American Structurepoint/Eng/1,392,393/2016 COIT Bond Capital Program Management American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
AGREEMENT FOR PROFESSIONAL SERVICES nTHIS AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement") is hereand 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, Inc. (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. Professional will not perform any of the Services detailed in
Exhibit A prior to obtaining a written Notice to Proceed from the City. Upon receiving a Notice to Proceed,
the Professional shall perform only those Services specifically detailed in the Notice. If the Professional
desires clarification of the scope of any Notice to Proceed, the Professional shall obtain such clarification
from the City in writing, prior to performing the service set forth in the Notice to Proceed. Any services
performed without the City's prior express written authorization will not be compensated.
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
IX:\joberlander\Con"aclsiAmencan S"uclurepoinl Revised Professional Services COIT Bond 2016.doc:3/24@0I6 3:25 PIA
1
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
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.
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 2016 COIT Bond 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 One Million Three Hundred Ninety-Two Thousand Three Hundred Ninety-Three Dollars ($1,392,393.00)
(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.
]X:ljoberlander\ContractsA'nerican Structurepoint Revised Professional Services COLT Bond 2016.doc:3/242016 3:25 PM]
2
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
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, 2015, 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.
•
PC:\joberlander\Cantracls\American Structurepoint Revised Professional Services COIT Bond 2016.doc:3/24/2016 3:25 PM]
3
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
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, to the fullest extent allowed by law, indemnify and hold harmless City and its officers,
officials, and employees from all liabilities, damages and costs, including, but not limited to, court costs and
reasonable attorney fees, to the extent caused by any failure to perform its services in accordance with the
applicable standards of reasonable professional care, including intentional or negligent acts or omissions, of
Professional and/or any of its employees or subconsultants in the performance of this Agreement. This
indemnification shall survive the termination of this Agreement. However, Professional shall not be obligated
to indemnify City or its officers, officials and employees for any portion of such liabilities, damages and costs
[X:\jobcrlander\Contracts\American Structurepoint Revised Professional Senices COIT Bond 2016.doc:3/24/2016 3:25 PM[
4
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
that is attributable to its or their own negligence or actionable fault.
7.10 Discrimination Prohibition.
Consistent with Indiana Code 5-16-6-1, 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.
[X:\jobcrlandcr\Commcts\American Stroclorepoint Revised Professional Scniccs COIT Bond 2016.doc:3242016 3:25 PM]
5
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
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 Carmel City Attorney
One Civic Square One Civic Square
Carmel, Indiana 46032 Carmel, Indiana 46032
ATTENTION: Jeremy Kashman
PROFESSIONAL:
American Sturcturepoint
7260 Shadeland Station •
Indianapolis, Indiana 46256-3957
ATTENTION: Rick 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 appropriate venue for and has jurisdiction over same.
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.
]X:ljoberlander\ContractsWnerican Struclurepuint Revised Professional Services COIT Bond 2016.doc:3/24/2016 3:25 PM]
6
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
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.
[X:\joberlander\Conlracts\American Sbacturepoint Revised Professional Services COIT Bond 2016.doc:3/242016 3:25 PM]
7
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
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, and in
accordance with standards of reasonable professional care for similar projects, including compliance with
applicable laws. In accomplishing the project, Professional shall take such steps as are appropriate to
ensure that the services involved are 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 not 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 seg., as
amended.
7.28 Job Site Safety
Neither the professional activities or the Professional, nor the presence of the Professional or its employees
and subconsultants at a construction/project site, shall relieve the general contractor of its obligations, duties
and responsibilities including, but not limited to, construction means, methods, sequence, techniques or
procedures necessary for performing, superintending and coordinating the work in accordance with the
contract documents and any health or safety precautions required by any regulatory agencies or applicable
laws. The Professional and its personnel have no authority to exercise any control over any construction
contractor or its employees in connection with their work or any health or safety programs or procedures.
7.29 Mediation
In an effort to resolve any conflicts that arise during the design and construction of the Project or following
the completion of the Project, the City and the Professional agree that all disputes between them arising out
of or relating to the Agreement or the Project shall be submitted to nonbinding mediation unless the parties
agree otherwise. Such nonbinding mediation shall be conducted in accordance with the Indiana Rules of
Alternative Dispute Resolution.
[X:\joberlander\ContractsWnerican Structurepoint Revised Professional Services COIT Bond 2016.doc:3/242016 3:25 PM]p
O
American Sturcturepoint,Inc.
Engineering Department-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL,'INDIANA AMERICAN STURCTUREPOINT, INC.
by and through its Board of Public
Works and Safety
BY: BY:
James Brainard, Presiding Officer Authorized Signature
Date:
Printed Name:
Title:
Mary Ann Burke, Member
Date: • FID/TIN:
• Last Four of SSN if Sole Proprietor:
Lori S. Watson, Member Date: •
Date:
ATTEST:
Christine Pauley, Clerk-Treasurer
Date:
•
•
[X:\joberlander\ContractsWnerican Structurepoint Revised Professional Services COLT Bond 2016.doc:3/24/20I6 3:25 PM]
9
American Structurepoint,Inc.
Engineering-2016
Appropriation#2016 COIT Bond; P.O.#33690
Contract Not To Exceed$1,392,393.00
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:
•
J mes Brainard, Presiding.Offic6r Authorize Signature'
Date:
Printed Name: (wits R. Co44er
Title: PresIIe01
Mary Ann B ke, Me ber `
Date: ---/ FI D/TI N: 35%/1a7 3/7
•
Last Four of SSN if Sole Proprietor:
Lori S. Wat§.9.D4 mber Date: MQre4 Q2, VoiG
Date:
'ATT •
ristine S. Paul y;��rk��Treasurer
Date: �J fp
•
)S:!Gmuaa Brof.Sr),&Garic Sr s\Fuginmrin^C016VrofzMienal Sersi:c. S•.ri Ynreinim.ri.,,?i2212OI6 10:17 AM)
9
0 AMERICAN STRUCTUREPOINT, INC.
Exhibit A
City of Carmel Program Management Scope Items
1) Program Management
a) Program Management Services
i) 2 days/week and weekly update meetings
b) Utility Coordination
i) Monthly utility meetings as needed and 1 day/week
c) Financial Tracking
i) 20 hours/month
ii) Track purchase order expenditures to ensure P.O. amount is not exceeded
iii) Track supplemental contract amounts and change orders for P.O. adjustment
iv) Balance to cash bank statement
v) Prepare accounts payable voucher for each invoice(per P.O.Number)
vi) Prepare disbursement request(list of invoices to be paid)
vii)Maintain financial spreadsheet(broken down by each income source) and distribute monthly
viii) Monitor receipt of invoice submittals so that they are received timely in order to meet City's claim
schedule
ix) Provide annual construction project cost report
x) Provide annual 1099 report and backup documentation
xi) Follow up on payment discrepancies
d) Traffic Study for 96th Street Corridor
i) The scope of services on this project will be to evaluate the existing conditions as well as recommend
any low-cost and systemic improvements along the 96th Street corridor from Haverstick Road to the
White River that can result in improving access management along this corridor along with improving
commuter mobility and safety in Carmel,Indiana.The ultimate goal of this corridor analysis will be
to help determine the optimal intersection control types and lane configurations. It should be noted
that the intersection of 96th Street&Keystone Parkway is excluded from this corridor analysis.
e) On Call Traffic Engineering Services
i) Traffic analysis and traffic studies development as well as review of any studies performed by other
consultants for the City (includes traffic impact studies, traffic impact analysis, traffic operations
analysis,traffic capacity analysis,etc.).
ii) Traffic signal design development as well as review of signal design performed by other consultants
for the City.
iii) Traffic signal timing development and/or re-timing of any signal or signal systems within the City's
jurisdiction.
iv) Peer review of roundabout analysis and design performed by other consultants for the City.
v) Review of traffic management plan and/or any MOT scheme proposed by other consultants for any
roadway projects within the City limits.
February 26,2016 Page 1 of 2 201502101
AMERICAN STRUCTUREPOINT, INC.
vi) Adjustment of traffic signal timings and/or phasing in order to better accommodate traffic during
MOT.
High-Level Regional Traffic Management Analysis and Intersection Improvement Sequencing Plan
i) The intent of this analysis is to compare the list of proposed projects,and particularly the intersection
improvement projects, to easily obtainable operations information in order to provide a holistic
approach to prioritizing the projects. The analysis will include the following items:
(1) Background data collection and coordination
(2) Identification of current hot spots
(3) Map of all proposed projects overlaid on current hot spot map
(4) Document any systems operation information,such as existing closed-loop traffic signal systems
(5) Document critical corridors for emergency services
(6) Recommendations for sequencing of proposed projects with the intent of minimizing overall user
delay during construction of the improvements. This includes recommendations for early
priorities that would allow for improved detour routes for subsequent projects.
February 26,2016 Page 2 of 2 201502101
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
1I�
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
9/yse Fe'mow n , being first duly sworn,deposes and says that.
he/she is familiar with andlhas 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. Lam been employed now and at all times relevant herein have beeemployed by-
/' aer,y..o t ,S/rk�f� oo;h� -(the"Employer")
in the position of lege/wrenfa
3. Lam 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 a a_ day of M arch , 20 1
Printed: ly S e F-e r•r,e''„. cL
I certify under'thepenalties for perjury under the laws of the United States of America-and the State of
Indiana that the,for,wing factual statements and representations are true.and correct.
SEAL .1 `S. Printed: lr 4,7 ,,,et
P.
r re n$e�'11,,e
<p
. v''
4
IRM y
w r
a Mir:Sa P.S4aY]cc.r aas
Company ID Number.254011
information Required for the E.Veriffy Program
information relating to your Company:
Company Name:,American Strustusepoint,Inc.
Company Facility Address:7260 Shadeland Station
Indianapolis,IN 46256
Company Alternate
Address:
County or Parish: MARION
Employer Identification •
Number: 361127317
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 9 site?if yes,please provide the number of sites verified for in
each State: .
• OHIO 1 site(s)
Page 92 of 13IE-Verify MOU for Employer(Revision Irate 10/29/08 nv.dhs,gov/E-Verify
"�'
" - ,,_{ as �
P t,' :t ITS'
rye- H 6•Yp11TY IS R 1[RVIC[Or me
Company ID Number.254011
• INDIANA 1 site(s)
Information relating to the Program Administrator(s)for your Company on policy questions or
operational problems:
Name: Chelsea•Shumaker
Telephone Number. (317)647 a 6600 Fax Numbers (317)543-0270
E-mail Address: • cshumaken atructurepoint.com
Page 13 of 131E Verify MOD for EmptoyeriRevision Date 10129A8 witrw.dhs.gov/E-Verify
it%
[-Tt¢IrT 35 A==VICE or LLl
Company ID Number.254011
To be accepted as a participant In E-Verlfy, you should only sign the Employer's Section
of the signature page. If you have any questions,contact E-Verify at 08B-464-4218.
Employer American StructurepeInt,Inc.
Chelsea Shumaker
Name(Please Type or Print) T3tla"
Electronically Signed 09/1712009
Signature Date
Department of Homeland Security—Verification Division
USC1 a Verification Division
Name(Please Type or Ring Title
Electronically Signed 09/1712009
Signature Date
Page 19 of 131E-Verify MOO for EmployeriRevision Date 10/29/08 www.dhs.govlE-Verify