American Structurepoint/Eng/54,400/106th Street Bridge Repair American Structurepoint,Inc.
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458 (140 .
Contract Not To Exceed$54,400.00 0
AGREEMENT FOR PROFESSIONAL SERVICES
THIS AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement') is hereby made and entered into by
and between the City of.Carmel, Indiana, acting by and through its Board of Public Works and Safety (hereinafter
"City"), and American Structurepoint (hereinafter"Professional").
•
RECITALS
WHEREAS City owns and is responsible for the operation and maintenance of its property, personnel, public
works and infrastructure; and
WHEREAS, from time to time, City needs professional assistance in fulfilling its foregoing responsibilities;
and
WHEREAS, Professional is experienced in providing and desires to provide to City the professional services
("Services") referenced herein; and
WHEREAS, City desires to engage Professional as an independent contractor for the purpose of providing to
City the Services referenced herein;
NOW, THEREFORE, in consideration of the foregoing recitals and the covenants and conditions set forth
herein, City and Professional mutually agree as follows:
SECTION 1. INCORPORATION OF RECITALS
The foregoing Recitals are hereby incorporated into this Agreement and made a part hereof.
SECTION 2. SCOPE OF SERVICES
2.1 City desires to engage Professional as an independent contractor for the Services set forth in attached
Exhibit A, incorporated herein by this reference.
2.2 Professional understands and•agrees that City may, from time to time, request Professional to provide
additional or modified Services to City. When City desires additional Services from Professional, the City
shall notify Professional of such additional Services desired, as well as the time frame in which same are to
be provided. Only after City has approved Professional's time and cost estimate for the provision of such
additional Services, has encumbered sufficient monies to pay for same, and has authorized Professional, in
writing, to provide such additional Services, shall such Services be provided by Professional to City. A copy
of the City's authorization documents for the purchase of additional Services shall be numbered and attached
hereto in the order in which they are approved by City.
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1
American Structurepoint,Inc.
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458
Contract Not To Exceed$54,400.00
2.3 Time is of the essence of this Agreement. •
•
SECTION 3. CITY'S RESPONSIBILITIES
3.1 City shall provide such information as is reasonably necessary for Professional to understand the Services
requested.
3.2 City shall provide all data required for provision of Services. Professional may assume that all data so
provided is correct and complete.
3.3. City shall arrange for Professional to enter upon public and private property as reasonably required for
Professional to perform the Services.
•
3.4 City shall'designate payment of the Services from City budget appropriation number 920-R4470299 funds.
3.5 City.shall designate the Mayor or his duly authorized representative to act on City's behalf on all matters
• regarding the Services.
SECTION 4. PROFESSIONAL'S RESPONSIBILITIES
4.1 Professional shall perform the Services pursuant to the terms of this Agreement and within any applicable
time and cost estimate.
•
4.2 Professional shall coordinate with City its performance of the Services.
4.3 Professional shall provide the Services by following and applying at all times reasonable and lawful
standards as accepted in the industry.
•
SECTION 5. COMPENSATION •
5.1 Professional estimates that the total price for the Services to be provided to City hereunder shall be no more
than Fifty Four Thousand Four Hundred Dollars ($54,400.00) (the "Estimate"). Professional shall submit an
invoice to City no more than once every thirty (30) days for Services provided City during the time period
. encompassed by such invoice. Invoices shall be submitted on a form containing the same information as that
contained on the Professional Services Invoice attached hereto as Exhibit B, incorporated herein by this
reference. City shall pay Professional for all undisputed Services rendered and stated on such invoice within
thirty five (35) days from the date of City's receipt of same.
5.2 Professional agrees not to provide any Services to City that,would cause the total cost of same to exceed the
• Estimate, without City's prior written consent.
•
•
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2
American Structurepoint,Inc. •
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458
Contract Not To Exceed$54,400.00
SECTION 6. TERM
Unless otherwise terminated in accordance with the termination provisions set forth in Section 7.1
hereinbelow, this Agreement shall be in effect from the Effective Date through,December 31, 2016, 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.
SECTION 7. MISCELLANEOUS
7.1 Termination.
7.1.1 The obligation to provide all or any portion of the Services under this Agreement may be terminated
by City or Professional,without cause, upon thirty(30)days' notice.
