HomeMy WebLinkAbout322740 03/12/18 CITY OF CARMEL, INDIANA VENDOR: 365399
s. ® ONE CIVIC SQUARE INSITUFORM TECHNOLOGIES USA INC CHECK AMOUNT: $""'102,903.66`
CARMEL, INDIANA 46032 1088 VICTORY DRIVE CHECK NUMBER: 322740
HOWELL MI 48843 CHECK DATE: 03/12/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER . AMOUNT DESCRIPTION
659 5023990 126591 102,903.66 OTHER EXPENSES
Voucher No. Warrant No.
'3�5 51'-ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WASTEWATER UTILITY ACCT.
CARMEL, INDIANA
Favor Of
T ehtiolo)ie 5 u5i �
l b fir Vic/o"'y &
�o u,& / MI /S s O
Total Amount of Voucher $
Deductions
46.5 c -_ Baa o 3 '
7, 050, 2 g
— ,tJ— - -- -- -4"
Amount of Warrant $
Month of Yr
Acct.
VOUCHER RECORD No.
Collection System
Pumping
Treatment&Disposal
Customer Accounts
Administrative&General
Reclaimed Water Treatment
Reclaimed Water Distribution
Total
Allowed
Board Members
Filed
BOYCE FORMS•SYSTEMS 1-800-382-8702 325
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 0702 Page I of 2
To: Jones&Henry Engineers,Ltd. Project: City of Carmel,IN.Concord Village Lining Contract 91,2017 Application No.: 1
1980 E.116th St.Ste.260
Carmel,IN 46032 Period From: 10101117 I
Attn: Tom Schreiber Owner/Engineer: Period To: 10131117
http://ecomm.eastemengineering;com/VieW/ViewJob.asnx?JObl[)=2922
From: Insituform Technologies USA,LLC. Job# 126691
1088 Victory Dr. Prime Contractor: Contract 91
Howell,MI 48843
Contract For: City of Carmel,IN.Concord Village Lining Contract 91,2017
Application is made for Payment,as shown below,in connection with the Contract.
CONTRACTOR'S APPLICATION FOR PAYMENT Continuation Sheet,AIA Document G703,is attached.
Change Order Summary 1. ORIGINAL CONTRACT SUM
$315,093.90
Change Orders approved in ADDITIONS DEDUCTIONS 2. Net change by Change Orders $0.00
previous months by Owner 3. CONTRACT SUM TO DATE(Line 1+2) $315,093.90
TOTAL $0.00 $0.00 4. TOTAL COMPLETED&STORED TO DATE $114,337.40
Approved this Month S. RETAINAGE:
Number Date Approved a. 10 %of Completed Work $11,433.74
b, %of Stored Material $0.00
TOTAL RETAINAGE $11,433.74 j
6. TOTAL EARNED LESS RETAINAGE $102,903.66 !
(Line 4 less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $0.00
TOTALS $0.00 $0.00 . ww I �� 1
Net Change by Change Orders $0.00 9. BALANCE TO FINISH,PLUS RETAINAGE $200,756.50
The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief,the work covered State of Michigan County of: Wayne
by this Application for Payment has been completed in accordance with the Contract Documents,that all amounts have been
Owner,and that current payment shown herein is now due.
NotaryPublic:
CONTRACTOR: Insituform Technologies USA,Inc.
.. My commission expires:
Amount Certified:
By Date: 10/31/17
Duan derske,Project Martafer 01achedexplanation ffaarotmldgersfrourdie aaountoplWedfor9
ARCHITECT'S CERTIFICATE FOR PAYMENT Owner/Engineer:
In accordance with the Contract Documents,based on on-site observations and the data comprising By Date'
the above application,the Architect certifies to the Owner that to the best of are Architect's knowledge This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to lite Contractor named herein.
information,andbelief,the work has progressed as indicated,the quality of the work is in accordance Issuance,payment,and acceptance of payments are without prejudice to any rights of lite owner or contractor I
with the contract documents,and the Contractor is entitled to payment of AMOUNT CERTIFIED under this contract.