Clark Dietz, Inc/Eng/314,891/Adl Serv #1/126th Street Multi-Use Path from Keystone Parkway to Hazel Dell Parkway -DesignClark Dietz, Inc.
Engineering Department - 2016
Appropriation: ASA #1, #94-650.04,2016 COIT Bond; P.O. #3,3928
Contract Not To Exceed $314,897.00
ADDITIONAL SERVICES AMENDMENT TO
AGREEMENT FOR PROFESSIONAL SERVICES
THIS AMENDMENT TO THE PROFESSIONAL SERVICES AGREEMENT ("Agreement") entered into by and
between the City of Carmel. and Clark Dietz, Inc. (the "Professional'), as City Contract dated May 4, 2016 shall
amend the terms of the Agreement by adding the additional services to be provided by Professional consistent with
the: Scope of Work attached hereto and incorporated herein as Exhibit "A". Furthermore, the terms of the Agreement
shall be°amend.ed to include. the E -verify requirement as stated in Indiana, Code § 22-5=1.7 et seq., which is attached
hereto and. incorporated herein as Exhibit "B", as well as the required &verify Affidavit, attached hereto and
incorporated herein as Exhibit "C". Also, pursuant to I.C. § 5-22-16.5, Professional shall certify that in signing this
document, itdoes not engage in investment activities within the Country of Iran. The terms and conditions :of the
Agreement shall not otherwise be affected by this Additional Services Amendment and.shail remain in full force and
effect.
IN WITNESS: WHEREOF, the parties hereto have made and executed this Amendment as follows:
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
By;
o P
James Brainard, Presiding Officer
Date:
-&A�t4�
Mary Ann urker embe
Date: la /s ,
Lori S. Watson tu716v
r
Date: lr� ��
Clark Dietz, Inc.
AuZ rized Signature
Printed Name
PCZ-. it 4 -dr
INS
FID/TIN: 11!4' • � ZnO501
Last Four of SSN if Sole Proprietor:
Date: /0 • Z' L�
1$:'.G unla..Prui.Src...l Dia, Inr. ASA EI Add S— Amcad .'.-±: °DI. .gill, EA",11�1 4:SY I'MI
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ENGINEERS
May 25, 2016
Mr. Jeremy Kashman, P.E.
City Engineer
Department of Engineering
City of Carmel
One Civic Sq
Carmel, IN 46032
Re: 126th Street Multi -Use Path from Keystone Parkway to
Hazel Dell Parkway, approximately 1.90 miles
City of Carmel
INDOT Des. No.: 1401703
Dear Mr. Kashman:
Clark Dietz, Inc. is pleased to submit our proposal to provide engineering services for
the above referenced project. The following elements of work are included in this
proposal:
1) Field Survey of Project area.
2) Preparation of Engineer's Report.
3) Design of a Multi -Use Path.
4) Preparation of a Bridge Feasibility Study for existing bridge over Cool Creek.
5) Utility Coordination Services.
6) Coordination with Roundabout Design at 126th Street & Gray Road.
7) Retaining Wall Design.
8) Geotechnical Investigation.
9) Environmental Report Preparation, Section 106 Documentation, and Waters
of the US Report.
10) Permit preparation, including Rule 5 Permit.
Enclosed please find the fee summary, fee justification, and documentation for each
fee element included in the contract, along with INDOT Approved Overhead Rate
letter and Profit Matrix calculation.
XI 111BR
16 � ((
® Clark Dietz, Inc. 8900 Keystone Crossing, Suite 900 Indianapolis, Indiana 46240 T: 317.844.8900 F: 317.844.9158
May 25, 2016
Page 2
Please note that the bridge design fee will be determined after the Bridge Feasibility
Study is completed. Also, right of way engineering and right of way services are not
included with this proposal, but can be included at a later date if requested.
Please review and provide any comments as necessary. We appreciate the
opportunity to provide these services to the City of Carmel and we look forward to
working with you again with this project.
Sincerely,
C..
all
J Loew, P.E.
Project Manager
Attachments
EXHIBIT
a, —A
20'1(
126th Street MU Path
City of Carmel, Hamilton County, IN
Cit? INDOT Des. No. 1401703
Transportation Alternatives Program (TAP) Project
Fee Summary
5/25/2016
Trail Design Items
Task Description
Fee
Sub -Consultant
Payment Medio
Field Survey
$
44,730.00
USI
Lump Sum
Abbreviated Engineer's Assessment
$
4,980.00
Lump Sum
Trail Design (PFC Plans, Stage 3 Plans, Final Tracings)
$
146,140.00
Lump Sum
Bridge Feasibility Study
$
11,500.00
Lump Sum
Pedestrian Bridge Design
$
-
Lump Sum
Utility Coordination
$
29,300.00
Hourly Rate
Coordination with Roundabout Design at 126th Street & Gray Road
$
7,200.00
Hourly Rate
Retaining Wall Design (2 Locations)
$
10,300.00
Lump Sum
Geotechnical Investigation
$
20,280.00
Earth Exploration
Unjt Cost
*Environmental Document Preparation (CE)
$
10,960.00
Green 3
Lump Sum
*Section 106 Documentation
$
5,001.00
Green 3
Lump Sum
J*Waters of the US Report
1 $
5,500.00 1
Green 3
Lump Sum
401/404 & IDNR Permit Preparation
$
13,800.00
Lump Sum
Rule 5 Permit Preparation
$
5,200.00
Lump Sum
$ 314,891.00
* Indicates professional service provided by DBE sub -consultant
Note 1. The scope of work for utility coordination assumes that no utilities will qualify for reimbursement and no utility agreements
will be required.
Note 2. Neither RW Engineering or RW Services are included in this Fee Proposal.
Note 3. Bridge Design Fee will be determined after Bridge Feasibility Study is completed.
Note 4. The Geotechnical Investigation assumes that the existing bridge will be modified. If it is determined that anew bridge will
be built over Cool Creek, the Geotechnical Investigation fee will require adjustment.
Note 5. If Roundabout at 126th & Gray Road is constructed prior to the trail, some additional field survey may be required to get
updated topography information at the roundabout location.
Date: 8/7/2015
CLASSIFICATIONS AND RATES
X HI ENI T A -
6f((
Rates Page USI Consultants, Inc.
Approved
Year of Work
Classification
Rates
2015-2016
2015
Engineer IV - Dept. Mngr.
$205.00
$205.00
Engineer III - Senior Project Mngr.
$168.00
$168.00
Engineer II - Project Manager
$151.00
$151.00
Engineer I - Intern
$110.00
$110.00
Designer II
$155.00
$155.00
Const. Project Mngr. IV - Dept. Mngr.
$168.00
$168.00
Const. Project Mngr. III
$140.00
$140.00
Survey Manager - Design
$188.00
$188.00
Assistant Survey Manager
$125.00
$125.00
Survey Crew Chief II
$108.00
$108.00
Survey Crew Chief 1
$108.00
$108.00
RNV Project Manager II
$123.00
$123.00
RNV Project Manager 1
$113.00
$113.00
RNV Technician
$0.00
$0.00
CADD Technician
$66.00
$66.00
Clerical
$95.00
$95.00
X HI ENI T A -
6f((
Rates Page USI Consultants, Inc.
Cost Estimate
126th Street Multi -Use Path (no bridge)
Carmel, Hamilton Co., Indiana
Unit
Unit Price
Total
GEOTECHNICAL FIELD
1.
Mobilization and Field Coordination
a. SPT Rig
1 ea
$240.00
$240.00
b. CPT
ea
$405.00
c. Field and utility coordination
1 LS
$800.00
$800.00
d. Field coordination with property owners
L 1-10
1 LS
$550.00
$550.00
ii. 11 -25
LS
$700.00
iii. Over 25
LS
$800.00
e. Mileage
mi
$3.15
2.
Truck mounted borings with split spoon sampling
ft
$17.10
3.
Truck mounted borings with drilling fluid
ft
$17.00
4.
Truck mounted core drilling
ft
$35.40
5.
Truck mounted borings
a. Truck mounted borings through bedrock or boulders or
concrete pavement
ft
$35.00
b. Bridge deck coring and restoration
ea
$310.00
6.
