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Home My WebLink About232844 05/21/14r Coq . " CITY OF CARMEL, INDIANA VENDOR: 00351429 ONE CIVIC SQUARE M.K. BETTS ENGINEERING INC CHECK AMOUNT: $ 133,716.14' ?� CARMEL, INDIANA 46032 PO BOX 2533 CHECK NUMBER: 232844 ANDERSON IN 46018 CHECK DATE: 05/21/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 610 5023990 3 133,716.14 OTHER EXPENSES APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 6702 (Instructions on reverse side) PACE ONE OF PAGES TO (OWNER): City of Carmel PROJECT: Well 30 APPLICATION NO: Three (3) Distribution to: One Civic Square Contract No. 82 E OWNER Carmel, IN 46032 PERIOD TO: 04/30/14 C ARCHITECT C CONTRACTOR FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C M. K. Betts Engineering PROJECT NO: C & Contracting, Inc. CONTRACT FOR: Invoice. No. 14-110. CONTRACT DATE: Application is made Pavment. as showelow, in CONTRACTOR'S APPLICATION FOR. PAYMENT Continuation Sh et,for AIA Document G703nisatt chedconnection with the Contract.. CHANGE ORDER SUMIAARY j 1. ORIGINAL CONTRACT SUM ........:.:.... .........$ 246,100.00 Change Orders approved in ADDITIONS DEDUCTIONS 2• Net change by Change Orders ................ ..... $ —0— previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 =2) .... ....... ... $ 246,100.00 TOTAL 4. TOTAL COMPLETED & STORED TO DATE...... ... ... $ 80,532.41 Approved this Month (Column G on 6703) Number Date Approved S. RETAINAGE: a. 10 % of Completed Work $ 3,468.70 (Column D+E on G703) b. 10 % of Stored Material $ 4,584.54 (Column F on G703) Total Retainage (Line 5a+5b or TOTALS Total in Column I of G703) ....... ....... ..... .. $ 8,053.24 Net chane by Change Orders 6. TOTAL EARNED LESS RETAINAGE 72,479.17 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)........ . $ 4,938.30 paid by the Contractor for Work for which previous Certificates for Payment were 8. CURRENT PAYMENT DUE .. ... ... . ........... ...... S 67,540.87 issued and payments received from the Owner, and that current payment shown 9, BALANCE TO FINISH, PLUS RETAINAGE .. ..... . .... . $ 173,620.83 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 30th day of April 2014 Notary Public: By: Date: April 30, 2014 My Commission expires: October 28 , 2015 . AMOUNT CERTIFIED...... .. ....... ..... .. ........... $ ARCHITECT'S CERTIFICATE FOR PAYMENT (Attach explanation if 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 g Date: indicated,the quality of the Work is in accordance with the Contract Documents,and This Certificate is not negotiable. The AMOUNTOUNT CERTIFIED is payable only to the the Contractor is entitled to payment of the AMOUNT CERTIFIED. Contractcr named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. 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 5/15/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/15/2014 3 $67,540.87 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 0 icer N VOUCHER # 135161 WARRANT # ALLOWED e 351429 IN SUM OF $ M.K. BETTS ENGINEERING & CONTRi P.O. Box 2533 Anderson, IN 46018 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 3 07-1052-12 $67,540.87 o4k.Iil . Voucher Total $67,540.87 Cost distribution ledger classification if claim paid under vehicle highway fund ! APPLICATION AND CERTIFICATE FOR PAYMENT A/A DOCUMENT 0702 (Instructions on reverse side) PAGE ONE OF PAGES TO (OWNER): City of Carmel PROTECT: Plant 4 Chemical Feed APPLICATION NO�: Three (3) Distribution to: One Civic Square Contract No. 83 L OWNER Carmel, IN 46032 PERIOD TO: 04/130/14 F1 ARCHITECT CONTRACTOR FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C M. K. Betts Engineering PROJECT NO: C & Contracting, Inc. I CONTRACT FOR: Invoice. No. 14-111.03 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 ...... .......... $ 100,900.00 Change Orders approved in ADDITIONS DEDUCTIONS 2. Net change by Change Orders ............... . ..... $ —0— previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 =2).... ... ...... $ 100,900.00 TOTAL 4. TOTAL COMPLETED & STORED TO DATE..... $ 99,850.00 Approved this Month (Column G on G703) 5. RETAINAGE: Number Date Approved I --� a. _ % of Completed Work $ (Column D+E ori G703) b. _ % of Stored Material $ i (Column F on G703) Total Retainage (Line 5a+5b or TOTALS Total in Column I of G703) .............. ..... $ 5,045.00 I 6. TOTAL EARNED LESS RETAINAGE ,... $ 94,805.00 . Net than e by Chan e Orders ............... The undersigned Contractor certifies that to the best of the Contractor's knowledge, (Line 4 less Line S 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)..,.. ..... $ 28,629.73 paid by the Contractor for Work for which previous.Certificates for Payment were 8. CURRENT PAYMENT DUE ........ . ..........' S 66,175.27 issued and payments received from the Owner, and that current payment shown 6,095.00 9. BALANCE TO FINISH PLUS RETAINAGE.. ....i. . ..... $ _ 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 met .js 30th; day of April 2014 Notary Public:"__�-w h1 By: Date: April 30, 2014 My Commission expires: October 28 , 2015 . l (Attaach explanation if amount certified differs from'.•. $ ARCHITECTS CERTIFICATE FOR PAYMENT p 'm 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 i best of the Architect's knowledge,information and belief the Work has progressed as v; 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. Contractcr named herein. Issuance,payment and!acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. 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 5/15/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/15/2014 3 $66,175.27 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 O i r VOUCHER # 135163 WARRANT# ALLOWED 351429 IN SUM OF $ M.K. BETTS ENGINEERING & CONTRi P.O. Box 2533 Anderson, IN 46018 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 3 07-1052-15 $66,175.27 �0 Voucher Total $66,175.27 Cost distribution ledger classification if claim paid under vehicle highway fund