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Home My WebLink About248835 08/26/15 w CITY OF CARMEL, INDIANA VENDOR: 361395 b `1 ONE CIVIC SQUARE GOLDMAN ELECTRICAL CONTRACTIN QFNCCK AMOUNT: $....54,587.00` '� =4 CARMEL, INDIANA 46032 2313 Et�dtll y QHECK DAECK TE: 08/26/15 08$26/15 INDPLS IN 835 46237 [TON GQ' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 106 5023990 38440 1111 54,587.00 OUTSIDE LIGHTING INST 1 Goldman Electrical Contracting, Inc. rT!.D 2313 E. Washington St AUG - 6 2015 Indianapolis, IN 46201 (317)787-9967 YY:__ !� 1INJIVOICE BILL TO INVOICE# 1111 Carmel/Clay Parks and DATE 08/03/2015 Recreation DUE DATE 09/02/2015 1411 E. 116th Street TERMS Net 30 Carmel, Indiana *623 ` Acrfvl,fy. QTY. : f'2A'rli , ' AMOUNT Services:AIA 1 54,587.00 54,587.00 AIA Billing#02 BALANCE DUE $54,587.00 Questions?Email Shannon@goldmanelectrical.com Thank you 3� AIAI, Application and Certificate for Payment .. JULYBILLING TO: Can-r ilCtay eoatd of Parks enTRecieation PROJECT: Founders Park Lighting Project .APPLICATION NO: 2 Distribution to: 1411.E•116th•Street 11675 Hazel Dell Parkway s PERIOD TO: 7131115 OWNER i> Carmel.IN 46278 Carmel,IN 48033 DATE OF CONTRACT: 4/16/15 ARCHITECT F#- 317-547-8000 b,ti1 CONTRACTOR X FIELD _ r MDPC PROJECT NO. a FROM: Goldman Electrical Contracting '(GEC) ARCHITECT: The Schneider Corporation GEC PROJECT.NO. 1036 OTHER 2313 E Washington Street 8901 Otis Avenue Y, SAI PROJECT N0. Indianapolis,IN 46201 Indianapolis,IN 46216 z ETRENT17=07 ?'"14MMOMM 17T212:1: 771 " The undersigned Contractor certifies that to the best of the Contractor's knowledge,information CONTRACTOR'S APPLICATION FOR PAYMENT and belief the Work covered by this Application for Payment has been Application is made for payment,as shown below,in connection with the Contract. pp P Y a'k�. completed in accordance-with.the Contract Documents,that ail amounts have been paid by the ,1 Continuation Sheet,AtA Document G703,is attached. Contractor for Work for which previous Certificates for Payment were issued and ; 1. ORIGINAL CONTRACT SUM...................... ......$ 108,722.00 tr' payments received from the Owner,.and the current payment shown herein is now due. 2. Net change by Change Orders.....•...................:.........................$ -20,000.00 CONTRACTOR: 3_ CONTRACT SUM TO DATE(Line 1+/-2).......................:...................$ 88,722.00 -,� By: William Goldman III-PfBSident Date: 8/3/2015 VA 4, TOTAL COMPLETED&STORED TO DATE(Column G on G703)...........$ 88,722.00., State of: Indiana 5. RETAINAGE: 1012 County of: Marion a. 5% of Completed Work „". Subscribed and sworn to before t-"p r• r- (Column D+Eon G703)(Ln 5a times Ln 4)..............$ 4,436.10 �� me this 3rd day of August year of 2015 b. Amt of discretions held back................ ....$ 0.00 ;';Nota Public: .� Notary Signature Name: Stiann2h Honeycutt Total Retainage(Lines 5a+5b or Total In Column I of G703).............S 4;436.10.;_?, My commission expires: 1/26/2019 Date { 6. TOTAL EARNED LESS RETAINAGE g ' (Line 4 Less Line 5 Total)........................................................$ 84,285.90b 4 ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observation and the data 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT......................................$ 29,698.90 ;� comprising this application,the Architect certifies to the Owner that to the best of the (Line 6 from prior Certificate) Architect's knowledge,information and belief the Work has progressed as indicated,the quality 8. CURRENT PAYMENT DUE................ ........ ................. .................$ 54,587.00 € of the Work is in accordance with the Contract Documents,and the Contractor <. 9. BALANCE TO FINISH,INCLUDING RETAINAGE % is entitled to paytment of the AMOUNT CERTIFIED. (Line 3 Less Line 6)...............................................................$ 4,436.10 ' All�C77 W AMOUNT CERTIFIED ar (Attach explanation it amount certified differs from the arrmount applied, initial all figures on th/s Application and CHANGEORDER SUMMARY ADDITIONS DEDUCTIONS on the Continuation tthat ct gedto ritor r heamounrcertited.) Totai'changes approved in previous months by Owner 0.00 ;ARCHITECT: r•„ Total approved this Month 20,000.00 By: f°.9 CO#i b y Cha forOrder Allowance TOTALS -0.00, 20,000.00 �� This Certifiat not ne tiabie. The AMOUNT CERTIFIED.si payable only to the Contractor g' NET CHANGES b Change Order 20,000.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any . rights of the Ovaneror Contractor under this Contract. ` uOLDMAN srrm7.-,1r;0 2313 E WASHINGTON ST INDIANAPOLIS, IN 46201 PHONE (317) 787-9967 - FAX (317) 784-6654 AFFIDAVIT& WAIVER OF LIEN X Final Partial AIA #2(THRU 07/31/15) State of IN, County of MARION , SS: WILLIAM GOLDMAN III (Name)being duly sworn states that he is PRESIDENT(Title) of GOLDMAN ELECTRICAL CONTRACTING CO. INC. (company)and has been hired by CarmellClay Board of Parks and Recreation (Owner)to furnish certain materials and/or labor as follows; ELECTRICAL for a project known as Founders Park Lighting Project (Project Name) Located in Carmel Indiana and does hereby further state on behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER)that there is due from the contractor the sum $ 54,587.00 (FIFTY FOUR THOUSAND FIVE HUNDRED EIGHTY SEVEN DOLLARS AND 00/00) X 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 solely in respect to said amount, and which waiver shall be effective only upon Receipt of payment thereof by the undersigned: (FINAL WAIVER)that the final balance due from the contractor is the sum of $ 54,587.00 GOLDMAN ELECTRICAL CONRACUING INC. �;�y��-�- Q-xt>N6 -- - President (Finn) (Signaturen,itle) WITNESS MY HAND AND NOTARIAL SEAL, this 3RD day of JULY, 2015 . , My Commission Expires 01/26/19 c— (Notary Public) Residing in MARION County SHANNON M HONEYCUTT (Printed). ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 Purchase Order No. 361395 Goldman Electrical Contracting, Inc. Date Due 2313 E Washington St Indianapolis, IN 46201 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 8/3/15 1111 Founders Park Lighting project 38440 $ 54,587.00 Total $ 54,587.00 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 5-11-10-1.6 120 Clerk-Treasurer Voucher No. Warrant No. Allowed 20 361395 Goldman Electrical Contracting, Inc. 2313 E Washington St Indianapolis, IN 46201 In Sum of$ $ 54,587.00 ON ACCOUNT OF APPROPRIATION FOR 106 Park Impact Fee PO#or INVOICE NO. kCCT#/TITLI AMOUNT Board Members Dept# 38440 1111 5023990 $ 54,587.00 1 hereby certify that the attached invoice(s), or 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 August 20, 2015 $ 54,587.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund