Davey Tree Service/DOCS/6,163.20/Chemical ApplicationDavey Tree Service
Department of Community Service - 2017
Appropriation #43-504.00;.P.Q. #100065
Contract Not To.Exceed $6,I63.20
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
Davey Tree Service, an entity duly authorized to do business in the State of Indiana ("Vendor").
TERMS AND CONDITIONS
1. 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 agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City
budget appropriation number 43-504.00 funds. 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 Six Thousand One Hundred Sixty Three Dollars and Twenty Cents
($6,1.63.20) (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 thirty-five (35) 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 Service. s 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.
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, 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
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.
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Davey Tree Service
Department of Community Service - 2017
Appropriation #43-504.00; P.O. #10006.5
Contract Not To Exceed $6,163.20
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.
6. 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.
8. 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
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.
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Davey Tree Service
Department of Community Service - 2017
Appropriation #43-504.00; P.O: #100065
Contract Not To Exceed $6,163.20
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
-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
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Davey Tree Service
Department of Community Service - 2017
Appropriation #43-504.00; P.O. ##100065
Contract Not To Exceed $6,163.20
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 a 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
One Civic Square
Carmel, Indiana 46032.
If to Vendor: Davey Tree Service
Mike Voiz.
6801 Hawthorn Park
Indianapolis, IN 46220
AND Douglas C. Haney,
Corporation Counsel
Department of Law
One Civic Square
Carmel, Indiana 46032
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.
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Davey Tree Service
Department of Community Service - 2017
Appropriation #43-504.00; P.O. #100065
Contract Not To Exceed $6,163.20
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 provi.de.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, 2017 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.
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Davey Tree Service
:Pepartmetit of`Community Service > 2017
A . it , . I
.pofg.pet, i6fift43-504.00; P Q� # 00.065
Contmeu.Not To -ExceedlUJ63.20
'IN WITNESS WHEREOF the paries herefo.:have made.an,d exqc.utedlhi$. Agreement as follows. -
CITY OFICARMEL, ,INDIANA
by and through its Board df Public
Works and Safety
Lod S. Msb
er
Date:
ATTEST-
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C 7
Ch.ristOe S.Auley, Clerk --1 �r4sqrer
Date2
DAVEY TREESERVICE
g,4e-s
Title
FIDMN-.; 3q017&11ti
Last Four 6(:88N if Sole Proprietbr
Date,- 1Z,
CHEMICAL APPLICATION
Quotes are due January 12I2017 at 9:00 am. Please submit to:
Department of Community Services
ATTN: Daren Mindham
One Civic Sq
Carmel, IN 46032
1. SCOPE OF SERVICES
This quote shall cover Chemical Application. The successful Contractor will furnish all labor, materials,
equipment and services necessary for Chemical Application.
II. CITY OF CARMEL REPRESENTATIVE
All questions related to this quote shall be addressed to:
Daren Mindham
Urban Forester
One Civic Sq
Carmel, IN 46032
Phone: 817-571-2417
Email: dmindham@carmel.in.gov.
Company Name: 1 he ��ive.y I ree E*x'f�. Signatures / —
QudteAmount: � 6, 1 63, 2, Date: i/ /o/ t'7
': �H I F5,!1,
/ 6 -F3
IN
IJ
CHEMICAL APPLICATION
Quotes are due January 12I2017 at 9:00 am. Please submit to:
Department of Community Services
ATTN: Daren Mindham
One Civic Sq
Carmel, IN 46032
1. SCOPE OF SERVICES
This quote shall cover Chemical Application. The successful Contractor will furnish all labor, materials,
equipment and services necessary for Chemical Application.
II. CITY OF CARMEL REPRESENTATIVE
All questions related to this quote shall be addressed to:
Daren Mindham
Urban Forester
One Civic Sq
Carmel, IN 46032
Phone: 817-571-2417
Email: dmindham@carmel.in.gov.
Company Name: 1 he ��ive.y I ree E*x'f�. Signatures / —
QudteAmount: � 6, 1 63, 2, Date: i/ /o/ t'7
': �H I F5,!1,
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qty °F cA��
City NEt{�9i F��\
1 DEPARTVtENT OF CO EV LAITY SERVIC'ES
Ill. WORK REQUIREMENTS
Applicable. Standards:
• Contractor must adhere to American National Standards Institute (ANSI Z133.1) current edition.
Work Requirements:
• Contractor shall be certified and hold all required applicators licenses from the state of Indiana.
Contractor shall possess any city right-of-way permits, as necessary. Contractor must comply with all
applicable environmental, chemical, and other laws when performing its obligations.
• Contractor shall not sub -contract. -any of the work included as part of this contract. All work shall be
completed by staff hired and employed by the Contractor.
• Contractor shall supply all needed labor, trucks, equipment, supplies, materials, safety devices and
other equipment necessary to complete the work.
• Operations shall be accomplished in such a manner as to not damage trees, grass or other plant
material. If damage occurs, the contractor is responsible for such repair or replacement and shall
contact the Carmel Representative to evaluate the damage.
• Traffic control is the sole responsibility of Contractor and shall be coordinated in advance with the
proper department(s) of the city. The blocking of public streets..shall not be permitted unless prior
approvals have been made with the appropriate city departments and the Carmel Representative
has been notified. Traffic control shall be accomplished in conformance with state, county and local
highway construction codes and all other applicable law. A traffic maintenance plan is required by
the Carmel Engineering Department for the blocking of any lane. The handbook to use unless,
otherwise directed, will be the CONCISE HANDBOOK FOR TEMPORARY TRAFFIC CONTROL,
Construction, Maintenance, and Utility Operations, 2014, SP -2.
• The staging of vehicles or other equipment on any public sidewalk or path is prohibited.
• Any injuries, damages, expenses or loss to any person or property, public or private, as a result of or
related to the project are the sole responsibility of the Contractor and shall be repaired or
compensated by the Contractor to the satisfaction of both the injured party and the Owner, at no
cost to the Owner.
• The Contractor will schedule project work to occur between the hours of 7:00 a.m. and 6:00 p.m.
Monday through Saturday, only, unless authorized by the Carmel Representative in advance.
Contractor shall not work on any city holidays.
•. Any alteration or modification of the work performed under the contract shall be made only by
written agreement between the Contractor and Carmel Representative and shall be made prior to
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DEPARTMENT OF C;O VINTU1 tTY SERVICES
commencement of the altered or modified work. No claim for extra work or materials shall be
allowed unless covered by such a written agreement executed by all parties hereto.
Contractor shall submit product labels of all proposed pesticides and chemicals for Carmel
Representative. approval prior to use.
• Contractor shall contact Carmel Representative prior to the start of any pest control applications.
This notification is meant to determine the time frame in which the pest control application work is
to be completed.
IV. LAYOUT OF QUOTE
CHEMICAL APPLICATIONS AND LOCATIONS
Scale — Early May: First application apply bifenthrin to the canopy and trunk of the tree until runoff.
Early to Mid-June(when catalpa trees bloom): Second application apply bifenthrin to suppress spider
mite outbreak from occurring as well as kill scale crawlers that were not affected by the first application.