7.1.2 The obligation to provide all or any portion of the Services under this Agreement may be terminated •
by City, for cause, immediately upon Professional's receipt of City's"Notice To Cease Services."
7.1.3 In the event of full or partial Agreement termination, and as full and complete compensation
hereunder, Professional shall be paid for all such Services rendered and expenses incurred as of
the date of termination that are not,in dispute, except that such payment amount shall not exceed
the Estimate. Disputed compensation amounts shall be resolved as allowed by law.
7.2 Binding Effect.
City and Professional, and their respective officers, officials, agents, partners and successors in interest are
bound to the other as to all Agreement terms, conditions and obligations.
7.3 No Third Party Beneficiaries. •
Nothing contained herein shall be construed to give rights or benefits to anyone other than the parties
hereto.
7.4 Relationship.
The relationship of the parties hereto shall be as provided for in this Agreement, and neither Professional nor
any of its agents, employees or contractors are City employees. Professional shall have the sole
• responsibility to pay to or for its agents, employees and contractors all statutory, contractual and other
benefits and/or obligations as they become due. Professional hereby warrants and indemnifies City for and
from any and all costs, fees, expenses and/or damages incurred by City as a result of any claim for wages, •
benefits or otherwise by any agent, employee or contractor of Professional regarding or related to the subject
matter of this Agreement. This indemnification obligation shall survive the termination of this Agreement.
•
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3
American Structurepoint,Inc.
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458
Contract Not To Exceed$54,400.00
7.5 Insurance.
•
Professional shall procure and maintain with an insurer licensed to do business in the State of Indiana such
insurance as is necessary for the protection of City and Professional from all claims under workers'
compensation, occupational disease and/or unemployment compensation acts, because of errors and
omissions, because of bodily injury, including, but not limited to,•the personal injury, sickness, disease, or
death of any of Professional's employees, agents or contractors' and/or because of 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 on attached Exhibit C. Such insurance policies shall
not be canceled without thirty(30) days' prior written notice to City.
7.6 Liens.
•
Professional shall not cause or permit the filing of any lien on any of City's property. In the event such a lien
. is filed and Professional fails to remove it within ten (10) days after the date of filing', City shall have the right
to pay or bond over such lien at Professional's sole cost and expense.
7.7 Default.
•
In the event Professional: (a) repudiates, breaches or defaults under any of the terms or conditions of this
Agreement, including Professional's warranties; (b) fails to perform the Services as specified; (c) fails to
make progress so as to endanger timely and proper completion of the Services and does not correct such
failure or breach within five (5).business days after receipt of notice from City specifying same; or (d)
becomes insolvent, files, or has filed against it, a petition for 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 terminate all or any part of this Agreement, without liability to Professional and to exercise
any other rights or remedies available to it at law or in equity.
7.8 Government Compliance.
Professional agrees to comply with all laws, executive orders, rules and regulations applicable to
Professional's performance of its obligations under this Agreement, all relevant provisions of which being
hereby incorporated herein by this reference,to keep all of Professionals' required professional licenses and
certifications valid and current, and to indemnify and hold harmless City from any and all losses, damages,
costs, liabilities, damages, costs and attorney fees resulting from any failure by Professional to do so. This
indemnification obligation shall survive the termination of this Agreement.
7.9 Indemnification.
Professional shall indemnify and hold harmless City and its officers, officials, employees and agents from all
losses, liabilities, claims,judgments and liens, including, but not limited to, all damages,,costs, expenses and
attorney fees arising out of any intentional or.negligent act or omission of Professional and/or any,of its
employees, agents or contractors in the performance of this Agreement. This indemnification obligation shall .
survive the termination of this Agreement.
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4
American Structurepoint,Inc.
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458
Contract Not To Exceed$54,400.00
C
7.10 Discrimination Prohibition.
Professional represents and warrants that it and each of its employees, agents and contractors shall comply
with all existing and future laws prohibiting discrimination against any employee, applicant for employment
and/or other person in the subcontracting of work and/or in the performance of any Services contemplated by
this Agreement with respect to hire, tenure, terms, conditions or privileges of employment or any matter
directly or indirectly related to employment, subcontracting or work performance hereunder because of race,
religion, color, sex, handicap, national origin, ancestry, age, disabled veteran status or Vietnam era veteran
status. This indemnification obligation shall survive the termination of this Agreement.
