E&B Paving/Eng/1,471,824.33/136th Street and Carey Road Roundabout and Carey Road and Hawthorne Drive Roundabout – ConstructionE & B Paving, Inc.
Engineering -2016
Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337 e
Contract Not To Exceed $1,471,824.33AGREEMENT FOR PURCHASE OF GOODS AND SERVICES
THIS AGREEMENT FOR PURCHASE OF GOODS AND SERVICES ("Agreement") is
hereby entered into by and between the City of Carmel, Indiana, acting by and through its Board
of Public Works and Safety ("City"), and 'E & B Paving, Inc. an entity, duly authorized to do
business in the State of Indiana ("Vendor").
TERMS AND CONDITIONS
1. ACKNOWLEDGMENT, ACCEPTANCE:
Vendor acknowledges that it has. read and understands this Agreement, and agrees that its execution of
same constitutes its acceptance of all of the Agreement's terms and conditions.
2. PERFORMANCE:
City agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City
budget appropriation number 2016 General Obligation Bond, 94-650.04 funds. Vendor agrees to provide the
Goods and Services and to otherwise perform the requirements of this Agreement by applying at all times
the highest technical and industry standards. Vendor 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 Vender
shall perform only those Services specifically detailed in the Notice. If the. Vender desires clarification of the
scope of any Notice to Proceed, the Vendor 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.
3. PRICE AND PAYMENT TERMS:
3.1 Vendor estimates that the total price for the Goods and Services to be provided to City hereunder
shall be no more than One Million. Four Hundred Seventy One Thousand Eight Hundred Twenty
Four Dollars and Thirty -Three Cents ($1,471,824.33) (the "Estimate"). Vendor shall submit an
invoice to City no more than. once every .thirty (30) days detailing the Goods and Services provided
to City within such time period. City shall pay Vendor for such Goods and Services within sixty (60)
days after the date of City's receipt of Vendor's invoice detailing same, so long as and to the extent
such Goods and Services are not disputed, are in conformance with the specifications set forth in
Exhibit A, are submitted on an invoice that contains the information contained on attached Exhibit B,
and Vendor has otherwise performed and satisfied all the terms and conditions of this Agreement.
3.2 Vendor agrees not to provide any Goods and Services to City that would cause the total cost of the
Goods and Services provided by Vendor to City hereunder to exceed the Estimate, unless City has
previously agreed, in writing, to pay an amount in excess thereof.
4. WARRANTY:
Vendor expressly warrants that the Goods and Services covered by this Agreement will conform to those
certain specifications, descriptions and/or quotations regarding same as were provided to Vendor by City
and/or by Vendor to and accepted by City pursuant to or as part of that certain City of Carmel Engineering
Department Bid Proposal Package for "Roundabout Improvements 136th Street and Carey Road/
Roundabout Improvements Carey Road and Hawthorne Drive" received by the City of Carmel Board of
Public Works and Safety on or about August 17, 2016, all of which documents are incorporated herein by
reference, and that the Goods and Services will be delivered in a timely, good and workmanlike manner and
free from defect. Vendor acknowledges that it knows of City's intended use and expressly warrants that the
Goods and Services provided to City pursuant to this Agreement have been selected by Vendor based upon
City's stated use and are fit and sufficient for their particular purpose
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E & B Paving, Inc.
Engineering - 2016
Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337
Contract Not To Exceed $1,471,824.33
5. TIME AND PERFORMANCE:
This Agreement shall become effective as of the last date on which a party hereto executes same ("Effective
Date"), and both parties shall thereafter perform their obligations hereunder in a timely manner. Time is of the
essence of this Agreement.
6. DISCLOSURE AND WARNINGS:
If requested by City, Vendor shall promptly furnish to City, in such form and detail as City may direct, a list of
all chemicals, materials, substances and items used in or during the provision of the Goods and Services
provided hereunder, including the quantity, quality and concentration thereof and any other information
relating thereto. At the time of the delivery of the Goods and Services provided hereunder, Vendor agrees to
furnish to City sufficient written warning and notice (including appropriate labels on containers and packing)
of any hazardous material utilized in or that is a part of the Goods and Services.
7. LIENS:
Vendor shall not cause or permit the filing of any lien on any of City's property. In the event any such lien is
filed and Vendor fails to remove such lien within ten (10) days after the filing thereof; by payment or bonding,
City shall have the right to pay such lien or obtain such bond, all at Vendor's sole cost and expense.
8. DEFAULT:
In the event Vendor: (a) repudiates, breaches or defaults under any of the terms or conditions of this
Agreement, including Vendor's warranties; (b) fails to provide the Goods and Services as specified herein;
(c) fails to make progress so as to endanger timely and proper provision of the Goods and Services and does
not correct such failure or breach within five (5) business days (or such shorter period of time as is
commercially reasonable under the circumstances) after receipt of notice from City specifying such failure or
breach; or (d) becomes insolvent, is placed into 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
(1) terminate all or any parts of this Agreement, without liability to Vendor; and (2) exercise all other rights
and remedies available to City at law and/or in equity.
9. INSURANCE AND INDEMNIFICATION:
Vendor shall procure and maintain in full force and effect during the term of this Agreement, with an insurer
licensed to do business in the State of Indiana, such insurance as is necessary for the protection of City and
Vendor from all claims for damages under any workers' compensation, occupational disease and/or
unemployment compensation act; for bodily injuries including, but not limited to, personal injury, sickness,
disease or death of or to any of Vendor's agents, officers, employees, contractors and subcontractors; and,
for 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 in attached Exhibit C. Vendor shall
cause its insurers to name City as an additional insured on all such insurance policies, shall promptly provide
City, upon request, with copies of all such policies, and shall provide that such insurance policies shall not be
canceled without thirty (30) days prior notice to City. Vendor shall indemnify and hold harmless City from and
against any and all liabilities, claims, demands or expenses (including, but not limited to, reasonable attorney
fees) for injury, death and/or damages to any person or property arising from or in connection with Vendor's
provision of Goods and Services pursuant to or under this Agreement or Vendor's use of City property.
Vendor further agrees to indemnify, defend and hold harmless City and its officers, officials, agents and
employees from all claims and suits of whatever type, including, but not limited to, all court costs, attorney
fees, and other expenses, caused by any act or omission of Vendor and/or of any of Vendor's agents,
officers, employees, contractors or subcontractors in the performance of this Agreement. These
indemnification obligations shall survive the termination of this Agreement.
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2
E & B Paving, Inc.
Engineering - 2016
Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337
Contract Not To Exceed $1,471,824.33
10. GOVERNMENT COMPLIANCE:
Vendor agrees to comply with all federal, state and local laws, executive orders, rules, regulations and codes
which may be applicable to Vendor's performance of its obligations under this Agreement, and all relevant
provisions thereof are incorporated herein by this reference. Vendor agrees to indemnify and hold harmless
City from any loss, damage and/or liability resulting from any such violation of such laws, orders, rules,
regulations and codes. This indemnification obligation shall survive the termination of this Agreement.