Cone penetrometer testing
a. Set up
ea
$68.00
b. Subsurface profiling
ft
$11.00
c. Profiling with pore pressure measurement
L Piezometric Saturation
ea
$85.30
ii . Penetration
ft
$13.15
iii. Pore water dissipation test
hr
$175.00
iv. Hydraulic conductivity and consolidation
ea
$65.00
d. Profiling with Shearwave Velocity Measurement
ft
$14.50
e. Sample
ea
$21.00
7.
Hand or truck soundings
20 ft
$11.00
$220.00
8.
Hand auger drilling
ft
$11.50
9.
Skid mounted borings with split spoon sampling
205 ft
$27.25
$5,586.25
10.
Skid mounted borings using drilling fluid
ft
$27.50
11.
Skid mounted core drilling
ft
$39.00
12.
Skid mounted boring through bedrock or boulders
ft
$41.00
13.
Skid mounted soundings
40 ft
$15.60
$624.00
14.
Skid Mounted Cone Penetrometer Testing (CPT)
a. Set up
ea
$102.00
b. Subsurface profiling
ft
$17.00
c. Profiling with pore pressure measurement
L Piezometric Saturation
ea
$130.00I�i
`r
�lr6sp'6�C
d. Metal protective outer cover for inclinometer and piezometer ea $113.00
casings
32. Geotechnical engineer 8 hr $105.00 $840.00
33. Railroad expenses Actual Cost
34. Twenty-four hour water levels r- P 7 _) `r
Unit
Unit Price Total
ii. Penetration
ft
$20.00
iii. Pore Water Dissipation Test
hr
$260.00
iv. Hydraulic Conductivity and Consolidation
ea
$79.00
d. Profiling with Shearwave Velocity Measurement
ft
$22.00
e. Sample
ea
$33.00
15.
Furnishing of a boat
Actual Cost
16.
Barge set-up expenses
a. Navigable water
i. Barge set-up
ea
$5,200.00
ii. Rental of support equipment and/or boat
Actual Cost
iii. Drill rig downtime
hr
$132.00
b. Non -navigable water barge set-up
ea
$4,500.00
17.
Additional disassembly and reassembly
a. Navigable water
ea
$1,900.00
b. Non -navigable water
ea
$1,700.00
18.
Barge mounted borings with split spoon sampling
ft
$29.75
19.
Barge mounted core drilling
ft
$40.25
20.
Barge mounted boring through bedrock or boulders
ft
$44.50
21.
Barge mounted soundings
ft
$17.60
22.
Casing through water
ft
$7.75
23.
Uncased sounding through water
ft
$5.00
24.
Set up for borings and machine soundings
a. Borings and machine soundings less than 20 ft deep
18 ea
$64.00 $1,152.00
b. Rock core borings
ea
$110.00
25.
Additional 2 -in. split spoon sampling
10 ea
$19.00 $190.00
26.
3 -in. split spoon samples
ea
$21.00
27.
3 -in. Shelby tube samples
ea
$57.00
28.
Bag samples
a. 300 -Ib sample
ea
$105.00
b. 25 -Ib sample
ea
$46.00
c 5 -Ib sample
ea
$40.00
29.
Field vane shear test
ea
$102.00
30.
4'/24n. cased hole
ft
$11.30
31.
Installation of Geotechnical Instruments
a. Inclinometer casing installation
ft
$13.40
b. Piezometer installation up to 25 ft below surface
ea
$230.00
c. Piezometer installation deeper than 25 ft below surface
ea
$260.00
d. Metal protective outer cover for inclinometer and piezometer ea $113.00
casings
32. Geotechnical engineer 8 hr $105.00 $840.00
33. Railroad expenses Actual Cost
34. Twenty-four hour water levels r- P 7 _) `r
a. Field measurements per borehole
b. PVC slotted pipe
35. Special borehole backfilling
a. 0 to 30 ft
i. SPT
ii. CPT
b. More than 30 ft
i. SPT
ii. CPT
c. Pavement restoration
36. Dozer rental
37. Traffic control
a. Flag crew
b. Equipment Rental
c. Flag crew with equipment
38. Centerline surveying
GEOTECHNICAL LABORATORY
39. Sieve analysis for soils
40. Hydrometer analysis
41. Sieve analysis for Aggregates
a. Analysis by Washing (AASHTO T-11)
b. Analysis by Using (AASHTO T-27)
42. Liquid limit
43. Plastic limit & plasticity index
44. Liquid Limit Ratio
45. pH test
46. Loss on Ignition Test
a. Loss on Ignition Test (Conventional)
b. Loss on Ignition Test (Sequential)
47. Moisture Content Tests
a. Moisture Content Test (Conventional)
b. Moisture Content Test (Microwave)
48. Expansion Index of Soils
49. Specific Gravity Test
50. Unit weight determination
51. Hydraulic Conductivity Test
a. Constant Head
b. Falling Head
52. a. Unconfined Compression Test
b. Remolding of soil samples with chemical admixtures in
chemical soil modification/stabilization
Unit Unit Price Total
8 ea $34.75 $278.00
ft $5.30
18 ea $97.00 $1,746.00
ea $43.00
ft $6.00
ea $1.75
2 ea $52.00 $104.00
Actual Cost
day
$550.00
Actual Cost
day
$665.00
Invoice Cost
Subtotal (Geotechnical Field)
$12,330.25
5 ea
$44.00
$220.00
5 ea
$50.50
$252.50
ea
$70.00
ea
$125.00
5 ea
$31.00
$155.00
5 ea
$22.50
$112.50
ea
$70.00
5 ea
$13.80
$69.00
ea
$22.00
ea
$50.00
70 ea
$6.00
$420.00
ea
$12.00
ea
$240.00
ea
$32.50
10 ea
$16.15
$161.50
ea
$210.00
ea
$260.00
5 ea
$42.00
$210.00
(3 samples is equal to 1 unit)
c. Point Load Strength Index of Rock
53. Compressive Strength and Elastic Moduli of Intact Rock
a. Compressive Strength of Intact Rock
b. Elastic Moduli of Intact Rock
54. Consolidation Test
55. Triaxial test
a. Unconsolidated - Undrained (UU)
b. Consolidated - Undrained (CU)
c. Consolidated - Drained (CD)
d. Pore Pressure measurement with a. or b.
and use of back pressure for saturation
56. Direct Shear Test
57. Moisture -Density Relationship Test
a. Standard Proctor
b. Modified Proctor
58. Soil Support Testing
a. California Bearing Ratio Test
b. Subgrade Resilient Modulus
59. Collapse Potential Evaluation Test
a. Silty Soil (Loess)
b. Cohesive or Expansive Soils
60. Water Soluble Sulfate Test
61. Water Soluble Chloride Test
62. Soil Resistivity Test
63. a. Slake Durability Index Test
b. Jar Slake Test
GEOTECHNICAL ENGINEERING
64. Geotechnical profile and related work
a. Without soil subgrade drawings
First mile
Each additional mile
b. With soil subgrade drawings
First mile
Each additional mile
c. Soil subgrade drawings (only)
First mile
Each additional mile
65. Geotechnical report
a. Without soil subgrade investigation
First mile
Unit Unit Price
ea $105.00
ea $40.00
ea $100.00
ea $400.00
ea $410.00
ea $320.00
ea $475.00
ea $650.00
ea $230.00
ea $550.00
ea $128.00
ea $140.00
ea $490.00
ea $460.00
ea
$352.00
ea
$420.00
3 ea
$100.00
ea
$100.00
ea
$125.00
ea
$120.00
ea
$12.00
Subtotal (Geotechnical
Laboratory)
LS $1,100.00
mi $500.00
LS $1,300.00
mi $570.00
LS $335.00
mi $210.00
Total
$300.00
$1,900.50
1 LS $1,510.00 $1,510.00
��'I I
Unit
Unit Price
Total
Each additional mile
1.1 mi
$650.00
$715.00
b. With soil subgrade investigation
First mile
LS
$1,775.00
Each additional mile
mi
$740.00
c. Soil subgrade investigation (only)
First mile
LS
$550.00
Each additional mile
mi
$340.00
Settlement analysis and recommendations for
66.
embankment
a. Proposed embankment
ea
$470.00
b. Proposed and existing embankment
ea
$520.00
67.
Ground modification design
ea
$1,375.00
68.
Slope stability analysis
a. C, 0 or C & 0 analysis
ea
$735.00
b. Corrective measures
ea
$735.00
c. Stage construction corrective method
ea
$1,275.00
69.
