MC Equipment, LLC/Street, Utilities/354,008/Freightliner 108SD Tandem With Plow MC Equipment,LLC
Street,Utilities Department-2019
Appropriation#44-650.01,02-2308-00 Fund;P.O.#103034,W10056
Contract Not To Exceed$354,008.00s .JAQ
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 MC Equipment, LLC an entity duly authorized to do business in the State of Indiana ("Vendor").
TERMS AND CONDITIONS
1. ACKNOWLEDGMENT, ACCEPTANCE:
Vendor acknowledges that it has read and understands this Agreement, and agrees that its execution of
same constitutes its acceptance of all of the Agreement's terms and conditions.
2. PERFORMANCE:
City agrees to purchase the goods and/or services (the "Goods and Services") from Vendor using City
budget appropriation number 44-650.01, 02-2308-00 funds. City is purchasing the Goods and Services
pursuant to the terms of State of Indiana OPA # 17667. 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 Three Hundred Fifty Four Thousand Eight Dollars ($354,008.00) (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.
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1
MC Equipment,LLC
Street,Utilities Department-2019
Appropriation#44-650.01,02-2308-00 Fund;P.O.#103034,W I0056
Contract Not To Exceed$354,008.00
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.
IS:'CQaavWofSvcs&Good,Svcs\Suen 20I912dC Equp000i LLC Goods led Sevi uAoc:I N7R01912 02 PM)
2
MC Equipment,LLC
Street,Utilities Department-2019
Appropriation#44-650.01,02-2308-00 Fund;P.O.#103034,W10056
Contract Not To Exceed$354,008.00
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
�S:'Cr,a.1,Pr.J Sro&God,Svcs\Strenu019\MC Eympmem LLC ands and Serwss.hs:10/i/2019 12:02 PM)
3
MC Equipment,LLC
Street,Utilities Department- 2019
Appropriation#44-650.01,02-2308-00 Fund;P.O.#103034,W 10056
Contract Not To Exceed$354,008.00
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 AND Douglas C. Haney,
Street Department Corporation Counsel
3400 W 131st Street Department of Law
Carmel, Indiana 46074 One Civic Square
Carmel, Indiana 46032
If to Vendor: MC Equipment, LLC
117 S Williams Drive
Columbia City, Indiana 46725
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.
�S:`Cmtr s`P,o Srsz&Goads Svcs�Svnh'019\MC F.gitipouot LLC Goods sod Sasx .doc:INf/:019 12:02 PSI]
4
MC Equipment,LLC
Street, Utilities Department-2019
Appropriation#44-650.01,02-2308-00 Fund;P.O.#103034,W10056
Contract Not To Exceed$354,008.00
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, 2019 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. DEBARMENT AND SUSPENSION
26.1 The Vendor certifies by entering into this Agreement that neither it nor its principals nor any of its
subcontractors are presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily
excluded from entering into this Agreement by any federal agency or by any department, agency or political
subdivision of the State of Indiana. The term "principal" for purposes of this Agreement means an officer,
director, owner, partner, key employee or other person with primary management or supervisory
responsibilities, or a person who has a critical influence on or substantive control over the operations of the
Vendor.
26.2 The Vendor certifies that it has verified the state and federal suspension and debarment status for all
subcontractors receiving funds under this Agreement and shall be solely responsible for any recoupment,
penalties or costs that might arise from use of a suspended or debarred subcontractor. The Vendor shall
immediately notify the City if any subcontractor becomes debarred or suspended, and shall, at the City's
request, take all steps required by the City to terminate its contractual relationship with the subcontractor for
work to be performed under this Agreement.
(5:`Comm-Who(Svu&Goods Sv s\Svert120191.,IC Equvmem LI.0 Gads and Savxes.do:10/712019 12:02 PM]
5
MC Equipment,LLC
Street,Utilities Department-2019
Appropriation#44-650.01,02-2308-00 Fund;P.O.#103034,W 10056
Contract Not To Exceed$354,008.00
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.
IN WITNESS WHEREOF,the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL, INDIANA MC Equipment, LLC
by and through its Board of Public
Works and Safety
By: By:
James Brainard, Presiding Officer Autho zed Signature
Date:
Ly11da '41// ,%�h
Printed Name
M ry A Burke, M b r
Date: jVl covi al P 94A-lothr
Title
Lori S. Watso �fe ber FID/TIN: 3 6-- 2 ,0 7 41 3 4
Date: I i/ o f/i
Last Four of SSN if Sole Proprietor:
ATT
Date: 29 9a 19
• 'ne S. Paule , Clerk re s 7r
Date: ///gd /7 1S^Cansn.l]Wlaf.Svcs&Guds Ss.\Sued‘2019\NC Equipment LLC Cads mod Serm.dcr 10/7r2019 12.02 PM1
6
•
W.A. J es Columbia City,IN
TRUCK EQUIPMENT www_wajonestruckequipment.com
Greg Hollander July 23,2019
City of Cannel Water Department
3450 W. 131st Street
Cannel,IN 46074
Greg,
Following is the quote for a tandem dump truck as per the INDOT bid with the
revisions you requested.
One(1)new Freightliner 108SD tandem axle chassis with standard spring rear
suspension and chain conveyor dump body per INDOT bid#800-16-110 QPA Year#4
contract cost of$154,421.00.
Revisions/Additions/Deletions:
Chassis to be painted red ILO yellow
Revise front suspension to be 9,500 lb driver side and 10,500 lb passenger side
Delete chipper hitch
Delete trailer brake system
Revise pintle hitch plate to be receiver style
Delete 50 ton pintle hitch
Relocate body access ladder to driver side ILO curb side
Delete liquid pre-wet tank assembly and pump
Add Aero electric tarp assembly with asphalt tarp
Delete Muncie Power central hydraulic system
Add Certified Power central hydraulic system
Delete truck half snow plow hitch
Delete rear spinner assembly
Original INDOT contract price Base Bid Tandem Axle Dump Truck $154,421.00
Revisions/Additions/Deletions listed above,deduct ($2,121.00)
Upgrade rear suspension to HaulMaxx,add $ 3,167.00
Option# 10—Addition of rear view camera and spreader light,add $ 2,147.00
Total package cost FOB Carmel,IN $157,614.00
Thank you for the opportunity to quote this equipment for your needs. Please feel free to
contact me at 317-371-8802 if you have any questions or need further information.
Sin - ely,
yp on/ i�a 1 an
Municipal Specialist
Exhibit o r
( �
1171 S.WILLIAMS DRIVE I COLUMBIA C11v, IN 46725 .PHONE: 260 244-7 661 j FAX 266U-244-7662
W.A. n Columbia City,J o es IN
TRUCK EQUIPMENT www.wajonestruckequipment.com
Dave Huffman July 23, 2019
City of Carmel Street Department
3400 W. 131st Street
Cannel,IN 46074
Dave,
Following is the quote for the 12 foot snow plow for the tandem dump truck with
side wing plow as per your request.
One(1)new Monroe MP41R12-ISCT Straight Blade Snow Plow complete with 12
foot moldboard with integral shield; 34"Husting plow half hitch;two cylinder(3")power
reverse cylinders with cushion valve;dual compression trip springs;rubber snow deflector;
moldboard painted orange; frame and hitch painted black; corner markers; hydraulic hoses
with quick disconnects from plow to front of truck;and all other standard equipment. Does
not include any wheels.
Total cost, add $8,382.00
Thank you for the opportunity to quote this equipment for your needs. Please feel free to
contact me at 317-371-8802 if you have any questions or need further information.
Sine ley,-�
L n ri Callahan
Municipal Specialist
Exhibit
1'i71 S_ NIL-IAMS DRIVE COLUMBIA CI-hf, IN 46725 PHONE: 260-244-7661 FAX 260-244-7662
V1.A■ Columbia City, IN
TRUCK EQUIPMENT www.wajonestruckequipment,com
Dave Huffman July 23, 2019
City of Carmel Street Department
3400 W. 131 st Street
Cannel, IN 46074
Dave,
Following is the quote for a tandem dump truck as per the INDOT bid with the
revisions you requested.
One(1)new Freightliner 108SD tandem axle chassis with HaulMaxx rear
suspension and dual auger dump body per INDOT bid# 800-16-110 QPA Year#4
contract cost of$162,226.00.
Revisions/Additions/Deletions:
Chassis to be painted red ILO yellow
Revise front suspension to be 9,500 lb driver side and 10,500 lb passenger side
Delete chipper hitch
Delete trailer brake system
Revise pintle hitch plate to be receiver style
Delete 50 ton pintle hitch
Relocate body access ladder to driver side ILO curb side
Delete liquid pre-wet tank assembly and pump
Delete QCP truck half plow hitch
Add 34"Husting truck half plow hitch
Add Aero electric tarp assembly with asphalt tarp
Delete Muncie Power central hydraulic system
Add Certified Power central hydraulic system
Delete rotate under spinner assembly
Add single receiver spinner assembly
Original INDOT contract price Option#2 Tandem Dual Auger Dump $162,226.00
Revisions/Additions/Deletions listed above,add $ 0.00
Option#8—Nine Foot Mid-Mount Patrol Wing Plow,add $ 12,202.00
Option# 10—Addition of rear view camera and spreader light,add $ 2,147.00
Rear view camera wash system and second spreader light,add $ 1,122.00
Total package cost FOB Carmel,1N $177,697.00
Thank you for the opportunity to quote this equipment for your needs. Please feel free to
contact me at 317-371-8802 if you have any questions or need further information.
Sine ly
on allahan
Municipal Specialist '�.xhibit
3(5(5
1171 S.WILLIA MS DRIVE I CGWPMBIA CI•TY .IN 46725 PtIONE.260-244-7661 ; AX:260-244 662
W.A.
■!-1■ � ��� Columbia
bia City,IN
TRUCK EQUIPMENT www.wajonestruckequipment.com
Dave Huffman July 23, 2019
City of Carmel Street Department
3400 W. 131 st Street
Carmel, IN 46074
Dave,
Following is the quote for the optional items for the Water Department tandem
dump truck as per your request.
Option# 1:
One(1)new Monroe MP41R11-ISCT Straight BIade Snow Plow complete with 11
foot moldboard with integral shield; 34"Husting plow half hitch; two cylinder(3")power
reverse cylinders with cushion valve; dual compression trip springs;rubber snow deflector;
moldboard painted orange;frame and hitch painted black;corner markers; hydraulic hoses
with quick disconnects from plow to front of truck;and all other standard equipment. Does
not include any wheels.
Total cost,add $8,194.00
Option#2:
34"Husting truck half hitch and rear spinner assembly,add $2,121.00
Thank you for the opportunity to quote this equipment for your needs. Please feel free to
contact me at 317-371-8802 if you have any questions or need further information.
Sin ely,
‘10.Lit4i4o an 1 `-
Municipal Specialist
Exhibit A
1171 S.WILLIAMS DRIVE f COLUMBIA CITY; IN 4.6725 PHONE 260-244-7661 I FAX.260-244-7562
W.A. J O n Columbia City,ty. IN
TRUCK EQUIPMENT www.wajonestruckequipment.com
Greg Hollander July 23,2019
City of Cannel Water Department
3450 W. 131st Street
Cannel, IN 46074
Greg,
Following is the quote for a tandem dump truck as per the INDOT bid with the
revisions you requested.
One(1)new Freightliner 108SD tandem axle chassis with standard spring rear
suspension and chain conveyor dump body per INDOT bid#800-16-110 QPA Year#4
contract cost of$154,421.00.
Revisions/Additions/Deletions:
Chassis to be painted red ILO yellow
Revise front suspension to be 9,500 lb driver side and 10,500 lb passenger side
Delete chipper hitch
Delete trailer brake system
Revise pintle hitch plate to be receiver style
Delete 50 ton pintle hitch
Relocate body access ladder to driver side ILO curb side
Delete liquid pre-wet tank assembly and pump
Add Aero electric tarp assembly with asphalt tarp
Delete Muncie Power central hydraulic system
Add Certified Power central hydraulic system
Delete truck half snow plow hitch
Delete rear spinner assembly
Original INDOT contract price Base Bid Tandem Axle Dump Truck $154,421.00
Revisions/Additions/Deletions listed above,deduct ($2,121.00)
Upgrade rear suspension to HaulMaxx,add $ 3,167.00
Option# 10—Addition of rear view camera and spreader light, add $ 2,147.00
Rear view camera wash system and second spreader light,add $ 1,122.00
Total package cost FOB Cannel, IN $158,736.00
Thank you for the opportunity to quote this equipment for your needs. Please feel free to
contact me at 317-371-8802 if you have any questions or need further information.
Sin ly,
L*'io' I. an
Municipal Specialist
Exhibit
1171•S.'WILLIAMS DRIVE "I COLUMB:A CITY, IN 46725 P'HIONE: 260-244-7661 I FAX 260-244-7662
EXHIBIT B
Invoice
Date:
Name of Company:
Address &Zip:
Telephone No.:
Fax No.:
Project Name:
Invoice No.
Purchase Order No:
Goods Services
Person Providing Date Goods/Services Provided Cost Per Hourly Total
Goods/Services Goods/ (Describe each good/service Item Rate/
Service separately and in detail) Hours
Provided Worked
GRAND TOTAL
Signature
Printed Name
EXHIBIT C
INSURANCE COVERAGES
Worker's Compensation& Disability Statutory Limits
Employer's Liability:
Bodily Injury by Accident/Disease: $100,000 each employee
Bodily Injury by Accident/Disease: $250,000 each accident
Bodily Injury by Accident/Disease: $500,000 policy limit
Property damage, contractual liability,
products-completed operations:
General Aggregate Limit(other than
Products/Completed Operations): $500,000
Products/Completed Operations: $500,000
Personal & Advertising Injury
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: $500,000 each accident
Injury and property damage: $500,000 each accident
Policy Limit: $500,000
Umbrella Excess Liability
Each occurrence and aggregate: $500,000
Maximum deductible: $ 10,000
EXHIBIT D
AFFIDAVIT
o yd / �U� �� , 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 allow and at all times relevant here}in have been employed by
i 6 4 If- e r� / (the"Employer")
in the position of Cowice./
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 / -Al day of o --72d�' 20
Printed: GL0yb
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:
INDIANA RETAIL TAX EXEMPT Page 1 of 1
IIt)T of CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103034
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
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
7/25/2019 357422 LEASE=0
W A JONES TRUCK BODIES&EQUIPMENT Street Department
VENDOR 1171 S WILLIAMS DR SHIP 3400 W. 131st Street
TO Carmel, IN 46074-
COLUMBIA CITY, IN 46725- (317)733-2001
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
38328
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1206 Fund:0 Capital Lease Fund
Account: 44-650.01
1 Each Freightliner 108SD Tandem w/Plow $196,394.00 $196,394.00
Sub Total $196,394.00
Send Invoice To:
Street Department
3400 W.131st Street
Carmel, IN 46074-
(317)733-2001
_ PLEASE INVOICE IN DUPLICATE
L DEPARTMENT I ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $196,394.00
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 UNOBUGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
`THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /)44.4� _
l/D_/AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY ` `t -
Dave Huffman James Crider
TITLE Director Administration
CONTROL NO. 1 03034 CLERK-TREASURER
City of Carmel INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
ONE CIVIC SQUARE W10056
CARMEL, INDIANA 46032 FEDERAL EXCISE TAX EXEMPT
THIS NUMBER MUST APPEAR ON INVOICES,A/P
35-6000972 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
8/1/2019 357422
w a jones truck equipment Carmel Utilities
VENDOR 1171 S WILLIAMS DR SHIP 30 W Main St
COLUMBIA CITY IN 46725 TO 2nd Floor
Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1. 00 Each TANDEM DUMP TRUCK BID 157, 614 .00 157, 614.00
NUMBER 800-16-110 QPA Yr 4 DEPRN 02-2308-00
PLEASE INVOICE IN DUPLICATE Credit 0 .00
Department Account Project Project Account AMOUNT
PAYMENT 157, 614 .00
SHIPPING INSTRUCTIONS
•A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
•SHIP PREPAID NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED VOUCHER HAS THE PROPER SWORN AFFADAVIT ATTACHED.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL 'I HEREBY CERTIFY THAT THERE IS AN OBLIGATED BALANCE IN
SHIPPING LABELS THIS APPROPRIATION SUFFICIENT TO PAY OR T E ABOVE ORDER.
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE
DOCUMENT CONTROL NO. W1 0056 CLERK-TREASURER