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Malinowski Consulting, Inc/Util/7,950/City-Wide Cost Allocation PlanMalinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 01-7320-08; P.O.# 503083 Contract Not To Exceed $7,950.00 Q� )prviedl BY AGREEMENT FOR PROFESSIONAL SERVICES THIS AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement") is hereby made and entered into by and between the City of Carmel, Indiana, acting by and through its Board of Public Works and Safety (hereinafter "City"), and Malinowski Consulting, Inc. (hereinafter "Professional"). RECITALS WHEREAS City owns and is responsible for the operation and maintenance of its property, personnel, public works and infrastructure; and and WHEREAS, from time to time, City needs professional assistance in fulfilling its foregoing responsibilities; WHEREAS, Professional is experienced in providing and desires to provide to City the professional services ("Services") referenced herein; and WHEREAS, City desires to engage Professional as an independent contractor for the purpose of providing to City the Services referenced herein; NOW, THEREFORE, in consideration of the foregoing recitals and the covenants and conditions set forth herein, City and Professional mutually agree as follows: SECTION 1 INCORPORATION OF RECITALS The foregoing Recitals are hereby incorporated into this Agreement and made a part hereof. SECTION 2 SCOPE OF SERVICES 2.1 City desires to engage Professional as an independent contractor for the Services set forth in attached Exhibit A, incorporated herein by this reference. 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 Vendor shall perform only those Services specifically detailed in the Notice. If the Vendor 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 2.2 Professional understands and agrees that City may, from time to time, request Professional to provide additional or modified Services to City. When City desires additional Services from Professional, the City shall notify Professional of such additional Services desired, as well as the time frame in which same are to be provided. Only after City has approved Professional's time and cost estimate for the provision of such additional Services, has encumbered sufficient monies to pay for same, and has authorized Professional, in writing, to provide such additional Services, shall such Services be provided by Professional to City. A copy [SAConvwts\Prof.S-s & Good: Svcs\Unlit-\20I8\MaJmoasln consulting, Inc. Pror —al 5—d-226/2018 10:46 AMI Malinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 01-7320-08; P.O.# 503083 Contract Not To Exceed $7,950.00 of the City's authorization documents for the purchase of additional Services shall be numbered and attached hereto in the order in which they are approved by City. 2.3 Time is of the essence of this Agreement. SECTION 3 CITY'S RESPONSIBILITIES 3.1 City shall provide such information as is reasonably necessary for Professional to understand the Services requested. 3.2 City shall provide all data required for provision of Services. Professional may assume that all data so provided is correct and complete. 3.3. City shall arrange for Professional to enter upon public and private property as reasonably required for Professional to perform the Services. 3.4 City shall designate payment of the Services from City budget appropriation number 01-7320-08 funds. 3.5 City shall designate the Mayor or his duly authorized representative to act on City's behalf on all matters regarding the Services. SECTION 4 PROFESSIONAL'S RESPONSIBILITIES 4.1 Professional shall perform the Services pursuant to the terms of this Agreement and within any applicable time and cost estimate. 4.2 Professional shall coordinate with City its performance of the Services. 4.3 Professional shall provide the Services by following and applying at all times reasonable and lawful standards as accepted in the industry. SECTION 5 COMPENSATION 5.1 Professional estimates that the total price for the Services to be provided to City hereunder shall be no more than Seven Thousand Nine Hundred Fifty Dollars ($7,950.00) (the "Estimate"). Professional shall submit an invoice to City no more than once every thirty (30) days for Services provided City during the time period encompassed by such invoice. Invoices shall be submitted on a form containing the same information as that contained on the Professional Services Invoice attached hereto as Exhibit B, incorporated herein by this reference. City shall pay Professional for all undisputed Services rendered and stated on such invoice within thirty five (35) days from the date of City's receipt of same. 5.2 Professional agrees not to provide any Services to City that would cause the total cost of same to exceed the Estimate, without City's prior written consent. 1S:\Can .U\Rof.S— & Goods Svcs\Utili.-\2018\Ma1ioowAl C—Itin8. Inc. Professional ServicesA-2262018 10:46 AMI 2 94alinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 0l -7320-08; P.O.# 503083 Contract Not To Exceed $7,950.00 SECTION 6 TERM Unless otherwise terminated in accordance with the termination provisions set forth in Section 7.1 hereinbelow, this Agreement shall be in effect from the Effective Date through December 31, 2018, 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. SECTION 7 MISCELLANEOUS 7.1 Termination 7.1.1 The obligation to provide all or any portion of the Services under this Agreement may be terminated by City or Professional, without cause, upon thirty (30) days' notice. 7.1.2 The obligation to provide all or any portion of the Services under this Agreement may be terminated by City, for cause, immediately upon Professional's receipt of City's "Notice To Cease Services." 7.1.3 In the event of full or partial Agreement termination, and as full and complete compensation hereunder, Professional shall be paid for all such Services rendered and expenses incurred as of the date of termination that are not in dispute, except that such payment amount shall not exceed the Estimate. Disputed compensation amounts shall be resolved as allowed by law. 7.2 Binding Effect City and Professional, and their respective officers, officials, agents, partners and successors in interest are bound to the other as to all Agreement terms, conditions and obligations. 7.3 No Third Party Beneficiaries Nothing contained herein shall be construed to give rights or benefits to anyone other than the parties hereto. 7.4 Relationship The relationship of the parties hereto shall be as provided for in this Agreement, and neither Professional nor any of its agents, employees or contractors are City employees. Professional shall have the sole responsibility to pay to or for its agents, employees and contractors all statutory, contractual and other benefits and/or obligations as they become due. Professional hereby warrants and indemnifies City for and from any and all costs, fees, expenses and/or damages incurred by City as a result of any claim for wages, benefits or otherwise by any agent, employee or contractor of Professional regarding or related to the subject matter of this Agreement. This indemnification obligation shall survive the termination of this Agreement. 7.5 Insurance Professional shall procure and maintain with an insurer licensed to do business in the State of Indiana such insurance as is necessary for the protection of City and Professional from all claims under workers' compensation, occupational disease and/or unemployment compensation acts, because of errors and omissions, because of bodily injury, including, but not limited to, the personal injury, sickness, disease, or ISXontrxaa\ProPsvca & Goods SvcsW1dj1im\2018V.9a1mowaki Coumlw8, Inc. Prof-asional Servjm.dm:2/262018 10:46 AMI Malinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 01-7320-08; P.O.# S03083 Contract Not To Exceed $7,950.00 death of any of Professional's employees, agents or contractors and/or because of 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 on attached Exhibit C. Such insurance policies shall not be canceled without thirty (30) days' prior written notice to City. 7.6 Liens Professional shall not cause or permit the filing of any lien on any of City's property. In the event such a lien is filed and Professional fails to remove it within ten (10) days after the date of filing, City shall have the right to pay or bond over such lien at Professional's sole cost and expense. 7.7 Default In the event Professional: (a) repudiates, breaches or defaults under any of the terms or conditions of this Agreement, including Professional's warranties; (b) fails to perform the Services as specified; (c) fails to make progress so as to endanger timely and proper completion of the Services and does not correct such failure or breach within five (5) business days after receipt of notice from City specifying same; or (d) becomes insolvent, files, or has filed against it, a petition for 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 terminate all or any part of this Agreement, without liability to Professional and to exercise any other rights or remedies available to it at law or in equity. 