Kelley Chevy, LLC/Police/27,600/2020 Chevrolet Traverse LS AWD Kelley Chevy,LLC
Police Department-2019
Appropriation#44-650.01 Fund;P.O. #102927
Contract Not To Exceed$27,600.00
ADDITIONAL SERVICES AMENDMENT TO '" ''�
AGREEMENT FOR GOODS AND SERVICES Jq0
THIS AMENDMENT TO THE AGREEMENT FOR GOODS AND SERVICES ("Agreement") entered into by
and between the City of Carmel and Kelley Chevy, LLC, (the 'Vendor"), as City Contract dated March 21, 2018 shall
amend the terms of the Agreement by adding the additional services to be provided by Vendor consistent with the
Scope of Work attached hereto and incorporated herein as Exhibit"A". The terms and conditions of the Agreement
shall not otherwise be affected by this Additional Services Amendment and shall remain in full force and effect.
IN WITNESS WHEREOF,the parties hereto have made and executed this Amendment as follows:
CITY OF CARMEL, INDIANA Kelley Chevy, LLC
by and through its Board of Public
Works and Safety
B : By.
CC rddift,
James Brainard, residing Officer Authorize Signature
ate: A l_ •
//I O�Y
Printed Name l/
Mary An Burke, Mem,v
Date: 7 /? f�ec //fl4'li G."
/2a J .ca/es /liohayer,
Title
u.e
Lori S' Wats•,'9Me er FID/TIN: 2 7- 109 g 6 413
Date:
Last Four of SSN if Sole Proprietor:
Date:
Christine Paul , Clerk-Tre, r r
Date: 00
S.C.vanu'ft.( d Good,Sy..'Pd>e Per•:SIYXelley(3esy.lie ASAJ..-72101.IdcPMI
F FORT
o
City of Fort Wayne 2020 ITB#6256064 LI m
v;'D1ANP
Vehicle Description: 2020 Chelet Traverse LS AD rO FACTORY HITCH
Federal Specification Number Standard 307 Item 105Avro W
Intermediate AWL/SIN
Model 1NV56
Standard Package/Equipment Group IAWD LS 1FL
Fort Wayne Required Options
Federal Option Code Wa.Option Code Option Description
TSA 6-speed treremf:ion M3V-9-speed 9-speed eUomaec transmission
ATC-D3-TCS Sm. Automate Tractor Carew
RKE Std. Remote keyless entry
PWL Std. Poser widows-locks-mirrors
TSBCR Std&Std TA Snenng at Cruse Control
BTCS a Call IOR IMatairenem system
DTG AKO Deep-era pass
PwD ARTS AL9 Poser drivels sear/power adjustable ker'bar
SRO U07 Rear back-up suable sensors
no code R9Y Free Merserprco DELETE
RN4 V92.VOa.CTT Racelver Hitch NOT available on tFL
ITotal Cost for Fort Wayne Specified Vehicle \
$27,600.00
Additional Options Available
Description Option Code Additonal Cost
All-Weather floor liners all sealing positions and cargo area PDF S 400 00
Front and rear molded splash guards VOK S 200 00
One FREE maintenance visit,tire rotation 8 vehicle inspection NO-R9Y S 35 00
Available Colors: GSK•Satin Steel Metallic; a:,r,-Silver Ice Metallic; GAZ-Summit White; G68•Mosaic Black Metallic
Shipping Charge Outside of Allen County Cost per mile
51.50 par nib based on Wheat anchors
Dealer Name _ Kelley Chevy.LLC
Contact Names Mark T.Wright
Phone Numbers Direct:260-399-7 �:1.-CG0437- FAX- 260-471-8330
Contact Omaha
Dealer Address Effective June 18,2019 5220 Value Drive
Fort Wayne,IN 46808
/ 1
Exhibit
o INDIANA RETAIL TAX EXEMPT Page 1 of 1
CitY of Ciirinriie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102927
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
6/6/2019 370298
KELLY CHEVROLET Police Department
VENDOR 500 EAST STATE BLVD SHIP 3 Civic Square
TO Carmel, IN 46032-
FORT WAYNE,IN 46805-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
36876
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund:0 Capital Lease Fund
Account: 44-650.01
1 Each 2020 Chevrolet Traverse LS AWD $27,600.00 $27,600.00
Sub Total $27,600.00
,40 0 F CA 841
ck.0
iti
i.
Send Invoice To:
Police Department
3 Civic Square ND
[
Carmel,IN 46032 AO Pi*
-
PLEASE INVOICE IN DUPLICATE I
DEPARTMENT I ACCOUNT PROJECT 1 PROJECT ACCOUNT 1 AMOUNT I
PAYMENT $27,600.00
SHIPPING INSTRUCTIONS *ANP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
`PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 & ic.t.-47 L.�-eM
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jim Barlow James Crider
TITLE Chief Administration
CONTROL NO. 1 02927 CLERK-TREASURER