229973 03/12/14 CITY OF CARMEL, INDIANA VENDOR: 00351000
® ONE CIVIC SQUARE HUNT PAVING COMPANY INC CHECK AMOUNT: $*****6,456.57*
a� CARMEL, INDIANA 46032 2450 S TIBBS AVE CHECK NUMBER: 229973
PO BOX 42517 CHECK DATE: 03/12/14
INDIANAPOLIS IN 46 242-0 51 7
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4462000 2 5,781.46 OTHER STRUCTURE IMPRO
211 R4462300 25265 2 675.11 136ST CULVERY REPLACE
CONSTRUCTION PROJECT INVOICE
DATE: January 2, 2014
COMPANY NAME: The Hunt Paving Company, Inc.
AND ADDRESS 2450 S. Tibbs Ave.
Indianapolis, IN 46206
TELEPHONE NO.: (317)-241-8313
FAX NO.: (317)-331-5941
PROJECT NAME: 136" Street Box Culvert Replacement at Anson
Almond Arm
PROJECT NO.: Project No. 13-02
INVOICE NO.: 2
TOTAL EARNINGS TO DATE: $ 47,701.46
MINUS 10% RETAINAGE: $ 0
TOTAL EARNED MINUS RETAINAGE: $ 47,701.46
MINUS PREVIOUS PAYMENTS: $ 41,244.89
TOTAL AMOUNT DUE: $ 6,456.57
Tiffany Boone <
Construction Inspector
City of Carmel "\\ �
utr
Via,
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF TWO PAGES
TO OWNER.' PROJECT: 913-02 APPLICATION NO: 2 Distribution to:
City of Carmel 136th Street Culvert Replacement at Anson Almond Arm =OWNER r
One Civic Square Carmel,IN =ARCI-tITECT
Carmel,IN 46032 PERIODTO: 6/18/2013 =CONTRACTOR
FROM CONTRACTOR:
The Hunt Paving Company,Inc.
2450 S.Tibbs Ave. PROJECT NOS: 13059
Indianapolis,IN 46206-0128
CONTRACT I'OR: CONTRACT DATE: 5/7/2013
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best ofthe Contractor's knowledge,
Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and
payments received from the Owner,and that current payment shown herein is now due.
ON,V,11111111111
1. ORIGINAL CONTRACT SUM $ 41,920.00 ���e
2. Net change by Change Orders $ rj'1 81,4(0 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line I f 2) $4,yi 1*01-,9210r00—
4. TOTAL COMPLETED&STORED TO $ 47,701.46 9 2
DATE (Column G on G703) By: Dater
5. RETAINAGE: / rn
a. 0 %of Completed Work $ 0 State of: ZILCIIt r / County of:� — e�O /
(Column D+E on G703) Subscribed and worn*bqloehis � day of Z 0.b. 0 %of Stored Material $ 0 Notary Publie,(Column F on G703) My Commission expirt�
Total Retainage(Lines Sa+5b or �. I A IN AN,
Total in Column IofG703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT loom
6. TOTAL EARNED LESS RETAINAGE $ 47,701.46 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated,
PAYMENT(Line 6 from prior Certificate) $ 41,244.89 the quality of the Work is in accordance with the Contract Documents,and the Contractor
8. CURRENT PAYMENT DUE $ 6,456.57 is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCETO FINISH,INCLUDING RELTAINAGE $ 0.00
(Line 3 less Line 6) AMOUNT CERTIFIED.. .......$
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation ifamount certified differs from the amount applied.Initial all figures on this
Total changes approved Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
in previous months by Owner ARCHITECT:
Total approved this Month 51 S 1.410 ttTM-37 By: Date:
TOTALS 5-1 B 1,4LO $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein.Issuance,payment and acceptance of payment are without
NET CHANGES by Change Order 51 01 AtP $-4;$96.5`? prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292
1
-CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2o1'2 ,
AIA Document G702,APPLICATION AND CER'T'IFICATION FOR PAYMENT,containing APPLICATION NO: 2
Contractor's signed certification is attached. APPLICATION DA'Z'E: 8/15/2013
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 6/18/2013
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: #13-02