7.11 E-Verify
Pursuant to I.C. § 22-5-1.7 et seq., Professional shall enroll in and verify the work eligibility status of all of its
newly-hired employees using the E-Verify program, if it has not already done so as of the date of this
Agreement. Professional is further required to execute the attached Affidavit, herein referred to as Exhibit D,
which is an Affidavit affirming that: (i) Professional is enrolled and is participating in the E-verify program, and
(ii) Professional does not knowingly employ any unauthorized aliens. This Addendum incorporates by
reference, and.in its entirety, attached Exhibit D. In support of the Affidavit, Professional shall provide the City
with documentation that it has enrolled and is participating in the E-Verify program. This Agreement shall not
take effect until said Affidavit is signed by Professional and delivered to the City's authorized representative.
Should Professional subcontract for the performance of any work under this Addendum, the
Professional shall require any subcontractor(s) to certify by affidavit that: (i) the subcontractor does not
knowingly employ or contract with any unauthorized aliens,-and (ii) the subcontractor has enrolled and is
participating in the E-verify program. Professional shall maintain a copy of such certification for the duration
of the term of any subcontract. Professional shall also deliver a copy of the certification to the City within
seven (7) days of the effective date of the subcontract.
If, Professional, or any subcontractor of Professional, knowingly employs or contracts with any
unauthorized aliens, or retains an employee or contract with a person that the Professional or subcontractor
subsequently learns is an unauthorized alien, Professional shall terminate the employment of or contract with
the unauthorized alien within thirty(30) days ("Cure Period"). Should the Professional or any subcontractor of
Professional fail to cure within the Cure Period, the City has the right to terminate this Agreement without
consequence.
. The E-Verify requirements of this Agreement will not apply, should the E-Verify program cease to exist.
7.12 Severability.
If any provision of this Agreement is held to be invalid, illegal or unenforceable by a court of competent
jurisdiction, that provision shall be stricken, and all other provisions of this Agreement that can operate
independently of same shall continue in full force and effect.
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5
American Structurepoint,Inc..
Engineering Department-2016
Appropriation#920-R4470299; :P.O.#33458
Contract Not To Exceed$54,400.00
7:13 Notice.
Any notice, invoice,order or other correspondence required or allowed to be sent pursuant to this Agreement
shall be written and either hand-delivered or sent by prepaid U.S. certified mail, return receipt requested,
addressed to the parties as follows:
CITY:
City of Carmel Douglas C.Haney -
Department of Engineering Corporation Counsel
One Civic Square One Civic Square
Carmel,Indiana 46032 Carmel, Indiana 46032
ATTENTION:Jeremy Kashman
PROFESSIONAL:
American Structurepoint,Inc.
7260 Shadeland Station
Indianapolis,Indiana 46256
ATTENTION:David A. Day,P.E.Willis R.`Conner
Notwithstanding the above,City may orally-provide to Professional any notice required or permitted'by this
Agreement,provided that such notice shall also then be sent as required by this paragraph within ten(10)
• business days from the date of such oral notice.
7.14 Effective Date.
The effective date ("Effective Date") of this Agreement shall be'the date on:which the last of the parties
hereto.executes.same. .
7.15 Governing Law: Lawsuits. -
This Agreement shall be governed by and construed in accordance with the laws of the State of Indiana,
except for its conflict of laws provisions, as well as by all ordinances and codes of the City of Carmel,.
• Indiana.The parties agree'.that, in the event a lawsuit is filed hereunder, they waive any right to a Jury trial
they may have,agree to'file such lawsuit in an'appropriate court'in Hamilton County, Indiana only,and agree
that such court is the a ro riate venue for and hasjurisdiction over same.
pp P -
• 7.16 Waiver.
Any delay or inaction on the part of either party in exercising or pursuing its rights and/or remedies hereunder .
or under law shall not operate to waive any such rights and/or remedies nor in any way affect the rights of
such party to require such performance at any time thereafter.
