InvigorateHR, LLC/HR/10,500/Workplace Conduct TrainingInvigorateHR, LLC
Department of Human Resources - 2018
Appropriation #43-570.01 P.O. #101985
Contract Not To Exceed $10,500.00
AGREEMENT FOR PURCHASE OF GOODS AND SERVICES apo
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 InvigorateHR, LLC, 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 43-570.01 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.
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 Ten Thousand Five Hundred Dollars ($10,500.00) (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.
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.
[C:U1sas�ctivingston�Desktop\(ioods and Services T—p[ e.d-10/8/2018 438 AM
InvigorateHR, LLC
Department of Human Resources - 2018
Appropriation #43-570.01 P.O. #101985
Contract Not To Exceed $10,500.00
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.
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.
[c:Ula 1chvingstmVesktopZfoods and Scvias Temple .dw: 101812018 938 AM]
InvigorateHR, LLC
Department of Human Resources - 2018
Appropriation #43-570.01 P.O. #101985
Contract Not To Exceed $10,500.00
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
[CAUs NctivingstmU)csktop`,Cioods and Smice T—plate.doc: 10/8/2018 9:38 AM1
InvigorateHR, LLC
Department of Human Resources - 2018
Appropriation #43-570.01 P.O. #101985
Contract Not To Exceed $10,500.00
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, IN 46032
Attention: Barb Lam
If to Vendor: InvigorateHR, LLC
2434 N Delaware Street
Indianapolis, IN 46205
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.
[CAUws\clivingston\DesMop`Goods and S—in Templaw.dac: 10/88018 9:38 AAS
4
InvigorateHR, LLC
Department of Human Resources - 2018
Appropriation #43-570.01 P.O. #101985
Contract Not To Exceed $10,500.00
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, 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.
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.
[CAUsers\cliviugstm\Desttop\Goods and Services Temp]ate.doc: 10/8!2018 9:38 AM
InvigorateHR, LLC
Department of Human Resources - 2018
Appropriation #43-570.01 P.O. # 10 1985
Contract Not To Exceed $10,500.00
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
Date: .�
Mary Ann rke, Membpr
Date:
Lori S.Wats , Member
Date: � - ( C) % , -7 t
ATTESP
Christine S. Pauley, Clerk-Treeprer
Date: �0 /7//j
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InvigorateHR, LLC
l
Authorized gnature
. Qj'�A I 'm � /j
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Ph ed Name ' ' j (j Pr
. LaW CU !A
Title
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Date:t�~ 1D-- ` Y
4101jlnviyorareffl? PROPOSAL FOR SERVICE.
City of Carmel—Workplace Conduct Training
InvigorateHR is pleased to present this proposal to the City of Carmel for workplace conduct
training. The proposal is comprised of the following:
Overview
• InvigorateHR background and areas of expertise
• Project approach
• Project fee
• Agreement for services
InvigorateHR is not your typical human resource consulting firm. Our approach is dynamic. We
are forward -thinking, meaning that our solutions are based on where your business is today and
your plans for its future. Our job is to keep up-to-date on the latest HR trends and best -practices
so that we can bring them to you.
Our expertise is in a wide range of people and human resource strategies. If it involves your
people, we have you covered. InvigorateHR's core areas of expertise include:
HR Strategy HR Essentials
• Employer Branding • Employee Handbooks
• HR Strategy/Business Strategy Alignment • HR Department Start Up
• Mission, Vision, Values Development • Job Descriptions
• Organizational Design • Onboarding/Orientation Programs
• Strategic Planning • Policy and Procedure Development
Talent Acquisition HR Administration and Compliance
About
• Behavioral Interview Strategies • Employee Relations Consulting
InvigorateHR
• Employee Referral Programs • FLSA Classifications Audits
• Employment Verification/Background Reports • General HR Consulting/Outsourcing
• Recruitment and Sourcing Strategies • HR Assessments
• Retained/Hourly Search • Workplace Conduct Investigations and
Training
Talent Management and Development
• Customized Employee Training Employee Communications and Surveys
• HR Staff Development • Change Management
• Leadership and Management Training • Employee Engagement Surveys
• Succession Planning • Employee Newsletters
• Exit Surveys
Performance Management
• Competency Development Compensation
• Pay -for -Performance Systems • Compensation Structures
• Performance Evaluation Systems • Job Pricing
• Performance Improvement Strategies • Pay Benchmarking
InvigorateHR will take the following approach to deliver the workplace conduct training:
• Design a two-hour workplace conduct training session focused on the following learning
objectives:
✓ Understand workplace conduct issues (including sexual harassment) and the importance of
an inclusive workplace.
Project
✓ Review basic laws and court decisions relating to workplace conduct and sexual
Approach
harassment.
✓ Identify what behaviors are/are not appropriate for work; discuss how these behaviors
impact the workplace and the organization.
✓ Understand how to create a culture of engagement and accountability; discuss boundaries
between work, personal, and social interactions/environments.
✓ Learn steps to foster an environment of mutual trust and respect.
Exhibit
4141inviqurareff)? PROPOSAL FOR SERVICES
Project Fee
• Deliver 14, two-hour sessions to approximately 50 participants per session over no more than 90
days or another agreed upon period of time. Four sessions will be held in the evening.
• Develop a participant training guide to be used during the session (client will be responsible for
printing and supplying the guide to each participant for each session).
$6,500
Hca nuc, 11UIF11119 aebblurib
Training Session Fees
In the event the client wishes to deliver the same training session after the 14 scheduled sessions InvigorateHR
will charge an a la carte fee per session. This feel is outlined below.
$500
Exhibit _P,
z�3
41
_InvigorateHR PROPOSAL FOR SERVICES
Agreement for Services
This Agreement for Services, effective October 3, 2018, is by and between the City of Carmel and InvigorateHR.
Fees and Reimbursable Costs. The fee estimate contained in the foregoing proposal is based upon the project scope outlined in the
foregoing proposal (1 pages). If the project scope should change during the course of the project, the fee structure will be evaluated and
revised, if necessary. Unless otherwise outlined, administrative and reimbursable expenses will be billed at actual cost. Administrative and
reimbursable expenses include, but are not limited to, travel costs (air, lodging, meals, incidentals, etc.), subcontractors, materials,
telephone charges, copies, delivery, etc. Mileage outside of the Indianapolis metro area will be billed at $0.545/mile. All extraordinary travel
expenses must receive the Client's approval. InvigorateHR shall provide to the Client substantiation of reimbursable costs incurred if requested in
advance.
Invoicing. InvigorateHR will submit invoices monthly for payment by the Client. Payment is due upon receipt net thirty (30) days. If the invoice
is not paid in full within thirty (30) days there will be a 1.5% late fee for each month past due (18.0% annualized). The Client shall pay any
attorney fees, court costs, or other costs incurred in collection of delinquent accounts. If payment of invoices is not current, InvigorateHR may
suspend performing further work.
Confidentiality. All Client information will be kept strictly confidential except when directed by the Client to discuss a specific issue with the
Client's counsel or another entity or as otherwise required by law.
Marketina. The Client agrees to allow the use of the Client's name on InvigorateHR listings, brochures, and reference lists.
Relationship of the Parties. In connection with this Agreement, each party is an independent contractor and as such will not have any
authority to bind or commit the other. Nothing herein shall be deemed or construed to create a joint venture, partnership, fiduciary, or
agency relationship between the parties for any purpose.
Warranties and Disclaimers. InvigorateHR warrants that its services will be performed in a good and workmanlike manner. THE PRECEDING IS
INVIGORATEHR'S ONLY WARRANTY CONCERNING THE SERVICES, ANY DELIVERABLE, AND ANY WORK PRODUCT AND IS MADE EXPRESSLY IN
LIEU OF ALL OTHER WARRANTIES AND REPRESENTATIONS, EXPRESS OR IMPLIED, INCLUDING ANY IMPLIED WARRANTIES OF FITNESS FOR A
PARTICULAR PURPOSE, MERCHANTABILITY, OR OTHERWISE. INVIGORATEHR WILL NOT BE RESPONSIBLE OR LIABLE FOR INDIRECT,
CONSEQUENTIAL, OR PUNITIVE DAMAGES OF ANY KIND, however arising, including but not limited to those for use of any products or services,
loss of time, inconvenience, lost profit, labor charges, or other incidental or consequential damages with respect to persons, business, or
property, whether as a result of breach of warranty, negligence, or otherwise. In no event shall InvigorateHR's liability hereunder exceed an
amount equal to the total fees paid by the Client under this Agreement.
Term. This proposal, with associated fee estimates, will expire if not agreed to within thirty (30) days. This Agreement will be effective upon the
date of your signature of approval and will end upon the completion of services as outlined. Either party shall have the right, however, to
terminate this Agreement, with or without cause, by giving thirty (30) days' written notice to the other party. If the Agreement is terminated
prior to completion of services, only fees for services completed, and administrative and reimbursable expenses incurred, will be due upon
the termination date.
Complete Agreement. This Agreement, and accompanying proposal, sets forth the entire understanding between the parties and
supersedes all prior agreements, arrangements, and communications, whether oral or written, with respect to the subject matter hereof.
If the above outlined services and fees are agreeable to you, please sign below and return a copy of the signed Agreement for Services
with the proposal to me. Please call me at 317.313.5980 if you have any questions. I look forward to working with you on this exciting project.
Client Representative
Date
InvigorateHR Representative Date
Exhibit
-A-
3 6c-�)
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
$500,000
$500,000
Policy Limit: $500,000
Each Occurrence Limit: $250,000
Fire Damage (any one fire): $250,000
Medical Expense Limit (any one person): $ 50,000
Comprehensive Auto Liability (owned, hired and non -owned)
Bodily Single Limit:
Injury and property damage:
Policy Limit:
Umbrella Excess Liability
Each occurrence and aggregate:
Maximum deductible:
$500,000 each accident
$500,000 each accident
$500,000
$500,000
$ 10,000
- Ve r w1w Fy
Company ID Number: 1350990
Approved by:
Employer
InvigorateHR
Name (Please Type or Print)
Title
Jeremy York
Signature
Date
Electronically Signed
10/16/2018
Department of Homeland Security— Verification Division
Name (Please Type or Print)
Title
USCIS Verification Division
Signature
Date
Electronically Signed
10/16/2018
Page 13 of 17 E -Verify MOU for Employers I Revision Date 06/01/13
U
Company ID Number: 1350990
Information Required for the E -Verify Program
Information relating to your Company:
Company Name
InvigorateHR
Company Facility Address
2434 N Delaware St
Indianapolis, IN 46205
Company Alternate Address
County or Parish
MARION
Employer Identification Number
463819395
North American Industry
Classification Systems Code
541
Parent Company
Number of Employees
1 to 4
Number of Sites Verified for
1
Page 14 of 17 E -Verify MOU for Employers I Revlslon Date 06101/13
Veri Fy
rp.....�
Company ID Number: 1350990
Are you verifying for more than 1 site? If yes, please provide the number of sites verified for in
each State:
INDIANA 1 site(s)
Page 15 of 17 E -Verify MOU for Employers i Revision Date 06/01/13
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Company ID Number: 1350990
Information relating to the Program Administrator(s) for your Company on policy questions or
operational problems:
Name Jeremy York
Phone Number (317) 313 - 5986
Fax Number
Email Address jeremy@invigoratehr.com
Page 16 of 17 E -Verify MOU for Employers I Revision Date 06/01/13
EXHIBIT D
AFFIDAVIT
VbhA Iltn(liz- , being first duly sworn, deposes and says that
he/she is fan iliar 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. le -now and at all th s relevant herein have been employed by
"vl VA - (the "Employer")
in the position ofG��
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 l day of AldkK , 20-19
1-Y.
I certify under the penalties for perjury under the laws of the United States of America and the State of
Luciana that the foregoing factual statements and representations are true and correct.
INDIANA RETAIL TAX EXEMPT
City
®� Carmel
CERTIFICATEN0.0031201550020
FEDERAL EXCISE TAX EXEMPT
ONE CIVIC SQUARE 35-6000972
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
Page 1 of 1
PURCHASE ORDER NUMBER
- -- --- 101985 --- THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
10/5/2018 371963
INVIGORATEHR, LLC Human Resources
VENDOR 2434 N. DELAWARE STREET SHIP 1 Civic Square
TO Carmel, IN 46032 -
INDIANAPOLIS, IN 46205 -
PURCHASE ID BLANKET I CONTRACT
29881 —
QUANTITY UNIT OF MEASURE
Department: 1201 Fund: 101 General Fund
Account: 43-570.01
PAYMENT TERMS
DESCRIPTION
1 Each Workplace Conduct Training
G�OFCgA
Send Invoice To:
Human Resources
FREIGHT
UNIT PRICE I EXTENSION
$10,500.00 $10,500.00
Sub Total $10,500.00
1 Civic Square
Carmel, IN 46032 -
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $10,500.00
SHIPPING INSTRUCTIONS A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
*SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLI GATED BALANCE IN
•C.O.D. SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEARALL SHIPPING L194
*THIS ORDER ISSUED IN COMPLIANCE WITH 194
CHAPTER 99, ACTS
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY --
Barbara Lamb James Crider
TITLE Director Administration
CONTROL NO. 101985 CLERK -TREASURER