American Structurepoint, Inc/Eng/Adl Serv #23/7,676/106th Street Bridge Over Keystone Parkway Damage American Structurepoint,Inc.
Engineering-2016
Appropriation#44-628.69; P.O.#34319
Contract Not To Exceed$7,676.00 ,.,,.:_
0 C II, ,
ADDITIONAL SERVICES AMENDMENT TO \, 11 . '
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 American Structurepoint, Inc. (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". 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 American Structurepoint,Inc.
by and through its Board of Public
Works and Safety
By: By:
k\n-c--- Ple -ey)---1 ,Ier.. .e w ,t,
James Brainard, Presiding Officer Authorized Signature /
Date:
David A. Day, PE
-_i (1)-,--; Printed Name
Ma Ann urke,'eV
Date: 7 kor Senior Project Manager
Title
Lori SI Watson ' embe FID/TIN: 35-1127317
-Date: i -a ( 7I1G
,z-2 Last Four of SSN if Sole Proprietor:
Date: November 17, 2016
i,
ristine Paul le Treasurer
Date: //1 /c"
1V,I aredronlrarisTru(SsO AGode S.t IEngineai412016\lnrricw Suva orcpnim:<SA*23.dr,I1/101201610-13 AM
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AMERICAN
■ STRUCTUREPOINT
INC.
111
November 2,2016
Mr.Jeremy Kashman,PE
Cannel City Engineer
One Civic Square
Cannel,Indiana 46032
Re: 106th Street over Keystone Parkway Collision Damage
Dear Mr.Kashman:
On behalf of American Structurepoint, Inc., I am pleased to submit this proposal for the design and
engineering plans for the inspection and repair of the 106th Street bridge over Keystone Parkway. The
bridge was hit by an illegal height vehicle on October 15,2016.
The professional services include emergency inspection, design and plans, assistance with the bidding
documents, and answering construction questions. The professional services included in the fee do not
include construction inspection,utility coordination,formal contract book, or a pre-construction meeting,
as our understanding is that these services will be added to the existing contract.
Upon receiving notice to proceed from the City of Cannel, American Structurepoint will complete the
above-described services and any necessary contract documents for the project for a lump-sum fee of
$7,676. Invoices will be forwarded to the City of Cannel on a monthly basis, in accordance with our
original contract.
We look forward to working with the City of Cannel on this project. If you should have any questions,
do not hesitate to contact me at(317) 547-5580.
Very truly yours,
American.Structurepoint,Inc.
GC
David A `Day,PE
Senior Project Manager •
Attachment
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2016.00108 [ t i
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AMERICAN STRUCTUREPOINT,INC.
MANHOUR JUSTIFICATION
PROJECT:Keystone Avenue Bridge Collision Damage Scope of Work: Collision Damage Repair
BRIDGE FILE NUMBER:106th Street
Date: 11/2/2016
ESTIMATED TIME
Project Project Staff Senior
WORK CLASSIFICATION Principal Manager Engineer Engineer Technician TOTAL
Project Research and Setup 1 3
Field Inspection 2 2
Repair Design(106th Street) 1 6 6
Repair Details(106th Street) 2 4 4
Preliminary Quantities 1 2
Preliminary Engineer's Estimate 1 1
Bid Documents 2 4
Construction Questions 2
TOTAL HOURS 4 18 16 2 4
Hourly Rates $ 250.00 $ 200.00 $ 145.00 $ 95.00 $ 135.00
SALARY COST $ 1,000.00 $ 3,600.00 $ 2,320.00 $ 190.00 $ 540.00 $ 7,650.00
DIRECT COSTS $26.40
TOTAL FEE $ 7,676.40
$0.44 60 $76.40
S26.00_ 0 $0.00
$26.40
Iawp.++�4 L C t E g
Keystone Ave Bridge Collision 2016.00108
Received
11 -09-16A11 :48 RCVD
City of Carmel
Department of Law
LETTER OF TRANSMITTAL
Date: November 8, 2016
To: Doug Haney
Corporation Counsel
From: Jeremy Kashman5,w\'
Department of Engineering
RE: American Structurepoint Additional Service Amendment
One additional service amendment is needed for American Structurepoint for the December 7th, BPW
meeting, please.
Attached please find the work proposal and purchase order.
Contract Information:
Project Name: ASA#23; 106th Street over Keystone Parkway Collision Damage - Design
Vendor: American Structurepoint
Amount: $7,676.00
Appropriation: PO#34319; 900-4462869
Signature: Willis R. Conner
Address: 7260 Shadeland Station
Indianapolis, IN 46256
Phone: 317/547-5580
Fax: 317/543-0270
Email: wconnerstructurepoint.com
C
INDIANA RETAIL TAX EXEMPT Page 1 of 1 I}1of II]rr11e]1 CERTIFICATE NO.003120155 002 0PURCHASE ORDER NUMBER
JL \LfJ FEDERAL EXCISE TAX EXEMPT 34319
ONE CIVIC SQUARE 35-6000972 _ THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
11/8/2016 00350562 Project 16-INS-105;Contract Date 04.06.16
AMERICAN STRUCTURE POINT, INC City Engineering's Office
VENDOR 7260 SHADELAND STATION SHIP 1 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46256--3957 Kate Lustig
PURCHASE ID I BLANKET CONTRACT I PAYMENT TERMS FREIGHT
10057
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
Department: 2200 Fund: 900 Grant Fund
Account: 44-628.69
1 Each ASA 23-106th Street Bridge over Keystone Parkway $7,676.00 $7,676.00
Damage-Design
Sub Total $7,676.00
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Send Invoice To: ' °, x a 1
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Kate Lustig
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1 Civic Square 44 `
Carmel, IN 46032- ; ; fs»,, ,
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT - -- PROJECT ACCOUNT AMOUNT
PAYMENT $7,676.00
SHIPPING INSTRUCTIONS •A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
*SHIP PREPAID. 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
'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
—
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 / r
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY -C/`—
TITLE
CONTROL NO. 3431 g f 1 CDV-TOGA CI IDCO
v INDIANA RETAIL TAX EXEMPT Page 1 of 1
III
//1t of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 34319
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER,DEUVERY 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
11/8/2016 00350562 Project 16-INS-105;Contract Date 04.06.16
AMERICAN STRUCTURE POINT, INC City Engineering's Office
VENDOR 7260 SHADELAND STATION SHIP 1 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46256--3957 Kate Lustig
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS 1FREIGHT
10057
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2200 Fund: 900 Grant Fund
Account: 44-628.69
1 Each ASA 23-106th Street Bridge over Keystone Parkway $7;676.00 $7,676.00
Damage-Design
Sub Total $7,676.00
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Send Invoice To: `� `r 1 _ r s
City Engineering's Office d
Kate Lustig ` 3h -• � /
1 Civic Square a:� 1s1
Carmel, IN 46032- �`'",.. , e ,r
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $7,676.00
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 UNOBUGATED 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
p
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE
CONTROL NO. 34319 CLERK-TREASURER