11. NONDISCRIMINATION:
Vendor represents and warrants that it and all of its officers, employees, agents, contractors and
subcontractors shall comply with all laws of the United States, the State of Indiana and City prohibiting
discrimination against any employee, applicant for employment or other person in the provision of any Goods
and Services provided by this Agreement with respect to their hire, tenure, terms, conditions and privileges of
employment and any other matter related to their employment or subcontracting, because of race, religion,
color, sex, handicap, national origin, ancestry, age, disabled veteran status and/or Vietnam era veteran
status.
12. E -VERIFY
Pursuant to I.C. § 22-5-1.7 et seq., as the same may be amended from time to time, and as is incorporated
herein by this reference (the "Indiana E -Verify Law"), Vendor is required to enroll in and verify the work
eligibility status of its newly -hired employees using the E -Verify program, and to execute the Affidavit
attached herein as Exhibit D, affirming that it is enrolled and participating in the E -verify program and does
not knowingly employ unauthorized aliens. In support of the Affidavit, Vendor shall provide the City with
documentation indicating that it has enrolled and is participating in the E -Verify program. Should
Vendor subcontract for the performance of any work under and pursuant to this Agreement, it shall fully
comply with the Indiana E -Verify Law as regards each such subcontractor. Should the Vendor or any
subcontractor violate the Indiana E -Verify law, the City may require a cure of such violation and thereafter, if
no timely cure is performed, terminate 'this Agreement in accordance with either the provisions hereof or
those set forth in the Indiana E -Verify Law. The requirements of this paragraph shall not apply should the. E -
Verify program cease to exist.
13. NO IMPLIED WAIVER:
The failure of either party to require performance by the other of any provision of this Agreement shall not
affect the right of such party to require such performance at any time thereafter, nor shall the waiver by any
party of a breach of any provision of this Agreement constitute a waiver of any succeeding breach of the
same or any other provision hereof.
14. NON -ASSIGNMENT:
Vendor shall not assign or pledge this Agreement, whether as collateral for a loan or otherwise, and shall not
delegate its obligations under this Agreement without City's prior written consent.
15. RELATIONSHIP OF PARTIES:
The relationship of the parties hereto shall be as provided for in this Agreement, and neither Vendor nor any
of its officers, employees, contractors, subcontractors and agents are employees of City. The contract price
set forth herein shall be the full and maximum compensation and monies required of City to be paid to
Vendor under or pursuant to this Agreement
16. GOVERNING LAW; LAWSUITS:
This Agreement is to be construed in accordance with and governed by the laws of the State of Indiana,
except for its conflict of laws provisions. The parties agree that, in the event a lawsuit is filed hereunder, they
waive their right to a jury trial, agree to file any such lawsuit in an appropriate court in Hamilton County,
JXAContmcts\ProLSvcs & Goods SvcAEnginceringl2016E & B Paving Inc. Goods & Services FORM - WITH E -Verify Language.doc:8/19/2016 2:29 PMJ
E & B Paving, Inc.
Engineering - 2016
Appropriation 2016 General Obligation Bond, 94-650.04; P.O. 934337
Contract Not To Exceed $1,471,824.33
Indiana only, and agree that such court is the appropriate venue for and has jurisdiction over same.
17. SEVERABILITY:
If any term of this Agreement is invalid or unenforceable` under any statute, regulation, ordinance, executive
order or other rule of law, such term shall be deemed reformed or deleted, but only to the extent necessary to
comply with same, and the remaining provisions of this Agreement shall remain in full force and effect.
18. NOTICE:
Any notice provided for in this Agreement will be sufficient if it is in writing and is delivered by postage
prepaid U.S. certified mail, return receipt requested, to the party to be notified at the address specified
herein:
If to City: City of Carmel
One Civic Square
Carmel, Indiana 46032
If to Vendor: E & B Paving, Inc.
17042 Middletown Avenue
Noblesville, IN 46060
Telephone: 317-773-4132
ATTENTION: Mark E. Jones
AND Douglas C. Haney,
Corporation Counsel
Department of Law
One Civic Square
Carmel, Indiana 46032
Notwithstanding the above, notice of termination under paragraph 19 hereinbelow shall be effective if given
orally, as1ong as written notice is then provided as set forth hereinabove within five (5) business days from
the date of such oral notice.
19. TERMINATION:
19.1 Notwithstanding anything to the contrary contained in this Agreement, City may, upon notice to
Vendor, immediately terminate this Agreement for cause, in the event of a default hereunder by
Vendor and/or if sufficient funds are not appropriated or encumbered to pay for the Goods and
Services to be provided hereunder. In the event of such termination, Vendor shall be entitled to
receive only payment for the undisputed invoice amount representing conforming Goods and
Services delivered as of the date of termination, except that such payment amount shall not exceed
the Estimate amount in effect at the time of termination, unless the parties have previously agreed in
writing to a greater amount.
19.2 City may terminate this Agreement at any time upon thirty (30), days prior notice to Vendor. In the
event of such termination, Vendor shall be entitled to receive only payment for the undisputed
invoice amount of conforming Goods and Services delivered as of the date of termination, except
that such payment amount shall not exceed the Estimate amount in effect at the time of termination,
unless the parties have previously agreed in writing to a greater amount.
19.3 The City may terminate this Agreement pursuant to Paragraph 11 hereof, as appropriate.
JXAContracts\Prof.Svcs @. Goods Svcs\Engin=ring@016\E & B PAng. I= Goods & Seim FORM - WITH E -Verify langaige.d=8/19/2016 2:29 PMj
4
E & B Paving, Inc.
Engineering - 2016
Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #34337
Contract Not To Exceed $1,471,824.33
20. REPRESENTATIONS AND WARRANTIES
The parties represent and warrant that they are authorized to enter into this Agreement and that the persons
executing this Agreement have the authority to bind the party which they represent.
21. ADDITIONAL GOODS AND SERVICES
Vendor understands and agrees that City may, from time to time, request Vendor to provide additional goods
and services to City. When City desires additional goods and services from Vendor, the City shall notify
Vendor of such additional goods and services desired, as well as the time frame in which same are to be
provided. Only after City has approved Vendor's time and cost estimate for the provision of such additional
goods and services, has encumbered sufficient monies to pay for same, and has authorized Vendor, in
writing, to provide such additional goods and services, shall such goods and services be provided by Vendor
to City. A copy of the City's authorization documents for the purchase of additional goods and services shall
be numbered and attached hereto in the order in which they are approved by City.
