OLCO, Inc/Eng/Adl Serv/73,836.27/Crooked Stick Drainage Improvements - ConstructionOLCO, Inc.
Engineering - 2016 ��'
Appropriation #2016 Storm Water Bond; P.O. #34299 Z JV<,��,
Contract Not To Exceed $73,836.27 Fd
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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 OLCO, Inc. (the "Vendor"), as City Contract dated September 21, 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, INDIANA
by and through its Board of Public
Works and Safety
By:
aures Brainard, Presiding Officer
Date: 9'—A l6
Mary Ann urce, iUber
Date: 7,
r
Lori S. W tson, M " nber
Date: !, I
AT�
C ristine Paul . rk- reasurer
Date: /
1X:iCmnruntP.f.s,a 3 Gcc& S,z,Euetami.eZU16A10C AM Sm,%.dz' &,-�-Y91Nlln 3:9; P11I
OLCO, Inc.
By:
i
-34
Authorized Signature
W .«.i r.w. �3C£tit11, c
Printed Name
Title
FIDITIN:����`c�
Last Four of SSN if Sole Proprietor:
Date: 6i i 3 (o
BID PROPOSAL SUMMARY PAGE
Complete the following information and place as the cover page to
your bid packet. Insert all documents into an envelope with project
name.and your company name clearly marked on the outside. ,Seal
"the envelope.
Company:
09'
j�-
Lto 53 Jc R m,a A
(
Project Name:
Date Submitted:
T9 OU
Base Bid
Amount:
Local Preference Law
lam claiming Local Preference (Circle One) YES
(All required documentation will be required in a post -bid submittal)
7XHIBIT A
(ofZ
Crooked Stick Drainage
September 7, 2016
DLCO, Inc.
Lme Item 1, "Quantity
`'IlJmt Total Bid Total PncejUrnt
. t <.
001- Mobilization/Demobilization
1
LS'
$
15,579.40
$
15,579.40
002 -Construction Engineering
1
15
$
1,220.00
$
1,220:00
003 - Maintenance of Traffic
1
LS'
$
10,9.80.00
$.
10,980.00
004 - Sidewalk Removal -
72
SYS
$
792.72
$
11.01
005 - Curb & Gutter Removal
270
LFT
$
3,477.60
$
12.88
006 -Grass Removal
58
SYS
$
213A4
$
3.68
007 - Common Excavation
104
CYS
$
3,599.44
$
34.61
008 - Inlet, J-16
2
EA
$
078.50
$
2,089.25
009 - Reinforced Concrete Pipe,. Class ll, 12 IN.
326
LFT
$
7;661:00
$
23.50
010. -Structural Backfill, Type1
100
CYS
$
2,074.00
$
20.74
011 -Sidewalk, Concrete, 4IN.
71
SYS
$
'3,638.04
$
51.24
012 - Curb Ramp, Concrete
21
SYS
$
4,227.30
$
201.30
013.- Concrete Roll Curb and Gutter
152
LFT
$
3,894.24
$
25.62
014 - HMA Surface, Type B,13 8::1 mm.
13
TON
$
1,903.20
$
146.40
015 - HMA Base, Type B, 63.5 -mm
22
TON
$
2,415.60
$
109.80
016 -Compacted Aggregate.Bas'e, No. 53
94
TON
$
3;721:46
$
39.59
017 =Thermoplastic, White Stop Bar, 24"
32
LFT
$
1,4:40.00
$
45.00
01.8 -Temp .clary Inlet.ProWction
3
EA
$
292.80
$
97.60
019 = Temporary Silt Fence
222
LFT
$
701.52
$
3.16
020 -Sodding
87
SYS
$
731.6.7
$
8.41
021 --Temporary. Seeding.
87
SYS
$
636:84
$
7.32:
022 - Core. Drill Existing Inlet
2
EA
$
274.50
$
137.25
023 - Concrete Washout.
1
EA
$
183.00
$
183.00
$
73,836.27
r—UBIT A
2 -�
DLCO, Inc.
Engineering - 2016
Appropriation #2016 Storm Water Bond; P.O. #34299
Contract Not To Exceed $73,836.27
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
Vendoror 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.
]VAsbmedlContatslProf.Svcs&Goods SvcslEngincering12016V01.00 Add?Ss Atnmd.doc:9/M162:23 PM]
DLCO. Inc.
Engineerina - 2016
Appropriation #2016 Storm Water Bond: P.O. #34299
Contract Not To Exceed $73,836.27
Exhibit "C"
E -Verify Affidavit
1l+L �,CLo�tiri(1.�1 , 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:
I am over eighteen (18) years of age and am competent to testify to the facts contained
herein.
2. 1 am now and at all times relevant herein have been employed by
[)LCo:,,, (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 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.
JAL,
EXECUTED on the day of Le���r"r , 20
. ;t_ .1dow"Z,. l
Printed: -1111"44 ��� e,,,,,4d
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.
Printed: f siti
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City ®f CarmelCERTIFICATE
INDIANA RETAIL TAX EXEMPT
NO.003120155 002 0
Page 1 of 1
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
34299
ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, AIP
CARMEL, INDIANA 46032-2584
VOUCHER, DELIVERY MEMO, PACKING SUPS,
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
9/9/2016
371108
Project 16 -SW -57; Contract Date 09.21.15
OLCO INC
City Engineering's Office
VENDOR 24053
SHIP 1 Civic Square
Jill Newport
TO Carmel, IN 46032-
BATESVILLE, IN 47006 -
Kate Lustig
PURCHASE ID BLANKET
CONTRACT
PAYMENTTERMS FREIGHT
8269
6
QUANTITY UNIT OF MEASURE
DESCRIPTION UNIT PRICE EXTENSION
Department 2200 Fund: 0
Account: 94-650.04
1 Each
2016 Storm Water Bond
ASA 1 - Crooked Stick Drainage
$73,836.27 $73,836.27
Sub Total $73,836.27
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 ACTSAMENDATORYTHEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE
CONTROL No. 34299 CLERK -TREASURER
' /VP 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 UNOBUGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
x
1
'ti r
Send invoice To:
t
Ix
Jill Newport
11-\
CrossRoad Engineers, P.C.
3417 Sherman Drive
Beech Grove,IN 46107
�i1
6
G.O./Storm Water Bonds
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $73,836.27
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 ACTSAMENDATORYTHEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE
CONTROL No. 34299 CLERK -TREASURER
' /VP 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 UNOBUGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
x
1