HomeMy WebLinkAbout231961 04/28/14 CITY OF CARMEL, INDIANA VENDOR: 00351429
ONE CIVIC SQUARE M.K. BETTS ENGINEERING INC CHECK AMOUNT: $"'""*270.00•
CARMEL, INDIANA 46032 PO BOX 2533 CHECK NUMBER: 231961
ANDERSON IN 46018 CHECK DATE: 04/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
609 5023990 2 270.00 1052 . 12
i
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VENDOR: 00351429 CHECK AMOUNT: $"'"4,290.30`
" CITY OF CARMEL, INDIANA M.K. BETTS ENGINEERING INC CHECK NUMBER: 230037
`= ONE CIVIC SQUARE PO BOX 2533
Is ® ANDERSON IN 46oia CHECK DATE: 03/12/14
CARMEL, INDIANA 46032
DESCRIPTION
AMOUNT
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER 1,147.50 OTHER EXPENSES
5023990 1 3,142.80
609 OTHER EXPENSES
609 5023990 2
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (instructions on reverse side) P.•iGEOvEOF PAGES
TO (OWNER): City of Carmel PROJECT: Well 30 APPLICATION NO: One (1) Distribution to:
One Civic Square Contract No. 82 L OWNER
Carmel, IN 46032 PERIOD TO: 02/28/14 C ARCHITECT
CONTRACTOR
FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C
M. K. Betts Engineering PROJECT NO: C
& Contracting, Inc,
CONTRACT FOR: Invoice. No. 14-110. 01 CONTRACT DATE:
Application is made for Payment. as shown below, in connection with the Contract..
CONTRACTOR'S APPLICATION FOR. PAYMENT Continuation Sheet, AIA Document G703, is attached.
I S 246,100.00
CHANGE ORDER SUMMARY 1 1. ORIGINAL CONTRACT- SUM ........:.:.............
i2. Net change by Change Orders ... .... S —0
;............ .
Change Orders approved in ADDITIONS DEDUCTIONS 246 100.00
previous months by Owner 3, CONTRACT SUM TO DATE (Line 1 =2).. ............ S ,
TOTAL 4. TOTAL COMPLETED &STORED TO DATE...... ...... S 3,792.00
Approved this Month (Column G on G703)
5. RETAINAGE:
Number Date Approved
a. 10 % of Completed ``'York S 275.00
(Column D+E on G703)
b. 10 % of Stored Material S 104.20
(Column F on G703)
Total Retainage (Line 5a+5b or
TOTALS Total in Column I of G703) ....... .............. S 379.20
6. TOTAL EARNED LESS RETAINAGE ....... ... 3,412.80
Net change by Change Orders
(Line 4 less Line 5 Total)
The undersigned Contractor certifies that to the best of the Contractor's knowiedge,
information and belief the Work covered by this Application for Payment has been 7. LESS PREVIOUS CERTIFICATES FOR 0_
completed in accordance With the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Certificate).....•••. S 3,412.80
paid by the Contractor for Work for which previous.Certificates for Payment were 8. CURRENT PAYMENT DUE ............. ............. S
issued grid pavments received from the Owner, and that current payment shown g BALANCE TO FINISH, PLUS RETAINAGE............. $ 242,687.20
herein is now due. (Line 3 less Line 6)
CONTRACTOR: M. K. Betts Engineering & Contracting, Inc.. State of: Indiana County of; Madison
Subscribed and sworn to before me this 28th day of Feb. 2014"
Notary Public:
Bv: Date: February 28,' 2014 My Commission expires: October 28 , 201S .
ARCHITECT'S CERTIFICATE FOR PAYMENT
AMOUNT CERTIFIED.....•• t•...ified differs
r0m the
5
(Attach explanation ii amount certified differs from the amount applied for)
In accordance with the Contract Documents,based on on-site observations and the ARCHITECT:
data comprising the above application,the'Architect certifies to the Owner that to the --,�—�— --
best of the Architect's knowledge,information and belief the Work has progressed as gv; Date:
indicated,the quality of the work is in accordance with the Contract Documents,and This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
the Contractor is.entitled to payment of the AMOUNT CERTIFIED. Coniracicr named herein. Issuance,payment and acceptance of payment are without
prejudice To any rights of the Owner or Contractor under this Contract.