ITEM DESCRIPTION OF WORK UNIT PLAN UNIT PRICE SCHEDULED QUANTITY COMPLETED AMOUNT COMPLETED
NO. QUANTITY VALUE FROM PREVIOUS THIS PERIOD TOTAL FROM PREVIOUS THIS PERIOD TOTAL AMOUNT
PERIOD QUANTITY PERIOD
1 Mobilization and Demobilization LS 1.00 $4,260.00 $4,260.00 1.00 1.00 4260.00 $0.00 $4,260.00
2 Maintenance of Traffic LS 1.00 $1,580.00 $1,580.00 0.00 1.00 1.00 0.00 $1,580.00 $1,580.00
3 Clearing Right-of-Way LS 1.00 $2,272.00 $2,272.00 1.00 1.00 2272.00 $0.00 $2,272.00
4 8'x3'Box Culvert,Provided per TS42 LS 1.00 $15,340.50 $15,340.50 1.00 1.00 15340.50 $0.00 $15,340.50
5 Street Cut Repair SYS 70.00 $128.10 $8,967.00 66.70 66.70 8544.27 $0.00 $8,544.27
6 Uniform Riprap TON 7.00 $117.00 $819.00 16.67 16.67 1950.39 $0.00 $1,950.39
7 Compacted Aggregate,No.53,Base TON 5.00 $114.65 $573.25 16.08 16.08 1843.57 $0.00 $1,843.57
8 Erosion Control Measures LS 1.00 $3,236.80 $3,236.80 1.00 1.00 3236.80 $0.00 $3,236.80
9 Construction Sign,Type A EA 4.00 $104.20 $416.80 3.00 3.00 312.60 $0.00 $312.60
10 Detour Route Marker Assemblies EA 13.00 $107.75 $1,400.75 15.00 15.00 1616.25 $0.00 $1,616.25
11 Road Closure Sign Assembly EA 4.00 $122.10 $488.40 4.00 4.00 488.40 $0.00 $488.40
12 Construction Sign,Type C EA 1.00 $166.40 $166.40 1.00 1.00 166.40 $0.00 $166.40
13 Construction Sign,Type B EA 2.00 $56.25 $112.50 0.00 0.00 0.00 $0.00 $0.00
14 Barricade,III-B LP 96.00 $9.60 $921.60 96.00 96.00 921.60 $0.00 $921.60
15 Mulched Seeding SYS 300.00 $4.55 $1,365.00 64.20 64.20 292.11 $0.00 $292.11
EWA Move Culverts(T&M Work) LS 1.00 $2,375.03 $2,375.03 0.00 1.00 1.00 0.00 $2,375.03 $2,375.03
EWA Additional Rip Rap I'S 1.00 $2,501.54 $2,501.54 0.00 1.00 1.00 0.00 $2,501.54 $2,501.54
GRAND TOTALS $46,796.57 $41,244.89 $6,456.57 $47,70L46
AIA DOCUMENT G703 CONTINUATION SHEET FOR G702 1992 EDITION AIA 01992
THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON,D.C. 20006-5232 G703-1992
AFFIDAVIT AND FINAL WAIVER OF CLAIMS AND LIENS
AND RELEASE OF RIGHTS
STATE OF Indiana )
) SS:
COUNTY OF Hamilton )
1
The undersigned,who is the (designate title)of The Hunt Paving Company, Inc.which
is the Subcontractor (designate whether subcontractor, supplier or otherwise) for the General Contractor
_(designate the type of work, supplies or services rendered)on the improvements constructed or being constructed on
the premises hereafter identified,declares that his contract with The Hunt Paving Company, Inc. is in the total amount
of$47,701.46 which includes extras and all change orders to the date hereof.
In consideration of the amounts and sums previously received, and the payment of$6,456.57 being the full
and final payment amount due,the undersigned does hereby waive and release to the Owner and to The Hunt Paving
Company, Inc. any and all claims and liens and rights to liens upon the premises described below, and upon
improvements now or hereafter thereon, and upon the monies or other consideration (due or to become due from the
Owner or from The Hunt Paving Company, Inc. or from any other person, firm, or corporation), said claims and liens
and rights to liens being on account of labor, services, materials,fixtures or apparatus heretofore furnished by orwhich
may be furnished at any time hereafter by or at the request of the undersigned. The Premises as to which said claims
and liens and rights to liens are hereby released are identified as follows:
Project Name: 136th Street Culvert Replacement Project No. 13-02
Address of Project: 136 Street at Anson Almond Arm
City: Carmel County: Hamilton State: Indiana
Owner: City of Carmel Board of Public Works & Safety
General Contractor: The Hunt Paving Company, Inc.
The undersigned further represents and warrants that he is duly authorized and empowered to sign and
execute this waiver on his own behalf and on behalf of the company or business for which he is signing; that he has
properly performed all work and furnished all the materials of the specified quality per plans and specifications and in a
good and workmanlike manner, fully and completely; that he has paid for all the labor, materials, equipment, and
services that he has used or supplied or may hereafter use or supply to the above premises; that he has no other
outstanding and unpaid payment applications, invoices, retentions, holdbacks, chargebacks, or unbilled work or
materials against The Hunt Paving Company, Inc. as of the date of the aforementioned last and final payment
application; and that any materials which have been supplied or incorporated into the above premises were either
taken from his fully-paid or open stock or were fully paid for and supplied.
The undersigned further agrees to reimburse and does hold harmless and fully indemnify Owner and The Hunt
Paving Company, Inc. for any losses or expenses should any such claim, lien or right to a lien be asserted (by the
undersigned or by any laborer, materialman, or subcontractor of the undersigned), including,without implied limitation,
attorney's fees incurred in the defense thereof.
In addition, for and in consideration of the amounts and sums received, the undersigned hereby waives,
releases and relinquishes any and all claims, rights or causes of action whatsoever arising out of or in the course of the
work performed on the above-mentioned project, contract or event.
Signed and delivered this day of /y 20�4 .
The Hunt Paving Company, Inc.
Individual or Corporation N
,io
By: 't /
Title: ,vv
. . def AOe undersigned Notary Public in and for said Count `S ate, 'ft,-'It
� rappeared
awl�• and acknowledged execution of the foregoing affidav a�t Ideed and
further stated that the facts recited are true of his personal nowledge. S w �lr b,
My Commission Expires SCJ ry Pub c ,�� ,'' ••....,.. .�' `��
Residence County: �"�ynww„�„qct► `
AFFIDAVIT AND FINAL WAIVER OF CLAIMS AND LIENS
AND RELEASE OF RIGHTS
STATE OF Indiana )
) SS:
COUNTY OF Hamilton )
The undersigned,who is the (designate title)of Indiana Sign&Barricade, Inc. which is
the Subcontractor (designate whether subcontractor, supplier or otherwise) for the Construction Signs
(designate the type of work, supplies or services rendered)on the improvements constructed or being constructed on
the premises hereafter identified,declares that his contract with The Hunt Paving Company, Inc. is in the total amount
of3 7$ 26.00 which includes extras and all change orders to the date hereof.
In consideration of the amounts and sums previously received, and the payment of$0.00 being the full and
final payment amount due, the undersigned does hereby waive and release to the Owner and to The Hunt Paving
Company, Inc. any and all claims and liens and rights todiens upon the premises described below, and upon
improvements now or hereafter thereon, and upon the monies or other consideration (due or to become due from the
Owner or from The Hunt Paving Company, Inc. or from any other person, firm, or corporation), said claims and liens
and rights to liens being on account of labor,services, materials,fixtures or apparatus heretofore furnished by orwhich
may be furnished at any time hereafter by or at the request of the undersigned. The Premises as to which said claims
and liens and rights to liens are hereby released are identified as follows:
Project Name: 136Lh Street Culvert Replacement Project No. 13-02
Address of Project: 136—Street at Anson Almond Arm
City: Carmel County: Hamilton State: Indiana
Owner: City of Carmel Board of Public Works & Safety
General Contractor: The Hunt Paving Company, Inc.
The undersigned further represents and warrants that he is duly authorized and empowered to sign and
execute this waiver on his own behalf and on behalf of the company or business for which he is signing; that he has
properly performed all work and furnished all the materials of the specified quality per plans and specifications and in a
good and workmanlike manner, fully and completely; that he has paid for all the labor, materials, equipment, and
services that he has used or supplied or may hereafter use or supply to the above premises; that he has no other
outstanding and unpaid payment applications, invoices, retentions, holdbacks, chargebacks, or unbilled work or
materials against The Hunt Paving Company, Inc. as of the date of the aforementioned last and final payment
application; and that any materials which have been supplied or incorporated into the above premises were either
taken from his fully-paid or open stock or were fully paid for and supplied.
The undersigned further agrees to reimburse and does hold harmless and fully indemnify Owner and The Hunt
Paving Company, Inc. for any losses or expenses should any such claim, lien or right to a lien be asserted (by the
undersigned or by any laborer, materialman,or subcontractor of the undersigned),including,without implied limitation,
attorney's fees incurred in the defense thereof.
In addition, for and in consideration of the amounts and sums received, the undersigned hereby waives,
releases and relinquishes any and all claims, rights or causes of action whatsoever arising out of or in the course of the
work performed on the above-mentioned project, contract or event.
Signed and delivered this day of 20 «.
Harg��10. Indiana Sin ar Inc.
.` '.. • •.• a� 'i In ual or r atio
::\onExpire,�••
.r C.e��okary a: �� B
�
w '•� c.
co
� � �`� Titl dlQ.vl'�
y ..°o e:
o:
'.�ihie::°:o'•• a�`
` forre me, the Jn�i�a geed� btary Public in and fo said County and State, personally appeared
l , and'Auk �edge d execution of the foregoing affidavit as his voluntary act and deed and
further stated that the facts recited are true of his personal knowledge.
My Commission Expires: otaryblic
Residence County:
a�
AFFIDAVIT AND FINAL WAIVER OF CLAIMS AND LIENS
AND RELEASE OF RIGHTS
STATE OF Indiana )
) SS:
COUNTY OF Hamilton )
The undersigned, who is the s (designate title) of Earth Images. Inc. which is the
Subcontractor (designate whether ubcontractor, supplier or otherwise) for the Mulched Seeding
(designate the type of work, supplies or services rendered)on the improvements constructed or being constructed on
the premises hereafter identified, declares that his contract with The Hunt Paving Company, Inc. is in the total amount
of1 061.86 which includes extras and all change orders to the date hereof.
In consideration of the amounts and sums previously received, and the payment of$0.00 being the full and
final payment amount due, the undersigned does hereby waive and release to the Owner and to The Hunt Paving
Company, Inc. any and all claims and liens and rights to liens upon the premises described below, and upon
improvements now or hereafter thereon, and upon the monies or other consideration(due or to become due from the
Owner or from The Hunt Paving Company, Inc. or from any other person, firm, or corporation), said claims and liens
and rights to liens being on account of labor, services, materials, fixtures or apparatus heretofore furnished by orwhich
may be furnished at any time hereafter by or at the request of the undersigned. The Premises as to which said claims
and liens and rights to liens are hereby released are identified as follows:
Project Name: 136th Street Culvert Replacement Project No. 13-02
Address of Project: l 3F Street at Anson Almond Arm
City: Carmel County: Hamilton State: Indiana
Owner: City of Carmel Board of Public Works & Safety
General Contractor: The Hunt Paving Company, Inc.
The undersigned further represents and warrants that he is duly authorized and empowered to sign and
execute this waiver on his own behalf and on behalf of the company or business for which he is signing; that he has
properly performed all work and furnished all the materials of the specified quality per plans and specifications and in a
good and workmanlike manner, fully and completely; that he has paid for all the labor, materials, equipment, and
services that he has used or supplied or may hereafter use or supply to the above premises; that he has no other
outstanding and unpaid payment applications, invoices, retentions, holdbacks, chargebacks, or unbilled work or
materials against The Hunt Paving Company, Inc. as of the date of the aforementioned last and final payment
application; and that any materials which have been supplied or incorporated into the above premises were either
taken from his fully-paid or open stock or were fully paid for and supplied.
The undersigned further agrees to reimburse and does hold harmless and fully indemnify Owner and The Hunt
Paving Company, Inc. for any losses or expenses should any such claim, lien or right to a lien be asserted (by the
undersigned or by any laborer, materialman,or subcontractor of the undersigned), including,without implied limitation,
attorney's fees incurred in the defense thereof.
In addition, for and in consideration of the amounts and sums received, the undersigned hereby waives,
releases and relinquishes any and-all-claims, rights or causes of action vvhatsoeverarisingl out of orin`the course of the.
work performed on the above-mention d project, contract or event.
Signed and delivered this ay of LA it 2014 .
Earth Images, Inc.
Individual or Corporation Name
By: -}—
Title: ���,t
B fore me, the undersigned Notary Public in and for said County and State,• personally appeared
and acknowledged execution of the foregoing affidavit as his voluntary act and dee,d'and
furthers ate6t at the facts recited are true of his personal knowledge.
My Commission Expires: l l-L(J" N to TF DAVID P. SLUSSER
< _ Noiary Public, State of Indiana
Residence County'. O w = Floyd County, C_mm.#557377
My Commission Expires
November 20, 2014
AFFIDAVIT AND FINAL WAIVER OF CLAIMS AND LIENS
AND RELEASE OF RIGHTS
STATE OF Indiana )
) SS:
COUNTY OF Hamilton )
The undersigned, who is the 1.2feSc"-V (designate title) of All Star Paving, Inc. which is the
Subcontractor(designate whether subcontractor, supplier or otherwise)for the Asphalt (designate the
type of work, supplies or services rendered)on the improvements constructed or being constructed on the premises
hereafter identified,declares that his contract with The Hunt Paving Company, Inc. is in the total amount of$8,636.90
which includes extras and all change orders to the date hereof.
In consideration of the amounts and sums previously received, and the payment of$0.00 being the full and
final payment amount due, the undersigned does hereby waive and release to the Owner and to The Hunt Paving
Company, Inc. any and all claims and liens and rights to liens upon the premises described below, and upon
improvements now or hereafter thereon, and upon the monies or other consideration(due or to become due from the
Owner or from The Hunt Paving Company, Inc. or from any other person, firm, or corporation), said claims and liens
and rights to liens being on account of labor, services, materials,fixtures or apparatus heretofore furnished by orwhich
may be furnished at any time hereafter by or at the request of the undersigned. The Premises as to which said claims
and liens and rights to liens are hereby released are identified as follows:
Project Name: 136th Street Culvert Replacement Project No. 13-02
Address of Project: 1361nStreet at Anson Almond Arm
City: Carmel County: Hamilton State: Indiana
Owner: City of Carmel Board of Public Works & Safety
General Contractor: The Hunt Paving Company, Inc.
The undersigned further represents and warrants that he is duly authorized and empowered to sign and
execute this waiver on his own behalf and on behalf of the company or business for which he is signing; that he has
properly performed all work and furnished all the materials of the specified quality per plans and specifications and in a
good and workmanlike manner, fully and completely; that he has paid for all the labor, materials, equipment, and
services that.he has used or supplied or may hereafter use or supply to the above premises; that he has no other
outstanding and unpaid payment applications, invoices, retentions, holdbacks, chargebacks, or unbilled work or
materials against The Hunt Paving Company, Inc. as of the date of the aforementioned last and final payment
application; and that any materials which have been supplied or incorporated into the above premises were either
taken"from his fully-paid or open stock or were fully paid for and supplied.
The undersigned further agrees to reimburse and does hold harmless and fully indemnify Owner and The Hunt
Paving Company, Inc. for any losses or expenses should any such claim, lien or right to a lien be asserted (by the
undersigned or by any laborer, materialman,or subcontractor of the undersigned),including,without implied limitation,
attorney's fees incurred in the defense thereof.
In addition, for and in consideration of the amounts and sums received, the undersigned hereby waives,
releases and relinquishes any and all claims, rights or causes of action whatsoever arising out of or in the course of the
work performed on the above-mentioned project, contract or event.
\t`'JO J� � trrri'Sjgned and delivered this day of __re_6ru u , 20 14 .
All Star Paving, Inc.
�. Individual or Corporation Name
By:
, •:. '` ���° Title: �r-cs+ dClI
���`�9f7ftSe11?�
4Be rq me,. the undersigned Notary Public in and for said County and State, personally appeared
kA'O ,'Kett\ , and acknowledged execution of the foregoing affidavit as his voluntary act and deed and
further stated that the facts recited are true of his personal knowledge.
y� �j
My Commission Expires:iF' / X 6 Notary Public
Residence County: .3e-y-►2 i �J
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom,
rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Hunt Paving Co. Purchase Order No.
POB 42517 Terms
Indianapolis, IN 46242-0517 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s) Amount
2/2/2014 2 136th Culvert Replacement at Anson Almond $ 675.11
1/2/2014 2 136th Culvert Replacement at Anson Almond $ 5,781.46
Total $ 6,456.57
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6.
20
Clerk-Treasurer
VOUCHER NC WARRANT NO.
Hunt Paving Co. ALLOWED 20
POB 42517 IN SUM OF $
Indianapolis, IN 46242-0517
$ 6,456.57
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITL AMOUNT
DEPT# I hereby certify that the attached invoice(s),
25265 2 211-R4462300 $ 676.11 or bill(s) is (are) true and correct and that the
materials or services itemized thereon for
0 2 2200-4462000 $ 5.761.46 which charge is made were ordered and
received except
3/10/2014
Sign ture
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund