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Home My WebLink About238920 11/05/14 iii�..GAgMf �•. CITY OF CARMEL, INDIANA VENDOR: 00350596 ONE CIVIC SQUARE RIETH-RILEY CONSTRUCTION CO INC CHECK AMOUNT: $""42,000.00' CARMEL, INDIANA 46032 PO BOX 276 CHECK NUMBER: 238920 INDIANAPOLIS IN 46206 CHECK DATE: 11/05/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 920 4470299 31851 32002465 42,000.00 106TH & KEYSTONE BARR q!ao ® 44q o 2q9 &TH- ILE1� CONSTRUCTION CO. INC. 91 P.O.Boz 276 Indianapolis,W 46206 Telephone: (317)634-5561 FAX: (317)631-6423 Progress Estimate No.: 1 Sold To: City of Carmel Customer No.: 194706 City Hall Job Number: A32OO4O4 1 Civic Square Invoice Number: 32002465 Carmel,IN 46032 Date: 10/21/14 Period Covered: 9/1/14-10/21/14 Terms: Due Upon Receipt Job: 106th&Keystone Barrier Wall Repair/Project#14-05 CONTRACTOR'S INVOICE 1 Original Contract Sum $42,000.00 2 Net change by Change Orders $0.00 (Co#_) 3 Contract Sum to Date (line 1 +line 2) $42,000.00 4 Total Contract Completed to Date $42,000.00 100.0% 5 Deductions: 0.00 % Retainage: $0.00 6 Total Earned Less Deductions (line 4-line 5) $42,000.00 7 Less Previous Billings $0.00 8 Invoice Amount Due (line 6-line 7) $42,000.00 Balance Remaining $0.00 0.0% A service charge of 1-1/2a/per month(18%annual rate)will be made on all account balances not paid,according to the terms stated. Office Use Only(Current Estimate Totals): Change Order Summary Total Estimate $42,000.00 Change Orders approved on previous estimates by Owner $0.00 Retalnage $0.00 Approved this Estimate $O.OD current payment Due $42,000.00 Total Net Change by Change Orders $0.00 7-2232,1 �Nto OCT 2014 �. CA�MEC ww Rieth-Riley Construction Co.,Inc. P.O.Box 276 Indianapolis,IN 46206 Telephone: (317)634-5561 FAX: (317)631-6423 Sold To: City of Carmel Progress Estimate#: 1 City Hall Customer#: 194706 1 Civic Square Invoice#: 32002465 Carmel, IN 46032 Date: 10/21/14 Period Covered: 9/1/14-10/21/14 Job: 106th&Keystone Barrier Wall Repair'/Project#14-05 This Estimate. -,Job to Date: Original Plan Change Order Item No. Item Description Quantity Quantity Total Quantity Units $per Unit Enter Units Total$ Units to Date $to Date,. 106th&Keystone Barrier 0 Wall Repair/Project#14-05 0.000 0.000 0.000 0.000 0.00 0.000 0.00 0.000 0.00 0 Contract Dated 7/2/14 0.000 0.000 0.000 0.000 0.00 0.000 0.00 0.000 0.00 P.O.#31851/Appropriation 0 #920-4470299 0.000 0.000 0.000 0.000 0.00 0.000 0.00 0.000 0.00 1 Mobilization/Demobilization 1.000 0.000 1.000 LSM 1,800.00 1.000 1,800.00 1.000 1,800.00 2 Maintenance of Traffic 1.000 0.000 1.000 LSM 12,200.00 1.000 12,200.00 1.000 12,200.00 Concrete Barrier Wall, 3 Remove&Replace 1.000 0.000 1.000 LSM 15,000.00 1.000 15,000.00 1.000 15,000.00 Remove&Replace Metal 4 Railing 1.000 0.000 1.000 LSM 7,000.00 1.000 7,000.00 1.000 7,000.00 5 Restoration 1.000 0.000 1.000 LSM 6,000.00 1.000 6,000.00 1.000 6,000.00 6 Maintenance of Traffic 1.000 0.000 1.000 LSM 0.00 0.000 0.00 0.000 0.00 Balance: 42,000.001 42,000.00 i AFFIDAVIT AND WAIVER OF LIEN (X ) Final ( ) Partial ( X ) Payment to Follow State of Indiana, County of Marion, SS: Kevin A. Tussey being duly sworn, states that he is the Area Office Manager of Rieth-Riley Construction Co., Inc. having contracted with City of Carmel , to furnish certain material, and/or labor as follows:, General Construction for a project known as: 106th & Keystone Barrier Wall Project 14-05 and owned by City of Carmel and does hereby further state on behalf of the aforementioned contractor. (Partial Waiver) That the balance due from the Contractor is the sum of Dollars ($). ( ) Receipt of which is hereby acknowledged; or ( ) The payment of which has been promised-as the sole consideration.for this Affidavit and Partial Waiver of Lien, which is given to and for said amount, effective upon receipt of such payment. (Final Waiver) That the final balance due from the Contractor in the sum of Forty Two Thousand Dollars ($ 42,000.00). ( ) Receipt of which is hereby acknowledged; or (X) The payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien,which is given to and for said amount, effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, and all lien or claim whatsoever on the above described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certified that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Rieth-Riley Construction Co., Inc. By: �—� Kevin ATussey, Area Office Manager WIT ESS MY H 7 n K ew m , this 22nd day of October 2014 Notary ic Seal (Notary Public) State of Indiana Printed Name: Erin B. Newlin Hamilton County My ommiNi1iWftWaEx 7Jt72017 Resident o : _R mitton�ottt ,,-Fr-�di 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 ° Rieth-Riley Construction Purchase Order No. POB 276 Terms Indianapolis, IN 46206 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 10/21/2014 32002465 106th&Keystone Barrier Wall Repair $ 42,000.00 Total $ 42,000.00 1 hereby certify that the attachedinvoice(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 NO WARRANT NO. Rieth-Riley Construction ALLOWED 20 POB 276 IN SUM OF$ Indianapolis, IN 46206 $ 42,000.00 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), or 31851 32002465 920-4470299 $ 42,000.00 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except j r ' 11/3/2014 ignature t City Engineer I i Cost Distribution ledger classification if Title claim paid motor vehicle highway fund I