ISeroru laldS,b&GoatAinlf;miniiing Sinciu.q..nt lx Prtofu+iaid Serricv.FORM Rol pm 2012.1.2140162SP..'I .. ._
6
American Structurepoint,Inc.
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458
Contract Not To Exceed$54,400.00
7.17 Non-Assignment.
Professional shall not assign or pledge this Agreement nor delegate its obligations hereunder without City's
prior written consent.
7.18 Entire Agreement.
This Agreement contains the entire agreement of and between the parties hereto with respect to the subject
matter hereof, and no prior agreement, understanding or representation pertaining to such subject matter,
written or oral, shall be effective for any purpose. No provision of this Agreement may be amended, added to
or subtracted from except by an agreement in writing signed by both parties hereto and/or their respective
successors in interest. To the extent any provision contained in this Agreement conflicts with any provision
contained in any exhibit attached hereto, the provision contained in this Agreement shall prevail.
7.19 Representation and Warranties.
Each party hereto represents and warrants that it is authorized to enter into this Agreement and that any
person or entity executing this Agreement on behalf of such party has the authority to bind such party or the
party which they represent, as the case may be.
7.20 Headings.
All headings 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.
7.21 Advice of Counsel.
•
The parties warrant that they have read this Agreement and fully understand it, have had an opportunity to
obtain the advice and assistance of counsel throughout the negotiation of same, and enter into same freely,
voluntarily, and without any duress, undue influence or coercion.
7.22 Copyright.
City acknowledges that various materials which may be used and/or generated by Professional in
performance of Services, including forms, job description formats, comprehensive -position questionnaire,
compensation and classification plan and reports are copyrighted. City agrees that all ownership rights and
copyrights thereto lie with Professional, and City will use them solely for and on behalf of its own operations.
City agrees that it will take appropriate action with its employees to satisfy its obligations with respect to use,
copying, protection and security of Professional's property.
7.23 Personnel.
•
Professional represents that it has, or will secure at its own expense, all personnel required in performing the
services under this agreement. Such personnel shall not be employees of or have any contractual
relationship with City. All of the services required hereunder will be performed by Professional or under his
supervision and all personnel engaged in the work shall be fully qualified to perform such services.
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7
American Structurepoint,Inc.
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458
Contract Not To Exceed$54,400.00
7.24 Records and Inspections •
•
Professional shall maintain full and accurate records with respect to all matters covered under this
agreement for three (3) years after the expiration or early termination of this Agreement. City shall have free
access at all proper times to such records and the right.to examine and audit the same and to make
transcripts there from, and to inspect all program data, documents, proceedings and activities.
7.25 Accomplishment of Project .
Professional shall commence, carry on, and complete the project with all practicable dispatch, in a sound
economical and efficient manner, in accordance with the provisions thereof and all applicable laws. In
accomplishing the project, Professional shall take such steps as are appropriate to ensure that the work
involved is properly coordinated with related work being carried on within City's organization.
7.26 IRAN CERTIFICATION.
Pursuant to I.C. § 5-22-16.5, the Professional shall certify that, in signing this Agreement, it does hot engage
in investment activities within the Country of Iran.
7.27 ACCESS TO PUBLIC RECORDS ACT
Professional understands and agrees that any"public record", as that term is defined in Indiana Code 5-14-3-
2(m), as amended, that is related to the subject matter of this Agreement, whether the same is in the
possession or control of the Professional or the City, shall be subject to release under and pursuant to the
provisions of Indiana's Access to Public Records Act, as codified in Indiana Code 5-14-3-1, et seq., as
amended.
•
•
•
(remainder of page intentionally left blank)
•
•
•
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8
American Structurepoint,Inc.
Engineering Department-2016
Appropriation#920-R4470299; P.O.#33458
Contract Not To Exceed$54,400.00
IN WITNESS WHEREOF,the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL, INDIANA AMERICAN STRUCTUREPOINT, INC.
by and through its Board of Public
Works and Safety
BY: BY:
frin
James Brainard,P esiding ffi Authon�ignature
Date: �// /�
Printed Name: Alicfrowv r , .ea//,,6
Title: . 4 p4e.
