Pearson Ford/Steet/768,857/Pick Up Trucks and Crew CabsPearson Ford, Inc.
Street Department - 2016
Appropriation #43-530.99, Capital Lease Fund $416,046.00 P.O. #33514; Utilities, $239,910.00 P.O. #W10001; Utilities,
$112,901.00 P.O. #S03013 �.
Contract Not To Exceed $768,857.00
AGREEMENT 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 Pearson Ford, Inc. an entity duly authorized to do
business in the State of Indiana ("Vendor").
TERMS AND CONDITIONS
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 agreesto purchase the goods and/or services (the "Goods and Services") from Vendor using City
budget appropriation number 43-530.99/Capital Lease funds $416,046.00 P.O. #33514: Utilities,
$239,910.00 P.O. #W10001: Utilities, $112,901.00 P.O. #S03073. 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 Seven Hundred Sixty -Eight Thousand Eight Hundred Fifty -Seven
($768,857.00) (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.
F 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 Street
Department Bid Proposal Package for "2016 Pickup Trucks" received by the City of Carmel Board of Public
Works and Safety on or about March 16, 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
S ,ret
WITH E -Verify L�ngw�ge.doc:5@52016 11:30 AM]
[XA 6nuict0rof.Sm & Goods Svcs\SgcctVAlfi�Pcarson Ford, Inc. Goods & Scniccs FORM •
Pearson Ford, Inc.
Street Department - 2016
Appropriation #43-530.99, Capital Lease Fund $416,046.00 P.O. #33514; Utilities, $239,910.00 P.O. #W10001; Utilities,
$112,901.00 P.O. #S03073
Contract Not To Exceed $768,857.00
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.
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.
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..
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.
�. 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
]X:\Contncls\ProfSvcs & Goods Svcs\Streel\2016\Pwrson Ford, Inc. Goods & Senices FORM - WITH E -Verify fangunge.doc:5/2512016 11-•30 AM]
2
Pearson Ford, Inc.
Street Department - 2016
Appropriation #43-530.99, Capital Lease Fund $416,046.00 P.O. #33514; Utilities, $239,910.00 P.O. #W10001; Utilities,
$112,901.00 P.O. #S03073
Contract Not To Exceed $768,857.00
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.
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.
]X:\Conuncts\ProCSvcs & Goods 8vcs\Street\2016\Pearson Ford, Inc, Goods & Senices FORM -WITH E-VeNy Language.doc:5125/2016 11.•30 AM]
Pearson Ford, Inc.
Street Department - 2016
Appropriation #43-530.99, Capital Lease Fund $416,046.00 P.O. #33514; Utilities, $239,910.00 P.O. #W10001; Utilities,
$112,901.00 P.O. #S03073
Contract Not To Exceed $768,857.00
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 6 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,
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 AND Douglas C. Haney,
One Civic Square ,Corporation Counsel
Carmel, Indiana 46032 Department of Law
One Civic Square
Carmel, Indiana 46032
If to Vendor: Pearson Ford, Inc.
10650 North Michigan Road
Zionsville, Indiana 46077
ATTENTION: Chad Barkdull
Notwithstanding the above, notice of termination under paragraph 19 hereinbelow shall be effective if given
orally, as long 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.
(X:1Co=cts\Prof.Secs & Goods Svcs\Slree02016\Pearson Ford, Inc. Goods & Senices FORM - WITH E -Verify hngunge.doc:5/252016 11:30 W
4
Pearson Ford, Inc.
Street Department - 2016
Appropriation #43-530.99, Capital Lease Fund $416,046.00 P.O. #33514; Utilities, $239,910.00 P.O. #W10001; Utilities,
$112,901.00 P.O. #S03073
Contract Not To Exceed $768,857.00
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.
[XACon0aclsTrof Svcs & Goods Svcs%S1rccA20161FCarson Ford, Inc. Goods & Senices FORM -WITH E -Verify Language.doc:525/2016 11:30 W
Pearson Ford, Inc.
Street Department - 2016
Appropriation #43-530.99, Capital Lease Fund $416,046.00 P.O. #33514; Utilities, $239,910.00 P.O. #W10001; Utilities,
$112,901.00 P.O. #S03073
Contract Not To Exceed $768,857.00
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
AJ_
ainard, Presiding O�i�r
no+o• 1:7 -
Pearson Ford, Inc.
