American Structurepoint/Eng/Adl Serv #1/46,800/106th Street Over Keystone Parkway Bridge Beam Repair - Construction Inspection American Structurepoint,Inc.
Engineering Department-2016
Appropriation#900-4462869; P.O.#33742 QRaL�`
Contract Not To Exceed$46,800.00 D{a p
ADDITIONAL SERVICES AMENDMENT TO
AGREEMENT FOR PURCHASE OF GOODS AND SERVICES
THIS AMENDMENT TO THE GOODS AND SERVICES AGREEMENT ("Agreement") entered into by and
between the City of Carmel and American Structurepoint, Inc. (the "Vendor"), as City Contract dated April 6, 2016
shall amend the terms of the Agreement by adding the additional services to be provided by Vendor consistent with
the Scope of Work attached hereto and incorporated herein as Exhibit"A". Furthermore,the terms of the Agreement
shall be amended to include the E-verify requirement as stated in Indiana Code §22-5-1.7 et seq.,which is attached
hereto and incorporated herein as Exhibit "B", as well as the required E-verify Affidavit, attached hereto and
incorporated herein as Exhibit "C". Also, pursuant to I.C. § 5-22-16.5, Vendor shall certify that in signing this
document, it does not engage in investment activities within the Country of Iran. The terms and conditions of the
Agreement shall not otherwise be affected by this Additional Services Amendment and shall remain in full force and
effect.
IN WITNESS WHEREOF,the parties hereto have made and executed this Amendment as follows:
CITY OF CARMEL,E\IDIANA American Structurepoint, Inc.
by and through its Board of Public
Works and Safety
By: By: (/1/
/ 7c7
rainard Presiding Officer Authorized Signatur
Date: , " — V"y!' a—'+‘
CAar k5 SJ —Printed Name
Mary Ann urke, Member
Date: S-- —/b r)s'rec4 OP /,V&I+oh .se,r�, (f
The
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Lori S. 'atson mbe FID/TIN: ?$-/4273/7
Date: 5 j4 //{2
Last Four of SSN if Sole Proprietor:
A / E
Date: 14-a6-.20/6
Christine Pauly,O(er -Treasurer
Date: ' 'z/4
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EXHIBIT"A"
INSPECTION FEE JUSTIFICATION
MANHOURS BY CLASSIFICATION
OWNER: City of Carmel
DESCRIPTION: 106th Street/Keystone Bridge Beam Replacement
PRECONSTRUCTION ACTIVITIES: 5/2/2016 to 5/6/2016 = 1.00 weeks
CONSTRUCTION ACTIVITIES: 5/9/2016 to 7/29/2016 = 12.00 weeks
POST-CONSTRUCTION ACTIVITIES: 8/1/2016 to 8/12/2016 = 2.00 weeks
15.00 weeks
EXHIBIT
4/12/2016 1 4-6
EXHIBIT"A"
LABOR
SENIOR RESIDENT PROJECT REPRESENTATIVE:
Regular time: 15 weeks @ 4 hours/week = 60 hours
SENIOR RESIDENT PROJECT REPRESENTATIVE = 60 hours
RESIDENT PROJECT REPRESENTATIVE:
Preconstruction Activities:
Regular Time: 1 weeks @ 24 hours/week = 24 hours
Construction Activities:
Regular Time: 12 weeks @ 24 hours/week = 288 hours
Overtime(assume 0%) 288 @ 0% _ - hours
Post-Construction Activities:
Regular Time: 2 weeks @ 24 hours/week = 48 hours
RESIDENT PROJECT REPRESENTATIVE TOTAL REGULAR HOURS = 360 hours
RESIDENT PROJECT REPRESENTATIVE TOTAL OVERTIME HOURS = - hours
EXPENSES
Mileage:
Project Engineer/Supervisor weeks @ miles/week = - miles
Inspector(s) 23 weeks @ miles/week = - miles
TOTAL MILEAGE = - miles
EXHIIT
4/12/2016 O- ‘
EXHIBIT"A"
INSPECTION FEE SUMMARY
CONSTRUCTION INSPECTION SERVICES
CLIENT: City of Carmel
DESCRIPTION: 106th Street/Keystone Bridge Beam Replacement
Rate Units Fee
Senior Resident Project Representative $ 120.00 60 $ 7,200.00
Resident Project Representative $ 110.00 360 $ 39,600.00
Resident Project Representative (Overtime) $ 126.50 - $ -
Intern(s)(Regular) $ 75.00 - $ -
Intern(s)(Overtime) $ 86.25 - $ -
Mileage $ 0.540 - $ -
TOTAL INSPECTION FEE $ 46,800.00
4 Ex1-11 rr
/12/2016
SERVICES BY PROFESSIONAL
A. ENGINEERING PERSONNEL
For the fulfillment of all services outlined in Section B below, the Professional will provide one part-
time Resident Project Representative, inspectors, and clerical and secretarial personnel as required for a
period of time necessary to complete the construction project and fmal construction report.