VOUCHER # 134342 WARRANT # ALLOWED
351429 IN SUM OF $
M.K. BETTS ENGINEERING & CONTRA
P.O. Box 2533
Anderson, IN 46018
Carmel plater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1 07-1052-12 $3,412.80
co0ec
i
Voucher Total $3,412.80
Cost distribution ledger classification if
claim paid under vehicle highway fund
< Fl �il
a
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
35-1429
M.K. BETTS ENGINEERING & CONTRACTING Purchase Order No.
P.O. Box 2533 Terms
Anderson, IN 46018 Due Date 3/6/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/6/2014 1 $3,412.80
I 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
Date icer
G
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 "(Instructions on reverse side] P.•\GEONE OF PAGES
TO (OWNER): City of Carmel PROJECT: Plant 4 Chemical Feed
APPLICATION NO: One (I) Distribution to:
One Civic Square Contract No. 83 C; OWNER
Carmel, IN 46032 PERIOD TO. 02/28/14 C ARCHITECT
G CONTRACTOR
FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C'
M. K. Betts Engineering
& Contracting, Inc. PROTECT NO: C
CONTRACT FOR: Invoice. No. 14-111. 01 CONTRACT DATE:
Application is made for Payment, as shown below, in connection with the Contract.
CONTRACTORS APPLICATION FOR. PAYMENT Continuation Sheet, AIA Document G703, is attached.
CHANGE ORDER SUMMARY 1. ORIGINAL CONTRACT SUM ........:.:.............5 100,900.00
Change Orders approved in I ADDITIONS DEDUCTIONS 2• Net change by Change Orders ..................... $ —0—
previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 =2).............. S 100,900.00
TOTAL 4. TOTAL COMPLETED &STORED TO DATE............ S 1,275..00
Approved this Month (Column G on G703)
5. RETAINAGE:
Number Date Approved a 10 y, of Completed WorkS 127.50
(Column D T E on G703)
b.0-o- % of Stored Material $ —0—
(Column F on G703)
Total Retainage (Line 5a+5b or
TOTALS Total in Column I of G703) ..................... $ 127.50
6. TOTAL EARNED LESS RETAINAGE 1,147.50
Netchan ebvChangeOrders ••-•••••••••••••••- $
The undersigned Contractor certifies that to the best of the Contractor's knowledge, (Line 4 less Line 5 Total)
information and belief the Work covered by this Application for Payment has been 7. LESS PREVIOUS CERTIFICATES FOR
completed in accordance with the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Certificate)......... 5 - —0—
paid by the Contractor for Work for which previous.Certificates for Payment were 8. CURRENT PAYMENT DUE .......................... 5 1,147.50
issued and payments received from the Owner, and that current payment shown 9• BALANCE TO FINISH, PLUS RETAINAGE............. 5 99,752.50
herein is now due. (Line 3 less Line 6)
CONTRACTOR: M. K. Betts Engineering & Contracting, Inc.. State of: Indiana County of: Madison -
Subscribed and sworn to before me this 28th day of Feb. 2014
Notary Public:` . -/✓1= �
By: Date: February 28, 2014 My Commission expires: October 28 , 2015 .
ARCHITECT'S CERTIFICATE FOR PAYMENT AMOUNT CERTIFIED ifa.... t cer .....differs from
t ... $
(Attach explanation it amount certified differs from rhe amount applied for.)
In accordance with the Contract Documents, based on on-site observations and the ARCHITECT:
data comprisinc the above application,the Architect certifies to the Owner that to the
best of the Architect's knowledge,information and belief the Work has progressed as gv: Date:
indicated•the quality of the Work is in accordance with the Contract Documents,and This Certificate is not negotiable. The AMOUNT CERTIFIED is payable 6nly to the
the Contractor is entitled to payment of the AMOUNT CERTIFIED. Contractcr named herein.Issuance,payment and acceptance of payment ar.e without
prejudice to any rights of the Owner or Contractor under this Contract.
VOUCHER # 134343 WARRANT # ALLOWED
351429 IN SUM OF $
M.K. BETTS ENGINEERING & CONTRF
P.O. Box 2533
Anderson, IN 46018
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
I
1 07-1052-15 $1,147.50
Voucher Total $1,147.50
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351429
M.K. BETTS ENGINEERING & CONTRACTING Purchase Order No.
P.O. Box 2533 Terms
Anderson, IN 46018 Due Date 3/6/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/6/2014 1 $1,147.50
i
hereby certify that the attached invoice(s), or bill(s) is (are)true and
;orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Offic