HomeMy WebLinkAbout302208 08/22/16 CITY OF CARMEL, INDIANA VENDOR: 370664
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j; ONE CIVIC SQUARE MILLER-EADS CO, INC. CHECK AMOUNT: $***109,126.80*
CARMEL, INDIANA 46032 4125 N.KEYSTONE AVE CHECK NUMBER: 302208
INDIANAPOLIS IN 46205 CHECK DATE: 08/22/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
659 5023990 2 109,126.80 OTHER EXPENSES
VOUCHER # 165842 WARRANT# ALLOWED
370664 IN SUM OF $
MILLER EADS CO INC
4125 N KEYSTONE AVE
INDIANAPOLIS, IN 46205
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2 07-1050-93 109,126.80
('d'VVeC'fd0 " (�I
Voucher Total 109,126.80
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
370664
MILLER EADS CO INC Purchase Order No.
4125 N KEYSTONE AVE Terms
INDIANAPOLIS, IN 46205 Due Date 8/2/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/2/2016 2 109,126.80
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
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PAYMENT APPLICA
TO: CITY OF CARMEL I PROJECT 2016C107 APPLICATION# 2 Distribution to:
BOARD OF PUBLIC WORKS&SAFETY ONE CIVIC S NAMEAND 106TH ST P.S.CONTROLS.CONTRACT 80A PERIOD THRU: 07131/ZO16 OWNGR
CARMEL,IN 46032 LOCATION: BOARD OF PUBLIC WORKS&SAFETY ONE pROjECT#s: ARCHITECT
Attn:Jones&Henry Engineirs Ltd CARMEL,IN 46032 03116/2016 CONTRACTO]
DATE OF CONTRACT.
FROM: MILLER-EADS CO.,INC. ARCHITECT:
4125 N.KEYSTONE AVENUE
INDIANAPOLIS,IN 462051
FOR: ELECTRICAL
1 11 Contractor's signature below is his assurance to owner,conceming the payment herein applied for,
CONTRACTOWS SUMMA OF WORK that:(1)the Work has been performed as required in the Contract Documents,(2)all sums previously
Ipaid to Contractor under the Contract have been used to pay contractoes costs for labor,materials
Application is made for payment as shown and other obligations under the Con r or prev ous pat d(3)Contractor is legally
Continuation Page is attached. entitled to this payment.- I
1. CONTRACTAMOUNT $152,720.00 CONTRACTOR: MILLER-EADS CO.,INC.
Date– -2�-SUM-OF ALL CHANGE ORDERS- $5.532.00-
-
3. CURRENT CONTRACT AMOUNT (Line 1 2) $158,252.00
01OLM U1. INDIANA
4. TOTAL COMPLETED AND STORED $158,262-00 <
111VUJILY U1. MARION
(Column G on Continuation Page)
Subscribed and swum to before
5. RETAINAGE:
a. 10.00% of Completed Work $15,825.20 me this 13th��ay of July 2016
b. 0.00% of Material Stored $0.00 Notary Public: Citliefine/d.Wyd-Dff
(Column F on Continuation Page My Commission 4ires: 08f16/23
Total Retainage(Line Sa+5b or
Column I on Continuation Pag $15,825.20 ARCHITECT'S CERTIFICATION
6. TOTAL COMPLETED AND STOI e)1 D LESS RETAINAGE $142,426.80 Architecrs signature below is his assurance to Owner,concerning the payment herein applied for,that.
(Line 4 minus Line 5 Totao Architect has inspected the Work represented by this Application.(2)such Work has been completed to
the extent indicated in this Application,and the quality of workmanship and materials conforms with the
7. LESS PREVIOUS PAYMENT APP111 ICATIONS $33,300.00 ion for Payment accurately states the amount of Work completed
Contract Documents.(3)this Applicar
8. PAYMENTDUE and payment due therefor,and(4)Architect knows of no reason why payment should not be made.
(Line 3 minus Line 6) $15,826.20 (if the certiftd amount is different from the payment due.you should attach an explanation.Initial all
the figures that a-changed to match the certified amount.)