The qualifications and experiences of personnel provided by the Professional are subject to approval by
the City, and no personnel will be assigned to the project until the City's approval is obtained.
The part-time Resident Project Representative will report to the City on all matters concerning contract
compliance and administration.
The part-time Resident Project Representative will coordinate project activities with City's project
manager.
B. DESCRIPTION OF SERVICES
1. Construction Schedule: Review and monitor the construction schedules prepared by the
Contractor for contract compliance and provide detailed documentation and recommendations
to the City concerning the schedule's acceptability.
2. Conferences: Schedule, conduct, notify participants, and provide minutes of preconstruction
meetings, partnering meetings, progress meetings, and such other job conferences as required
for the timely and acceptable conduct of the job. Attend Public Information Meetings
conducted by the City.
The Professional shall be available for conferences as requested by the City to review working
details of the project. The City may review and inspect the activities whenever desired during
the life of the agreement.
3. Liaison: Serve as the City's liaison with the Contractor, working principally through the
Contractor's field superintendent or such other person in authority as designated by the
Contractor. The full-time Resident Project Representative shall be thoroughly familiar with the
plans and specifications applicable to the project to monitor the Contractor for compliance with
the provisions therein. Any deviation observed shall be addressed to the Contractor by the
Resident Project Representative. Recommendations to obtain compliance also shall be reported
to the City.
4. Cooperate: Cooperate with the City in dealing with various federal, state, and local agencies
having jurisdiction over the project.
5. Obtain from the Contractor
a. A list of his proposed suppliers and subcontractors
b. Additional details or information when needed at the job site for proper execution of the
work
6. Certification of Materials: Check for completeness of certifications of materials delivered to the
site.
7. Shop Drawings
a. Receive shop drawings and falsework drawings. Check falsework drawings for
completeness and obtain structural engineer's approval of the proposed design.
Forward shop drawings to the desEXHIBIT
gn consultant for review and approval.
Exhibit"A" - "H I I T %Tr 2014.00444
b. Review the approved shop falsework drawings, specifications and other submissions,
record receipt of this data, maintain a file of all drawings and submissions, and check
construction for compliance in accordance with the Contract Documents.
c. Alert the Contractor's field superintendent when it is observed that materials or
equipment is being or is about to be used or installed before approval of shop drawings
or samples, where such are required, and advise the City when it is necessary to
disapprove work as failing to conform to the Contract Documents.
8. Review of Work,Inspection, and Tests
a. Conduct on-site inspections for the City, of the work in progress, as a basis for
determining that the project is proceeding in accordance with the Contract Documents
b. Accompany visiting inspectors representing local, state, or federal agencies having
jurisdiction over the project and report details of such inspections to the City
c. Verify that the required quality control sampling and testing has been accomplished and
materials certification has been provided by the Contractor
d. Perform concrete and compaction testing.
9. Modification: Consider and evaluate the Contractor's suggestions for modifications in
drawings and/or specifications and report them with recommendations to the City.
10. Records
a. Prepare and maintain at the job site orderly files of correspondence, reports of job
conferences, shop drawings and other submissions, reproductions of original Contract
Documents, including all addenda, change orders, and additional drawings subsequent
to the award of the Contract,progress reports, and other project related documents
b. Keep a diary or logbook, recording hours on the job site, weather conditions, list of
visiting officials, decisions, general observations, and specific observations with regard
to test procedures. Upon request, furnish copies of such a diary or logbook to the City.
