HomeMy WebLinkAbout321013 01/25/18 R�/u�.Cggy�` .
CITY OF CARMEL, INDIANA VENDOR: 371899
. .6 ONE CIVIC SQUARE BO-MAR INDUSTRIES, INC. CHECK AMOUNT: $****24,225.55*
a°: CARMEL, INDIANA 46032 3838$.ARLINGTON AVE. CHECK NUMBER: 321013
.�''�rtiH_Fb. INDIANAPOLIS IN 46203 CHECK DATE: 01/25/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 R4460807 100729 3 24,225.55 MONON STATIC DEVICES
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
VOUCHER NO. WARRANT NO.
ALLOWED 20 ACCOUNTS .PAYABLE VOUCHER
Vendor# 371894
IN SUM OF$
B.O-MAR INDUSTRIES, INC. CITY'.OF.CARMEL
3838'S.ARLINGTON AVE. An invoice or 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 pet.unit,etc..
INDIANAPOLIS,..IN 46203
Payee
$24,225.55.
Purchase Or
ON ACCOUNT OF APPROPRIATION•FOR der
#
Redevelopment Commission Terms
Date Due .
PO# ACCT#. DATE INVOICE# DESCRIPTION:
DEPT# INVOICE# Fund#. . " AMOUNT ° DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
Bard Members
100729 3 44-608.07: $24,225.55 t hereby'certify that the attached invoice(s),or 12/31/17... . 3 Center.Green signage .$24,225.55
902 Encumbered. 902 Prior-Year 902 902
bill(s)is(are)true and correct and.that the
materials orservices itemized thereon for
which charge is made were ordered and
received except
Monday.January.22r 2018.
Mestetsky, Henry
.I hereby certify that.the attached invoice(s),or'bill(s),is.(are)true.and correct and I have
. audited•same.in accordanceWith.IC 5-
11-10,1.6
20. .
Cost distribution ledger classification if claim paid motor vehicle highway fund.. Tre I k-
sur
. . er a er
. C
APPLICATION AND CERTIFICATE.FOR PAYMENT AIA DOCUMENT 0702 PAGE 1 OF1
1 TO GC: Carmel AedeWopmerit Commission •APPLICATION NO.:: •Distribut 6h to:
PERIOD TO: 12/31717 OWNER
FROM CONTRACTOR: ARCHITECT
j Bormat Industries,Inc. PROJECT NO.: � { CONTRACTOR
l 3838t$.Arlington Ave:
Indisnapoiis,IN 46263
CONTRACTFOR Carmel Center Green Signage' CONTRACT DATE:. 97.197201.7
j
Th1sundqiz gmed.ConM=rcerbrw9 Uwtto Megmt otthe oomradoYs knowledge,fiftmaaon and
-CONTRACTOR'S'A'PPLICATION FOR PAYMENT +the work omwetiby this Applicatlon for Payment tm,eeen competed in 90000.1mce with t ie
Appliication is madb for pap*hL os;shown below in oonrteetlon with the. 'Copnbad Documents,Mail amounts have been patd_by the Conhailorfor Work forvM,ch pnWous
i Contrad.iContinuation Sheet,AA Document 13703,is attadied: a0emlicates for Payment rime issued and payer ieceived hom the0wne.and,tliat cvnent
f 1.ORIGINAL..CONTRA.CTSUM: $ 174,354.00 . rpaymentowenameh lanowdue
2-Net change by.Change,Ordsirs $
i 3 CONTRACT SUM To DATE.(Ilne 1+2) $ 174;354.00. . CONTRACTOR: •Bo-mar Industries,Inc.
4 TOTAL COMPLETED&STORED TO.DAVE $; 150,271 28
:.(Column G on G703) �-
l 5 RETAINAGE:. i1,; ��5.—/' .
a:10•%of Completed Wo* .15,027.13* : 'Buchanan,:Treasurer
(Columns D+E:on 13703).,
b. Stibred,MaWrial % 10 -
(Columns:F on G703) State of: Indiana
Total Retainege(line 59+5b or County ofi: Marion
Total in Column I'of 13703) $ 15,027.13 Subscribed and,ftom to.before
. 6 TOTAL EARNED LESS.RETAINAGE $ . 135 244,.15 me this /. _day of�('JI,rn he-v
_ 2017
(Line 4 less Llne 5 TotaQ .
7.LESSIPREVIOUS CERTIFICATES FOR PAYMENT.
(Line 6 from prior.Certificate).. $ 1.11,018:60. ��N � i4
8.CURRENT PAYMENT.DUE 24,225.55
9 BALANCE.TO FINISH,INCLUDING RETAINAGE.: INotary.Public: . ;
(1-ine3.1ess.Line6) $ 39,109.85
a
My commission expir+es•: — +
4 FARC ITECTS ERTIFICATE FOR•PAYMENT
I I�accordance with the Cantiad Dodmrents,used on-elle dbseivations end theme .. .
�appi�n,tlieArelilEect cutlltesto'Cie Owner:Rrat to the.t�eatoftlreArohStecYs knaM�p
.'ma6mi and befief the Work has pmgmmd as Indicated,the quirdy of the.Work is in accordance•
( , with ft Conrad Documents,and.tho ContradGi is entitled to payment Mthe AMOUNT CERTIPtED.
CHANGE.ORDER SUMMARY. ,ADDmONS. DEDUCTIONS AMOUNTCERTIFiED.'
TOtial changes approved in ((Aft;*exphnatlon iremotmt ceAVW dmesrro it fhe am uid..AppW tor.,,
previous months.by OWner-
. . .
Total roved this Month 2 917..28 r. i
TOTALS By.. ,i,w l . 1 .d.X1S 1 �f
Date:. ( L, ? I
NET CHANGES b Change Order.., - ... . rsc yam is not r,egotrame ThBAMouNrcetTiF D is Mable'only m the contraddr named
herein Issuance•paymeni eiid acceptance of pfyment are wno-It pmliidioemany dghla of the. .
�oT flue Ownei or Corrtrador under this Contrail. . .
t .
G703
CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 of 2 PAGES
AIA Document G702,APPLICATION;AND CERTIFICATE FOR PAYMENT;containing., APPLICATION,NUMBER: 3
Contractor's signed Certification is attached.. APPLICATION DATE: 12/15/17
In tabulations below,amounts:Are stated to the nearest dollar.: PERIOD FROM: 9119117
Use Column Ion.Contracts where variable retainage for Ilne.items may apply., TO: .12131/17 ,
GCS PROD NO:
A B G D E: F : G H: i
ITEM DESCRIPTION of WORK Scheduled Previous THIS APPLICATION Total Completed % BALANCE RETA kAAGE
No_. VALUE Application Work in Place, Stored Material and.Stored' (W TO FINISH:
1 Sign Type•30 90,454:00 90;454.00 - 90,454.00 100% - 9,045.40
2 Installation of Sign Type 30' 3,000:0.0 3, 000:00 - 39000.00 100% 300:00 .
3 Sign'Type 20' 14,400:00 14,400.00 - 14,400.00 100% ' - 1,440.00
4 Sign-Type' 10/15 : 60;000:00 . 12,000.00 24,000.00 36;000.00 '60% : 24;000.00 3,600.00 :
5 Installation of Sign Type 10/15. 3,000.00 . " - - - 3,000.00 -
6 Bond 31500.00 31500.00. - 3,500.00 100% : 350.00
7 C/O-Sign Type 20 2,917:28 - 2;917.28. 2,917:28. . 100% - .291.73
TOTAL 177;271.28 .123,354.00. 26,91728 - 150;27.1.28 27,000.00 -15;027.13 .
G702 AND`G703 BILLINGPay.App 3 12151Txlsx . Page 1
CONTRACTOR'S AND SUPPLIER'S AFFIDAVIT AND WAWER OF LIEN
o
final E Partial tl.Pa„mmt to Folbw
The undersigned;being first duly sworn on his oath or affirming,states that:
1 Jill Buchanan-, (Name) is the Treasurer (7`itle) of
Bo--Mar Industrles
(Company),(hereinafter called'.'Comparry'} of and is familiar -with the facts herein stated and makes this affidavit for and on behalf of himself and the Company,being duly
authorizcdto.bind the Cocnpany'by.the statements herein contained
2 The Company,Having contracted with Carmel Redevelopment.Commission has performed work and labor
or furnished materials supplies'or equipmenf.in the construction:of certain improvements on.the real estate commonly
known as Carmel.Center Green Signage located at Carmel Center Green . in;
Carmel IN (State),:which real estato is owned by:
Carmel Redevelopment Commission (hereinafter called"Owner")
3 Company has,or will-within 10 days receipt of payment due from Carmel Redevelopment Commission ':noted in Item.4,:
paid for all work;labor,matcrials,,equipment,and suppliers performed of furnislied.by it and by its subcontractors,material-men
and suppliers upon such premises or in connection therewith and no person,other than Company;.has any claim or right to a lien .
for any work;materials or services on account of any transaction undertaken by company with respect to said premises,.
except as specifically noted below;
Name of Company Amount Owed Explanation for Withholding.Payment
NON);
4 The amount due to Company from Carmel Redevelopment-Commission :
PARTIAL WAVIER that the balance due is the sum of
Twenty-four Thousand Two'Hundmd Twenty-five and 55/100
ty ( $ 24;225.55:):
...receipt of which.is hereby acknowledged,or
the payment of which:is promised as the sole consideration for this Affidavit and Partial and Waiver of Lien.which is given
to and for said amount;effective upon receipt'of such.payment
FINAL WAIVER that the final balance due is the sum of
receipt of which is hereby acknowledged,or
D the payment of which-is promised as.the sole consideration of this affidavit and Final.Waiver of Lien which shall become effective
upon.receipt of such payment
THEREFORE,the undersigned waivers and releases under the statutes of the state of Indiana;.unto the Owner
of said premises,any and all lien of claim whatsoever on.the above-described property and impmvements thereon account of LABOR
or.material or both,.furnished by undersigned thereto,and further certifies that no other party has any claim or right to a.lion on account.
of any work performed or material furnished to:the undersigned for-said project;except as noted above,and within the scope of this
and waiver.
Bo-Mar.Industries,Inca.. .
Title Treasurer
(�igna -officer)
Subscribed'and sworn before me this 15th day of December. 2017.
County of Residence: Marion "
(Notary Public}
4/?A/2025
(My Commission Gxpires)