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317243 10/11/2017 1�o,c�9yfi e CITY OF CARMEL, INDIANA VENDOR: 371368CHECK AMOUNT: $****55,045.00* ONE CIVIC SQUARE 15215 RIVER BAUMGARTNER & COMPANY, INC. CHECK NUMBER: 317243 f ��; CARMEL, INDIANA 46032 NOBLESVILLE N 46062 CHECK DATE: 10/11/17 MtroN o� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT ASPHALT-STATION— DESCRIPTION 42 1120 4350100 100654 092117-1 19,361.00 BUILDING REPAIRS & MA 1120 4350100 092117-2 33,691.00,993.00 STA 42 CONCRETE REMOV 1120 4350100 100696 092117-2 0 2 03 < < S » m O O q > M O i § § 2 2 9 a o 0 \ 0 k / w X O E 2 2 k G < z �_ 0 � % O % 0 ® OD > go U) § U k k 0 9 a 0 0 _0 \ > , 2 X o / G \ 0 ? X 3 6 © _ X 0 CL ° z 2 z 2 } \ > � 0 $ | \ ) c k z $ J i 3 9 A Er k $ § / / / § % k & $ m m 2 2 k 0 0 o A 3 f _ E 7 f; #f c f 3 2 2 \ O k i a a I » - CL 7 o i & 3 § & ? m i ° § o» CCD/ — R gt ƒ » E E $ /k ƒ g R E m 3 c e , - , ± %I 2 m § i s k< § ® m \ \ 0) # J E �$ 0 \ ) \ \ § k 7 z0 �4 7 a7 z - _ O� ° j m ƒ k k C o 2 / © D ƒ / 0 Z 9 o 2; k k \ | 0< / & 0 > m / Sr \Ro - > M 7 § R m 0$ CS. 0 / \ j E \ \ r- O I ¥ z co 3C O ® m / % ¢ ƒ § m / & = o $ m / 7 0 \ ƒ 3 ] § k CL f PO 9 CD/ CD X / ) / CD CD § Z \ Baumgartner& Company, Inc. 15215 River Road I NVO I C E Noblesville IN 46062- Invoice No:092117-1 (317) 296-7225 Date:9/14/2017 Due Date:9/14/2017 Bill To: Carmel Fire Department Job No:217180-LB 2 Civic Square Description:Carmel Fire Department Statior Carmel IN 46032 PO#: Description Extended Price Carmel Fire Department, Carmel, IN - PO#100654 Base Contract 19,361.00 Thank You For Your Business! Amount Now Due: 19,361.00 Terms: BAUMGARTNER ASPHALT COMPANY, INC. d/b/a BAUMGARTNER& COMPANY ASPHALT SERVICES 15215 River Road Noblesville, IN 46062 AFFIDAVIT AND FINAL WAIVER OF LIEN (For use with final payment application) Notice: This Waiver is Contingent Upon Receipt of Payment to Follow STATE OF INDIANA,COUNTY OF HAMILTON,SS: Date: September 21,2017 TO: Owner: Carmel Fire Department 2 Civic Square Carmel,IN 46032 Project: Carmel Fire Department Station 42 Carmel,IN Baumgartner Scope of Work:Asphalt Paving The undersigned, being duly sworn, deposes, certifies and says that: (i) he is an officer of, and is duly authorized to make this Affidavit and Final Waiver of Lien on behalf of BAUMGARTNER ASPHALT COMPANY, INC. d/b/a BAUMGARTNER & COMPANY ASPHALT SERVICES (`Baumgartner"); (ii) Baumgartner has contracted with General Contractor or Owner to furnish certain labor and/or materials as follows: Asphalt Paving, for the above Project; (iii)the final balance due from General Contractor or Owner for labor performed and material furnished to said Project is Thirty Six Thousand Six Hundred Eighty Four and 00/100 Dollars ($36,684.00); (iv) the payment of this amount has been promised as the sole consideration for this Affidavit and Final Waiver of Lien; (v) this Affidavit and Final Waiver of Lien is given to and for this amount, and is effective only upon receipt by Baumgartner of such payment; and (vi) no other party has a valid claim or right to a lien on account of any work performed,materials or equipment furnished or services rendered for said Project for which this Affidavit and Final Waiver of Lien is given, provided the final balance due is paid to Baumgartner so that any indebtedness associated with the performance of the Contract and the amount due herein may be satisfied. FOR GOOD AND VALUABLE CONSIDERATION,and in anticipation of the payment to Baumgartner of the amount set forth above and effective upon receipt of this amount, Baumgartner, for itself and its employees, hereby waives and releases unto the General Contractor and Owner any and all rights to hold, assert, enforce or file any and all claims and liens which Baumgartner now has or may have against the Project (including without limitation the real property on which such Project is located and the improvements thereon), for any and all labor performed, materials and equipment furnished, and services 1 provided to or for the Project by or through Baumgartner to the extent of the payment received for which this Affidavit and Final Waiver of Lien is given. Date: 09/21/16 CONTRACTOR: BAUMGARTNER ASPHALT COMPANY,INC. d/b/a BAUMGARTNER& COMPANY ASPHALT SERVICES By: Craig aumgartner, resident STATE OF INDIANA ) SS: COUNTY OF HAMILTON ) Subscribed and sworn to before me, a Notary Public, in and for said County and Sta this 2 t day of September,2017. MELISSA R.ORR 4�a��t(;TE Op"I NOTARY PUBLIC +AT,Pi, STATE OF INDIANA Signature: TIPTON COUNTY Me issa R.Orr Notary Public 4r COMM.