Shrewsberry & Associates/Eng/Adl Serv #1/12,100/Roundabout Landscape Improvements – 106th Street and Towne RoadShrewsberry & Associates, LLC
Engineering Department - 2016 _
Appropriation: ASA#1; 94-650.04, COTTBond Fund; P.O. #34306 �ko
Contract Not To Exceed $12,100.00 `J AO
ADDITIONAL
-'
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 Shrewsberry & Associates, LLC (the "Vendor'), as City Contract dated April 6, 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 V. 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 WITNESSWHEREOF, 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
M
;sUOfficer
6
Mary Ann Urke, Member
Date:
Lori S. W, t5on, M ber'
Date: r ° /t 5 r
C \fes
�rl._Trn� m icer
Shrewsberry & Associates, LLC
By
uthorized Signature
�• �I a-t� tc14 tso►-,
Printed Name
Tifie
FID/TIN: 35--?w4&W
Last Four of SSN if Sole'Proprietor:
Date: 19 --f-D _ U t (,f.
1WrWUeuM4S=Qfxa.f. S+.d6!�3'soR{+;`3016Wvca ghAtaa." Uc ASA el Mutsu Aswj 3.2mou w,Qi E.v if,wfn.pa-jwmi62(S AM)
July 28, 2016
Scope of Services
TASK I: CONCEPT DEVELOPMENT
The first step in this process will be a site visit and photographic documentation of existing conditions for this
roundabout at 106th and .Towne Road. The City of Carmel will provide base design information accurately
reflecting the existing as -built condition of the roundabout in electronic AutoCadd design information, to initiate
the conceptual design activities.
Concept Development activities and deliverables will consist of the following:
• Site visit and photography
• Base map preparation
• Concept development preparation. Concept will be consistent with concept prepared earlier as part of
the base agreement
• Concept presentation submission for review and comment
TASK II - V: DESIGN DEVELOPMENT THROUGH PUBLIC BIDDING PROCESS
Activities and deliverables associated with the roundabout at 106th and Towne Road will be consistent with the
tasks previously approved roundabouts included in the Base Agreement.
ASSUMPTIONS
• The City will provide available plans, studies, surveys or as -built drawings of the site in AutoCAD format
for use as the base for plan development.
• Fee for preparation of a topographic survey is not included.
• Traffic improvements or a traffic study is not included in this scope of services.
• Right-of-way research is not included in this scope of work.
• Extensions or evaluation of existing utilities beyond the site are not included in this scope of work.
FEE COMPENSATION
Shrewsberry is prepared to immediately begin the Concept Development process for this roundabout following
Notice to Proceed from the Client. Shrewsberry will submit Concept Development deliverables for review and
approval 2 weeks following receipt of base mapping information from the Client. Following approval of the
Concept Development submission Shrewsberry will include activities associated with this roundabout in
conjunction with submissions for the previously approved roundabouts. Proposed fee compensation for the
roundabout at 106th and Towne Road is included in the attached Amendment Change Order.
Fi1BiT
S.\Project Files\2016\16-0076\Proposal and Scope\160729 106th & Towne scope.doc
CHANGE ORDER
PRoJECT:.Roundabout Landscape Improvements AMENDMENT NUMBER: #1
at Various Locations
DATE: 7/29/2016
CLIENT. City of Carmel, CONSULTANT'S PROJECT NO. 16-0076
CONTRACT DATE: April 6th, 2016
CONTRACT FOR: City of Carmel - Roundabout
Landscape Improvements at
Various Locations
The Contract is changed as follows:
One (1) project site is included under this contract amendment:
106th and Towne Road Roundabout - Landscape Improvements
s 12,100 (Lump Sum)
Not valid until signed by Client and Consultant
Theoriginal Contract Sum was............................................................................................................................................. $ 45,150
Net change by previously authorized Change Orders................................................................................................... $ 0
The Contract Sum prior to this Change Order was...................................................................................................... $ 45,150
The Contract Sum will be increased/decreased
by this Change Order in the amount of........................................................................................................... $ 12,100
The new Contract Sum including this Change Order will be.................................................................................... $ 57,250
The Contract Time will be changed by ( 0 ) days
NOTE: All other provisions of the original contract remain unchanged.
MREWSBERRY & ASSOCIATES, LLC City of Carmel, Engineering
CLIENT
One Civic Square
Carmel. IN 46032
CONSULTANT
7321 Shadeland Station, Suite 160
Indianapolis, 1N 46256
By
Title
Date
S:\Project Files\2016\16-0076\Proposal and Scope\160729 -106th&Towne Amendmentdoc
By
Date
Title
DCHIBI 9 A
2O�Z--
IBM
r
shrewsharry
7321 Shadeland Station
OWNER ❑
Suite 16o
CONSULTANT ❑
t�■
Indianapolis, 1N 462$6
OTHER ❑
317-804799
FAX: 317-841-4790
www.shrewsusa.com
AMENDMENT
s r e w e r r
CHANGE ORDER
PRoJECT:.Roundabout Landscape Improvements AMENDMENT NUMBER: #1
at Various Locations
DATE: 7/29/2016
CLIENT. City of Carmel, CONSULTANT'S PROJECT NO. 16-0076
CONTRACT DATE: April 6th, 2016
CONTRACT FOR: City of Carmel - Roundabout
Landscape Improvements at
Various Locations
The Contract is changed as follows:
One (1) project site is included under this contract amendment:
106th and Towne Road Roundabout - Landscape Improvements
s 12,100 (Lump Sum)
Not valid until signed by Client and Consultant
Theoriginal Contract Sum was............................................................................................................................................. $ 45,150
Net change by previously authorized Change Orders................................................................................................... $ 0
The Contract Sum prior to this Change Order was...................................................................................................... $ 45,150
The Contract Sum will be increased/decreased
by this Change Order in the amount of........................................................................................................... $ 12,100
The new Contract Sum including this Change Order will be.................................................................................... $ 57,250
The Contract Time will be changed by ( 0 ) days
NOTE: All other provisions of the original contract remain unchanged.
MREWSBERRY & ASSOCIATES, LLC City of Carmel, Engineering
CLIENT
One Civic Square
Carmel. IN 46032
CONSULTANT
7321 Shadeland Station, Suite 160
Indianapolis, 1N 46256
By
Title
Date
S:\Project Files\2016\16-0076\Proposal and Scope\160729 -106th&Towne Amendmentdoc
By
Date
Title
DCHIBI 9 A
2O�Z--
IBM
r
shrewsharry
Shrewsberry & Associates, LLC
Engineering Department - 2016
Appropriation: ASA #1; 94-650.04, COIT Bond Fund; P.O. #34306
Contract Not To Exceed $12,100.00
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.
[SXonrncm\Prof.Svcs & Goods Svcs\Engin=ing12016\Shrewsbcr y & Aas naves. LLC ASA #1 Add? Svcs A..d 3-27-2012 with E -Verify language.doc: 10/42016 8:59 AM]
Shrewsberry & Associates, LLC
Engineering department - 2016
Appropriation: ASA #1; 94-650.04, COIT Bond Fund; P.O. #34306
Contract Not To Exceed $12,100.00
Exhibit V
ll II '' t E -Verify Affidavit
. ?)I �CJ� 0 G � s Q n- , 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. 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
:5hr2tOSbkr rc - t AS60ciekS LLX-- _ (the "Company") in the position
3. I am fanuliar 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 andparticipates in the, federal ENerify 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 —,5 —dAy of . QC -
20L.
Printed:- • Bjak:e. LV i �Sa71
I certify under the penalties for perjury; under the law's of the United. States of America and the State of
Indiana that the foregoing factual- statements and representationsare true and correct:
Printed;bLk& W i ISM
�S:Stt:amvAKlm-!(1 Qasw ds�' yUhrFA�mRanya.umwtl ur ASA a1 ASfisnaAmid S-J7•blu.ala:v.if)!a;¢�phcll141:0�n6:lDARt)
City ®f Carmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
Page 1 of 1
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
34306
THIS NUMBER MUST APPEAR ONINVOICES, AIP
ONE CIVIC SQUARE
35-6000972
CARMEL, INDIANA 46032-2584
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
iJ a
ter .q 1
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
f i
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
9/30/2016
370383
Project 16 -ENG -13; Contract Date 03.09.16
SHREWSBERRY
City Engineering's Office
VENDOR 7321 SHADELAND STATION, STE 160
SHIP 1 Civic Square
Send Invoice To:
TO Carmel, IN 46032 -
INDIANAPOLIS, IN 46256 -
Kate Lustig
PURCHASE ID
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
8879
Brownsburg, IN 46112
QUANTITY
I UNIT OF MEASURE
DESCRIPTION
I UNIT PRICE EXTENSION
Department., 2200 Fund: 0 COIT Bond Fund
Account: 94-650.04
1 Each ASA 1 - Roundabout Landscape Improvements -106th and $12,100.00 $12,100.00
Towne Road
Sub Total $12,100.00
2016 COIT Bond PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $12,100.00
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. ORDERED BY
TITLE
CONTROL NO. 34306 CLERK -TREASURER
A1P 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 APP . PRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
i
iJ a
ter .q 1
i
f i
Send Invoice To:
-
Skip Tennancour
American Structurepoint, Inc.
5s .Jf
8425 Wicklow Way
Brownsburg, IN 46112
2016 COIT Bond PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $12,100.00
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. ORDERED BY
TITLE
CONTROL NO. 34306 CLERK -TREASURER
A1P 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 APP . PRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
i