SUMMARY OF CHANGE ORDERS ADDITIONS DEDUCTIONS
Total changes approved in ARCHITEC-r
previous months $0.00 $0.00 By: Date:
Total approved this month Neither this a ion nor payment applied for herein is assignable or negotiable.Payment shall be
TOTALS $5,532.00 $0.00 made only to Contractor,and is without prejudice to any rights of Owner or Contractor under the
NETCHANGES] 1 Contract Documents or otherwise.
PAYMENT APPLICATION Quantum Software Solutions,Inc.Document
' \
CONTINUATION PAGE Page 2of 2
PROJECT: 2016C107 APPLICATION#: 2
106TH ST P.S.CONTROLS,CONTRACT 80A DATE OF APPLICATION: 07/13/2015
Payment Application containing Contractors signature is attached. PERIOD THRU: 07/31/2016
PROJECT#s:
A B C D E F G H I
COMPLETED WORK STORED TOTAL % BALANCE i
SCHEDULED RETAINAGE
ITEM# WORK DESCRIPTION AMOUNT AMOUNT MATERIALS COMPLETED AND COMP. TO
AMOUNT PREVIOUS THIS PERIOD (NOT IN D OR E) STORED (G/C) COMPLETION (If Variable)
PERIODS (D+E+F) (C-G)
101 MOBILIZATION,PRE-CON AND
102 SUBMITTALS $15,000.00 $7,000.00 $8,000.00 $0.00 $15,000.00 100% $0.00
201 CONTROL LOGIC-PLC CONTROL- – — --- - - — – -- _
202 SYSTEM
203 MATERIAL&EQUIPMENT $76,036.00 $30,000.00 $46,036.00 $0.00 $76,036.00 100% $0.00
204 INSTALLATION MATERIAL $5,750.00 $0.00 $5,750.00 $0.00 $5,750.00 100% $0.00
205 INSTALLATION'LAB IR $30,584.00 $0.00 $30,584.00 $0.00 $30,584.00 100% $0.00
206 PROGRAM&COMMISSION $25,350.00 $0.00 $25,350.00 $0.00 $25,350.00 100% $0.00
900 —CHANGE ORDERS-
901 ADD PANELVIEW FOR SPARE $5,532.00 $0.00 $5,532.00 $0.00 $5,532.00 100% $0.00
TOTALS I $158,252.00 $37,000.00 $121,252.00 $0.00 $158,252.00 100% $0.00
CONTINUATION PAGE Quantum Software Solutions,Inc.Document
t.
EXHIBIT D
CONTRACTOR'S AFFIDAVIT AND WAIVER OF LIENS AND CLAIMS
(_) FINAL {x) PARTIAL (x') PAYMENT TO FOLLOW-
-OWNER' City of Carmel, Indiana PROJECT: 1061h Street P.S. Controls
Department of Public Works. Contract 80A
CONTRACTOR: Miller-FADS Company, inc. CONTRACT
DATE:
T. Christopher Chastain being duly sworn states that he or she Is the President of
CONTRACTOR, whlch.was awarded Contract No. BOA ' with the OWNER In accordance with
the contract terms and conditions to install and/or furnish certain materials and labor as follows:
electrical (`Work")for the Project,
DOES HEREBY STATE,WARRANT AND REPRESENT ON BEHALF OF THE CONTRACTOR the following:
PARTIAL WAIVER That the balance due from OWNER is the sum of($ 109,126.80 )
O Recelpt of which is hereby acknowledged;or
4() Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF
LIENS AND CLAIMS and which Is given to and for said amount effective upon receipt of such payment.
FINAL WAIVER That the final balance due from OWNER Is the sum of($ J.
( ) Receipt of which is hereby acknowledged;or
( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF
LIENS AND CLAIMS which is given to and for said amount effective upon receipt of such payment.
