Globe Asphalt Paving Co., Inc/Eng/503,892.58/Towne Road Trail Construction and Culvert ReplacementGlobe Asphalt Paving Co., Inc.
Engineering Department - 2017
Appropriation # 2016 COLT Bond Fund, P.O. #: 100180
Contract Not To Exceed $503,892.58 oh
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
Globe Asphalt Paving Co., Inc., 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 94-650.04 2016 COIT Bond Fund 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 Five Hundred Three Thousand Eight Hundred Ninety Two Dollars and Fifty
Eight Cents ($503,892.58) (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 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.
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 Engineering
Department Bid Proposal Package for "Towne Road Trail Construction and Culvert Replacement, Project #
16 -SW -18" received by the City of Carmel Board of Public Works and Safety on or about February 15, 2017,
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.
]S:�Conmcis\Prof.Svcs & Goods SvmTnginoming12017K .be AsphAt Paving Co Goods and S—i—doc2117f20171:48 PM]
Globe Asphalt Paving Co., Inc.
Engineering Department - 2017
Appropriation # 2016 COIT Bond Fund, P.O. #: 100180
Contract Not To Exceed $503,892.58
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.
9. 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.
[SAC..1—tAPrdS— & Goods Svcs\Engi —ing%1017\G1obc Asphalt Paving Co Goods and S—ia d=211712017 10:30 AM)
2
Globe Asphalt Paving Co., Inc.
Engineering Department - 2017
Appropriation # 2016 COIT Bond Fund, P.O. #: 100180
Contract Not To Exceed $503,892.58
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 time 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
jSXontacts\Prof.Sv6 @ Goods Sv Tngineedng12017\rlobe Asphalt Paving Co Goods and Savices.doc2/17/2017 10:30 AM]
Globe Asphalt Paving Co., Inc.
Engineering Department - 2017
Appropriation # 2016 COTT Bond Fund, P.O. #: 100180
Contract Not To Exceed $503,892.58
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: Globe Asphalt Paving Co., Inc.
6445 East 30th Street
Indianapolis, IN 46219
ATTENTION: William A. Shumaker
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.
1SXontma Trof.Svos & Goods Sves1Engin=ingt2017\G1obe Asphalt Paving Co Goods and S—ic-d-2/17/2017 10:30 AM]
4
Globe Asphalt Paving Co., Inc.
Engineering Department - 2017
Appropriation # 2016 COIT Bond Fund, P.O. #: 100180
Contract Not To Exceed $503,892.58
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, 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. IC 5-16-13.
The provisions of IC 5-16-13 are hereby incorporated into this Agreement by reference.
29. 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.
[S:'Cnnlrects\Prd.Sv & Goods Svw\Enginoahng\2017NGlobe Asphalt Paving Co Goods and Savi=.d=2Jl72017 10:30 AM[
Globe MplialtTaving Co., Inc.
Engineering Department - 2017
Appropriation #2616 C61T.Bond Fund, P.O. #: 100180
Contract Not To, Exceed $503;892.58
This; AgrOment- may only be modified "by written amendment executed by both parties `hereto, or their
-successors hintetest.
IN -WITNESS. - -WHE,RE.QFIr-th6.-Parties,her6to have made and executed thi Areement as follows:
CITY"Or _GARME4,, INDIANA.
by
gh its ,Board "'t Public
Works
or k �s and:Safety
EM`/,II
ATTEST -
C -7
-Ch �ilerV-rdasurer'
'06W � V11-
GLOBE ASPHALT PAVING rCo., INC,
Authorized Signature
Print d N
-e Me
Title
Fib/TIN:.te ./ S-3 1,
Last'Fdlft of SSN if Sole Proprietor
Date: 4) 7--)
BIDDER'S ITEMIZED PROPOSAL
AND DECLARATIONS
City of Carmel
Instructions To Bidders:
This form shall be utilized by all Bidders. Except as otherwise specifically provided, all Parts shall
be filly and accurately filled in and completed and notarized.
Project: TOWNE ROAD TRAIL CONSTRUCTIONAND
CUL VERT REPLACEMENT
Proposal For Construction of:
Trail construction and culvert replacement from 96"i Street
to 106"' Street
Date:1 ���a �� l q, ca_ v J
To: City of Carmel, Indiana, Board of Public Works and Safety
1
EXHIBIT
Version 2016-08-31 1 a � 3
ITEMIZED PROPOSAL
Part 3 PROJECT: Towne Road Trail
CONTRACT ITEMS AND UNIT PRICES Bid Date:
MODIFIED Per Addendum #1 February 15, 2017
It
No
Description
Estimated_
Quantity
Unit
Unit Price
Amount.
Dollars ' ,' Cents
Dollars ; Cents,'
1
CONSTRUCTION ENGINEERING
1.0
L.S.
$ 18,000.00
$' 18,000.00
2
MOBILIZATION AND DEMOBILIZATION
1.0
L.S.
$ 24,000.00
$ 24,000.00
3
CLEARING RIGHT OF WAY
1.0
L.S.
$ 26,064.15
$ 26,064.15
4
EXCAVATION, COMMON
792.0
C.Y.
$ 26.51
$ 20,995.92
5
TEMPORARY INLET PROTECTION
5.0
EACH
$ 131.25
$ 656.25
6
TEMPORARY SILT FENCE
3066.0
L.F.
$ 2.10
$ 6,438.60
7
SUBGRADE TREATMENT, TYPE V
3581.0
SYS
$ 4.20
$ 15,040.20
8
STRUCTURE BACKFILL, TYPE 1
143.0
C.Y.
$ 42.00
$ 6,006.00
9
STRUCTURE BACKFILL, TYPE 2
56.0
C.Y.
$ 42.00
$ 2,352.00
10
STRUCTURE BACKFILL, TYPE 5
101.0
C.Y.
$ 81.38
$ 8,219.38
11
COMPACTED AGGREGATE NO. 53 BASE
1194.0
TON
$ 26.51
$ 31,652.94
12
ASPHALT FOR TACK COAT
1.0
TON
$ 660.00
$ 660.00
13
HMA FOR SIDEWALK {MULTI -USE PATH}
791.0
TON
$ 88.00
$ 69,608.00
14
SIDEWALK, CONCRETE
23.0
SYS
$ 52.50
$ 1,207.50
15
CURB RAMP, CONCRETE
93.0
SYS
$ 152.25
$ 14,159.25
16
HAND RAIL, STEEL
105.0
L.F.
$ 207.00
$ 21,735.00
17
CURB, CONCRETE, MODIFIED {(FOR HANDRAIL)}
105.0
L.F.
$ 42.00
$ 4,410.00
18
CURB AND GUTTER, CONCRETE
86.0
L.F.
$ 36.75
$ 3,160.50
19
CURB AND GUTTER, ROLL CURB
74.0
L.F.
$ 31.50
$ 2,331.00
20
BENCH MARK POST
1.0
EACH
$ 825.00
$ 825.00
21
GEOTEXTILES
82.0
SYS
$ 13.59
$ 1,114.38
22
RIPRAP, REVETMENT
62.0
TON
$ 84.00
$ 5,208.00
'23
MULCHED SEED/NG U
4000.0
SYS
$ 3,68
$ 14,720.00
24
TOPSOIL
4.0
C.Y.
$ 52.50
$ 210.00
E� ���
26�-3
Item
No.
Description
:,.
Estimated
Quantity
Unit
Unit Price
Amount
Dollars : :: Cents
Dollars Cents7
25
PLANT, DECIDUOUS TREE, SINGLE STEM, OVER 2 IN. TO
2.5 IN.
13.0
EACH
$ 498.75
$ 6,483.75
26
STRUCTURE, REINFORCED CONCRETE, BOX SECTIONS,
12 FT. X 4 FT.
70.0
L.F.
$ 1,638.00
$ 114,660.00
27
VALVE BOX {ADJUST TO GRADE}
1.0
EACH
$ 262.50
$ 262.50
28
METER PIT {ADJUST TO GRADE}
1.0
EACH
$ 189.00
$ 189.00
29
PIPE, TYPE 2, CIRCULAR, 8 IN.
85.0
L.F.
$ 49.67
$ 4,221.95
30
PIPE, TYPE 2, CIRCULAR, 12 IN.
419.0
L.F.
$ 47.88
$ 20,061.72
31
PIPE, TYPE 2, CIRCULAR, 15 IN.
40.0
L.F.
$ 50.66
$ 2,026.40
32
PIPE, TYPE 1, DEFORMED, MIN. AREA 15.6 SFT
14.0
L.F.
$ 309.75
$ 4,336.50
33
HMA FOR STRUCTURE INSTALLATION, TYPE B
59.0
TON
$ 125.00
$ 7,375.00
34
PIPE END SECTION, DIAMETER 12 IN.
8.0
EACH
$ 866.25
$ 6,930.00
35
PIPE END SECTION, DIAMETER 15 IN.
1.0
EACH
$ 945.00
$ 945.00
36
CASTING, ADJUST TO GRADE {1 STORM - 4 SANITARY}
5.0
EACH
$ 420.00
$ 2,100.00
37
INLET, E7
2.0
EACH
$ 1,968.75
$ 3,937.50
38
PIPE CATCH BASIN, 24 IN.
3.0
EACH
$ 1,417.50
$ 4,252.50
39
AGGREGATE FOR DRAINAGE FILL
6.0
C.Y.
$ 61.25
$ 367.50
40
MODULAR BLOCK WALL
193.0
S.F.
$ 18.68
$ 3,605.24
41
MODULAR BLOCK WALL ERECTION
193.0
S.F.
$ 50,50
$ 9,746.50
42
ROAD CLOSURE SIGN ASSEMBLY
2.0
EACH
$ 194.25
$ 388.50
43
DETOUR ROUTE MARKER ASSEMBLY
21.0
EACH
$ 120.75
$ 2,535.75
44
CONSTRUCTION SIGN, A
4.0
EACH
$ 131.25
$ 525.00
45
MAINTAINING TRAFFIC
1.0
L.S.
$ 6,825.00
$ 6,825.00
46
BARRICADE, III -A
72.0
L.F.
$ 11.55
$ 831.60
47
BARRICADE, III -B
72.0
L.F.
$ 11.55
$ 831.60
48
SIGN, SHEET, RELOCATE
4.0
EACH
$ 420.00
$ 1,680.00
Total Bid Price = I $ 503,892.58
�,f%w�- 114 �
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:
Commercial General Liability:
General Aggregate Limit (other than
Products/Completed Operations):
Products/Completed Operations:
Personal & Advertising Injury
Each Occurrence Limit:
Statutory Limits
$1,000,000 each employee
$1,000,000 each accident
$1,000,000 policy limit
$6,000,000
$5,000,000
$5,000,000
Comprehensive Auto Liability (owned, hired and non -owned)
Bodily Injury and Property Damage: $5,000,000 each occurrence
Umbrella Excess Liability
If a commercial umbrella liability policy is used to satisfy the minimum limits of liability
requirements, the combined limits must equal these minimum limits of liability.
EXHIBIT D
APF><�.
a. �L^�'��-�� , being first dilly sworn, deposes and says that
lie/his 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 Cl 8) years of age and am competent to testify to the facts contained
herein,
2. 1 now acid at all times •elevant he • in.have been employed by
1 (the "Employer")
in the position of _ ilr� c ,� f
3. 1 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 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 day of , 20' /
Printed: d.,��u�r(a. r
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/[rue and correct.
City® Carmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
Page 1 of 1
PURCHASE ORDER NUMBER
SHIPPING INSTRUCTIONS
FEDERAL EXCISE TAX EXEMPT
100180
ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032-2584
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
VOUCHER, DELIVERY MEMO, PACKING SUPS,
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
2/16/2017
108335
Project 16 -SW -18; Contract Date 03.01.17
GLOBE ASHPHALT PAVING CO
City Engineering's Office
VENDOR PO BOX 19168
SHIP 1 Civic Square
TO Carmel, IN 46032 -
INDIANAPOLIS, IN 46219 -
Kate Lustig
PURCHASE ID
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
12861
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE EXTENSION
Department: 2200 Fund.0
Account: 94-650.04
1 Each
Send Invoice To:
Skip Tennancour
American Structurepoint, Inc.
8425 Wicklow Way
Brownsburg, IN 46112
2016 COIT Bond 1 PLEASE INVOICE. IN DUPLICATE
COIT Bond Fund
Towne Road Trail Construction and Culvert Replacement $503,892.58
Sub Total
$503,892.58
$503,892.58
DEPARTMENT ACCOUNT
I PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $503,892.58
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
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945'—�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jeremy Kashman Douglas Haney
TITLE Director Corporation Counsel
CONTROL N0. 100180 CLERK -TREASURER