Mary An urke,fttlem r
Date: pl / 7//o' FID/TIN:
Last Four of SSN if Sole Proprietor..
Lori S Watso ember Date: •
Date: % I C7
A ST•
Christine S. P ey rk-Treasurer
afe:.
•
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9
0 AMERICAN STRUCTUREPOINT, INC.
EXHIBIT A
The Professional will provide services for City projects as described below.
The information and services to be furnished by the City are as set out in Appendix 1, attached to this
Agreement and made an integral part hereof.
The Professional shall begin the services to be performed under this Agreement upon receipt of the
written notice to proceed from the City and shall deliver the work to the City in accordance with the
schedule contained in Appendix 2, attached to this Agreement and made an integral part hereof
The Professional shall receive payment for the services performed under this Agreement as set forth in
Appendix 3, attached to this Agreement and made an integral part hereof.
106th STREET OVER KEYSTONE PARKWAY BRIDGE COLLISION DAMAGE
I. EMERGENCY FIELD INSPECTION
A. The Professionals shall inspect the damage to the existing bridge structure on 106th
Street over Keystone Parkway and develop an inspection summary report in the form of
a memo to the City.
II. BRIDGE REPAIR PLANS
A. The Professional shall prepare design details, contract plans, special provisions for the
specifications, and opinions of probable cost for the repair of 106th Street bridge over
Keystone Parkway.
B. Upon completion and final approval of the services by the City, the Professional shall
deliver to the City the following:
1. One set of final approved contract plans drawn to a suitable scale on standard
22"x 34"or 11"x 17"sheets prepared on bond paper
2. Special Provisions for incorporating into the City's standard front end
documents
3. An electronic (PDF) set of final approved contract plans and contract book
specifications.
4. A copy of the opinion of probable construction cost
C. Additional general data will be issued at the mutual agreement of the Professional and
the City, and electronic files will be submitted to the City as requested. The
Professional does not authorize or assume liability for any reuse of the documents or
digital materials described in this section for any purpose other than this project and the
specific use intended unless adapted by and approved by the Professional. •
EXHIBIT
Exhibit A fi 201600108
0 AMERICAN STRUCTUREPOINT, INC.
D. In fulfillment of this Agreement,the Professional shall comply with the requirements of
the appropriate regulations and requirements of the City and other public agencies
having a legal jurisdiction over the project.
III. CONSTRUCTION QUESTIONS
A. The Professional shall make themselves available to answer questions in regards to the
design during construction of the repairs.
IV. CONSTRUCTION OBSERVATION
A. If desired by the City, the Professional can provide construction observation services.
This work would be completed under a separate supplemental agreement at a later time.
EXHIBIT
2 0-0
Exhibit A 201600108
0 AMERICAN STRUCTUREPOINT, INC.
APPENDIX 1
INFORMATION AND SERVICES TO BE FURNISHED BY CITY
The City shall furnish the Professional with the following, as appropriate:
1. A City's representative with decision-making authority on all inquiries
2. Assistance to the Professional by placing at its disposal all available information pertinent
to the project, including but not limited to, property owner information, deeds, plans of
adjacent developments, and section corner information
3. Specifications and standard drawings applicable to the project
4. All written reviews pertinent to the project that are received by the City
5. Guarantee of access to enter upon public and private lands, as required for the Professional
under this Agreement
6. All legal services, as may be required for development of the project
EXHIBIT A
3 cf7
Appendix 1 201600108
0 AMERICAN STRUCTUREPOINT, INC.
APPENDIX 2
SCHEDULE
The Professional will complete the services described in this Agreement using the following schedule:
REPAIR DESIGNS
A. Final Plans and Specifications to be completed within 30 days of receipt of written Notice to
Proceed
EXHIBIT A
�.� crf�
Appendix 2 2016.00108
AMERICAN STRUCTUREPOINT, INC.
APPENDIX 3
COMPENSATION
A. Amount of Payment
The Professional will receive payment for the work performed under this Agreement as
follows,unless a modification of the Agreement is approved in writing by the City.
1. Bridge Repair Plans, Survey&Construction Questions (lump-sum) $54,400
B. Method of Payment
1. Payment for lump-sum items will be made monthly to the Professional on a percent-
complete basis upon submission to the City of an invoice.
EXHiBIT A
cr7
Appendix 3. 201600108
a
•
AMERICAN STRUCTUREPOLNT,INC.
106th Str•
eet Bridge over Keystone Ave
MANHOUR JUSTIFICATION •
•
106th Street Bridge over Keystone Ave January 26,2016
DESCRIPTION: Field Survey •
' ESTIMATED TIME.
Land Party Instrument Property Senior
3 WORK CLASSIFICATION Surveyor thief Man Research - Technician TOTAL •
RESEARCH 1 I I
'Assessor/Auditor Maps 0.5 ! I
!Owners Names&Addresses 0.5
Deeds 1
!Section Corner Ties 0.5 !
Recorded Surveys I 0.5 •
!Utility Maps I 0.5 I •
lUTILITY COORDINATION 1 I
Utility Call In ! 0.5 I
Onsite Meeting I 1 I 1 I
I I •
SURVEY CONTROL - I 1 f
Set&Reference 5 Control Points ! 3 3 ) I
GPS Locate 5 Control Points I I 3 I 3
Recover 4 Section Corners I 2 I 2 .
GPS Locate 4 Section Corners I 2 ! 2 I I 1
'Bench Circuit 2 2
! I I
TOPOGRAPHIC SURVEY l 2
j 106th Street Bridge and limited survey of Keystone Ave ! 12 _ 12 j
UTILITIES,SEWERS&DRAIN PIPES ! 2 1 !
106th Street Bridge and limited survey of Keystone Ave L. 2 2 1 I
COMPUTATIONS r
Property&Right of Way Line Computations 8
•Plot Survey Data I B
SKELETON FIELD BOOK 1 1 1 I
I
?TOTAL HOURS 161 281 281 4 81
'HOURLY RATE $ 110.00 I$ 82.50 I$ 82.50 $. 80.00 $ 95.00 I
1SUBTOTAL • $ 1,760.00 1$ 2,310.00 1,$ 2,310.00 $ 320.00 $ 760,001.$ 7,460.00 jj
I DIRECT COST I ! 1 I$ 67.20
jTOTAL FEE I I 1 1 1$ 7,527.20.
Direct Costs
Hotel 2 rooms x 0 nights x$90/night= $0.00
Per Diem 2 men x 0 days x$30/day= S0.00
Travel Time 3 trips x 40 miles x 0.561mile= .. . .$67:20
$- 67.20
•
EXHIBIT
Sheet 1 6 201600108
AMERICAN STRUCTUREPOINT,INC.
MANHOUR JUSTIFICATION
PROJECT:106th Street over Keystone Parkway Bridge Collision Damage Scope of Work: Collision Damage Repair
BRIDGE FILE NUMBER:106th Street
Date: 1/26/2016
ESTIMATED TIME I
Project 1 Project Staff 1 Senior
WORK CLASSIFICATION Principal Manager ! Engineer Engineer ' Technician Technician TOTAL
1 I 1
Project Research and Setup 2 81 1 i
Field Inspection 2 1 •
Summary Memo 2 ,, 1
Preliminary Quantities { 41 2 4
Preliminary Engineers Estimate ( ) 21 2 - I
Title Sheet • I { 11 1 1 41
Index Sheet { I 1 21
Maintenance of Traffic I 1{ 4 41 12 241
General Plan .. f j 41 I 8 16 •
Removal Details ' • { 1 I 41 4 .16i 24
Railing Details { { 41 4 81 16
Slab Details { I 41 4 81 16,
Sidewalk Details I. I .4 4 81 161
Beam Replacement Details • I 11 2 2 21 101
Beam Repair Details I 1 41 4 8I 241
!Final Quantities I 1 2 4! 8
Bridge Summary ! . 11 11 21
Final Engineer's Estimate I 2 4 I
Bid Documents 1 8 81
Construction Questions I 8 81 8 • —
TOTAL HOURS . i • 5! 70 461 20 801 154
Hourly Rates 1 $ 230.00 1 $ 195.00 $ 130.00 1-$ 90.00 $ 130.00 1$ 90.00
SALARY COST 1 $ 1;150.00 1 $ 13,650.00 $ 5,980.00 .$ 1,800.00 $ 10,400.00 $ 13,860.00 1$ 46,840.00
DIRECT COSTS ! (• I • I $44.00
TOTAL FEE ! �� 1 1 1 $ 46,884.00
Direct Costs Unit Cost Quantity Cost
Mileage $0.44 . 100 . . $44.00
Meals $26.00 0 • $0.00 •
Total . • $44.00 •
•
•
EXHIBIT
70cl
201600108
EXHIBIT B
Invoice
Date:
Name of Company:
Address &Zip:
Telephone No.:
Fax No.:
Project Name:
Invoice No.
