/ 0/ `5_
IV. LAYOUT OF QUOTE
Cit of Carme_
DEPARTMENT OF COMMUNITY SERVICES
Please provide a price for each tree species per caliper size and note if the species is currently in stock.
(Actual species may vary):
Tree Species
2.00"
2.50"
3.00"
6' and 8'
Able to supply at
least 20 of one size
(circle)
American hornbeam
0
13 (}
Yes No
Bald cypress
���,�
I 0
Yes No
Elm, hybrid
'
((,' Ste
Yes , No
Hackberry
4 0
i 19
0 No
Gingko
Yes No
Honeylocust
(TES'
t
S
Yes No
Japanese tree lilac
Yes No
Japanese zelkova
'.
'.
0 No
planetree
0(,
Yes No
Oak
Ilar4-IS)
8London
Cill No
Redbud
Yes No
River birch, single -stem
t..
13 0i)
Se No
Serviceberry
C Yes" No
Tuliptree
! 2
Yk No
Yes No
Yellowwood
Norway spruce
eillarl2131,Yes
No
.4- II -1/
2 -
Delivery cost to holding area(withiinl5 miles of Carmel): Price per 75 tree(6 V 5 t
Other qualifications/notes: 'V J k GtiJL 1.c — I. 7 S L. /
l;
Ci
of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35-60000972
PAGE
PURCHASE ORDER NUMBER
32739
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER. DELIVERY MEMO. PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
6/30/2015
VENDOR
Shade Trees Unlimited
P.O. Box 152
Columbia City, IN 46725
SHIP
TO
DOCS Department
1 Civic Square
Carmel, IN 46032
(317) 571-2418
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE I
DESCRIPTION
UNIT PRICE
EXTENSION
Account 44-624.00
1 Each Trees
Send Invoice To:
DOCS Department
1 Civic Square
Carmel, IN 46032 -
PLEASE INVOICE IN DUPLICATE
$40,000.00 $40,000.00
Sub Total: $40,000.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
1192 DOCS
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 32739
ORDERED BY
TITLE
CLERK -TREASURER
VENDOR COPY
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.
• I HEREBY CERTIFY THAT THERE IS A UNOB ATED BA ' CE IN
THISAPPRR ION SUFFtIENTTF PAY H€ABO ORDER.
$40,000.00
Director