11. Reports: Furnish to the City at periodic intervals, as required, progress reports of the project,
including the Contractor's compliance with the approved construction schedule
12. Progress Estimates: Review progress estimates prepared by the Contractor for periodic partial
payments to the Contractor and deliver to the City for review and processing. The payments to
the Contractor will be based on estimates of the value of work performed and materials
complete in place in accordance with the contract.
13. Work Schedule and Suspension: The Professional's crew will be required to regulate their
workweek to conform to the Contractor's hours in accordance with the directions of the City. If
work on the construction project is suspended and all matters concerning contract compliance
and administration are complete,the services of the Professional may also be suspended without
cost to the project.
14. Contract Administration: The Professional will administer the contract in accordance with
City's procedures.
15. If directed by the City, the Professional shall prepare, as needed, design, survey, right-of-way,
and other services consistent with the previous services that have been performed by the
Professional on this project. These services will be performed and paid for based on an
amendment to this agreement to be negotiated between the City and the Professional.
Exhibit"A" EXT# 2014.00444
16. If the City requests services beyond the scope of this agreement and capabilities of the
Professional, Professional will prepare an amendment to provide these services through a
subconsultant approved by the City.
17. CONSULTANT shall not at any time supervise, direct, or have control over Contractor's work,nor
shall CONSULTANT have authority over or responsibility for the means, methods, techniques,
sequences,or procedures of construction selected or used by Contractor, for security or safety at the
Site, for safety precautions and programs incident to the Contractor's work in progress, nor for any
failure of Contractor to comply with laws and regulations applicable to Contractor's furnishing and
performing the Work.
Exhibit"A" il6fc 2014.00444
American Structurepoint,Inc.
Engineering Department-2016
Appropriation#900-4462869; P.O.#33742
Contract Not To Exceed$46,800.00
EXHIBIT"B"
E-verify requirement
All terms defined in I.C. § 22-5-1.7 et seq. are adopted and incorporated into this section of the Amendment.
Pursuant to I.C. § 22-5-1.7 et seq.,Vendor 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 Addendum. Vendor.is further
required to execute the attached Affidavit,herein referred to as"Exhibit C", which is an Affidavit affirming that: (i)Vendor is
enrolled and is participating in the E-verify program,and(ii)Vendor does not knowingly employ any unauthorized aliens.This
Addendum incorporates by reference, and in its entirety, attached "Exhibit C." In support of the Affidavit, Vendor 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 Vendor and delivered to the City's authorized representative.
Should Vendor subcontract for the performance of any work under this Addendum, the Vendor 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.Vendor shall maintain a copy..of such
certification for the duration of the term of any subcontract. Vendor shall also deliver a copy of the certification to the City
within seven(7)days of the effective date of the subcontract.
If Vendor, or any subcontractor of Vendor, knowingly employs or contracts with any unauthorized aliens, or retains
an employee or contract with a person that the Vendor or subcontractor subsequently learns is an unauthorized alien, Vendor
shall terminate the employment of or contract with the unauthorized alien within thirty (30) days ("Cure Period"). Should the
Vendor or any subcontractor of Vendor 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.
[S:\Contracts\Prof-Svcs&Goods Svcs\Engioccrurg\2016\Amcri000 Structurepoint Add!Svcs Amend 3-27-2012 with E-Vcrify Imrguage-doc:4252016 2:52 PM[
American Structurepoint,Inc.
Engineering.Department-2016
Appropriation#900-4462869; P.O.#33742
Contract Not.To Exceed$46,800.00
Exhibit°C'
E-Verify Affidavit
gen 13raa ,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 and at all times relevant herein have been employed by
• M Sf;uchaetr..;/ 41 r... . (the "Company") in the position
of Vire ryes aeA
3. I am familiar with the employment policies,practices, and procedures of the Company and
have the authority to act on behalf of the Company.
4. The Employer is enrolled and participates in the federal E-Verify program and has
provided documentation of such enrollment and participation to the City of Carmel,
Indiana.