Purchase Order No:
Goods Services
Person Providing Date Goods/Services Provided Cost Per Hourly Total
Goods/Services Goods/ (Describe each good/service Item Rate/
Service separately and in detail) Hours
Provided Worked
GRAND TOTAL
Signature
Printed Name
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
EXHIBIT D
AFFIDAVIT
/✓,'`v —' ,being first duly sworn,deposes and says that
he/she is familiar with and has personal knowledge of the facts herein and,if called as a witness in this
matter,could testify as follows:
1. I am over eighteen(18)years of age and am competent to testify to the facts contained
herein.
2. I am now nd at all times relevant herein have been employed by
eit&b,Lr Sncri .��.,..�- - i•,,c.. - - (the"Employer")
in the position of vice
3. I am familiar with the employment policies,practices,and procedures of the Employer and
have the authority to act on behalf of the Employer.
4. The Employer is enrolled and participates in the federal E-Verify program.Documentation
of this enrollment and participation is attached and incorporated herein.
5. The Employer does not knowingly employ any unauthorized aliens.
6. To the best of my information and belief,the Employer does not currently employ any
unauthorized aliens.
7. FURTHER AFFIANT SAYETH NOT.
EXECUTED on the / day of ,20 I le
41'" A)6--)
Printed: / :, A *•..,
I certify under the penalties for perjury under the laws of the United States of America and the State of
Indiana that the foregoing factual statements and repre ations are true and correct.
Printed: 47—)
,,43.sago
e e
t USA r
Iy a-Y[AIR I8 A96RY7 GC 11or ON9
Company ID Number:254011
information Required for the E-Verify Program
Information relating to your Company:
Company Name:American Structurepoint,Inc.
Company Facility Address:-7260 Shadoland Station
Indianapolis,IN 46266
Company Alternate
Address: .
County or Parish: M ARION
Employer Identification -
Number: 351127317
North American Industry
Classification Systems
Code:541
Parent Company:
Number of Employees: 100 to 499
•
Number of Sites Verified
for: 2
Are you verifying for more than 1 site?If yes,please provide the number of sites verified for in
each State:
• OHIO 1 site(s)
Page 12 of 131E Verify MOU for Employerpievision Date 10/29/08 .dbs.gov/E-Verify
"v‘
_ d e-
. , en1- I � a .f �tsTnr
.a&. __ y El=NIT/IS A SSAVICC OF DNS
Company ID Number.254011
• INDIANA • 1 site(s)
Information relating,to the Program Administrators)for your Company on policy,.questions or
operational problems: - _ •
Name: Chelsea Shumaker
Telephone Number: (317)647-6680 = Fax Number. (317)643-0270
E-mail Address: cshumakentnstructurepoIntcom
•
•
•
•
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Page 13 of 131E-Verify MOU for EmployerlReviaion Date 10129;08 wst.dhs.govl -Verify
w
,� x erly Y-YBRlff iB A EBAYlii Of DMZ
Company ID Number.254011
•
To be accepted as a participant in E Verify, you should only sign the Employer's Section
of the signature page. If you have any questions, contact E-Verify at 888-464-4218.
Employer American Structurepolnt,Inc.
Chelsea Shumaker
Name(Please Type or Print) This
Electronically Signed 09/17/2009
Signature
Department of Homeland Security—Verification Division
USCIS Verification Division
Name(Please Type or Rini) Title
Electronically Signed 09/1712009
Signature Date
•
Page 11 of 131E Verify MOU for EmployerlRevision Date 10/29/08 .dhs.gov/E«Verify