100�
Authorized Signature
cAk
&r 414
Printed Name
MaryAnr�Burke, Memb
Da e;6C�`'AW4'VCL'j ScLL
Title
Lori S. Wa son, ber FID/TIN: 3S 0,5 T? Ll
Date: -7
Last Four of SSN if Sole Proprietor:
ATTE
Date:
f
Ch istine S. Paul , Clerk- r a surer
Date:
jX:\ContractslProf.Svcs & Goods Svcs\SI=A2016Tcarson Ford, Inc. Goods & Scniccs FORM -WITH E -Verify 4ingngc.doc:5/25/2016 11:30 AM]
NOTICE TO BIDDERS
CITY OF CARMEL
Notice is hereby given that the Board of Public. Works and Safety for the City of Carmel, Hamilton County,
Indiana, will receive sealed bids, until 10:00 a.m., local time, on Wednesday, March 16th, 2016 at
the office of the Clerk -Treasurer,. One Civic Square, 3:d Floor, Carmel, Indiana, 46032, for the following
items:
18 (Eighteen) 2016 or Newer'/4 Ton, 4 Wheel Drive, Regular Cab Pickup Trucks with Two Salt Boxes
3 (Three) 2016 or Newer 1 Ton, 4 ' Wheel Drive, Crew Cab Pickup Trucks
1 (One) 2016 or Newer Ford F-550 or equivalent 18000 lb minimum, 4 Wheel Drive, Dump Truck
1 (One) 2016 or Newer Ford F-250 or equivalent 4 Wheel Drive Extended Cab Truck
1 (One) 2016 or Newer Ford F-350 or equivalent 4 Wheel Drive Regular Cab Truck
1 (One) 2016 or Newer Ford Explorer 4WD or equivalent
All bids are to be sealed with the word "BID —2016 PICKUP TRUCKS" on the lower left hand comer of
the envelope. Bids will be opened and read aloud at 10:00 A.M. on March 16th, 2016 at the Board of
Public Works and Safety meeting on the 2°d floor of Carmel City Hall, One. Civic Square, Carmel, IN. All
persons interested in bidding shall register a`contact name and address with the Street Department to ensure
that all changes or questions and answers are available for review by all interested parties.
The specifications are set forth in detailed documents on file at the Carmel Street Department, 3400 W.
1315` Street, Carmel, IN 46074.
Questions regarding this solicitation must be written and delivered to the Carmel Street Department. All
responses will be written and made available with the specifications at the Street Department. Please call
the Street Department to confirm whether or not any such written questions and/or responses exist.
The submitted proposal must be in compliance with IC 36-1-9 et seq.
The Board of Public Works and Safety reserves the right to reject any and all bids.
David Huffman
Street Commissioner
Please publish February 25th and March 3`d, 2016.
Carmel Street Department, 3400 W. 1315L. Street, Carmel, IN 46074
I
1
ITEMIZED COSTS
THIS IS TO BE THE SECOND PAGE OF ENTIRE BID.
EXHIBIT 6�
2bl
aura+ ..ra. !+.�-.. q., ... '�.. _ 'at;t5 1.Rr ��.w. _•�i .,
r • F''r. �'� .
i k� aY!. yt art
BLUE F250 PICKUP TRUCKS
10
3 j a 3
(OR EQUIVALENT)
RED F250 PICKUP TRUCKS
S
(OR EQUIVALENT)
RED F350 CREWCAB TRUCKS
3.
3s;
(OR EQUIVALENT)ko
4
RED F550 DUMP TRUCK
1
rr 2
(OR EQUIVALENT)
( J
RED F250 EXTENDED CAB TRUCK
(OR EQUIVALENT)
RED F350 REGULAR CAB TRUCK
(OREQUIVALENT)
1
3 6b0 l�f�
RED FORD EXPLORER SUV
1
a'
(OR EQUIVALENT)
POLY SLIDE -IN
SALT SPREADERS
2
THIS IS TO BE THE SECOND PAGE OF ENTIRE BID.
EXHIBIT 6�
2bl
TRADE-IN LIST OF VEHICLE
g, VNiL ggn g
p9mgmPlil"ea
�!�
1�2
2500 Chevy.Truck'(1998)
VIN: IGCGK24R3W2273810
C) 0
2500 Chevy Truck (1999)
VIN: IGCGK24R2XR708205
2500 Chevy. Truck (2000)
-) L4 D
VIN:,lGC.GK24R54RI96036
L
2500 GMC Crew. Cab (2004)
C)C)C)
VIN: 1GTHK23U74F250636
2500 GMC Crew Cab.(2004)
1465 0
VIN: IGTHK23U54F251378
2500 GMC Crew Cab (2004)
�7_CO
VIN: 1.GTHK23U84E251570
2500 Chevy Truck (2000)
VIN- IGC.QK24R1YRI69786
3500 GMC 1 -TON (2004)
0
VIN: . 1 GDJK34GO4E3 82610
F150 4x4 (2003)L'
4112
F150 4x4 (2003)'Ll
YY( 90
#109
F150 4x4 (2007)*
#25
Chevrolet with Plow and Bed (2001)E4300
#46
Chevrolet with Plow- K2500 HIS (2002) "*
0,50
#43
EXF,flBIT
36 �_L�
WLI"s
F350 4x4 with Plow (2003)7L
#11:6..
2500 Chevrolet 4x4 (2000)Q*-
2000)'x;* -5
-
5
Ford F250 4x4 (2006)***
#6
Ford F250 4x4( 2006)'**
#12
2500 Chevrolet 4x4 (1998)'**
5
#49
Ford F250 4x4(**`* 2004)�
4 0�0
#118
2500 Chevrolet 4x4 (2006}* *"k
#132
2500 Chevrolet 4x4 (2006),* *
C)c) 0
3
#143
2500 Chevrolet 4x4 (2006)m
S
#144
Ford F250 4x4 (2008)**r*
#148
Ford F250 4x4 (2008) **
C, C) C)
#149
QCONTACT STREET DEPARTMENT FOR VIEWING OF THESE TRUCKS: C1
JAMES BENTLEY AT 317-733,2001
Ck
CONTACT SEWER DEPARTMENT FOR VIEWING OF THESE TRUCKS: r
JEFF COOPER 317-716-5882
*: CONTACT WATER DEPARTMENT FOR VIEWING OF THESE TRUCKS: O
G.REG.HOLLANDER AT 317-733-2855
THESE ARE TO BE THE THIRD & FOURTH X61.1 1T
PAGES OF THE ENTIRE BID.
City of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120156 002 0
FEDERAL EXCISE TAX EXEMPT
35-6000972
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL -1997
PAGE 1
PURCHASE ORDER NUMBER
S03073
THIS NUMBER MUSTAPPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO; PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
5/18/2016
237560
PEARSON FORD INC
VENDOR 10650 NORTH MICHIGAN ROAD
ZIONSVILLE IN 46077
Carmel Utilities
SHIP 30 West Main St. Ste 220
TO Carmel, IN 46032
CONFIRMATION I BLANKET I CONTRACT I PAYMENTTERMS I FREIGHT
QUANTITY I UNIT OF MEASURE I DESCRIPTION I UNIT PRICE I EXTENSION
1.00 Each truck leases ?112,901.00 $112,901.00
DEPRN 02-2308-00
PLEASE INVOICE IN DUPLICATE Credit $0.00
Department Account Project Project Account AMOUNT
PAYMENT $112,901.00
SHIPPING INSTRUCTIONS • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
SHIP PREPAID NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
C.O.D. SHIPMENTS CANNOT BE ACCEPTED VOUCHER HAS THE PROPER SWORN AFFADAVIT ATTACHED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ' I HEREBY CERTIFY THAT THERE IS AN OBLIGATED BALANVCE IN
SHIPPING LABELS THIS APPROPRIATION SUFFICIENT TO PAY FORTH AB VE ORDER.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
V.
TITLE
DOCUMENT CONTROL NO. 503073 CLERK -TREASURER
City of Carmel;
ONE CIVIC SQUARE
CARMEL, INDIANA 46032
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
I FEDERAL EXCISE TAX EXEMPT
35-6000972
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL -1997
PAGE 1
PURCHASE ORDER NUMBER
W10001
THIS NUMBER MUST APPEAR ON INVOICES,AA/P
VOUCHER, DELIVERY MEMO; PACKING SLIPS;
SHIPPING LABELS AND ANYCORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
5/18/2016
237560
PEARSON FORD INC. Carmel Utilities
VENDOR 10650 N. MICHIGAN RD. SHIP 30 W Main St
ZIONSVILLE IN 46077 TO 2nd Floor
Carmel, IN 46032
CONFIRMATION I BLANKET I CONTRACT PAYMENTTERMS I FREIGHT
QUANTITY I UNIT OF MEASURE I DESCRIPTION I UNIT PRICE I EXTENSION
1.00 Each truck leases ?239,910.00 $239,910.00
DEPRN 02-2308-00
PLEASE INVOICE IN DUPLICATE Credit $0.00
Department Account Project I Project Account AMOUNT
PAYMENT $239,910.00
SHIPPING INSTRUCTIONS
• SHIP PREPAID
' C.O.D. SHIPMENTS CANNOT BE ACCEPTED
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS
' THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. W10001
• 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 AFFADAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN OBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT 0 PAY OR T E ABOVE ORDER.
ORDERED BY
TITLE
CLERK -TREASURER
PART 1
BIDDER INFORMATION
(Please Type or Print)
1.1 Bidder Name: f -'e" :5 (pV/1, te) CCA
1.2 Bidder Address: Street Address: �'(%( s� �L%' t Kt Jk1`9 P.y�
City: Z -OWS w `State: �LV� Zip: 0-7
Phone#:(m)b73-3333 Fax#:(3t) )33-3/3a
1.3 Bidder is a/an [mark one]:
Individual Partnership . L Indiana Corporation;
Foreign (Out of State) Corporation; State: ;
Joint Venture ' Other:
1.4 [The following must be t
venture parties is a foreign corporation. Note: To do business in or with the City of
Carmel, Indiana, foreign corporations must register with the Secretary of the State of
Indiana as required by the Indiana General Corporation Act as stated therein and
expressed in the Attorney General's Opinion #2, dated January 23, 1958.1
1 Corporation Name:
.2 Address:
3 Date registered with State of Indiana:
.4 Indiana Registered Agent:
Name:
Address:
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11iO�t'�tl@LEligibility Verification John Hughes JHUG9444
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Address 1: 10650 N Michigan Rd Address 1:
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Total Number of Employees: 100 to 499
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Organization Designation:
Employer Category: None of these categories apply
NAICS Code: 441 - MOTOR VEHICLE AND PARTS DEALERS
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EXHIBIT D
AFFIDAVIT
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. 1 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
pP_C SGw�. EM:411 (the "Employer")
in the position of Le)"wu wt. k,+ K96t4 a
3. I am familiar with the employment policies, practices, and procedures of the Employer and
have the authority to act on behalf of the Employer.
4. The Employer is enrolled and participates in the federal E -Verify 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 my information and belief, the Employer does not currently employ any
unauthorized aliens.
7. FURTHER AFFIANT SAYETH NOT.
EXECUTED on the day of���
Printed: (1`- l -���� 0c,
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.
_c(
Printed:
CONTRACT CHECKLIST
Department: Carmel Street Department
Department Head or designee and telephone number: David Huffman: 317-733-2001
Vendor name, contact, telephone/ fax numbers and address: _&argon F 4
106.So N, )AJ �y 12cl �rons6i I (e 7A Y&O
�/7- f5 3-333
Request BPW Date: ASAP Contract Type: ! a. aterials (supplies, equipment, etc)
b. Service (consulting, training, etc)
7I c. Public Works projects subject to
formal bid package/ procedures
Date and Initials Cap
YA�Xl� D.H. 1. Contract approved as to business termsb Department- Director and/or designee
a�os- 0� N3-s3a 1 S 014e, -fats d ,t ses
�10 9I D.H. 2. a. Line Item and Major Budget Classification, or
b.. Request Board Approval on condition precedent that sufficient funds are
appropriated (for Service Contracts. Only).
3. Original of contract and this checklist to BPW Secretary
4. Contract approved as to form by DOL
5. Contract returned to sponsoring Department (to obtain vendor's signatures)
6. Signed contract submitted to BPW Secretary for placement on BPW Agenda
7. BPW consideration: Approved
Disapproved
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:
Property damage, contractual liability,
products -completed operations:
General Aggregate Limit (other than
Products/Completed Operations):
Products/Completed Operations:
Personal & Advertising Injury
Policy Limit:
Each Occurrence Limit:
Fire Damage (any one fire):
Medical Expense Limit (any one person)
Statutory Limits
$100,000 each employee
$250,000 each accident
$500,000 policy limit
$500,000
$500,000
$500,000
$250,000
$250,000
$ 50,000
Comprehensive Auto Liability (owned, hired and non -owned)
Bodily Single Limit:
Injury.and property damage:
Policy Limit:
Umbrella Excess Liability
Each occurrence and aggregate:
Maximum deductible:
$500,000 each accident
$500,000 each accident
$500,000
$500,000
$ 10,000
EXHIBIT D
AFFIDAVIT
C"— 6^C,alaL a , 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. 1 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
peCz s EM0� 1, - (the "Employer")
in the position of Lo'mAwt.. hct-± K4614
3. I am familiar with the employment policies, practices, and procedures of the Employer and
have the authority to act on behalf of the Employer.
4. The Employer is enrolled and participates in the federal E -Verify program. Documentation
of this enrollment and participation is attached and incorporated herein.
5. The Employer does not knowingly employ any unauthorized aliens.
6. To the best of my information and belief, the Employer does not currently employ any
unauthorized aliens.
7. FURTHER AFFIANT SAYETH NOT.
EXECUTED on the day of WA -Q ` "' , 2U � �O.
Printed:
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: