CSU, Inc./Eng/49,639.55/Carmel Drive and City Center Fiber Optic SplicingCSU, Inc.
Engineering - 2017 e
Appropriation: General Obligation Fund; P.O. #100500Contract Not To Exceed $49,639.55
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,
CSU, 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 agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City
budget appropriation number General Obligation 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 Forty Nine Thousand Six Hundred Thirty Nine Dollars and Fifty Five Cents
($49,639.55) (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, 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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1 1
CSU, Inc.
Engineering - 2017
Appropriation: General Obligation Fund; P.O. #100500
Contract Not To Exceed $49,639.55
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.
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CSU, Inc.
Engineering - 2017
Appropriation: General Obligation Fund; P.O. #100500
Contract Not To Exceed $49,639.55
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
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CSU, Inc.
Engineering - 2017
Appropriation: General Obligation Fund; P.O. #100500
Contract Not To Exceed $49,639.55
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
Attention: Jeremy Kashman
If to Vendor: CSU, Inc.
3919 Clarks Creek Road
Plainfield, IN 46168
Attention: Lori L. Paul
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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4
CSU, Inc.
Engineering - 2017
Appropriation: General Obligation Fund; P.O. #100500
Contract Not To Exceed $49,639.55
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. 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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CSU, Inc.
Engineering - 2017
Appropriation: General Obligation Fund; P.O. #100500
Contract Not To Exceed $49,639.55
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
By:
James Brainard, Presiding Officer
ATTEST:'
.Christine S. Pauley, Clerk -Treasurer
Date: A-7
CSU, INC.
By:
Authorized Signature
LIZ,"
Punted Name
I d e,/
Title
FID/TIN:
Last Four of SSN if Sole Proprietor:
Date: G -.1 Y — ,Xo.17
IC Im-1 FilesK wr ql 0u0ou01RONF811AM Iw Uoudr S'-- d.:6114120171120 ARAB
I (c- E_ N C.. Z
Date: 3/6/2017
Customer: City of Carmel
Job Name: Guilford & Ctty Center
CSU, Inc is a certified WBE contractor with the State of Indiana and the City of Indianapolis
CSU, Inc. agrees to perform the following services In a professional and safe manner. We will perform said
duties as expeditiously as the construction schedule and weather permits. This proposal Is valid for 30 days.
$eerrn ntu Ulm LAB + EQ MAT ULp.. Extension
Labor & Equipment
1
,
LS
$
24,648.67
5
-
$ 24,648.67,
_
$ 24,648.67
Splicing
1
LS
$
- 7,679.00
$
1,150.00
$
8,829.00
$ 8,829.00
Electric
1
LS
$
4,687.50
$
-
$_
4,687.50 __
.=._,.
$ _ 4,687.50
Manholes 4AA Split
2
Ea
$
3,775.00
$
3,775,00
—
$ 7,550.00
Conduit 6.1.25"
S10
If
$
3.00
$
3.00,
_
$ 1,830,00
,Tracerwire _
300.
ff
$
0.15
$
0:15
45.00
_-. Flow F8l
4
Yds _
S
90.00.
:S
90.00
_
S 360.00
Stone
4
Ton .
5
31.25
$
31,25
$.._... 125.00
Ground Rods, Clamps, Gr wire
2
ea
$ .
21.69.
$.
21.69
—
S _ 43.38
Fiber Cables144-SM.,6SM -
1 ...-
LS
$ ..
1,521.00
'$.
1,521.00 _
_
S __- 1,521.00.
S.
$
P, 141 ' I.
Includes: Equipment and tabor to Install Pipe
Misc consumable materials.
Excludes: Underground obstructions that prevent normal.drilling operations. te, sandstone, cobbles.,.
Private Utility Locates
Prevailing Wage Scale
Jobsite Materials
Weekend Premiums
5 49,639.55
It Is agreed that the contract price for the scope of work will be
Payment to be due and payable 30 calendar days after work is completed. Past due Invoices are
subject to one and a half percent per month service charge, plus reasonable attorney fees necessary to
collect past due Invoices
This proposal shall become a contract, binding upon both partl es, upon being signed by an authorized agent
for CSU, Inc. and by the Client.
Client
Printed:
Title:
Date:
CSU, Inc.
By: £dw■a
Printed: Ed Evans
Title: Business Development
Dater 3/6/2017_..
'EXHIBIT, ■
1 6'D
r
s
City of Carmel
o
Pdma q'
rrryru•
lnfo=ation & Comm 6on S
UMC.? vstems
Scope of Work requirements for CoC Fiber Optic cables due to the Rebuild of the
intersection at Guilford Road and City Center Drive.
The City of Carmel, CoC, has 2 fiber optic cables that run West on the North side of City Center Drive
that will be affected during the rebuilding of the intersection along City Center Drive at Rangeline Road,
Guilford Road, and Carmel -Drive. One of those cables is an old 6 strand multimode cable being fed
from the traffic box at Rangeline Road. This cable does not have sufficient slack to be used in the new
construction therefore we will need to re -feed the existing cameras from a newer 144 strand fiber optic
cable. This cable is newer and has sufficient resources and slack to be used in the new construction of
the roundabouts at 3 locations. There are a total of 5 working cameras fed from 3 different locations that
will need to have service restored to them when the 3 projects comes to completion. We are able to
disconnect them while construction is being done. The process to reconfigure the fiber network to
accomplish this is outlined below and divided into 3 separate projects.
City Center Drive and Guilford Road Roundabout Project Location: Guilford and City Center
Place two 4x4 split manholes one at the N. side of City Center and E of Guilford Rd on 2 existing 4'
conduits with working fiber cables, 1-144 SM strand and another 6 MM strand. The other manhole will
be placed on the N. Side of City Center W of Guilford on 2 existing 4' conduits with working fiber
cables, 1-144 SM strand and another 6 MM strand. Place 14" conduit and 1-4" conduit w/4 way
maxcell .ducts by directional drilling between the new manholes. Place new 144 strand fiber cable
between new manhole and prep for splicing. Pull all slack from the 2-24" traffic handholes to new 4x4
manholes in both directions. Then schedule a night mop for the cut over of the old 144 strand cable to
the new cable. Have two splice crews one at each manhole. The old 144 strand fiber cable will then be
cut and pulled each way back to the new manholes. The new fiber will have been prep for the cut over.
The old fiber cable has some 18 hot fibers. The hot fiber will be spliced first and then the dark fibers.-
We
ibers:We will be adding two new splice cases one at each manhole. Also place and splice a 12 strand fiber
from the new manhole to the P 1 cabinet and terminate on the NW corner of the new roundabout. The
specific fiber strands used will be determined and shared at the time work is started. Also pull a 6 strand
fiber and #10 power cables to the two cameras and terminate at each end after the road construction
places the new infrastructure conduits, handholes, and street light poles. The one camera at 240', the
NEMA Box and Camera removed by CoC, will need to be replaced on the project at the time of cable
placement. The other at 680' is still on the pole and just needs to be reattached in the NEMA box. Both
the 6 strand MM fiber cable and power cables will be home runs back to the P1 cabinet. You will place
and run the power and fiber cables to the P 1 in newly placed conduit infrastructure provided in new road
project. A 19 in/12 U wall mount rack needs to be placed for fiber terminations, rack mount power surge
protector (to be included in this scope), as well as re -placement of network switch. Power panel and 2
separate quad 120v ground receptacles need to be placed if now done so on the project by road project.
°EXHIBIT
—_A -
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[File name] 3
AA
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irDV\ b'S
The City of Carmel will unplug the cameras and make dark the fiber prior to work beginning. We will
also remove the one camera and NEMA box that will be remounted by those doing this work. All work
needs to be done on a time sensitive nature. The City of Carmel and the engineering groups have a tight
time schedule to meet due to road closures and do so in haste.
The splice arrangements and dedication of fiber in both splices are as follows:
The working strands are 1-8, 25-30, and 143-144. Please splice these first. All others are dark.
Splice case on the Northeast side, adjacent to the P1 traffic box, will be a 144 SM straight splice with the
following exception:
A 12 strand SM fiber will be added to the splice and the first 6 strands will be spliced to strands 121-126
coming from the east. Strands 7-12 of the 12 strand SM fiber will be spliced to the strands 121-126
going west. Basically strands 121-126 will go into and back out of the P1 traffic box. The 12 strand SM
fiber will be terminated into the first 12 of the 24 port fiber patch panel. Ports 12-24 will be used to
terminate the 2 separate 6 strand MM fiber cables to each camera in this scope.
The splice case on the Northwest side will be a 144 SM straight splice without exception other than the
case should be of the type that will accept additional fiber cables at a future time.
Please contact me with any questions and bid associated to this scope of work.
Thank you in advance,
Information & Communications Systems
Communications Field Technician
31 1 st Ave. NW.
Carmel, IN 46032
Office 317-571-2591, Cell 317-671-3096
[File name]
"EXHIBIT ■
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
o��_ L. k 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 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
CJ U Zn C. (the "Employer")
in the position of es sd"
3. lam -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 / y� day of Cri A e- 2011.
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: �2• G- / ci y f
City®� ������
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
Page 1 of 1
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
100500
. ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
6/9/2017
368347
Project 16 -ENG -25; Contract Date 06.21.17
CSU INC
City Engineering's Office
VENDOR 3919 CLARKS CREEK ROAD
SHIP 1 Civic Square
TO Carmel, IN 46032-
PLAINFIELD, IN 46168 -
Kate Lustig
PURCHASE ID
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
16135
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE EXTENSION
Department., 2200 Fund: 0 General Obligation Bond
Account., 94-650.04
1 Each Carmel Drive and City Center Fiber Optic Splicing
$49,639.55 $49,639.55
Sub Total $49,639.55
a
Send Invoice To:
City Engineering's Office
ti
Kate Lustig
1 Civic Square r*� '
Carmel, IN 46032-.`"I
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $49,639.55
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. 100500 'CLERK -TREASURER
. 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
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLI GATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
Jeremy Kashman
Director
Douglas Haney
Corporation Counsel