A & F Engineering/Eng/Adl Serv #6/12,900/126th Street Reconstruction – Rangeline Road to Keystone Parkway – Supplemental Right of Way Engineering Services A&F Engineering Co..LLC iQFtOb<<`
Engineering-2016 o i
Appropriation#94-650.04;ASA#6;2016 COIT Bond Fund;P.O.#34335 \JAO 1
Contract Not To Exceed$12,900.00
. ADDITIONAL SERVICES AMENDMENT TO
AGREEMENT FOR PROFESSIONAL SERVICES
THIS AMENDMENT TO THE AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement") entered into
by and between the City of Carmel and A& F Engineering Co., LLC (the"Vendor"), as City Contract dated January 6,
2015 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, INDIANA A&F Engineering Co.,LLC
by and through its Board of Public
Works and Safety
By: By:
NO+ re.5cy /141/14 -- .
James Br
ainard, Presiding Officer Authonzed Signature •
Date: 414/401,
Printed Name
ary A/Burke, Memb .
Date: V%c-2. 't.tea s.. w,_-r
} Title
Lori Si.Watson,/ er • FID/TIN: 3 5 - a2-O 3 4`f 2
Dater
Last Four of SSN if Sole Proprietor: •
4 : .
_.
Date: $ - 30 - I 6
Christine Pauley lerk / r/f.,�
Date: JU
:
IX:1Con"ansl'r(Svcs S Goad,,SvestEngneenngt2d165A A.F Efigiirming ASA a6 Add7 Sons Amm d 3-7.740I2 mid,E.Veri[r Iong ogo doe:836:21,16 Rd 1,AUI
i‘A&F :4.INEERING TRAN: ETADIESIGN GIH GHWAY DES GINS TRAFFIC ENG VEERRANNACYSES
PARKING LOT DESIGN•TRANSPORTATION PLANNING STUDIES
Transportation & Site Engineering CONSTRUCTION OBSERVATION•SITE ENGINEERING
Creating Order Since 1966 REGISTRATION
WILLIAM J.FEHRIBACH,P.E. INDIANA
OF COUNCIL ILLINOIS
STEVEN J.FEHRIBACH, P.E. KENTUCKY
PRESIDENT MICHIGAN
OHIO
R.MATTHEW BROWN,P.E. MISSOURI
VICE PRESIDENT
TEXAS
JOSEPH T.RENGEL, P.E.
VICE PRESIDENT
June 6, 2016
Mr. Jeremy Kashman, RE.
City Engineer
City of Carmel
One Civic Square
Carmel, Indiana 46032
Re: Supplemental Request for Right of Way Engineering Services
Reconstruction of 126th Street from Rangeline Road to Keystone
Dear Mr. Kashman,
We have appreciated working with you and your staff on the accelerated design project on 126th Street in
preparation to start construction in the fall 2016. As discussed, I have arranged for the preparation of legal
descriptions and plats for the City to coordinate the right of way acquisition for this project. At this time,
A&F is requesting a supplemental in order to coordinate and deliver these items.
Our proposed fees are as follows:
Permanent Right-of-Way Parcels 3 each at$2,200.00 = $ 6,600.00
Right of Entry Parcels 7 each at$ 900.00 = $ 6,300.00
Total $12,900.00
If you have any questions or concerns, feel free to contact me.
Sincerely,
.A&F Engineering Co., LLC
j"le' am'
'Joseph T. Rengel, RE,, PTOE
Vice President
/ oft -
8365 KEYSTONE CROSSING, SUITE 201 — INDIANAPOLIS, INDIANA 46240
TELEPHONE (317) 202-0864 — FACSIMILE (317) 202-0908
A&F Engineering Co.,LLC
Engineering-2016
Appropriation#94-650.04;ASA#6;2016 COIT Bond Fund;P.O.#34335
Contract Not To Exceed$12,900.00
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.
tX:\Contracts\ProfSvcs&Goods Svcs\Engincering12016W&F Engineering ASA fl6 Add?S\CS Amend 3-27-2012 xith E-Verify language.doc:8/30/2016 10:41 AM]
A&F Engineering Co.,LLC
Engineering-2016
Appropriation#94-650.04;ASA#6;2016 COIT Bond Fund;P.O.#34335
Contract Not To Exceed$12,900.00
Exhibit"C"
E-Verify Affidavit
�7
�0 ,being first duly sworn, deposes and says that
h tshe 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
0. t L • Go. LL c (the "Company") in the position
of V s,1.4.e.p& -�
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.
EXECUTED on the 30 day of u-0,,,Lt.z4- ,20 1�,
Printed:) . 4f Tf ''Xi;44,1
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.
�khd .
Printed: a.,4--1&&
O c-c.s. \-lawayty
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Ca) INDIANA RETAIL TAX EXEMPT Page 1 of I
1tyof C4i;r1J�el CERTIFICATENO.0031201550020- PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 34335
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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. ,_.-_. DESCRIPTION_._.. .
8/25/2016 003050 Project 16-ENG-04;Contract Date 01.06.15
A&F ENGINEER CO.,INC City Engineering's Office
VENDOR 8365 KEYSTONE CROSSING SHIP 1 Civic Square
SUITE 201 TO Carmel, IN 46032-
INDIANAPOLIS, IN 46240- Kate Lustig
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
7828
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2200 Fund: 0 COIT Bond Fund
Account: 94-650.04
1 Each ASA 6-126th Street Reconstruction-Rangeline to Keystone $12,900.00 $12,900.00
Supp. ROW Engineering Svcs.
Sub Total $12,900.00
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Send Invoice To: , l' ` r =__- �. `4 j
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Skip Tennancour L4 ', r
American Structurepoint, Inc.
8425 Wicklow Way ., .. - ... '" e,
Brownsburg, IN 46112 y '' Ism. /`,,,i,
2016 COLT Bond PLEASE INVOICE IN DUPLICATE
r DEPARTMENT ➢ ACCOUNT i PROJECT i PROJECT ACCOUNT AMOUNT
PAYMENT $12,900.00
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
r-
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 P� '"
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE r d .14 =
CONTROL NO. 34335 CLERK-TREASURER
• elr,' -.;
.., .
Company ID Number:478164
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 A&F Engineering Co LLC
Lisa Pipes -
Name(Please Type or Print) Me —
,Electronically Signed 12/22/2011
'Signature mate
Department of Homeland Security—Verification Division
USCIS Verification Division
Name(Please Type or Print) 7PUe
Electronically Signed 12/22/2011
Signature Date
Information Required for the E-Verify Program
Information relating to your Company:
Company Name:A&F Engineering Co LLC
Company Facility Address:8365 Keystone Crossing
Suite 201
Indianapolis,IN 46240
Company Alternate
Address:
County or Parish; MARION
Employer Identification
Number; 352093442
Page 12 of 13 IE-Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov!E-Verify