THEREFORE,through the date hereof,Contractor waives and releases the Owner and Project of all liens or claims,
Including, but not limited to, claims for materials, equipment, labor, superintendence and other services or Work
performed orfumished by Contractor and further affirms that no other party has any claim or right to lien on account
of any materials, equipment, labor, superintendence and other services or Work performed-or furnished to or for.
Contractor for the Project. Contractor agrees to Indemnify, defend and hold the Owner and Project harmless,
—including-dbsts-and-attorneys'-fees;fror i and-against-any--and=all-'clalms-or:liens-for any-subcontractors,materials,-==-- ——
supplies, equipment or labor furnished for, in connection with or Incorporated Into the Project by, through or under
Contractor through the date hereof. This Affldavlt and Waiver of Liens Is given to Induce Owner to pay the amount
Indicated above. Contractor represents that all employees,subcontractors,or materialmen have been paid or will be
paid from these funds.
That through the date hereof, all Affidavits and Waiver of Liens and.Claims are.true, correct and unconditional and
that there is no claim either legal or equitable to defeat the validity of said Affidavits and Waiver of Liens and Claims.
That the following are the.names of all parties who have furnished material or labor, or both,for said Work and 'all
parties having contracts or subcontracts for specific portions of said Work or for material used In the construction
thereof and.the amount due or to become due to each, and that the Items mentioned Include all labor and material
required to complete said Work according to Project plans and specifications:
1 2 3 4 5 6 7
CONTRACTOR TYPE OF AMOUNT OF TOTAL NET NET BALANCE
WORK CONTRACT RETAINED • PREVIOUSLY• AMOUNT TO
PAID THIS BECOME
PAYMENT DUE
N/A
TOTAL
AMOUNT OF ORIGINAL CONTRACT 152.720.00 WORK COMPLETED TO DATE 158,252.00
EXTRAS TO CONTRACT 5.532.00 LESS RETAINAGE 15,825.20
TOTAL CONTRACT&EXTRAS 158.252.00 NST AMOUNT EARNED 142.426.80
CREDITS TO CONTRACT .00 NET PREVIOUSLY PAID 33,300.00
ADJUSTED TOTAL CONTRACT 158,252.00 NET AMOUNT OF THIS PAYMENT 109,126.80
BALANCE TO BECOME DUE
CITY OF CARMEL Contractor's Affldavlt and
1061h Streat P.S.Controls/451-8733.001 A-21 i Waiver of Liens and Claims
I
I i ,E
This Instrument has been executed as of the 20th day of Jul ,.2016^ J
CONTRACTOR: _:Mille-FADS Company, Inc._ _
By: ,• �_ ,�
Name: T. Christopher Chastain
,Title: President 1
STATE OF INDIANA J
COUNTY
OF MARION I
Sworn to and subscribed before me the undersigned authority,on this . 20th day of
July , 2016 J i
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`��,•�\k-�E S. tti�c�, Ci
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;���ti• ' p�; N ary Pub c, State
%r:, NOTARY "� d of Indian
U• SEP L Catherine S.Wycoff
Printed.Name of i '
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Notary_ i
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My Commission Expires:
August 16, 2023
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CITY OF CARMEL Contractor's Affidavit and
108°i Street P.S.'Controls/451-8733.001 A-22 Waiver of Liens and Claims
i
. 1
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I - -
EXHIBIT E
SUBCONTRACTOR AFFIDAVIT AND WAIVER OF LIENS AND CLAIMS
i
(_} FINAL Lv�PARTIAL (_) PAYMENT TO FOLLOW
OWNER: City of Carmel, Indiana PROJECT: 1 Oe Street P.S. Control l
Department of Public Works. Contract 80A
SUB- CONTRACT
CONTRACTOR: DATE:
r
,NyInnoin W0+5 being duly swom states that 4e or she is the OU)(10W of
SUBCONTRACTOR, which entered into a contract in writing with A F0215 ("CONTRACTOR") who was
awarded Contract No. BOA with the OWNER In accordance with the contract terms and
condif1on� to install and/or furnish certain materials and labor as follows:
W. iny0ice 4br ecy*ml RAM ("Work")for the Project,
DOES HEREBY STATE,WARRANT AND REPRESENT ON BEHALF OF THE SUBCONTRACTOR the following:
PARTIAL WAIVER That the balance due from.CONTRACTOR is the sum of($ R!f raJ4 4O ).
( Receipt of which is hereby acknowledged;or
( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF
LIENS AND CLAIMS and which Is given to and for said amount effective upon receipt of such payment.
FiNAL WAIVER That the final balance due from CONTRACTOR Is the sum of($ ).
( } Receipt of which is hereby acknowledged;or
( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF
LIENS AND CLAIMS which is given to and for said amount effective upon receipt of such payment.
THEREFORE, through the date hereof,Subcontractor waiyes•and releases the Owner, Contractor and Project of all
liens or claims, Including, but not limited to, claims for materials, equipment, labor, superintendence and other
services or Work performed or furnished by Subcontractor and further affirms that no other party has any claim or
right to lien on account of any materials,equipment,labor,superintendence and other services or Work performed or
furnished to or for Subcontractor for the Project. Subcontractor agrees to Indemnify,defend and hold the Owner,
Contractor and Project harmless,including costs and attorneys'fees,from and against any and all claims or liens for
any sub-subcontractors, materials,supplies, equipment or labor furnished for,in connection with or incorporated into ,
the Project by,through or under Subcontractor through the date hereof. This Affidavit and Waiver of Liens is given to
induce Contractor to pay the amount indicated above. Subcontractor represents that all employees, subcontractors
or materialmen have been paid or will be paid from these funds.
That through the date hereof,all Affidavits and Waiver of Liens and Claims are true, correct and unconditional and
that there is no claim either legal or equitable to defeat the validity of said Affidavits and Waiver of Liens and Claims.
That the following are the names of all parties who have furnished material or labor, or both,for said Work and all i
parties having contracts or subcontracts for specific portions of said Workor for material used in the construction f
thereof and the amount due or to become due to each, and that the items mentioned include all labor and material
required to complete said Work according to Project plans and specifications:
I
1 2 3 4 5 6 7
SUBCONTRACTOR TYPE OF AMOUNT OF TOTAL NET NET BALANCE
WORK CONTRACT RETAINED PREVIOUSLY AMOUNT TO '{
PAID THIS BECOME 1
PAYMENT DUE
TOTAL
AMOUNT OF ORIGINAL CONTRACT WORK COMPLETED TO DATE
EXTRAS TO CONTRACT LESS RETAINAGE i
TOTAL CONTRACT&EXTRAS NET AMOUNT EARNED i
CREDITS TO CONTRACT • NET PREVIOUSLY PAID i
ADJUSTED TOTAL CONTRACT NET AMOUNT OF THIS PAYMENT 11
BALANCE TO BECOME DUE !�
P�
CITY OF CARMEL .�
10&Street P.S.Control/451-8733.001 A-23 Subcontractor's Atftdavlt and
f WntuPr of i Ian.0 And raalme '
d
This instrument has been executed as of the day of ,2016. j
SUBCONTRACTOR: TORIC ENGINEERING j
By: ftno
Na e:
Title:
STATE OF INDIANA
COUNTY '
OF dLs
Sworn a subscribed before me the undersigned authority on this oZ tP day of
20_11p. .
n.1,4"
i
otary Public, State
of
-4
_. °
Printed Name of 'i
'•<.;:_ NotaryAm
AllF- a,n o S I
N�fullflfNtNf��
[SEAL]
My Commission Expires:
7
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l
CITY OF CARMEL
1061'Street P.S.ControV451-6733.001 A-24 Subcontractor's Affldavlt and
Waiver of Liens and Claims