22. TERM
Unless otherwise terminated in accordance with the termination provisions set forth in Paragraph 19
hereinabove, 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.
23. HEADINGS
All heading 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.
24. BINDING EFFECT
The parties, and their respective officers, officials, agents, partners, successors, assigns and legal
representatives, are bound to the other with respect to all of the covenants, terms, warranties and obligations
set forth in Agreement.
25. NO THIRD PARTY BENEFICIARIES
This Agreement gives no rights or benefits to anyone other than City and Vendor.
26. IRAN CERTIFICATION:
Pursuant to I.C. § 5-22-16.5, the Vendor shall certify that, in signing this document, it does not engage in
investment activities within the Country of Iran.
27. ADVICE OF COUNSEL:
The parties warrant that they have read this Agreement and understand it, have had the opportunity to obtain
legal advice and assistance of counsel throughout the negotiation of this Agreement, and enter into same
freely, voluntarily, and without any duress, undue influence or coercion.
28. ENTIRE AGREEMENT:
This Agreement, together with any exhibits attached hereto or referenced herein, constitutes the entire
agreement between Vendor and City with respect to the subject matter hereof, and supersedes all prior oral
or written representations and agreements regarding same. Notwithstanding any other term or condition set
forth herein, but subject to paragraph 16 hereof, to the extent any term or condition contained in any exhibit
attached to this Agreement or in any document referenced herein conflicts with any term or condition
contained in this Agreement, the term or condition contained in this Agreement shall govern and prevail.
This Agreement may only be modified by written amendment executed by both parties hereto, or their
successors in interest.
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E & B Paving, Inc
Lngineerin- - 2016
Appropriation 2016 General Obligation Bond, 94-650.04; P.O. #31337
Contract Not To Exceed $1,471,824.33
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
By:
James Brainard, Presiding Officer
Date: - —
Mary An�Aurke, M e /
Date: �O
Lori S. Watson be
Date: / I
E & B Paving, Inc.
By:
Authorized Slg ature , :�,�,
141;
mark E. James
Printed Name —
Area �/� .......
Title
Title��������if
FID/TIN: 35-1139301
Last Four of SSN if Sole Proprietor:
Date: X22, 20162016
{S',Ccmna\dic(Ars \ Gawis A';\\Ertinmrixg\!+�U,�Ti 8 D. Pr\'{n� Ili Gcv.1.fi S:na FGfC.I - 1YIT11 F.-Yai(,.'t augmc:4x a: ta':'�h•:.;'i PUS
6
I
BIDDER'S ITEMIZED PROPOSAL
,AND DECLARATIONS
City`of Carmel
Instructions To Bidders.-.
This form shall be utilized by.all Bidders. Except as othei-wise specifically provided, .:all Parts
shall be fully and accurately f lied n and completed and notarized
Project;
Proposal For Construction of
.Date. must 11, 2616
Roundabout Improvements 136th Street and Carey Road
Roundabout Improvements Carey Road and.Hawthorne
Drive
.Part la: 1361f' Street and Carey Road Intersection
,Reconstructioii to a:Single:Iane Roundabortt.
Part lb: 1360 Street and Keystone _Parkway Signal
Metering. Installation
Part :2; Carey. ,Road and Hawthorne Drive Intersection.
Reconstruction to a Single Lane Roundabout
To: City of Carmel, Indiana, Boatd of Puh&.:Works And Safety
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PART 2
BID PROPOSAL
2.1 Base Bid
The undersigned Bidder proposes to furnish all necessary labor, machinery; tools,
apparatus, materials, equipment, service and other necessary supplies,, and to perform and
.fulfill all obligations 'incident thereto in strict accordance With and. within the time(s)
provided by `the terms and conditions of the Contract Documents for the. above described
Work:: and Project,"including any and all addenda thereto, for the Unit Prices applicable. to
the Contract Items as stated :in ,Part 3 hereof, which Unit Prices; when multiplied by
estimated uni '
t'quantities for such Contract Items, total one M�.11ica; Ftxar Hiux].red sev�ty
end, Eight.RzCired. Twaty.-Ft u :and .'Thirty Three tears
($ ,1,471,824:33. ). The.
Bidder acknowledges that evaluation of the lowest B,id shall be based on such price and
further acknowledges; that the unit quantitieslisted in Part.3 of this Proposal are estimates
solely for the purpose of Bid evaluation and Contract award, and are not to be: construed
as exact: or binding: The. Bidder further understands that .all Work which may result on
the Contract shall be compensated for on a; Unit. Price basis and that the OWNER and
ENGINEER cannot and do not .guarantee the amount or quantity of any item. of Work to
be performed or furnished under the Contract;
-V
C)
SEAL J
SEAL _
l
L/rl! kliltt\1,
PART3
CONTRACT ITEMS AND UNIT PRICES
Part la: 136`" Street &Carey Road Intersection Reconstruction
,jxVIN(3
SEAL -
Contract
Item No.
Description
Estimated
Unit
Quantlty
Unit.Ptice
Item Total
0001
CONSTRUCTION ENGINEERING
1.00 IS
$
9,500.00
$
9,500.00
90,02.
INSPECTION HOLE, GREATER THAN.3 FT
2.00 EACH
$
623.00
S
1;250.006,
0003
INSPECTION HOLE, 31FT DEPTH OR.LESS
2.00 EACH
$
300.00
$
600.00
0004
MOBILIZATION AND DEMOBILIZATION
1.00 LS
$
33,13 1 ;07
S.
33,131.07
0005
CLEARING RIGHT OF WAY
1.00 LS
$
14,000.00
$
19,000.60
0006
HOUSES, AND BUILDINGS, REMOVE
1:00_ LS
$
14,000.00
$
94,000.00
0607
EXCAVATION, COMMON
1555:00 CYS
$
49.00
$
76,195.00
0008
TEMPORARY`INLETP.ROTECTION
14.00 EACH
$
85;00
$
1,190.00
0009
TEMPORARY MULCH,
3.00 TON
$
1,000:00
$
3,000.00
0010
TEMPORARY SILT FENCE
470.00 LFT
$
3.00
$
1,410.00
0011
NO3 STONE
100.00 TON
24.00
S.
2,400;00,
0012
TEMPORARY GEOTEXTILE
235:00 'SYS
$
3`.00
$
705.00
000
TEMPORARY:SEED MIXTURE
130.00 LBS
$
4.00
$
520.00
6014
SUBGRADE TREATMENT, TYPE IB or.IC
2,183.00 SYS
$
25:50
$
70,966.50
0015
STRUCTURAL BACKFILL, TYPE 1
147.00 CYS
$
48.00
$
7;056.00
0.016
STRUCTURAL BACKFILL, TYPE 3
.84.00 CYS
$
48.00
$
4,032.0.0
0017
COMPACTED AGGREGATE, NO. 53
257.00 TON
$,
32.00
$
8,224.00
0018
WIDENING WITH PCC BASE, 6.'IN
10.60 SYS
5
60:00
$
600.00
0019
MILLING, ASPHALT, 1 1/2 IN:
321:00 SYS
$
10,00
$
3,210:00
0020
HMA, SURFACE, TYPE B, 9.5 inin
37.00 TON
$
100:00
$.:
3,700.00'
0021
HMA, SURFACE, TYPE C, 9.5 iron
15,8.00 TON
$
1.13:00.
S
17,854.00
0022
HMA; INTERMEDIATE, TYPE.B, 19.0.
Imm
31:00 TON
$
90.00
$
2,790.00
0023
HMA; INTERMEDIATE„TYPE C, 19.0
MM
554.00 TON
$
60:00
$
33,240.00
0024
HMA, BASE, TYPE C, 25.0 nun
720:00 TON,
S
60.00.
$
43,200.00.
0025
JOINT ADHESIVE,_SURFACE
436.00 LFT
S.
0.10
$
43.60
0026.
JOINT ADHESIVE, INTERMEDIATE
392.00 LFT
$
0.15
$
58.80
0027
LIQUID ASPHALT SEALANT
436:00 LFT
$
0.20
$
87.20
0028
ASPHALT FOR TACK COAT
4.00 TON
S.
350.00
$
1,400.00
0029
DECORATIVE.CONCRETE PAVEMENT; TRUCK
APRON, 7 IN
361.00 SYS
$
60.00
$
21,660.00
0030
SIDEWALK, CONCRETEy4IN
8.00 SYS'
$
42.00
$,
336.00
6031
CURB RAMP; CONCRETE
24.00 SYS
$
140:00
$
3,360.00.
0032
DETECTABLE WA. RNING SURFACES
5.00 SYS
$
90:00
$
450.00
0033
IHAND RAIL, PEDESTRIAN
58.00 LFT
$
308:00
$
17,864.00
0034
STRAIGHT CONCRETE CURB
108.06 M
S
35:60
$
3,780.00
0035
CENTERCURB,TYPE D, CONCRETE
15.00 LFT
$
90.00
$
11350.00
0036
CURB AND'GUTTER.CONCRETE TYPE II
975.00 LFT
$,
18.00
$
17;550.00
0037
MODIFIED ROLL CURB
607.00 LFT
$:
24:00
$
14,568.00
0038
PCCP FOR APPROACHES, 6 IN
104,00 SYS
$
43.00
$
4,472.06
0039
MAILBOX ASSEMBLY, SINGLE,'RESET
1:00 EACH
S.
175:00.
$
1:75.00
0646.
GEOTEXTILES
16.00 SYS
$'
4.00
$
64.00
0041
RIPRAP; REVETMENT
8.00 TON
$.
80:00
$
640.00.
0042:
MOBILIZATION' AND:DEMOBILiZATION FOR
100 EACH
$
250.00
$
500.00
0043
TOPSOIL
163.00 CYS
$
50.00,
$
8,150.00.
DI/II T A-
-3
u-f�S
0,044
SODDING, NURSERY
1,953.00 SYS
$
3.25
$
6,347.25
0045
IRRIGATION CONTROLLER BOX
1.00 EACH
$
1,000:00:
S
1,000.00
0046
FIELD OFFICE,.B
4.00 MO.S.
$
2,100.00
$.
8,400.00
0047
PIPE ENDSECTION; PRECAST CONCRETE, 151N
1:00 EACH
$
785.06
$
785.00
0048
PIPE, CLASS III RCP, CIRCULAR 15 IN
16.00 LFT
S
50.00
$
800.00
0049
PIPE, CLASS.111 RCP; CIRCULAR 12 IN
501.061FT
S
$
18,036.00
0050
CONCRETE ANCHOR, 12 IN
1.00` EACH
$
800.00
$
800.00
0051
MANHOLE, J10
1:00 EACH
S
41800.00.
$
4,800.00
0052
STORMWATER.BMP, 15
1.00•EACH
$
14,00.0.,00
$
14,000.00
0053
INLET,.A2
1:00 EACH
$
1,750.00
$.
1,750.00-
00'54
INLET, J10
4.00 EACH
$
2,100.00
$
8,400.00
0055
INLET, M10
2.00 EACH
2,100.OQ;
$,
4,200.00
0056
MANHOLE, C4
1.00' EACH
$
2,800.00
$
2,800.00
0057
MANHOLE, C2
1.00 EACH
$
2;900.00
$
2,900.00
0058
MANHOLE, CIO
3.00 :EACH
$
3,100.00
S.
9;300.00
0059
AGGREGATE, FOR: DRAINAGE FILL
15.00CYS
$
47.00
`$
705.00
0060.
MODULAR,BLOCK WALL ERECTION
.383.00. SFT
$
29.00
$
11,107.00
0061
MODULAR BLOCK WALL WITH GROUND
383.00 SFC
S
23.00
S.
8,809.00
0.062
CONSTRUCTI.ON SIGN; C
2:00 EACH
$
280.00
S
360.00
00.63
ROAD CLOSURE SIGN ASSEMBLY
10.00 EACH
$
170:00
S7
1,7.0.0.60
0064
DETOUR ROUTE MARKER ASSEMBLY, MULTIPLEROT JTFS
1.00 EACH
$
387.00
$
337.00
0065
DETOUR ROUTE MARKER ASSEMBLY
31.00 EACH
S
129.00
'$
3,999.06
0066
CONSTRUCTION SIGN, A
7:00 EACH
$
195.00
$.
1,365.00
0067
CONSTRUCTION SIGN, B
33.00 EACH
S
105.00,
S
3,465`00
0068
MAINTAINING TRAFFIC
1.00 Ls.
S.
1.1,945.68
S
11,945.68
0069
BARRICADE; III -A
168.06 'LFT
S
10.00
1,680.00
0070
BARRICADE, III -B.
72.00 LFT
$
11.00
.S
792.00
0071
DECORATIVE STREET.S.IGN ASSEMBLY,
DIRECTIONAL, INSTALLED
3.00 EACH
$
2,337.00
S
7,011.00
0072
SIGN POST, SQUARE, TYPE 2, REINFORCED
151.00 LFT
$
19.00
$
2,869.00
0073
SIGN„ SHEET, WITHlLEGEND 0.080'
83:00 SFT
$
17.10
$'
1,419.30.
0074
SIGN; SHEET, WITH LEGEND 0.100 IN
12.0.0. SFT
S
19.00
S,
228.00
0075
TRAFFIC SIGNAL AND EQUIPMENT, REMOVE -AND
SALVAGE
1.06 EACH
$
1,465.00
$
1,465.00
0076
CONDUIT; STEEL,. GALVANIZED, 2IN
92.00117T
$
26'.50
:S
2,438.00
0077
CONDUIT,.PVC, 4.1N, SCHEDULE 80
136.00 LFT
$
20.86 .
S
2,828.80
0078
CONDUIT„PVC, 41N., SCHEDULE8,0 WITH 3-1.25 IN
136.00 LFT
S
35:00
$.
4,760.00
0079
HANDHOLE, LIGHTING
2.00 EACH
S
745.00'
.$
1,490.00
0080
LUMINAiRE,.LED, 152 WATT
4.00.EACH
$
3,702.00
S:
14,808:00
0081
LIGHTING FOUNDATION, CONCRETE, WITH
GROUNDING, 30 IN k,96 IN
4:00 EACH
S
1,057.00
$
4,228:00
0082
LIGHT POLE; 30 FT E.M.H:, 8 FT MAST ARM, DECO
MAP BASE
4.00 EACH
$
3,997.00
$
15,988.00
0083
SERVICE -PO INT, II
1:00 EACH
S
7,01.4.00
7,014.00
0084
CABLE,:POLE CIRCUIT THWN, NO 1.0 COPPER,STRANDFD. 11C,
590.00 .LFT
$
0.65
$
383.50
00.85
CONNECTOR KIT, UNFUSED.
4.00 EACH
$
36.90•
$
147:60
0086
CONNECTORKIT,,FUSED
4,00'EACH
S
39.60
.$
158.40
0087
MULTIPLE.COMPRESSI011>�]
ERPROOFED .�
10.00. -EACH
S
11.20
$
112:00
0088
INSULATION LINK, NOl� WATERPROOFED '; LC} =.
11.0.0 EACH
S,
8.60
$;
94.60
0089
JINSULATIONIINK, WgEMOMIWAI I
8.00:EACH _
$
11:30.
8
90A0,
//,'1��tlitt?llll010\\\
r-Nfl-MIT A
0090
CABLE -DUCT MARKER
4:00 EACH
$ 184:00
$ 736.00
0091
WIRE,:NO 10 COPPER, I/C
3,280.00 LFT
$ 0.65
S 2,132.00
0092
TRANSVERSE MARKING THERMOPLASTIC
CROSSWALK, WHITE 24 IN
70.00 LFT
$ 10.00
$ 700:00
0093
LINE; THERMOPLASTIC, SOLID, WHITE, 4 IN
156.0.0 LFT
$ 1.35
S 210.60
0094
TRANSVERSE MARKING, THERMOPLASTIC, YIELD,
WAITE,24IN (SHARKS'TEETH)
48.00 LFT
$ 26.00
S 1,248.04
0095
LINE, THERMOPLASTIC; DOTTED, WHITE, 8 IN (2 FT
LINE, 2 FT GAP)
49,00 LFT
S 6.00
S 294:00
0096
LINE, THERMOPLASTIC; SOLID, YELLOW; 4 IN
904.00 LFT
$ 1.35
$ 1;220.40
0097
SNO.WPLOWABLE RAISED PAVEMENTMARKER
15.00 EACH
$ 40.00
S 600.00
0098
2 IN..HDPE SDR1:1'.FORCE MAIN
251.00 LI=T
S 38.00
$ :9,538.00
0099
2IN. CONNECTION FO , .i�lAXb114Ch11/
2.00 EACH
$. 360:00
S 600.00
6100
HYDRANT ASSEMI L 'vAND
Y} • ' •� ; _
ADJUST TO GRA jv •; / ��
2.00 EACH
$ 1,000.00
S 2000.00
0101
ADJUST VALVEE'O GJAA
3:00 EACH
$ 85:00
S 253.00
� L Part` 1 a. To a1 $, 672,182.70
Subnutted:By. S B Inc.
Signature:'MaE Area { Thr
//j711111111��
Part 1b: 136" Street and Keystone Parkway Signal Metering Installation
Contract
Item No.
Description
Estimated
Quantity
Unit
Unit Price
Item Total
1.001
MOBILIZATION AND DEMOBILIZATION
1.00
LS
$ 8,183.18
S 8,183.18
1002
ANCHOR PLATE FOR SIGNMO.UTING TO TRAFFIC
BARRIER, DRILL AND EPDXY
1.00
EACH
$ 305.00
$ 305.00
1003
CONTROLLER; RESET TIMING
1.00
LS
S 6,552.00
$ 6,552.00
1004
MAINTAINING TRAFFIC
1;00
LS
$ 5,54107
$, .5,541.07
1005
SIGN POST, SQUARE, TYPE 1, REINFORCED
ANCHOR RASP
70.00
LFT
$ 20.00.
$ 1,400.00
1,006
SIGN, SHEET, WITH LEGEND 0.080"
20.00
SFT
S 17:90
$ 358.00.
1007
HANDHOLE, SIGNAL, TYPE 1
2.00
EACH:
$' 1,57200
$ 3,144.00
1,008
CONDUIT,.STEEL, GALVANIZED,.2 IN
.140.00
LFT
S 26.50
S 3;710.00
1009
SIGNAL PEDESTAL FOUNDATION, A
Loo
EACH
S 893.00
$ :893.00;
1010
SIGNAL POLE,.PEDESTAL; 4FI'
1.00
EACH;
$ 2,678:00
$ 2,618.00
10.1.1
SIGNAL POLE, PEDESTAL -15 FT
4.00
EACH
$ 3,190.00
S 12,760.00
1012
RECEIVERTROCES.SOR
1.00
EACH
$ 7096:00
$' 7,196.00
1013
WIRELESS MAGNETOMETER DETECTOR
12.00
EACH
$ 789.00
$_ 9;468.00
1014
WIRELESS REPEATER
2.00
EACH
$ 2;397:00
S 4,794.00
1095
TRAFFIC SIGNAL HEAD,' SECTION, 12IN;,LED (RED,
4.00
EACH
S :1,416.00
S` .5,664.00
1016
SIGNAL SERVICE
1.00
EACH
S 1,667;00
$ 1:,667,00
1017
SIGNAL CABLE; SERVICE, COPPER. 3C18GA
15.00
LFT
$ 1.70
$ 25.50
10:18
SIGNAL CABLE; CONTROL, COPPER 7C/ 14GA
314.00
LFT
$ 2.10
S 659.40
1019
CONTROLLER C ABINET FOUNDATION, P 1
1:00
EACH
$, 1,536;00
$ 1,536.00
1020
LIGHTING FOUNDATION, CONCRETE, WITH
GROUND , 30 IN X 30 INX. 96 IN
4:00
EACH
$ 1,057.00
$' 4,228.00
1021
TRANSVERSE Iv1ARKING'MULTI-COMPONENT,
STOP LINE, 24"
36.00.
LFT
S 50.00
$. 1,800.00
�...=mac 6V�•t
�Ol'
1022 1 HMA PATCHING, TYPE D (UNDISTRIBUTED) 45.00 TON $ 125.00 $ 5,625.00
Part lb Total = $ $8,187.15
Submitted By: E
Signature. ^ -.--%�
E. I Area N13nac�r
Part .1 c: Lantfsc'aping.cit :136th Street and Carey Road Roundabout.
Contract
Item No.
Description
Estimated
011niltitv
Estimated
Quantity
Unit
Unit Price
Lfem.Total
1:100
EVERGREEN SHRUB, NO.SCONTAINER
CONSTRUCTION ENGINEERING
16.00
EACH
5 42.00
S 672:00
1101
DECIDIOUS SHRUB, NO.3 CONTAINER
2002
15.00
EACH
$ 41.00.
$ 615.00
1102
ORNAMENTAL GRASS; NO 1 CONTAINER
26,133.48
48.00
EACH
$ F$.00
$ 8.64.00
.1103
PERENNIAL; PLUG CONTAINER
S
129.00
EACH
$ 4.50
$ 580.50
1104
IRRIGATION SYSTEM
350.00
1:00
LS
$ 11,593.4`1
$ 11,,593.41
1105
YIASONRY WALL
S
.4.5.00
LFT
$ 392:67
S: 17,670:15
1106
DECORATIVE CONCRETE
CYS
101.00
SYS
$ 111.82
-$ 11,293:82
1108
SODDING, NURSERY ��� ' ,•
//
-100.00
Svs
$ 0.01
$ (1,00)
1109
DE. CIDIOUS SHRUB, NO. `..Qj 'yAINER
TEMPORARY CHECK DAM
14.00
EACH
:$ 45.00
$ 630:00
1.110
HARDWOOD MULCH � �
2009
8.00;
CVS
$ 75.00
:$ 600.00
[tl-1'FREE
AND SIiRUfi$ SOIITM[
680.00
31.00
CYS
$ 100.Q0
y 3,100.00
Part 2 a : Carey Road and Hawthorne Drive Intersection Reconstruction
Pali I c Total = ? 47,617.88
Submitted By: E & IB ,
Signature:
E. , Area Mmager
Contract
Item No.
Description
Estimated
011niltitv
Unit.
Unit Price
Item Total
2001
CONSTRUCTION ENGINEERING
1.0
LS
S
9,200.0.0
$
9.,200.00
2002
MOBILIZATION AND DEMOBILIZATION
1..0
LS
S
26,133.48
S
26,133.48
2003.
CLEARING RIGHT OF WAY
1.0
LS
$
161000.00
S
16,000.00
20.04
HEADWALL, REMOVE
1.0
EACH
$
350.00
8
350.00
2005
EXCAVATION, COMMON
554.0
CYS.
S
90:00
$
49,860.00
200E
BORROW
440.0
CYS
S
1.00
$
'440.00
2007
SEDIMENT, REMOVE
5.0
CYS
S5500
$
275.00
2008
TEMPORARY CHECK DAM
12.0'
TON
S
65:00
S
780.00
2009
'TEMPORARY INLET. PROTECTION
8.0
EACH
'S
85.00
$
680.00
2010
INLET FILTERS
8.0
EACH
S
350.00
$
21800.00
201,1.
TEMPORARY MULCH
0.6
TON
S
1,250.00
$
750.00.
2012
TEMPORARY SILT FENCE
1,152.0.
LFT
$
1.50
$
1,728.0.0
2013.
NO. 2, STONE
100.0
TON
$.
25.00
S
2,500.00.
2014
TEMPORARY SEED MIXTURE
70:0
LBS
S
7.00
$
490.00
2015
SUBGRADETREATMENT,.TYPEIC
.3,564.0
SYS
S
•20.00
S
71,280.00
2016
STRUCTURE BACKFILL, TYPE 1
104.1
CYS
S.
50.00
$ .
5,205.00
2.01.7
COMPACTED AGGREGATE. NO. 53.
75.0
TON
S
35.00
S.
2,625.00
2018:
HMA, SURFACE; TYPE'C, 9.5mm
225.0
TON
$
83:00
S
18;675.00
2019
HMA,,INTERMEDIATE,.TYPE'C',
375,0
TON
$
60.0,0
S.
22,500.00
2020
HMA, BASE, TYPE'C',.25.0mm
1,027.0
TON
S
50.00
$
51;350.00
2021
HMA, INTERMEDIATE, TYPE'C OGi 19.0imn
419.0
TON
$
60.00
$
25,140.00
2022
JOINT ADHESIVE, SURFACE
1,486.0
LFT
S
0;10
S
148.60
2023
JOINT ADHESIVE;: INTERMEDIATE
1,486.0
LFI'
S
0.15
$
22290
2024
LIQUID ASPHALT: SEALANT
1,486.0
LFT
S
0.20
S
297.20
E?�C R B 6 T
)+t L�t
6, of '8�
2025
ASPHALT FOR TACK COAT
2.7
TON
$ 350.00
$ 945.00
2026
DECORATIVE CONCRETE PAVEMENT, TRUCK
APRON. 7 IN -
192:2
SYS
$. 45.00
$ 8,649.00
2027
SIDEWALK, CONCRETE _141N.)
245.0
SYS.
$ 37.00
$. 9,065.00
2028
CURB RAMP,.CONCRETE
175.0
SYS.
$ 122.00
$ 2.1,350.00
202.9
IDETECTABLE WEARING. SURFACE
27.0
SYS
$ 90.00
$ 2,430.00
2030
CURB, CONCRETE
138.0
LFT
$ 30.00
$ 4,140.00
2031
CURB, TURNOUT
65
LFT
$ 80.00'
.S 520.0.0
2032
COMBINED CURB & GUTTER. CONCRETE; TYPEZ
1,094.6
LFT'
$ 14.00
$ 15;316.00
2033
COMBINED CURB &':GUTTER; CONCRETE, TYPE III
243.0
LFT
$ 40.50
$ 9,84L:50
2034
ROLLED CURB &GUTTER, CONCRETE, MODIFIED
482.0
LFT
$ 15.00
$ 7,230,00
2035
RIPRAP, REVETMENT
4.2
TON
$ 95.00
$ 399.00
2036
GEOTEXTILES
5:6
SYS
$ 15.00
S 84.00
2037
MOB, & DEMOB: FOR SEEDING
2.0
EACH
$ 250.00
S 500.00
2038
WATER
4.1
kGAL
$ 1.00
3 4.10
2039
SODDING.
