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Home My WebLink About301435 07/28/16 i CITY OF CARMEL, INDIANA VENDOR: 00350596 q2 ONE CIVIC SQUARE RIETH-RILEY CONSTRUCTION CO INC CHECK AMOUNT: $*t'*24,820.00` =q CARMEL, INDIANA 46032 PO BOX 276 CHECK NUMBER: 301435 INDIANAPOLIS IN 46206 CHECK DATE: 07/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 R4350200 33470 032002886 24,820.00 PAVING I i i i I i I i VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) RIETH-RILEY CONSTRUCTION CO INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 276 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service INDIANAPOLIS, IN 46206 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $24,820.00 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 33470 32002886 43-502.00 $24,820.00 1 hereby certify that the attached invoice(s),or 6/9/16 32002886 $24,820.00 2201 Encitnthered 201 2201 201 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 Tuesday,July 26, 2016 Dave Huffman Director 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer i I r Mr"fD/ RIE1 -� t CONSTRUCTION Co, INC. i 100% Qualify' • 100% Employee Owned • Over 100 Years P O Box 276;lntlianapo6s,IN 46206 Tel (317)634-5561hFa 0631 6423 Progress Estimate No.: 1 Sold To: Carmel Street Department Customer No.: ,x222161_ 3400 W. Main Street Job Number: w "C3200356 Carmel, IN 46074 Invoice Number: 4 32002886 Date: z Peiiod Covered 6/6/76;`619116' Terms: 4, pue:upori`Recept Job: P.O#33470/ 116th & Guilford Path Extension-Connection CONTRACTOR'S INVOICE 1 Original Contract Sum $24,820.00 2 Net change by Change Orders $0.00 3 Contract Sum to Date (line 1 +line 2) $24,820.00 4 Total Contract Completed to Date $24,820.00 5 Deductions: 0.00 % Retainage: $0.00 6 Total Earned Less Deductions (line 4-line 5) $24,820.00 7 Less Previous Billings $0.00 8 Invoice Amount Due (line 6-line 7) $24,820.00 A service charge of 1-1/2%per month(18%annual rate)will be made of all account balances not paid,according to the terms stated. Office Use Only(Current Estimate Totals): Change order Summary Total Estimate $24,820.00 Change Orders approved on previous estimates by Owner $0.00 Retainage $0.00 Approved this Estimate $0.00 Current Payment Due $24,820.00 Tat al let Change by Change Orders $0.00 "R'llEHjj , L , CONSTRUCTION CO. , INC. 100% Quality • 100% Employee Owned • Over 100 Years P.O.Box 276,Indianapolis,IN 46206 Tel.:(317)634-5561 Fax:(317)631-6423 Sold To: Carmel Street Department Progress Estimate#: 1 3400 W.Main Street Customer#: 222181 Carmel,IN 46074 Invoice#: 32002886 �R/ � R RIETH-R�LEY Date: 6/9/16 Period Covered. 6/6/16-6/9/16 Job: P.O#33470/116th&Guilford Path Extension-Connection j Original Plan :"Change Order Ouantlty t.Total�Quantity Units $per Und Enter Units E m Total$ units to D to sl o o a Item No dtem Descri tion Quanti ate $to Date P.O#33470/116th&Guilford Path Extension-Connection 0.000 0.000 0.000 0.000 0.00 0.000 0.00 0.000 0.00 116th&Guilford Path Extension- 1 Connection 1.000 0.000 1.000 LSM 24,820.00 1.000 24,820.00 1.000 24,820.00 - --- -- -Total: - - ----24,820.00 - - - - ---24;820.00 Deductions: 0.00 0.00 Balance: 24,820.00 24,820.00 I f AFFIDAVIT AND WAIVER OF LIEN I (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 Carmel Street Department , to furnish certain material, and/or labor as follows:, Asphalt Paving and Related Items for a project known as: PO #33470 / 116th & Guilford Path Extension - Connection 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 Twenty FourThousand Eight Hundred Twenty 00/100 Dollars ($24,820.00 ). ( ) 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: Kevjw< Tussey, Area Office Manager ITNESS M r �R r EAL, this 5th ay of July 2016 Notary Public Seal (Notary Public) State of Indiana Printed Name: Erin B. Newlin Hamilton County mnciR�J-l�f�/fl?! Resident of: M] ton ou , I EXHIBIT B Invoice Date: June 9, 2016 Name of Company: Rieth-Riley Construction Co. , Inc. Address &Zip: 1751 W. Minnesota Street, Indianapolis, IN 46221 Telephone No.: 317-634-5561 Fax No.: 317-631-6423 Project Name: 116th & Guilford Path Extension - Connection Invoice No. 32002886 Purchase Order No: 33470 Goods Services Person Providing Date Goods/Services Provided Cost Per Hourly Total — I Goods/ (Describe each good/service Item Rate/ Service separately and in detail) Hours Provided Worked Rieth-Riley Construction Co., Inc. 6/9/16 per attached invoice 24820.00 N/A 24820.00 GRAND TOTAL $24820. )0 Signature Kevin A. Tussey Printed Name