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316482 9/26/2017 CITY OF CARMEL, INDIANA VENDOR: 00350596 ONE CIVIC SQUARE RIETH-RILEY CONSTRUCTION CO INC CHECK AMOUNT: $'1,137,368.44' *? ?4 CARMEL, INDIANA 46032 PO BOX 226 CHECK NUMBER: 316482 9.y,. INDIANAPOLIS IN 46206 CHECK DATE: 09/26/17 ON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201S 4350200 100678 32003318 1,137,368.44 2017 RESURFACING STRE n = H -0 ;o $ « \ § \ ] § 9 7 2f ? w O n \ 0 k / m / q / \ C $ § Z 0 / 2 S @ - ® z E e ? ƒ O 7 $ / 00 4tCD G \ _ \ C w C) § / 3 0 / / / / @ & 0 2 0 m 3 J 7 O CL ° ® 0 2 7 z 2 E § > O 0 k / Q m | \ t Z % & i g - 2 > / 0 7 / / cn \ k ° / o S $0 ® G o � m f $ M a ;2. E / $ m - 9 / 2 i E Er - k $ 3 3 \ S = E 7 0 k k O CD CL a ¢ k / E \ § ® \ [ w E f = D § % 2 j \ / k« R \ q o \ ƒ e a � > / _ CLƒ ® & ) rr \ \ CD ; m 7 CL CD r D \ \ 0 ) O 0 0 C0 @ � o k g} \ § k ƒ \ = C o C' � CL c © � _� z CD A } ) S %k k k \ 0< q = —u e� SL / 0 > }f CD _ §/ D) e03 6� ° g =rq ƒ r / M n j E \ \ r- 0 £ 3 7 & % CD C ° C % 0 �_ % $ / / q m E _ g \ CD§ \ } k FL CL P } § / § E_ \ 2 ƒ } \ \ 00 ® o § t w o !kLE1r7M"W mEY CONSTRUCTION CO. , INC. 100% Qualil~y • 100% Employee Owned • Over 100 Years P.O.Box 276,Indianapolis,IN 46206 Tel.:(317)634-5561 Fax:(317)631-6423 Progress Estimate No.: 1 Sold To: City of Carmel Customer No.: 194706 City Hall Job Number: 3200716 1 Civic Square Invoice Number: 32003318 Carmel, IN 46032 Date: 9/14/17 Period Covered: 7131117-9/9/17 Terms: .lob: P.O.#100678/2017 Paving Project CONTRACTOR'S INVOICE 1 Original Contract Sum $1,735,814.51 2 Net change by Change Orders $0.00 3 Contract Sum to Date (line 1 +line 2) $1,735,814.51 4 Total Contract Completed to Date $1,137,368.44 5 Deductions: 0.00 % Retainage: $0.00 6 Total Earned Less Deductions (line 4-line 5) $1,137,368.44 7 Less Previous Billings $0.00 8 Invoice Amount Due (line 6-line 7) $1,137,368.44 A service charge of 1.112%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): chance Order Summary Total Estimate $1,137,368.44 Change Orders approved on previous estimates by Owner $0.00 Retainage $0•00 Approved this Estimate $0.00 Current Payment Due $1,137,368.44 Total Net Change by Change Orders $0.00 co b CA Ut N N A A A W u W W N N N N N -+ tD m V m N W N Q d W K 3 O N o 4 0) 3 mmm o'0 al A mm020imAN rD)(1)J, A Og m�w>-u (� vva0n co via a N -*-<U)CC -Om �m NN W<m >>0 0 - Elp O 0,� N N r d N S o o D O <O O CD 'ypi O X O T E N Z »d �_ .+.O O.N S y O _. �. G�.O N.m O10 0 6f O N �,v v A obi a o v m n C) c n m E m m(�° 0 c m m m _ o t co a � oc� ^ Sm 0 > Dp�° o - y gN � Fnoo3o ° c W e m 0) Z c ? g o (D n ao D O y y �n m D m m o f f in s ° C o 3 V .P N 3 Z cl.: w u-I mm ;Do y a�-sCo o Df �CCm W s 0) d-iN O °� O N � N OI `� N Gt to S [i d 0) O Dc C W A N O N D O N N W O) M D d Z v t f n � C)v O O N N m o m G) u m F a -u 9 m n C m r W p S O' O. 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Address &Zip: 1751 W. Minnesota Street, Indianapolis, IN 46221 Telephone No.: 317-634-5561 Fax No.: 317-631-6423 Project Name: 2017 Paving Project Invoice No. 32003318 Purchase Order No: 100678 Goods Services Person Providing Date Goods/Services Provided Cost Per Hourly Total Goods/Services Goods/ (Describe each good/service Item Rate/ Service separately and in detail) Hours Provided Worked Rieth-Riley Construction Co., Inc. 9/15/17 2017 Paving Project $1,137,368.44 $1,137,363.44 GRAND TOTAL Signature Kevin A. Tussey Printed Name AFFIDAVIT AND WAIVER OF LIEN ( ) Final ( X) 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:, Asphalt Paving and Related Items for a project known as: 2017 Paving Proiect #100678 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 One Million One Hundred Thirty Seven Thousand Three Hundred Sixty Eight and 44/100 Dollars ($1,137,368.44). ( ) Receipt of which is hereby acknowledged; or (X) The payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien, which is given to and for said amount, effective upon receipt of such payment. (Final Waiver) That the final balance due from the Contractor in the sum of Dollars ($ ). ( ) Receipt of which is hereby acknowledged; or ( ) 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. Erin B. Newlin Kevin A. Tussey, Area Office Manager WITNESS M`P4Mff[Y'A* NOTARIAL SEAL, this15 h day of September 2017 SEAL Hamilton County 2 State of Indiana (Notary Public) Printed Name: Erin B. Newlin My Commission Expires June 17, 2025 My commission expires: 6/17/25 Resident of: Hamilton County, Indiana