7.8 Government Compliance Professional agrees to comply with all laws, executive orders, rules and regulations applicable to Professional's performance of its obligations under this Agreement, all relevant provisions of which being hereby incorporated herein by this reference, to keep all of Professionals' required professional licenses and certifications valid and current, and to indemnify and hold harmless City from any and all losses, damages, costs, liabilities, damages, costs and attorney fees resulting from any failure by Professional to do so. This indemnification obligation shall survive the termination of this Agreement. 7.9 Indemnification Professional shall indemnify and hold harmless City and its officers, officials, employees and agents from all losses, liabilities, claims, judgments and liens, including, but not limited to, all damages, costs, expenses and attorney fees arising out of any intentional or negligent act or omission of Professional and/or any of its employees, agents or contractors in the performance of this Agreement. This indemnification obligation shall survive the termination of this Agreement. 7.10 Discrimination Prohibition Professional represents and warrants that it and each of its employees, agents and contractors shall comply with all existing and future laws prohibiting discrimination against any employee, applicant for employment and/or other person in the subcontracting of work and/or in the performance of any Services contemplated by this Agreement with respect to hire, tenure, terms, conditions or privileges of employment or any matter directly or indirectly related to employment, subcontracting or work performance hereunder because of race, religion, color, sex, handicap, national origin, ancestry, age, disabled veteran status or Vietnam era veteran status. This indemnification obligation shall survive the termination of this Agreement. [S:\Conwacts\Prof.SV & Goods Svcs\Utilities\2018\NbJmowski Consulting, Inc. Professional Servi—d-2262018 10:46 AK 4 Malinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 0l -7320-08; P.O.# S03083 Contract Not To Exceed $7,950.00 7.11 E -Verify Pursuant to I.C. § 22-5-1.7 et seq., Professional shall enroll in and verify the work eligibility status of all of its newly -hired employees using the E -Verify program, if it has not already done so as of the date of this Agreement. Professional is further required to execute the attached Affidavit, herein referred to as Exhibit D, which is an Affidavit affirming that: (i) Professional is enrolled and is participating in the E -verify program, and (ii) Professional does not knowingly employ any unauthorized aliens. This Addendum incorporates by reference, and in its entirety, attached Exhibit D. In support of the Affidavit, Professional shall provide the City with documentation that it has enrolled and is participating in the E -Verify program. This Agreement shall not take effect until said Affidavit is signed by Professional and delivered to the City's authorized representative. Should Professional subcontract for the performance of any work under this Addendum, the Professional shall require any subcontractor(s) to certify by affidavit that: (i) the subcontractor does not knowingly employ or contract with any unauthorized aliens, and (ii) the subcontractor has enrolled and is participating in the E -verify program. Professional shall maintain a copy of such certification for the duration of the term of any subcontract. Professional shall also deliver a copy of the certification to the City within seven (7) days of the effective date of the subcontract. If Professional, or any subcontractor of Professional, knowingly employs or contracts with any unauthorized aliens, or retains an employee or contract with a person that the Professional or subcontractor subsequently learns is an unauthorized alien, Professional shall terminate the employment of or contract with the unauthorized alien within thirty (30) days ("Cure Period"). Should the Professional or any subcontractor of Professional fail to cure within the Cure Period, the City has the right to terminate this Agreement without consequence. The E -Verify requirements of this Agreement will not apply, should the E -Verify program cease to exist. 7.12 Severability If any provision of this Agreement is held to be invalid, illegal or unenforceable by a court of competent jurisdiction, that provision shall be stricken, and all other provisions of this Agreement that can operate independently of same shall continue in full force and effect. 7.13 Notice Any notice, invoice, order or other correspondence required or allowed to be sent pursuant to this Agreement shall be written and either hand -delivered or sent by prepaid U.S. certified mail, return receipt requested, addressed to the parties as follows: CITY: Carmel Utilities 30 West Main Street Suite 220 Carmel, Indiana 46032 [SX-w\P,&Svcs &G..& Svcs\Ulililics\2018\M.1mov Ju Cmwllmg. Inc. Profasioual Servicacdac:2262018 10:46 AMI Douglas C. Haney Corporation Counsel One Civic Square Carmel, Indiana 46032 Malinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 01-7320-08; P.O.# S03083 Contract Not To Exceed $7,950.00 PROFESSIONAL: Malinowski Consulting, Inc. 755 W Carmel Dr Suite 203 Carmel, IN 46032 ATTENTION: Charles F. Malinowski Notwithstanding the above, City may orally provide to Professional any notice required or permitted by this Agreement, provided that such notice shall also then be sent as required by this paragraph within ten (10) business days from the date of such oral notice. 7.14 Effective Date The effective date ("Effective Date") of this Agreement shall be the date on which the last of the parties hereto executes same. 7.15 Governina Law: Lawsuits This Agreement shall be governed by and construed in accordance with the laws of the State of Indiana, except for its conflict of laws provisions, as well as by all ordinances and codes of the City of Carmel, Indiana. The parties agree that, in the event a lawsuit is filed hereunder, they waive any right to a jury trial they may have, agree to file 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. 7.16 Waiver Any delay or inaction on the part of either party in exercising or pursuing its rights and/or remedies hereunder or under law shall not operate to waive any such rights and/or remedies nor in any way affect the rights of such party to require such performance at any time thereafter. 7.17 Non -Assignment Professional shall not assign or pledge this Agreement nor delegate its obligations hereunder without City's prior written consent. 7.18 Entire Agreement This Agreement contains the entire agreement of and between the parties hereto with respect to the subject matter hereof, and no prior agreement, understanding or representation pertaining to such subject matter, written or oral, shall be effective for any purpose. No provision of this Agreement may be amended, added to or subtracted from except by an agreement in writing signed by both parties hereto and/or their respective successors in interest. To the extent any provision contained in this Agreement conflicts with any provision contained in any exhibit attached hereto, the provision contained in this Agreement shall prevail. [S:\ -tacts\P,&S— & Goads Svcs\Utihu.\2018\Ma1mc—ki Consulting, Inc. Professiwal S—i—d«:2262018 10:46 AMS Malinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 01-7320-08; P.O.# S03083 Contract Not To Exceed $7,950.00 7.19 Representation and Warranties Each party hereto represents and warrants that it is authorized to enter into this Agreement and that any person or entity executing this Agreement on behalf of such party has the authority to bind such party or the party which they represent, as the case may be. 7.20 Headings All headings 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. 7.21 Advice of Counsel The parties warrant that they have read this Agreement and fully understand it, have had an opportunity to obtain the advice and assistance of counsel throughout the negotiation of same, and enter into same freely, voluntarily, and without any duress, undue influence or coercion. 7.22 Copyright City acknowledges that various materials which may be used and/or generated by Professional in performance of Services, including forms, job description formats, comprehensive position questionnaire, compensation and classification plan and reports are copyrighted. City agrees that all ownership rights and copyrights thereto lie with Professional, and City will use them solely for and on behalf of its own operations. City agrees that it will take appropriate action with its employees to satisfy its obligations with respect to use, copying, protection and security of Professional's property. 7.23 Personnel Professional represents that it has, or will secure at its own expense, all personnel required in performing the services under this agreement. Such personnel shall not be employees of or have any contractual relationship with City. All of the services required hereunder will be performed by Professional or under his supervision and all personnel engaged in the work shall be fully qualified to perform such services. 7.24 Records and Inspections Professional shall maintain full and accurate records with respect to all matters covered under this agreement for three (3) years after the expiration or early termination of this Agreement. City shall have free access at all proper times to such records and the right to examine and audit the same and to make transcripts there from, and to inspect all program data, documents, proceedings and activities. 7.25 Accomplishment of Project Professional shall commence, carry on, and complete the project with all practicable dispatch, in a sound economical and efficient manner, in accordance with the provisions thereof and all applicable laws. In accomplishing the project, Professional shall take such steps as are appropriate to ensure that the work involved is properly coordinated with related work being carried on within City's organization. [S:\Conir ts%ProfBvcs & Good Svcs\U1di1 ea\2018\Mi11n AA Cansulong. Inc. Professional Servi—d-2/262018 10:46 AMI 7 Nfalinowski Consulting, Inc. Utilities Department - 2018 Appropriation # 01-7320-08; P.O.# S03083 Contract Not To Exceed $7,950.00 7.26 Iran Certification Pursuant to I.C. § 5-22-16.5, the Professional shall certify that, in signing this Agreement, it does not engage in investment activities within the Country of Iran. 7.27 Access to Public Records Act Professional understands and agrees that any "public record", as that term is defined in Indiana Code 5-14-3- 2(m), as amended, that is related to the subject matter of this Agreement, whether the same is in the possession or control of the Professional or the City, shall be subject to release under and pursuant to the provisions of Indiana's Access to Public Records Act, as codified in Indiana Code 5-14-3-1, et sec., as amended. 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 1/1:� James Brainard, Pr WdiOis r Date: ,7 G Mary Ann urke, Member Date: Lori S. Mat ber Date: t l e) A T• istine S. Pa�1 NVir surer Date: Malinowski Consulting, Inc. Signature Printed Name: ,fiu�s `/�%¢t Ivo ws� Title: oef--TT FID/TIN: ZU — 86 Last Four of SSN if Sole Proprietor: Date: 4M2 a/-/ 13 , ---?—o/ e% [SXmt-1slProf Sv & Good Sv Wuht m120I8ULlin—L cansulung. Inc. Prof—mal Servic-doc2262018 10:46 nbn it malcon MALINOWSKI CONSULTING, INC. December 11, 2017 The Honorable James Brainard Mayor City of Carmel One Civic Square Carmel, IN 46032 Re: Promos_ al for the Preparation of the City -Wide Cost Allocation Plan -201 Dear Mayor Brainard: Section is Introduction The purpose of this letter is to provide the City of Carmel with a formal proposal outlining how Malinowski Consulting, Inc. (Malcon) can be of assistance in the area of providing technical expertise in the preparation of the City -Wide Cost Allocation Plan (CAP). Section 2: Background The City of Carmel operates a number of funds that account for the operations of the City sewer and water utilities. Over the years the City General Fund has charged various administrative costs back to these funds. In an effort to identify a more equitable and systematic approach to reimbursing the General Fund it's "fair share" of costs, it is the desire of the City elected officials and utility managers to look for alternatives to previous methods. This desire has led to the discussion of enhancing the cost methodology by utilizing Federal guidelines as a starting basis to create a City -Wide Cost Allocation Plan to recover indirect costs of operating the sewer and water utilities in an equitable and transparent manner. Section 3: Objectives The objectives of the Cost Allocation Plan are to: • Perform a comprehensive review of all centrally provided resources (accounting, payroll, information technology, etc.) and equitably allocate those indirect costs to all City funds and departments. • Prepare the computation in a straight forward method that is easily understood by all stakeholders. • Actively search for sources of indirect cost reimbursement to the City General Fund. Section 4: Scope To achieve the objectives of this service, Malcon will cover all aspects of the CAP preparation. This will include the following: • CAP Data Collection: Malcon will perform all data collection activities. City staff will provide direction as to where the information can be obtained. • CAP Presentation to City Officials: After the compilation of the CAP, Malcon will meet with the appropriate City Officials (Mayor, Council, Administrator, Utility Director, etc.) to review the results of the analysis. Exhibit __2L 75,5 w. Carmel Drive, Suite 203 I Carmel, IN 46032 O 317.818.1876 877.346.7986 malconindiana.com CARMEL, INDIANA - PROPOSAL FOR THE PREPARATION OF THE COST ALLOCATION PLAN -2017 Section 4: Scope (Cont.) • Audit Defense to Federal and State Auditors: In the event that State or Federal auditors have questions regarding how the CAP was prepared, Malcon is prepared to explain and defend the CAP results. Section 5: Approach The approach to this assignment will include these steps: • Identify central services (i.e. accounts payable processing, technology services, facility operations, etc.) by scheduling on-site meetings with City department managers to identify all potential central service areas. • In cooperation with the accounting staff, determine wages and fringe benefits for the central service departments. • Gather and review the appropriate activity statistics (ex. paychecks processed by department) to determine allocation statistics. • Review City expenditure claims from the General and other Funds to ensure a full costing of central services has been performed. • Compile all data collected from various City departments into an electronic format that will generate the appropriate report. • Review the CAP with City staff to foster an understanding of the CAP document. • Respond quickly to questions posed the Indiana State Board of Accounts or other auditors. Section 6: Timing The Central Service Cost Allocation Plan will be prepared and submitted to the Mayor by June 30, 2oi8. Section 7: Staffing Malcon will utilize the expertise of our Indiana based consulting staff: • Charles Malinowski, President • Barbara Malinowski, Operations Manager • Daniel Vaughn, Senior Consultant • Matthew Lowery, Consultant Section S: Qualifications The following are key qualifications that make Malcon uniquely suited for this assignment: • Malcon is an Indiana Corporation serving Indiana local government since 2004. • Currently working with 21 Indiana Counties to perform County -Wide Cost Allocation Plans for Federal reimbursement purposes. • The President of Malcon has over 30 years of national experience preparing CAP for States, Counties, and Cities. • Malcon successfully prepared Carmel's 2012 CAP. Exhibit 14 Page 2 Z Of I CARMEL, INDIANA -PROPOSAL FOR THE PREPARATION OF THE COST ALLOCATION PLAN -2017 Section 9: Fees and Expenses Proposed Fee — 2017 Cost Allocation Plan: $7,950.00 This fee is inclusive of all services to be performed. Section io: Closing It is a privilege to submit this proposal to the City of Carmel to provide for the preparation of the cost allocation plan. The comprehensive approach outlined above will optimize recoveries to the General Fund, meet and exceed industry guidelines and substantially enhance the reliability and defense of the Cost Allocation Plan. If this proposal meets with your approval, please have the appropriate City official sign in the acceptance section and return one signed copy. Respectfully sub itted, .r Charles F. President Page 3 Exhibit A 3�Y CARMEL, INDIANA - PROPOSAL FOR THE PREPARA'T'ION OF THE COST ALLOCATION PLAN -2017 ACCEPTANCE This agreement is between the City of Carmel and Malinowski Consulting, Inc. (Malcon) to provide the preparation of the City -Wide Cost Allocation Plan (CAP) for the Year Ended December 31, 2017. The professional fees shall be as follows: Proposed Fee — 2011 Cost Allocation Plan: $7,950.00 The Central Service Cost Allocation Plan will be prepared and submitted to the Mayor by June 30, 2018. This agreement shall be in effect from the date of signature, entered below, until either party wishes to change the scope of the services or the professional fee. Either parry may terminate the agreement with a thirty -day (30) written notice. This fee is inclusive of all services to be performed. An invoice will be submitted to the City after acceptance of the CAP by the Mayor and is payable within 45 days. The following signatures will be considered as evidence of the acceptance of the above-described terms. Acceptance by the City of Carmel, Indiana Name: Title: Date of Signature: Attest: Name: Title: For Malino sulting, Inc. By: Name: Charles F. Malinowski Title: President Page 4 Exhibit -A �L d' I 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 Statutory Limits $100,000 each employee $250,000 each accident $500,000 policy limit 11 111 11 111 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 ', 11 111 1 111 ACORO� CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY) 03/13/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Brenda Russell NAME: Walker &Associateslnsurance Agency PHONE(317)353-8000 FAX (317)351-7149 AIC No Ext : A/C, No): 7364 E Washington Street E-MAILBrenda walkers nC .Com ADDRESS: Y INSURER(S) AFFORDING COVERAGE NAIC / EACH OCCURRENCE E 1,000,000 Indianapolis IN 46219 INSURERA: Selective Insurance Co. of Southeast 39926 INSURED INSURER B: Malinowski Consulting, Inc INSURER C : 755 W Carmel Drive INSURER D: Suite 203 INSURER E: Carmel IN 46032 INSURER F COVERAGES CERTIFICATE NUMBER: CL1831312193 REVISION NLIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRPOLICY LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER E F MM/DD/YYYY POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE1XI OCCUR S1987260 06/01/2017 06/01/2018 EACH OCCURRENCE E 1,000,000 PREMISES Ea occurrence E 300,000 MED EXP (Any one person) E 10,000 PERSONAL BADV INJURY E 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC El JE7X OTHER: GENERAL AGGREGATE E 3'000'000 3,000,000POLICY E A AUTOMOBILE X LIABILITY ANYAUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED �/ NON -OWNED AUTOS ONLY /� AUTOS ONLY S1987260 06/01/2017 06/01/2018 COMBINED SINGLE LIMIT E 1,000,000 Ea accident BODILY INJURY (Per person) E BODILY INJURY (Per accident) E PROPERTY DAMAGE E Per accident E A X UMBRELLA LIAB EXCESS LAB X OCCUR CLAIMS -MADE S1987260 06/01/2017 06/01/2016 EACH OCCURRENCE E 1,000,000 AGGREGATE E 1,000,000 DED I I RETENTION E E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVEElNIA OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I PER 5TH - STATUTE ER E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYEE E E.L. DISEASE - POLICY LIMIT E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Carmel IN ACCORDANCE WITH THE POLICY PROVISIONS. 30 W. Street, Suite 200 AUTHORIZED REPRESENTATIVE Carmel IN 46032 � A © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE F DATE(MWDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 03/14/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER PAYCHEX INSURANCE AGENCY INC 150 SAWGRASS DR ROCHESTER, NY 14620 CONTACT N PHONE NNo Ext): 877 762-6796 AJC No): 977 677-0447 MAIL A chex ravelers.com INSURER(S) AFFORDING COVERAGE NAIC u (877) 362-6785 INSURER A: THE TRAVELERS INDEMNITY COMPANY INSURED MALINOWSKI CONSULTING INC INSURER B: INSURER C: 755 W CARMEL DRIVE SUITE 203 INSURER D: CARMEL, IN 46033 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 926469010541370 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES Ea ocamence $ CLAIMS -MADE F—]OCCUR MED EXP (Any one on $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED AUTOS AUTOS BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS �PROPEERR Y DAMAGE $ UAB HOCCUR EACH OCCURRENCE $ JUMBRELLA EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YM N/A UB -582M9089-17 11/29/2017 11/29/2018 X STATUTE ER H E.L. EACH ACCIDENT $ 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) ❑ E.L. DISEASE - EA EMPLOYEE $ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CITY OF CARMEL INDIANA 30 W MAIN STREET STE 200 CARMEL, IN 46032 Of -I1 Leia14 lir _11ILei 2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (,, � • ��� J ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD EXHIBIT D AFFIDAVIT /114 /2/— E S r/114 4 L / /i/p u /s 4% / being first duly sworn deposes and says that he/she is familiar with and has personal knowledge of the facts herein and, if called as a witness in this matter, could testify as follows: 1. I am over eighteen (18) years of age and am competent to testify to the facts contained herein. 2. I am now and at all times relevant herein have been employed by /I Z,ii✓d PQ5-'� / �'D�✓ �y�7i� 6, /,✓ C- (the "Employer") in the position of ?12& s / z> 6^r7- 3. I 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 —�37Wday of 1"'Ot C y , 20Z9 r - Printed: L<,��fL�-��j��L/NO �.✓s<-� I certify under the penalties for perjury under the laws of U ' d tates of America and the State of Indiana that the foregoing factual statements and repre nt ' n e true and -correct. Printed: C /��L �� Li s✓d «J S�� - Alt" E-Verifv.Mw �uw Company ID Number: 630619 To be accepted as a participant in E -Verify, you should only sign the Employer's Section of the signature page. If you have any questions, contact E -Verify at 888-464-4218. Employer Malinowski Consulting, Inc. _Malinowski se Type or Print) Title /08/2013 Department of Homeland Security - Verification Division Name (Please Type or Print) Title ignature Date (I Information Required for the E -Verify Program nformation relating to your Company: Consulting, Inc. West Cannel Drive 203 IN 46032 Company Alternate Address: Coun or Parish: Employer Identification Number: 208695464 Page 12 of 13 1 E -Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify E-Verifv.I ql Company ID Number: 630619 North American Industry Classification Systems Code: 541 Administrator. Number of Employees: 1 to 4 Number of Sites Verified fo r: 1 ,e you verifying for more than I site? If yes, please provide the number of sites verified for each State: INDIANA 1 site(s) Information relating to the Program Administrator(s) for your Company on policy questions or operational problems: Name: Charles F Malinowski Telephone Number: (317) 818 - 1876 Fax Number: E-mail Address: charles@malconindiana.com Namc: Barbara E Malinowski Telephone Numbcr: (317) 818 - 1876 Fax Number: E-mail Address: barbara(a)malconindiana.com Page 13 of 13 1 E -Verity MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify