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HomeMy WebLinkAboutProfessional Services Agreement - Request for Qualifications Agreement for Print Shop Services Awarded - Kill-N-Em, Inc. dba Carothers PrintingYi f 1316 CoUNTY-CITY BUILDING �rf PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD I A I' %� FAX 574/ 235-9171 SOIJTH BEND. INDIANA 46601-1 830 sir a � CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS November 12, 2019 Lynda R. Dixon-Podemski Kill-N-Em, Inc. d/b/a Carothers Printing Company 2118 South Franklin St. South Bend, IN 46613 RE: Professional Services Agreement Dear Ms. Dixon-Podemski: The Board of Public Works, at its meeting held on November 12, 2019, approved the above referenced agreement for 2020/21 Print Shop Services in unit prices. Enclosed please find a copy of the agreement for your records. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, w Linda M. Martin, Clerk Enclosure GARY A. GILOT GENEVIEVE E. MILLER ELIZABETH A. MARADIK LAURA L. O'SULLIVAN THERESE J. DORAU AGREEMENT FOR PROFESSIONAL SERVICES This Agreement For Professional Services (this "Agreement") is entered into on , 2019 (the "Effective Date"), by and between the City of South Bend, acting by and through its Board of Public Works (the "City"), and Kill-N-Em, Inc. d.b.a. Carothers Printing Company, an Indiana corporation (the "Company") (each a "Party" and collectively the "Parties"). For and in consideration of the mutual covenants and promises contained herein, the Parties agree as follows: 1 Services. The Company will provide to the City the professional services (the "Services") set forth in the statement of work attached hereto as Exhibit A, (the "SOW"), which SOW is incorporated herein. In the event of any conflict between the terms of this Agreement and the terms of the SOW, the terms of this Agreement will prevail. The Company will execute its duties and obligations under this Agreement in accordance with the prevailing professional standard of care for projects of similar design and complexity. 2. Comr)ensation. In exchange for the Company's satisfactory performance of the Services, and subject to the terms and conditions of this Agreement, the City will pay the Company the fees stated in the pricing schedule attached hereto as Exhibit B (the "Pricing Schedule") pursuant to the City's use of specific Services. Company must submit City a detailed invoice which sets forth the amount of materials used, the type of material used and the cost for each material used. The City will pay the invoice within forty-five (45) days of invoice receipt unless discrepancies exist on the invoice. 3. "I"ern; Termination. This Agreement shall be effective starting January 1, 2020 and remain in effect until December 31, 2021. This Agreement shall be renewable pursuant to mutual agreement amongst the parties hereto, as evidenced in writing, for no more than two (2) renewals not to exceed two (2) years per renewal. in accordance with its terms, this Agreement will end upon the Company's satisfaction of all her obligations hereunder and the City's final payment therefor. Notwithstanding the foregoing, effective immediately upon delivery of a written termination notice to the Company, the City may terminate this Agreement, in whole or in part, for any reason, if the City determines that such termination is in the best interest of the City upon thirty (30) day written notice. In addition, in accordance with Ind. Code 6-1.1-18, payments are subject to appropriation by the City. If the City makes a written determination that funds are not appropriated or are otherwise unavailable to support the continuation of this Agreement, it shall be cancelled. A determination by the City that funds are not appropriated or are otherwise unavailable to support the continuation of performance shall be final and conclusive. In the event of early termination, the City will compensate the Company for work satisfactorily performed prior to the City's delivery of a termination notice. 4. Remedies for Breach of Contract. Failure to complete the Services in accordance with this Agreement will be considered a material breach. In the event of such breach, the City may suspend all payments to the Company and may pursue any and all remedies available at law or in equity. 1 5. Point of Contact. The City employee identified in Section 10 below will serve as the City's principal point of contact for purposes of this Agreement. 6. Relatiotiship. The Company shall at all times be an independent contractor for the performance of the Services rather than an employee of the City, and no act or omission to act by the Company shall in any way bind or obligate the City. This Agreement is strictly for the benefit of the Parties and not for any third party or person. This Agreement was mutually negotiated and prepared by the Parties at arm's length such that neither Party will be deemed to be the drafter of this Agreement for purposes of applying any presumption against one of the Parties concerning the construction of this Agreement's terms, and each of the Parties hereto has reviewed and approved the form of this Agreement after the opportunity to consult with independent legal counsel. The City and the Company hereby renounce the existence of any form of agency relationship, joint venture, or partnership between the Company and the City and agree that nothing contained herein or in any document executed in connection herewith shall be construed as creating any such relationship between the City and the Company. 7. lndeninification of Ci . The Company hereby agrees to defend, indemnify, and hold harmless the City, its officials, employees, and agents from any and all claims of any nature which arise from the performance by the Company under this Agreement and from all costs and attorney fees in connection therewith, except for claims arising out of the negligence of the City, its officials, directors, employees, and agents. The obligations of the Company under this section shall survive the termination of this Agreement. 8. Work Product: wnc_ �rsliip. The Services performed by the Company shall be considered property of the City. The Company shall request permission from the City prior to using any City requested document for marketing purposes, such permission shall not be unreasonably denied. 9. A„ signnient. The Company shall not assign or subcontract the whole or any part of this Agreement or her obligations hereunder without the prior written consent of the City. The Company must notify the City and receive verbal approval from an authorized City representative prior to subcontracting any work. 10. Notices. Any notice required or permitted to be delivered hereunder shall be deemed to be delivered, whether or not actually received, when deposited in the United States Postal Service, postage prepaid, registered or certified mail, return receipt requested, addressed to the City or the Company, as the case may be, at the address set forth below. Company: City: Carothers Printing Company City of South Bend 2118 South Franklin Street 227 W. Jefferson Boulevard, Suite 1200 N. South Bend, IN 46613 South Bend, IN 46601 Attn: Lynda Podemski Attn: Controller's Office 11. E Ual 0 �vortuJ1ily.; Non -Discrimination; (otl1f1i,tnce. The Company shall comply with all applicable laws and regulations concerning hiring and employment practices and policies 2 for any activity covered by this Agreement. The Company shall comply with all state, federal, and municipal laws, regulations, and standards applicable to her activities pursuant to this Agreement including, but not limited to, the requirements imposed by Ind. Code 22-9-1-10 (non- discrimination), the provisions of Ind. Code 5-22-16.5 (disqualification for dealings with the government of Iran), and the provisions of Ind. Code 22-5-1.7 (requiring E-Verify for new employees and prohibiting employment of unauthorized aliens). Each of the foregoing provisions is incorporated herein as if set forth in full, and the Company certifies that she is in compliance with each such provision and shall remain in compliance through the term of this Agreement. 12. Contractor's Affidavit. The Company agrees, as a condition precedent to the effectiveness of this Agreement, that she will execute and submit to the City and any other appropriate bodies an affidavit in the form attached hereto as Exhibit C. 13. I?1 ggJ,ree WgTk 1Lacp. The Company hereby agrees to make a good faith effort to provide and maintain a drug -free workplace. The Company will give written notice to the City within ten (10) days after receiving actual notice that the Company or an employee of the Company within the State of Indiana has been convicted of a criminal drug violation occurring in the workplace. 14. Entire A Bement-, Amendment; App icabl Law. This Agreement sets forth the entire agreement and understanding between the Parties as to the subject matter hereof, and merges and supersedes all prior discussions, agreements, and understandings of any and every nature between them. This Agreement may be amended only by separate writing, signed by the Company and an authorized representative of the City. This Agreement will be construed and interpreted according to the laws of the State of Indiana, and any dispute arising out of this Agreement or otherwise concerning the Company's rendering of the Services will be resolved in the courts located in St. Joseph County, Indiana, unless the Parties mutually agree to a different method of dispute resolution. 15. Severabilit. All provisions of this Agreement shall be considered as separate terms and conditions, and in the event any one shall be held illegal, invalid, or unenforceable, all the other provisions hereof shall remain in full force and effect as if the illegal, invalid, or unenforceable provision were not a part hereof, unless the provision held illegal, invalid, or unenforceable is a material provision of this Agreement, in which case the Company and the City agree to amend this Agreement with replacement provisions containing mutually acceptable terms and conditions. 16. Force Mag=ur . The Company shall not be responsible for any failure or delay in the performance of any obligation hereunder, if such failure or delay is due to a cause beyond the Company's reasonable control, including, but not limited to acts of God, flood, fire, volcano, war, third -party suppliers, or labor disputes. [Signature page follows.] 3 IN WITNESS WHEREOF, the Parties hereto have caused this Agreement For Professional Services to be effective as of the Effective Date stated above. CITY OF SOUTH BEND BOARD OF PUBLIC WORKS ..... _.. ............... ark Gilot, resident Therese Dorau, Member Elizabeth Maradik, Member�� Cie e�eve lallea, b A a. O'Sullivan, Member ATTEST: L ! tla Martin, Clerk Date: //f <a /�}c� / 9 i -la `a°ot ., .s I) Company ,e. _. . Date: �- �� EXHIBIT A Services In accordance with the terms of this Agreement, the Company will serve as the City's primary print shop service provider. Company shall be capable of performing a wide variety of print shop services, including, but not limited to, full color digital, offset and custom ink production, full -service letter press, black and white copying, lead type, thermograph printing and bindery services. The City must approve a "draft" product prior to the authorization of final work product. The City will not be financially responsible for any work product that needs to be redone if the City did provide its prior approval. Company shall have a turnaround time between 3-5 business days upon receipt of an order from the City. Should the Company not be able to meet this timetable, it must immediately notify the City and present an alternative and await approval from the City. For certain items and upon request, Company shall provide storage for City documents such as envelopes and departmental letterhead. There shall be no additional costs for this storage service. When needed, the City will provide the appropriate watermark paper style to the Company at the City's sole expense. Company shall use 57198U Medium Blue Riso EZ Duplicator standard letterhead on the appropriate projects. The below is a non -exhaustive list of City owned buildings where deliveries pursuant to this Services bargained for under this Agreement may occur. The City reserves the right to add or subtract locations from time to time and that no additional delivery fees may be charged as long as the location is owned by the City. List of City Buildings and Corresponding Addresses Location Name Address Central Services 1045 West Sample Street, South Bend, 46619 VPA - Experience Lodge Century Center 301 South St. Louis Blvd., South Bend, 46617 120 Martin Luther King Jr. Blvd., South Bend, 46601 Human Rights Commission 319 North Niles Avenue, South Bend, 46617 Water Works - Colfax 125 West Colfax Avenue, South Bend, 46601 Palais Royale 105 West Colfax Avenue, South Bend, 46601 Morris Performing Arts Center 211 North Michigan Street, South Bend, 46601 Water Works - Main Street 209 North Main Street, Suite 207, South Bend, 46626 Water Works - North Station Organic Resources 830 North Michigan Street, South Bend, 46617 4340 Trade Drive, South Bend, 46628 Elbel Golf Course Studebaker Golf Course 26595 Auten Road, South Bend, 46628 718 East Calvert, South Bend, 46613 Erskine Golf Course 4200 Miami Street, South Bend, 46614 Martin Luther King Center Solid Waste 1522 Linden Avenue, South Bend, 46628 3113 Riverside Drive, South Bend, 46628 Animal Control Center 521 Eclipse Place, South Bend, 46628 Charles Black Center 3419 West Washington Street, South Bend, 46619 Water Works - Olive Street 915 S. Olive Street, South Bend, 46619 Rum Village Nature Center 2626 South Gertrude Street, South Bend, 46614 VPA - Park Maintenance Facility 1020 High Street, South Bend, 46601 Building Department 125 South Lafayette Blvd. Suite 100, South Bend, 46601 VPA - O'Brien Recreation Center 321 East Walter Street, South Bend, 46614 Fire Department 1222 South Michigan, South Bend, 46601 Police Department 701 West Sample Street, South Bend, 46601 Street Department 731 South Lafayette Blvd., South Bend, 46601 Safety & Risk Department 731 South Lafayette Blvd., South Bend, 46601 City Clerk's Office 227 West Jefferson Blvd. 4th Floor, South Bend, 46601 Controller's Office 227 West Jefferson Blvd. 12th Floor N, South Bend, 46601 City Engineer Office 227 West Jefferson Blvd. 13th Floor N, South Bend, 46601 Department of Community Investment 227 West Jefferson Blvd. 14th Floor S, South Bend, 46601 Legal Department 227 West Jefferson Blvd. 12th Floor S, South Bend, 46601 Code Enforcement 227 West Jefferson Blvd. 13th Floor S, South Bend, 46601 Neat Group 227 West Jefferson Blvd. 13th Floor S, South Bend, 46601 Radio Shop 1045 West Sample Street, South Bend, 46619 311 Call Center 125 S. Lafayette Street, South Bend, 46601 IT Department 227 West Jefferson Blvd. 12th Floor N, South Bend, 46601 Mayor's Office 227 West Jefferson Blvd. 14th Floor N, South Bend, 46601 Diversity and Inclusion Office 228 West Jefferson Blvd. 14th Floor N, South Bend, 46601 Traffic and Lighting 731 South Lafayette Blvd., South Bend, 46601 Sewer Department 731 South Lafayette Blvd., South Bend, 46601 Waste Water 3113 Riverside Drive, South Bend, 46628 Office of Sustainability 227 West Jefferson Blvd. 13th Floor N, South Bend, 46601 EXHTRiT R Pricing Schedule ***The costs below include production/setup fees, materials and shipping/delivery to City buildings. Pricing shall be applicable for the duration of this Agreement.*** -.----- --------------- __--_- ............._ . 4 Part 5 Part Quantity 2 Part Form 3 Part Form Form Form 100 $45.00 $63.00 $80 50 $105.00 200 _............. ...�...�.�.................. �_.._...................w.www�............ �........._............... $86.00 $85.00 $112.00 $188.00 250.._ _�_�._........www ...... $151.00 $222.50 500 _....._ _......_------ ........ $.�.�_ ..........w......................................�muwn�_�� 103.00 .. $129.50 $170.00...�� .............$.........0.__....... 360.00 750 $129.75 $169.50 $219.75 N/A 1000 .� ........... _........ _............. _........._w 1.00 $204.00 $263.00 N/A 1500 $205.50 $281.00 _._.._.... $379.50 ....... . _.. . N/A 2000 $254.00 $352.00 $476.00 N/A Quantity #10 Regular Envelope & 6.. . .... . . . . .... . . . . ................................................. ...... . .75 . . .......................... -- #10 Window & 6.75 #7wCoin Envelopes 500 _ m._..._......_.._......._...�._ $58.00 .............................w $69.50 $320.00 1000 ........................... $70.00 $83.00 �._.._$60....._......._ 0.00 2500 $137.50 .._....._._..................................._................................a ... $170.00 .............._. ............... $990.00 5000 $260.00 $325.00 �....�_.........�.�_.�.�_.. N/A 7500 $382.50 $480.00 ....................w_ N/A Quantity 8.5X11 90# Index 1 Sided 8.5X11 90# Index 2 Sided .._._......................._.........................________ -._.-- 250 $45.00 $62.50 500 ........._._ $70.00 $105.00 ..................._................_......_...........-- 1000 ��..._._.._. �_ $100.00 .................. ... ....... .................... ..� -....w.� $170.00 2500 $200.00 $300.00 00 Quantity 8.5X11 110# Index I Sided ��� ....,....... _............ _........w.....�........... 8.5X1190#Index 2 Sided 250 $50.00 $67....0 500._ .. ..........1000 .......................................... ._.._._.... $80.00 mm.m.m... $115.00 $120.00 ............................................ A.m............$190.00 I _......_..... 2500 ......._����..��..5000 $250.00 $350.00 $450.00 ......�.....$.6m50.00.. u._ _.�.__ �..........� .......... Quantity— Color CoBusiness Cards _........................................._.�_ ......... 250 _ $42.00 500 $ 50.00 1000 $68.25 *** Quantity Does not Matter for Copies, price is per copy basis Type 20# White Paper/Black Ink 20# Color Paper/Black Ink.:.....:.. ..... ......... .....:.:.......:: ........... 1 Sided $0 060 $0.075 2 Sided $0.075 $0.090 Quantity Watermark Stock � �� � �..................: 500 $80.00 1000„�..................._............:.::.::.::.:.:.:��.:.:����.:.:�.:.:.:.:......�:.:.:.:.�$105.00.. ..:.....���� ......_.._.._, w 2500 $195.00 Quantity Door Hangers 0 $90.000 1000 ��:........:...:500:..:::.:..:.:.:.:....:.:_ $165.000 .................��.............������.:.�$.337.500 -Banners 10X4 __......._........................:.:.:.:.:.:.:...:.:_:.:...:.:.:.:.:.:.:.:.:.:_:.:.:.:.$8.�..�...._.::� Time Increment Hourly Rate for Special Projects/Design Work 15 Minutes $15.00 �.��_.���.��._..:.:.:.:.:.:_....�:.:_._...�:.:.:.:.:.:.:.:..........._$30.00 30 Minutes ....... . ........................ w..�W..�w 45WMinutes $45.00 60 Minutes $60.00 70# White Husky/Black Ink $0.080 EXHIBIT C Contractor's Affidavit When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF SS: ..._ .................................. COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 1 Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5, Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6.. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated l .s . _ day of I D , 20 o :ractor/l: idder (Firm) 1- ... C Sigtiaturc of Contractor/Bidder or l Agent Printed Name and Title Subscribed and sworn to before me this g_ day of Ut4tbr 201�' M Commission Expires Y p Notary, "U' lic OEM nCounty of Residence � J� :SEA BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name 10/29/19 Michael Schmidt Department gtywidemm mmmmmmmm BPW Date November 12, 2019 Phone Extension 574-235-9977 aartmun:�rwurnwauwirarrrr�mr,�mnr u��,��.ezn. �:�,eau+�.m�iuwa��wrar��saumm,awrwnmreibmuN�mr.rrw �..���N... .... _.. u. mtr�ra;�m.�rn+e��m� ,.,,�. esrtr^emw�u^s �. Submittal to Boa m.� Ro uired Prior t Board Legal Attorney Name Clara McDaniels Controller review is required for all Contracts $5,000.00 or more Controller ® and greater than one year in length per the City Purchasing Policy Purchasing ® Michael Schmidt ��..(�.... �wwwww Check the Appriiate Item Type a/rod' for All Submissions Agreement ® Contract A--, Asvu �.� Proposa.I.......... Addendum...m �I Professional Services ❑ Amendment E] Bid Opening El Bid Award ` Req. to Advertise ❑ Title Sheet ❑ Quote Opening F-1 Quote Award Chg Order No. ❑ C/O & PCA No. PCA Ease./Encroach. ❑ Traffic Control Resolution �j Other: Claim .................� ...._ ...... Recuired Inform.....�...ww..��_�. ation Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Kill-N-Em, Inc. dba Carothers Printing Comp ❑' Yes If Yes, Approved by Purchasing ❑ No ❑ MBE Completed E-Verify Form Attached El Yes ❑ WBE ❑ No Print ShopServiceVendor All City Departments See attached Execute Contract stemming from RFQ or Amount of ❑ Increase $ �❑ Decrease $ Previous Amount Current Percent of Change New Amount Total Percent of Change: Time Extension: Dispersal After Approval Copy Original Michael midt, Matt Chlebowsk, Ben Dougherty ® ❑ . Dan Parkeh..........................