Quantity
Genus
DBH
Mao
Pe Location
20
Oak
3-5"
1
126`h St; Towne Rd to Shelborne Rd, median
16
Oak
3-5"
1
126`h St; Shelborne Rd to Tuscany Blvd, south side
64
Oak
2-3"
2
Towne Rd; W 116th St to W 146`h St, median
33
Maple
3-6"
2
Towne Rd; W 126`h St to V11 Main St
1
Oak
8"
2
Towne Rd; W Main St, roundabout
1
Oak
6"
2
Towne Rd; W 126`h St, roundabout
79
Oak and others
2-6"
3
W 141 St; Inglenook Ln west to Magic Stallion Or, north and south side
102
Oak and others
3-9"
4
Oak Ridge Rd; 136`h St to 146`h St, east and west sides and median
27
Oak
3-5"
5
Illinois St; south of W Carmel Or to E116 St, median
18'
Oak and others
3-5"
6
Old Meridian St; Pennsylvania St to N Guilford Rd, median
8
Oak & hornbeam 3-4"
7
Pennsylvania St; College Or to E 116`h St, median
5
Honeylocust
2-3"
8
Rangeline Rd. and W Main St; NW, SW and SE corners, tree pits
10
Honeylocust
4-6"
9
W Main St; west of 3rd Ave NW to East of Knoll Ct, north side; tree pits
5*
Honeylocust
3-5"
10
S. Rangeline Rd; south of W City Center Or, on -street parking bump -
outs; west side
11
Oak
2=6"
10
W City Center Or; Rangeline Rd west to 3`d Ave SW, median
24
Oak
3-7"
11
W City Center Or; 3rd Ave SW west to S Guilford Rd, median
5
Oak & Hackberry 3-5"
12
W City Center Or; 5 Guilford Rd southwest to W Carmel Or, median
12
Honeylocust
6-8"
13
E Carmel Or; east of S Rangeline Rd, north and south side
16
Oak
5-9"
14
E Carmel Or; Medical Or east to Aaa Way, north and south side
17
Honeylocust
3-4"
15
E 116`h St; east of S Rangeline Rd to Keystone Pkwy, median
25
Honeylocust
4-5"
16
E 116`h St; west of S Rangeline Rd to College Ave, median
17
Honeylocust
3-4"
17
Westfield Blvd; E 96`h St to E 99`h St, median
40
Honeylocust
6-13"
18
Hazel Dell Pkwy; south of E Main St to E 126`h St, east and west side
y
F`^ Ib, — A
3o -P3
EXHIBIT B
Invoice
Name of Company:
Address & Zip:
Telephone No.:
Tax 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 Statutory Limits
Employer's Liability:
Bodily Injury by Accident/Disease:
$1.00,000 each employee
Bodily Injury by Accident/Disease:
$250,000 each accident
Bodily Injury by Accident/Disease:
$500,000 policy limit
Property damage, contractual liability,
products -completed operations:
General Aggregate Limit (other than
Products/Completed Operations): $500,00.0
Products/Completed Operations: $500,000
Personal & Advertising Injury
Policy Limit: $500,000
Each Occurrence Limit: $250,000
Fire Damage (any one fire): $250,000
Medical Expense Limit (any one person): $ 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
AFIFIDAVIT
C( 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. I am over eighteen (18) years of age and am competent to testify to the facts contained
herein.
2. 1 am.now, , nd at all times relevant herein have been employed by
TSL'- 1 Cc - a 7 (tile `°EmpIover")
in the position of 6ra✓Y- IIC A -Y -
I am familiar with the employment policies, practices, and procedures of the Employer and
have the authority to ac.t.on behalf of the Employer.
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 _2-0 day or `S -r I (.-)CCC., .20
I certify under the penalties for perjury under the laws of the United States of America and the State of
in+mrwhat the foregoingfactual statements and representations are true and'correct.
Ohtp
CD
Pri n ted.-f-mr*lflolaL22
gTHER LYNNE MICOZZI
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NOTARY PUBLIC
_ STATE OF OHIO
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m'6 2018
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�ofCarmel
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INDIANA RETAIL TAX EXEMPT
CERTIFICATE N0.003120155 002 0
Page 1 of 1
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
100065
ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, AIP
CARMEL, INDIANA 46032-2584
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
1/12/2017
00351274
DAVEY TREE SERVICE
Dept of Community Service
VENDOR 6801 HAWTHORN PARK
SHIP 1 Civic Square
TO Carmel, IN 46032 -
INDIANAPOLIS, IN 46220 -
PURCHASE ID BLANKET CONTRACT
PAYMENT TERMS FREIGHT
11959
QUANTITY UNIT OF MEASURE
DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund., 101 General Fund
Account., 43-504.00
1 Each Chemical Application $6,163.20 $6,163.20
Sub Total $6,163.20
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Send Invoice To: '
Dept of Community Service
1 Civic Square
Carmel, IN 46032- ., Li 9, f
PLEASE INVOICE IN DUPLICATE
F— DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $6,163.20
SHIPPING INSTRUCTIONS ' AIP 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
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Mike Hollibaugh Douglas Haney
TITLE Director Corporation Counsel
CONTROL NO. 100065 CLERK -TREASURER