1,135.2
SYS
$ 3;.50
S 3;973.20
1040
P4P-EKY-P-E'-rl,-`C-i1RG1J1- R -"N:
m-.0
LF -T
$
8
2041
PIPE, RCP; CIRCULAR IN:
222.0
LFT`
$ 37.00
$ 10;804,00
2042
PIPE END SECTION, DIAMETER 12 N.
1.0
EACH
$ 750.00
S 750;00
2043
AGGRI:�-GA-T-1; I -BR-' NDE-RDR-A N8
49:1
Com$_
$ -
$'
U44
GE-OTC-i-T4U- FG1? n,_�„yD"E.oTXRArM"
$�"�?
zSa S
$: -
$ -
2045
INLET, J 10
4.0
EACH
$ 2,100.00
$ 8,400:00
2046
INLET, M 10
2.0
EACH
S. 2,1:00.00
S. 4,200.00
2047
MANHOLE; C4
3.0
EACH.
$ .3,100.00
'$ 9,300.60
2048
CASTING, ADJUST TO GRADE- UNDISTRIBUTED
5.0
EACH
$ 365.00•
$ 1,825.00
2049
MAINTAINING TRAFFIC
1.0
LS
$ 51000.06
$ 5,000,00
2050
SIGNPOST, SQUARE TYPE 1 REINFORCED ANCHOR
169.0
LFT
$ 19.76
$ 3,329.30
2051
DECORATIVE STREET SIGNS, INSTALLED
4.0
EACH
$ 2314.00
$' 9,256.00
.2052
SIGN,.SHEET, WITH LEGEND, 0.086 IN.'
49.2
SFT
$ 17.30
$ 851.16
2053
SIGN, SHEET, WITH LEGEND, 0.100. IN.
75.0
SFT
$ 19.00
$ 1,425.00
2054
CONDUIT,. STEEL, GALVANIZED, 2IN.
205.5
LFT
$ 22.50
$ 4,623..75
2055
CONDUIT, PVC 4 IN.•SCHEDULE 80
3385
LFT
$ 20.80
$ 71040.80
2056
CONDUIT, PVC 4 IN. SCHEDULE 80 WITH 3-1.25 IN.
338:5
LFT
$ 34.40
'S: 11;644.40
2057
4=1C NO.4 Cu CONDUCTOR IN PLASTI.C'DUCT
502.5
LFT
$ 11.50
'$ 51778;75
205.8
LIG14T POLE, ORNAMENTAL 30 FT. E.M H., 8 FT.
MAST.ARM, DECO WRAP BASE
8.6
EACH
$ 3,9.97.00
$ 31,976.00
1059
LIGHTINGTOUNDATION, CONCRETE, W f
GROUNDING; 30 IN:X 96 IN.
8.0
EACH
$ 1,057.00
$ 8,456.00
2060
LUMINAW,LED,.152WATT
8.0
EACH
$ 3;7.02.00
:$ 29;616.00
2061
HANDHOLE, STREETLIGHTING
1.0
EACH
$ 74,5.00
$ 745.00
2062
SERV. ICE' POINT, 7I; METERED
1.0
EACH
$ 7,014.00
$, 7;014,00
2063
IRRIGATION CONTROLLER BOX
1.0
EACH
$_ 1,000.00
:$ 1,000:00
.2064
TRANSVERSE MARKING, THERMOPLASTIC;
CROSS! ggyjWiIkiilaIN.
\, y .. J .
192.0
LFT
S 10.00
$ 1,920:00
2065
LIN F HSR OPLA . , ,LID; WHITE,.4IN.
: J
1;359:0
LFT
$ 1.35:
S 1;834;65
2066
LIfitE,fiHEROPLASTIC; _7ED, WHITE,"8 IN.
56:0
LFT
$ 6.00'
'$ 336.00
1111 U\0\\\�
2067
TRANSVERSE MARKING, THERMOPLASTIC, YIELD
LINE, WHITE, 24 IN.
64.0
LFT
$ 26:00
S 1,664.00
2068
LINE, THERMOPLASTIC; SOLID WHITE, 6 IN.
100.0
LFT
2.55
'S 255.00
2069
LINE, THERMOPLASTIC; SOLID,.YELLOW, 4 IN.
1,243.0
LFT
$ 1.35
S 1,678.0.5
2670
LINE, THERMOPLASTIC, SOLID YELLOW; 8 IN.
208.0
LFT
$ 3.40
$ 707.20
2071
SNOWPLOWABLE RAISED PVMT MARKING (BLUE)
2.0
EACH
'S 70.00.
:$ 140.00
2072
CEN`I'ERCURB, TYPE D, CONCRETE
13:6
SYS
$ .132,00
$ 1,795.20.
2073
HYDRANT ASSEMl3LY,.REMOVF/REPLACE.AND
ADJUST
2.0
EACH
$ 1'000 '.00
$ 2,00.0.00
2074
ADJUST VALVE TO:GRADE
4.0
EACH
S .85.00
S 340.00
2075_
RECTANGULAR RAPID FL..ASHER BEACON NVf
PUSH uvi-TON ACTIVATION
4.0
EACH
$ 9;585:00
$ 38,340.00.
2076
CABLE, POLE CIRC.QIT, THWN, NO, I0, COPPER,
STRANDED; 1:fC
400.0
LFT
$ 0.65
$ 260:00
2077
CONNECTOR KIT, UNFUSED
4:0
EACH
$ 36.90
'S 147;60
2078
CONNECTOR KIT, FUSED
4.0
EACH
$ 19:60
:$ 158;40:
2079
MULTIPLE COMPRESSION FITTING, NON-
W .1 EI PROOFED
18.0
EACH
$ 1.1.20
$ 201.60
2080
INS ULATION:LIN ,;i t l l -':k ._ ¢-ED
8.0
EACH
$ 8.60
$ 68.80
208.1
iNSULATIONL� ATGRPROb,.
8.0
EACH
$ 1:1.30
$ 80.40
2082
A11I.1 ING, A$PLIAL'I' -
412.0
SYS
$ 10.00_
_$ 4,120.00
OCAL
01;II IIIA\\
�
Pala 2h:.Lnndscapin_ at. Carev Road and Hawthorne Deive Roundabout
Part 2 Total.= $ 612;969.04
Submitted By:. E: &. B , ..?,ne.
.Signature:
E. , Area Mmager
Contract
Item No.
Description
Estimated
Quuntity
Unit Unit Price
Item Total
2100
ORNAMENTAL TREE, 8 F'1'. HE, IGHT'
2.00
EACH 5375.00'
$
750.00
2101
EVERGREEN. SHRUB, NO. 3 CONTAINER
23:00
EACH 544.00
$
1,012.00
2.102
DECIDIOUS SHRUB .N0.3 CONTAINER
26.00
EACH $47.00
$
1,222.00
2I03
ORNAMENTALGRASS NO, -CONTAINER
86.00
EACH.I7.50
S
1;5,05:00
2104
PERENNIAL,NO: I CONTAINER
487.00
EACH $18:25
$
8;887.75
.2105
IRRIGATIONSYSTE'M
1.00
LS, 58,490.64
$
8,490.64
2106
MASONRY-R'ALL
31.00
LFT $459.67
$
14,249.77
2107
DECIDIOUS SHRUB, NO: 1 CONTAINER
50.00
EACH $24.00
$
1400.00
2108
PERENNIAL, PLUG CONTAINER
186.00
EACH $3.90
5
725.40
2109
HARDWOOD: MULCH
1-7.00
CYS $75.00
$
2;025.00
2.110
TREE. AND SOIL. PLANTING 1}IIN
108.00
CYS 5100.00
S
10;800.00
Part 2b Total= Is 50;867:56
Submitted By:
g PAVJ;�' Fbrk E. Alm,Mkt
I `\
• \Z�'
aA F-1 L'i A
ilall►I
�61
EXHIBIT B
Invoice
Name of Company:
Address & Zip:
Telephone No.:
Fax No.:
Project Name:
Invoice No.
Purchase Order No:
Date:
Signature
Printed Name
Goods
Services
Person Providing
Goods/Services
Date
Goods/
Service
Provided
Goods/Services Provided
(Describe each good/service
separately and in detail)
Cost Per
Item
Hourly
Rate/
Hours
Worked
Total
GRAND TOTAL
Signature
Printed Name
EXHIBIT C
INSURANCE COVERAGES
Worker's Compensation & Disability
Employer's Liability:
Bodily Injury by Accident/Disease:
Bodily Injury by Accident/Disease:
Bodily Injury by Accident/Disease:
Commercial General Liability:
General Aggregate Limit (other than
Products/Completed Operations):
Products/Completed Operations:
Personal & Advertising Injury
Each Occurrence Limit:
Statutory Limits
$1,000,000 each employee
$1,000,000 each accident
$1,000,000 policy limit
$6,000,000
$5,000,000
$5,000,000
Comprehensive Auto Liability (owned, hired and non -owned)
Bodily Injury and Property Damage: $5,000,000 each occurrence
Umbrella Excess Liability
If a commercial umbrella liability policy is used to satisfy the minimum limits of liability
requirements, the combined limits must equal these minimum limits of liability.
EXHIBIT D
AFI`IDAVIT
Mark E. Jcnes beim 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:
I am over eighteen (18) years, of age and ani competent to testify to the facts contained
herein.
2. I am now, and at .ill tinies.rclevant herein have been employed by
E & B PaviM, Inc.(the `'Employer'')
in the position of Arm M-gg x
3. I am Iamiliar with the employment policies, practices, and procedures of the Employer and
have the authority to .act on behalf of tine Employer.
4. The Employer is enrolled and participates in tine federal E -Verity program. Documentation
of this enrollment and participation is attached and incorporated herein.
The Employer does not knowingly employ any unauthorized aliens.
6. To the best of nay information said belief, the Employer does not currently employ any
Unauthorized aliens.
FURTHER AFFIANT.SAYETH NOT.
EXECUTED on tlae ;22nd clay of _-- t 120 16.
Printed: & Jam.
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 aaepresentations are true and correct.
Printed:
Company ID Number: 426977
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 E&B Paving, Inc.
hilli :Dockter
ame (Please Type or Pring
ElectrorOVOWftoed
Title
0612812011
igneture o
ate q � R �
relB 0
Depart ent of Homela d Security —Verification Division
SCIS Verification Division
ame (Please Type or Print)
lectronically Signed
Title
6128/2011
lgnature
Date
Information Required for the E -Verify Program
Information relating to your Company:
Company Name:
E&B Paving, Inc.
Company Facility Address!
286 West 300 North
Anderson, IN 46012
Company Alternate
Address:
County or Parish:
MADISON
Employer Identification
Number:..
5113930
Page 12 of 141 E -Verify MOU for Employer I Revislon Date 09/01/09 www.dhs.gov/E-Verify
Company ID Number: 426977
North American Industry
Phillip Dockter
Classification Systems
Code:
237
Administrator:
(765) 643.- 0699
Number of Em to ees:
100 to 499.
Number of Sites Verified
for.
Lori Hughes
Are you verifying for more than I site? If yes, please provide the number of sites verified for
n each State:
• INDIANA 1 site(s)
Information relating to the Program Administrator(s) for your Company on polity
questions or operational problems:
Name:
Phillip Dockter
Telephone Number;
(765) 374 - 0350
Fax Number,
(765) 643.- 0699
E-mail Address:
phil.dockterf4_,ebpaving.com
Name:
Lori Hughes
Telephone Number:
(765) 643 - 5358
Fax Number;'
(765) 643 - 0699
E-mail Address:
teri.bughes@ebpaving.eom
Name:
Gayle $ehm
Telephone Number.
(765) 374 .0352
Fax Number.
(765) 643 - 0699
E-mail Address:
gayle.bebm@ebpaving.com
Name:
Sarah Shuter
Telephone Number.
(765) 374 - 0342
Fax Number:
(765) 643 -0699
E-mail Address:
sarah.shutee@ebpaving.com
Page 13 of 14 1 E -Verify MOU for Employer I RevWon Date 09/01/09 Www.dhs.9ovJE-Verify
City ofCarm l
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
Page 7 of 1
PURCHASE R NUMBER
FEDERAL EXCISE TAX EXEMPT
CORD;
3433
ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A1P
CARMEL, INDIANA 46032-2584
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.
IDESCRIPTION
8/1912016
T0002120
Projects 16 -ENG -26 and 16 -ENG -09
E & B PAVING INC
City Engineering's Office
VENDOR 12600 STATE ROAD 38 E
SHIP 1 Civic Square
TO Carmel, IN 46032-
NOBLESVILLE, IN 46060 -
Kate Lustig
PURCHASE ID BLANKET
CONTRACT
PAYMENT TERMS FREIGHT
7691
QUANTITY UNIT OF MEASURE
DESCRIPTION UNIT PRICE EXTENSION
Department: 2200 Fund: 0 General Obligation Bond
Account., 94-650.04
1 Each 136th Street and Carey Road Roundabout Construction and 1,471,824.33 $1,471,824.33
Carey Road and Hawthorne Drive RAB Construct
Sub Total $1,471,824.33
Send Invoice To:
Jill Newport
CrossRoad Engineers, P.C.
3417 Sherman Drive
Beech Grove, IN 46107
G.O./Storm Water Bonds PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $1,471,824.33
SHIPPING INSTRUCTIONS
'SHIP PREPAID.
'C.O.D. SHIPMENT CANNOT BE ACCEPTED.
'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.
AM VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY
TITL
CONTROL NO. 34337 CLERK -TREASURER