5. The Company does not knowingly employ any unauthorized aliens.
FURTHER AFFIANT SAYETH NOT. z,
EXECUTED on the 2 �0 day of %9,t.i
Printed: Gu1ef2�,.�J
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 representations are true and correct.
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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 T . ..
(PleaseType or Print) line
Electronically Signed 09/17/2009
Signature Date
Department of Homeland Security-Verification Division
USCIS Verification Division
Name(Please type or Print) Title
Electronically Signed • 09/17/2009
Signature Date
•
Page 11 of 131E Verify MOU for EmptoyerlRevision Date 10/29/08 wwmdhs.gov/E-Verify
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Company ID Number,254011
into—nuation Required for the EAVerify Program
Information relating to your Company:
Company Name:American Structurepoint,Inc.
Company Facility Address:7260 Shadeland Station
Indianapolis,IN 46256
Company Alternate
Address:
County or Parish: MARION
Employer Identification
Number: 351127317
North American Industry
Classification Systems
Cods: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 EmployerlRevision Date 10/29/08 www.dhs.gov/E«Verify
„ YP V33172]!A£ZRVSC•C Of 333
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)647-6580:: - Fax Number. (317)543-0270
E-mailAddress: cshumaker@sstructurepoint.com
•
Page 13 of 13IE-Verify MOU for EmployerlRevision Date 10/29/08 wvvw.dhs.gov/E-Verify
Received
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:: Ol ;; ;; ® ;; J: ;;;:; City of Carmel
.ulun III II �: C�
s � Department of Law
"T7T'r7m 11.
CITY Co I— EL
JAMES BRAINARD, MAYOR
LETTER OF TRANSMITTAL
Date: April 14, 2016
To: Doug Haney
Department of Law
From: Jeremy Kashman .Vtt 6
Department of Engineering
RE: American Structurepoint Additional Service Amendment
One additional service amendment is needed for American Structurepoint for the May 4th, BPW
meeting, please.
Attached please find the work proposal and purchase order.
Contract Information:
Project Name: ASA#1 106th Street over Keystone Parkway Bridge Beam Repair— Construction Inspection
Vendor: American Structurepoint
Amount: $46,800.00
Appropriation: PO#33742; 900-4462869
Signature: Willis R. Conner
Address: 7260 Shadeland Station
Indianapolis, IN 46256
Phone: 317/547-5580
Fax: 317/543-0270
Email: wconnerastructurepoint.com
DEPARTMENT OF ENGINEERING
ONE CIVIC SQUARE, CARMEL, IN 46032 OFFICE 317.571.2441 FAX 317.571.2439
EMAIL engineering@carmel.in.gov
o INDIANA RETAIL TAX EXEMPT Page 1 of 1
II1
JL JL t of (�\ /ar}��Jle1 i CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
/ FEDERAL EXCISE TAX EXEMPT 33742
ONE CIVIC SQUARE 35-6000972 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
4/14/2016 00350562 + Project 16-INS-01
cor-, ,-«c,-, /2-4 i I b
AMERICAN STRUCTURE POINT, INC Engineering
VENDOR 7260 SHADELAND STATION SHIP 1 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46256--3957 Kate Lustig
PURCHASE ID I BLANKET CONTRACT I PAYMENT TERMS FREIGHT
4021
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2200 Account: 44-628.69 Fund: 900 Grant Fund
1 Each AS Pt- I 106th Street over Keystone Parkway Bridge Beam Repair.- $46,800.00 $46,800.00
Construction Inspection
Sub Total $46,800.00
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F Zfl' � K' �S .�� T iC 'r
Send Invoice To: \ F 7.-,, 1 < A;l.
• / 1
Engineering . <'
Y
Kate Lustig a N. -,k #�3
b
1 Civic Square .; r ----. -- 'i'„ { 4;.
Carmel, IN 46032- k-u,, _ 1, T,%a ;, f
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $46,800.00
SHIPPING INSTRUCTIONS *A/P 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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL ,
*THIS ORDER ISSUED IN COMPUANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY // .'ems
41,,,
/
TITLE
CONTROL NO. 33742 CLERK-TREASURER