Bridge foundation analysis and recommendations
a. Shallow foundation
ea
$450.00
b. Deep foundation
i. Deep foundation analyses
ea
$800.00
ii. Wave equation analyses
ea
$310.00
iii. Liquefaction analysis
ea
$250.00
iv. Group - 3D analysis
ea
$400.00
c. Settlement analysis for bridge pier foundation
i. Bridge pier
ea
$360.00
ii. Embankment plus pier
ea
$400.00
iii. Embankment plus pier plus all other loads
ea
$460.00
d. Foundation on bedrock
ea
$350.00
70.
Retaining structure analysis recommendations
a. Conventional retaining structures and other types such
as MSE Walls and Bin walls
i. Shallow foundation
1 ea
$820.00
$820.00
ii. Deep foundation
ea
$1,080.00
iii. Settlement analysis for retaining wall foundation
ea
$350.00
b. Pile retaining structure analysis and recommendations
i. Free standing structure
ea
$950.00
ii. Retaining structure with tie -back system
ea
$1,380.00
c. Drilled -in -pier retaining structure analysis
i. Free standing structure
ea
$975.00
ii. Retaining structure with tie -back system
ea
$1,400.00
d. Soil nailing wall analysis
ea
$940.00
71.
Seepage analysis
ea
$1,320.00
72.
Deep dynamic compaction analysis
ea
$1,330.00
1l..aa• Jf � u' 4 Y
Unit Unit Price Total
Subtotal (Geotechnical Engineering) $3,045.00
CONSTRUCTION INSPECTION AND MONITORING
73.
Mobilization of testing equipment
LS
$150.00
74.
a. Monitoring geotechnical instrumentation
hr
$70.00
$450.00
b. Filed Inspector
hr
$70.00
75.
Integrity testing
Actual Cost
76.
Field Compaction Testing
FOUNDATION EVALUATION BY NON-DESTRUCTIVE METHODS
a. Dynamic Cone Penetration Test (DCPT)
hr
$70.00
a. Surface test/Pier or foundation
b. Light Weight Deflectometer Test (LWD)
hr
$70.00
77.
Dynamic pile analysis
ea
$975.00
78.
Static load test
ea
$975.00
79.
Dynamic pile load test
Actual Cost
80.
CAPWAP-C analysis
ea
$450.00
81.
Final construction inspection report
ea
$875.00
Subtotal (Construction Inspection and
Monitoring)
FOUNDATION EVALUATION BY NON-DESTRUCTIVE METHODS
82.
a. Surface test/Pier or foundation
Actual Cost
b. Borehole test/Pier or foundation
Actual Cost
GEOPHYSICAL INVESTIGATION
83.
Geophysical Investigations
Invoice Cost
GEOTECHNICAL PROJECT MANAGEMENT
84.
Project Management
a. Project Coordination
mi
$1,600.00
b. Project Website
LS
$3,100.00
85.
Geotechnical Review
a. Structure Report
ea
$310.00
b. Roadway Report
mi
$260.00
PAVEMENT INVESTIGATION
1.
Mobilization of coring equipment
LS
$200.00
2.
Mobilization mileage for coring equipment
mi
$1.70
3.
Pavement core (partial depth)
ea
$120.00
4.
Pavement core (full depth)
ea
$180.00
5.
Sub -base sample
ea
$59.00
6.
Cement concrete pavement core density determination
ea
$31.00
7.
Cement concrete core compressive strength test
ea
$30.00
8.
Bituminous extraction test
ea
$80.00
9.
Sieve analysis of extracted aggregate test
ea
$53.50
10.
Recovery of asphalt from solution by Abson method
ea
$315.00
11.
Theoretical maximum specific gravity test
ea
$67.00
12.
Bulk specific gravity test
ea
$29.00
13.
Air voids calculation
ea
$27.00
14.
Core report for partial depth core
ea
$32.00
A
EEM P3 1"r
1WIt
Unit Unit Price Total
15. Core report for full depth core ea $40.00
16. Pavement analysis and report ea $730.00
Subtotal (Pavement Investigation)
Summary of Fees
Geotechnical Field $12,330.25
Geotechnical Laboratory $1,900.50
Geotechnical Engineering $3,045.00
Construction Inspection and Monitoring
Pavement Investigation
Geotechnical Total $17,275.75
Pavement Design $3,000.00
TOTAL $20,275.75
Clark Dietz, Inc.
Engineering Department - 2016
Appropriation: ASA #1, #94-650.04,2016 COIT Bond; P.O. #33928
Contract Not To Exceed $314,891.00
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.
USACon1mcts\Prof.S 6 & Goad Sva\Eogutccring\2016\0. .14 Ine ASA HI Add? S— A—d 3-27-2012 with E -Verify l.g-gaAd 5/312016 10:46 AMU
Clark Dietz, Inc.
En�oincering Department - 2016
Appropriation: ASA #I, #94-650.04,2016 COIT Bond; P.O. #33928
Contract,Not To Exceed .$314,891.00
Exhibit "C
E -Verify Affidavit
being first duly sworn, deposes aiid `says that
lie/she is familiar with and has personal knowledge of the facts herein and, if called as a witness in this
matter, could testify as follows:
1. I am over eighteen (18) years of age and am competent to testify to -the facts contained
herein.
2, I am now and at all times relevant herein have been employed by.
Ap" Le
(the "Company") in the position
of
3. I am familiar with the employment policies, practices, and procedures. of the Company and'
have the authority to act on behalf of the Company.
4. The .Employer is enrolled and participates in the. federal .E -Verify' program arid has,
provided documentation of such enrollment and participation to the .City of. Carmel,
Indiana.
5. The Company does not knowingly employ any unauthorized aliens.
FURTHER AFFIANT SAYETH NOT.
EXECUTED on the day of
I certify under the penalties for perjury under the laws the United States of America and the State of
Indiana that the foregoing factual statements and rep sen tions pie and correct.
(S.'.Cc•:nra:ro-Wrol.$+'s K G..�I. Seea9inrinccrine�'il1 G`d'Luk IJicv_ h- 'S:\ -I AM I Se:. A:nad Y27 ftli' ai0. F>Ycrar Iit.46 AM!
-'& � V14 4��' b r fy-
Company ID Plumber: 440231
North American Industry
Classification Systems
Number of Employees: `20 to 99
3
Number of Sites Verified
for: t
_... _.........._....__. _......._......
►re you verifying for more than I site? If yes, please provide the number of sites verified for
n each State:
e INDIANA I sitc(s)
f
Information relating to the Program Administrator(s) for your Company on policy
questions or operational problems:
Name: .sill A Newport
Telephone Number: (317) 780 - 1555 ext. 120 Fax Number, (317) 780 - 6525
E-mail Address: jnewporl(dcrossroadengineers.eom
Name: Walter G Charics
Telephone Number: (317) 780 - 1555 ext. 115 Fax Number: (317) 780 - 6525
E-mail Address: celinries(a)crossroaticngincers.com
Page 13 of 131 E VerifyMOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify
Company ID Number: 436844
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 Clark Dietz, be
lon Hownariec
Name (Please Type orPrintj
;ElectronicaifySigned .. .0810212011
:Slgnature , pate
Department of Homeland 5ecurlty— Verification Division
tSCIS Verification Division
'Name (Please Type or Print) ` Title_
Electrotroicaily Signed i 0310212011
,'signature !� Date
! Information Required for the E-Verify Program
.Information relating to.ypr Company_
I .<
i Company Name',Clark Dietz, Inc
i t
`. Company Facility Address...118 S. Clinton St.
'Suite 700
i ..
Chicago, IL 60616 i
i
Company Alternate
Address:
i .
,
County or Parish:. ?COOK
Employer ldentificatlon
Number. ';371212061
Page 12 of 13 1 E -Verify MOU for Employer I Revision Dale 09/91/09 www.dhs.gov/E-Verify
Company ID Number: 436844
North American Industry
l Classification Systems i
Code; 641
Administrator,
Number,of Empioyg 1111.499
Number of Sites Verified
for: 7
-Are you verifying for more than t site? If yes, please provide the'number of sites verified for
=int each State:
o WISCONSIN 3 site(s)
o ILLINOIS 2 sitc(s)
? o INDIANA 2 sites)
Information relating to the Program Administrator(s) for your Company on policy
questions or operational problems:
Name: Jon B 1101yanice
Telephone Number: (312) 648.9900 est. 259 Fax Number:
E-mail Address: jon.hotvanicc dark dietz.eom
Name: Juanita cabal
Telephone Number: (312) 648 -9900 Fax Number:
E-mail Address: joanno.cabaj®clar•k-dietz.com
Page 0 of 13 I E -Verify MOU for Employer I Revision Data 09/01/00 vvm.dhs.gov1E-Ver(fy
LETTER OF TRANSMITTAL
Date: May 25, 2016
To: Doug Haney
Department of Law
From: Jeremy Kashmanu-
Department of Engineering
RE: Clark Dietz, Inc. Additional Service Amendment
One additional service amendment is needed for Clark Dietz for the June 15th BPW meeting, please.
Attached please find the work proposal and purchase order.
Contract Information:
Project Name: ASA #1 126th Street Path from Keystone Parkway to Hazel Dell Parkway - Design
Vendor: Clark Dietz, Inc.
Amount: $314,891.00
Appropriation: PO #33928; 2016 COIT Bond
Signature: James Loew, P.E.
Address: 8900 Keystone Crossing, Suite 900
Indianapolis, IN 46240
Phone: 317/808-9158
Email: iim.loew(c�clarkdietz.com
May 25, 2016
Mr. James Loew, P.E.
Clark Dietz, Inc.
8900 Keystone Crossing, Suite 900
Indianapolis, IN 46240
.JAMES BRAINARD, MAYOR
RE: Additional Service Amendment #1, PO #33928
Dear Mr. Loew:
As we discussed, the City of Carmel has a need for additional professional services and pursuant to our current
contract with Clark Dietz, Inc., dated May 4, 2016, I have requested and received from you the proposed scope of
services and fee estimates for the following work task:
Additional Service Amendment #1— 126th Street Path from Keystone Parkway to Hazel Dell Parkway -
Design
Not to Exceed: $314,891.00
Per our contract procedural requirements, I hereby approve these Additional Professional Services estimates, and
request that the Board of Public Works ratify the above referenced Contract Amendment.
PLEASE NOTE
Please be advised that "Additional Services" performed on City contracts must be billed separately from the original
contract and other additional services. More importantly, the invoice must reference the appropriate Additional
Service #.and P.O. # shown above. Invoices received without the Additional Service # referenced will be returned
for proper identification. Thank you for your continued assistance in providing the City of Carmel with your
professional, quality services. If you should have any questions, please give me a call.
Sincerely,
Jer y Ka an, P.E.
City Engineer
Reviewed and approved by:
i4 vn_�,
S. C. Engell ' g
Director of Administration
DEPARTMENT OF ENGINEERING
ONE CIVIC SQUARE, CARMEL, IN 46032 OFFICE 317.571.2441 FAx 317.571.2439
EMAIL engineering®carmel.in.gov
City ®f Carmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO.003120155 002 0
Page 1 of 1
PURCHASE ORDER NUMBER
SHIPPING INSTRUCTIONS
FEDERAL EXCISE TAX EXEMPT
33928
ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A1P
CARMEL, INDIANA 46032-2584
4
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR
CITY OF CARMEL - 1997
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
5/24/2016
060650
Project 15-17; Contract Date 05.04.16
CLARK DIETZ, INC
City Engineering's Office
VENDOR 8900 KEYSTONE CROSSING #900
SHIP 1 Civic Square
TO Carmel, IN 46032 -
INDIANAPOLIS, IN 46240 -
Kate Lustig
PURCHASE ID BLANKET CONTRACT
PAYMENT TERMS
FREIGHT
5145
QUANTITY UNIT OF MEASURE
DESCRIPTION
UNIT PRICE EXTENSION
Department., 2200
1 Each
Account: 94-650.04 Fund: 0 COIT Bond Fund
ASA 1 -126th Street Multi -Use Path from Keystone Parkway $314,891.00 $314,891.00
to Hazel Dell Parkway - Design
Sub Total $314,891.00
Send Invoice To:
Skip Tennancour
American Structurepoint, Inc.
8425 Wicklow Way
Brownsburg, IN 46112
2016 COIT Bond PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT
PROJECT PROJECTACCOUNT AMOUNT
9 f a
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
i
4
2016 COIT Bond PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT
PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $314,891.00
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 COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE
CONTROL NO. 33928 CLERK -TREASURER