#888709 COMM.EXPIRES 08.02.2024 My Commission Expires: June 2,2024 My County of Residence Is: Tipton 2 0 2 CA g $ « _\ � j � ) § / z / k E0 7 n / / > m 0 / q Z q Z OL co S k �_ m f % g 2 2 O % 2 w > > a OD a) kSon 0) # q k¢ 7 �§ > S 4 > CD 21 q 7 / k § m 7 � 6 � 6 # ■ � @ � 2 0 0 CL ® 2 z 2 ( _ w > 9 & f $ § O / R � c m | % io S k' $ \ \ / / CD / 0 k § CL i E J J m $ • , G o a 7 R - & 7 f ; # f E f 3 { [ o E : - CL a m E ° CD I o ! E ; k & / % ( J E % 2 0 ° E a ° & ® C - ` k CL CD 0 \ / a ® E S CD. c ( o / a) o a f -0 o o %« m § z E k k\ }/ Ek\ \ m mD \ .« ; k S S -n z j_ C k 8 2 2 k g ¥ k O C2 j - j C q ƒ k C o ) / _ D \ / C) Z / E ik k k # OR/ 3 7 � 2 § \ D \o ] _ 0 D �/ C U vCL 2 ƒ » ] ; /{ cD» § / \ G n /\/ E \ \ O 3 � Z % CD $ CD . r _ % m / CD n [ CD / � \ k 8 \ { \ § CDk « ° CL q 2 2 � CD \ \ \k E . CD 9 ° E k CA Baumgartner& Company, Inc. 15215 River Road I NVO I C E Noblesville IN 46062- Invoice No:092117-2 (317) 296-7225 Date:9/14/2017 Due Date:9/14/2017 Bill To: Carmel Fire Department Job No:217180-LB 2 Civic Square Description:Carmel Fire Department Statior Carmel IN 46032 PO#: Description Extended Price Carmel Fire Department, Carmel, IN CO#1 -Additional Area 3,993.00 CO#2 - 18" Under Cut 31,691.00 Thank You For Your Business! Amount Now Due: 35,684.00 Terms: BAUMGARTNER ASPHALT COMPANY,INC. d/b/a BAUMGARTNER& COMPANY ASPHALT SERVICES 15215 River Road Noblesville, IN 46062 AFFIDAVIT AND FINAL WAIVER OF LIEN (For use with final payment application) Notice: This Waiver is Contingent Upon Receipt of Payment to Follow STATE OF INDIANA,COUNTY OF HAMILTON,SS: Date: September 21,2017 TO: Owner: Carmel Fire Department 2 Civic Square Carmel,IN 46032 Project: Carmel Fire Department Station 42 Carmel,IN Baumgartner Scope of Work:Asphalt Paving The undersigned, being duly sworn, deposes, certifies and says that: (i) he is an officer of, and is duly authorized to make this Affidavit and Final Waiver of Lien on behalf of BAUMGARTNER ASPHALT COMPANY, INC. d/b/a BAUMGARTNER & COMPANY ASPHALT SERVICES ("Baumgartner"); (ii) Baumgartner has contracted with General Contractor or Owner to furnish certain labor and/or materials as follows: Asphalt Paving,for the above Project;(iii)the final balance due from General Contractor or Owner for labor performed and material furnished to said Project is Nineteen Thousand Three Hundred Sixty One and 00/100 Dollars ($19,361.00); (iv) the payment of this amount has been promised as the sole consideration for this Affidavit and Final Waiver of Lien; (v) this Affidavit and Final Waiver of Lien is given to and for this amount, and is effective only upon receipt by Baumgartner of such payment; and (vi) no other party has a valid claim or right to a lien on account of any work performed, materials or equipment furnished or services rendered for said Project for which this Affidavit and Final Waiver of Lien is given, provided the final balance due is paid to Baumgartner so that any indebtedness associated with the performance of the Contract and the amount due herein may be satisfied. FOR GOOD AND VALUABLE CONSIDERATION,and in anticipation of the payment to Baumgartner of the amount set forth above and effective upon receipt of this amount, Baumgartner, for itself and its employees, hereby waives and releases unto the General Contractor and Owner any and all rights to hold, assert, enforce or file any and all claims and liens which Baumgartner now has or may have against the Project (including without limitation the real property on which such Project is located and the improvements thereon), for any and all labor performed, materials and equipment furnished, and services 1 provided to or for the Project by or through Baumgartner to the extent of the payment received for which this Affidavit and Final Waiver of Lien is given. Date: 09/21/16 CONTRACTOR: BAUMGARTNER ASPHALT COMPANY,INC. d/b/a BAUMGARTNER& COMPANY ASPHALT SERVICES By: Craig,l( Baumgartner, President STATE OF INDIANA ) SS: COUNTY OF HAMILTON ) Subscribed and sworn to before me, a Notary Public, in and for said County and Sta is st day of September,2017. MELD R•ORR Signature: NOTARY PUBLIC Melissa R. Orr,Notary Public ,•io�'�V. r STATE OF INOV *. *'s TIPTON COUNTY COMM.#885709 COMM.EXPIRES 08-02-2024 ion xp�-es: June 2,2024 My County of Residence Is: Tipton 2