250378 1 0/07/1 5 �f
*' CITY OF CARMEL, INDIANA VENDOR: 369341
® ONE CIVIC SQUARE PERFORMANCE CONTRACTING INC CHECK AMOUNT: $*****3,400.00*
?� CARMEL, INDIANA 46032 16400 COLLEGE BLVD CHECK NUMBER: 250378
'Mh ION.G� LENEXA KS 66219 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
106 5023990 38393 1IN0053991 3,400.00 WILFONG PAVILION PANE
$ �, Performance Contracting,Inc.
" I 9810 Mayflower Pk Dr
SEP 3 0 2015 Ste 100
Carmel,IN 46032
BY:
Phone:317-872-4812 Fax:317-334-5872
Progress Billing Invoice Number: 01IN-0056991
Invoice Date Terms
Carmel Clay Parks and Recreation September 21,2015 Net 30(AR)
1411 E. 116th Street
PCI Branch PCI Project Number
Carmel, IN 46032 551 15-07698
PCI Customer No Customer Contract No.
01-104707
Project name Draw Number Period Customers Project No. Purchase Order No.
W ilfong Pavilion wall panels 2 09/01/15-09/30/15 38393
Original Contract Amount 3,900.00
Change orders 0 thru 0 0.00
Revised Contract Amount 3,900.00
Previously Billed 500.00
This Period 3,400.00
Total To-Date 100% 3,900.00
Less Retention 0% ( 0.00)
Sub-Total 3,900.00
Less Previous Invoices ( 500.00)
TOTAL AMOUNT DUE THIS INVOICE: 3,400.00
Remit to: Performance Contracting Group, Inc.
Box 872346
Kansas City, MO 64187
1&0
� �� Performance Contracting,Inc. APPLICATION FOR PAYMENT
9810 Mayflower Pk Dr
rrrrcxrns.< r Ste 100
CCt\IiL\('IL\( I\t
r Carmel,IN 46032
DRAW NUMBER: 2
To: Carmel Clay Parks and Recreation PROJECT: W ilfong Pavilion wall panels PERIOD TO: 09/30/15
1411 E. 116th Street SCOPE: CUSTOMERS PROJECT NO:
Carmel, IN 46032 PO NO: 38393
INVOICE NUMBER: 011N-0056991
INVOICE DATE: 09/21/15
Application is made for payment,as shown below Performance Contracting,Inc.certifies that to the best of our knowledge,information and
belief the Work covered by this Application for Payment has been completed in accordance with
1.ORIGINAL CONTRACT SUM............................................... 3,900.00 the Contract Documents,that all amounts have been paid by Performance Contracting,Inc.
2.Net Change By Change Orders.......................................... 0.00 for Work for which previous Certificates for Payment were issued and payments received
3.CONTRACT SUM TO DATE (Line 1 +/-2)........................ 3,900.00 from t n an t current payment shown herein is now due.
4.TOTAL COMPLETED&STORED TO DATE 3,400.00
By. ' Date:9/25/2015
(Column C7 on SOV) r idI
State of:
S.RETAINAGE
a. 0.00 %of Completed Work 0.00 County of: 140,m I lloi1
(Columns C4+C5 on SOV) Subscribed and sworn to before
b. 0.00 %of Stored Material 0.00
me this 25th day of September,2015
FIELD
(Column C6 on SOV) Notary C.SCH-seal
�eires:
Notary public a SealState ollndlana
Nota Public. MYCommisslonEx 'Total Retainage(Line 5a + 5b or rY pues act 20.2016
M Commissioo/� -2/�Total in Column C10 of SOV)........................................... 0.00 y �� '�l1"[7Cl/1
6.TOTAL EARNED LESS RETAINAGE.................................. 3,900.00 ARCHITECTS CERTIFICATE FOR PAYMENT
(Line 4 less Line 5 Total)
In accordance with Contract Documents,based on-site observations and the date comprising
7.LESS PREVIOUS CERTFIFCATES FOR PAYMENT this application,the Architect certifies to the Owner that to the best of the Architect's knowledge,
(Line 6 from prior Certificate)........................................................ 500.00 information and belief the Work has progressed as indicated,the quality of the Work is in accordance
with the Contract Documents,and the Contract is entitled to payment of the AMOUNT CERTIFIED.
8.CURRENT PAYMENT DUE................................................ 3,400.00
AMOUNTCERTIFIED..................................................................................................................$
9.BALANCE TO FINISH,INCLUDING RETAINAGE............
0.00 (Attach explanation if amount certified differs from the amount applied for:/ntial all figures on
this Application and on the Continuation Sheet that are changed to conform to the amount
certified.)
CHANGE ORDER SUMMARY ADDITIONS DEDUCTION ARCHITECT:
Total changes approved in previous
months By Date:
0.00 0.00 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to Performance Contracting,
Inc..Issuance,payment and acceptance of payment are without prejudice to any right of the Owner or
Total approved this Month 0.00 0.00 Contractor under this Contract.
TOTALS 0.00 0.00
NET CHANGES by Change Order _ 0.00
�C1 Performance Contracting,Inc. Progress Invoice Page 1 of 1
9810 Mayflower Pk Dr
h.V.IiN(.ice( Ste 100
Carmel,IN 46032
Project: Wilfong Pavilion wall panels Invoice Number: 01IN-0056991 Invoice Date: 09/21/15
Customer: CITY OF CARMEL Draw Number: 2 PCI Project Number: 15-07698
Billing Period: 09/01/15 thru 09/30/15 Customer Project/PO: /38393
C1 C2 C3 C4 CS C6 C7 C8 C9 C10 C11
WORK COMPLETED MATERIALS TOTAL
SCHEDULED STORED ON COMPLETED
VALUE From previous This period SITE STORED ON BALANCE TO
Activity ID DESCRIPTION OF WORK application (NOT IN SITE TO DATE % FINISH
(C7/C3) RETAINAGE NET BILLINGS
Billed % C4 OR CS) (C4+C5+C6) (C3-C7)
Wall Panels-Material 500.00 0.00 500-OC 100.00°/ 0.00 500!30 100.00% 0.00 0.00 500.00
Wall Panels-Labor 3,400.00 500.00 2,900.0 8S 29°/ 0.00 3,400.00 100.00% 0.00 0.00 2,900.00
Project Total 3,900.00 500.00 3,400.0 11
87.18°/ 0.00 3,900.00 100.00% 0.00 0.00 3,400.00
SPICI 9810 Mayflower Park Drive Suite 100 Carmel, IN 46032
PERFORMANCE Phone: 317-872-4812 Fax: 317-334-5872
CONTRACTING INC
Conditional Waiver and Release Upon Final Payment
Upon receipt by the undersigned check from Carmel Clay Parks & Recreation
(Maker of Check)
in the sum of $3,400.00 payable to Performance Contracting, Inc.
(Amount of Check) (Payee or Payees of Check)
and when the check has been properly endorsed and has been paid by the bank upon which it is
drawn, this document shall become effective to release any mechanics' lien, stop notice, or bond
right the undersigned has on the job of
Wilfong Pavillion
(Owner)
located at 11675 Hazel Dell Parkway Carmel IN 46033
(Job Description)
This release covers the final payment to the undersigned for all labor, services, equipment or
material furnished on the job, except for disputed claims for additional work in the amount of
Before any recipient of this document relies on it, the party should verify evidence of payment to the
undersigned.
Dated: September 25, 2015 Performance Contracting, Inc.
By:
Carol rod ,tou , Contract Administrator
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.
369341 Performance Contracting Group, Inc. Terms
Box 872346
Kansas City, MO 64187
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9/21/15 11NO056991 Wilfong Pavilion Acoustic Panel Installation 38393 $ 3,400.00
Total $ 3,400.00
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
120
Clerk-Treasurer
i
Voucher No. Warrant No.
369341 Performance Contracting Group, Inc. Allowed 20
Box 872346
Kansas City, MO 64187
In Sum of$
$ 3,400.00
ON ACCOUNT OF APPROPRIATION FOR
106 Park Impact Fee
PO#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
38393 T. 11NO056991 5023990 $ 3,400.00 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
October 2, 2015
'PAW"VXPU
Signature
$ 3,400.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund