HomeMy WebLinkAbout323529 03/29/18 1y u.CggM�
CITY OF CARMEL, INDIANA VENDOR: 00350511
! ONE CIVIC SQUARE SMOCK FANSLER CORP CHECK AMOUNT: $****22,800.75*
a CARMEL, INDIANA 46032 2910 W MINNESOTA ST CHECK NUMBER: 323529
vM`TDN. ` INDIANAPOLIS IN 46241 CHECK DATE: 03/29/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 R4460841 100530 2 12,960.75 DEMOLITION OF 15 1ST
902 R4460841 101082 2 9,840.00 ADDITIONAL SIDEWALK 1
Prescribed by State Board of Accounts City Form No.201(Rev.1995)'
VOUCHER NO: : WARRANT N4.
ALLOWED 20 ACCOUNTS ,PAYABLE VOUCHER
Vendor.# 00350511
„ IN SUM OF$
SMOCK FANSLER CORP C
ITY.OF CARMEL
2910:W MINNESOTA ST An'invoic.e or bilGto be'propedy itemizetl must show:kind of service,where performed;datesservice
rendered;.by whom,rates per day,number.of.hours,rate per hour,.number of units,price per.unit,etc.., ,
INDIANAPOLIS, IN 46241
Payee: .
$9;840:00
Purchase Order#
.. :ON ACCOUNT OF APPROPRIATION FOR
Terms
Redevelopment Commission
'Date Due , .
PO# ACCT# DATE INVOICE# 'DESCRIPTION:
-DEPT# INVOICE.# Fund.#. AMOUNT Board Members : DEPT# . FUND# (or note attached invoices)or bill(s)) AMOUNT.
101082 2 44-608.41 $9,840.00 I:herebycertify that the attached invoice(s),or 11/30/17- 2 Retainage for151stAve demo and •. $9,840.00
902 Encuisbered. 902, Prlor'Year . 902 . 902 construction
bill(s)is(are)true and'correct and.that the.
materials or'services item ized.thereon for
Tr
•
which_charge is made were'ordered and .
received except
•
Tuesday, March 27,'2018
Mestetsky;Henry
hereby certify that.the'attached invoice(s),orbill(s),is,(are)true and correct and I have .
audited.same.in accordancewith.IC 5-11-10-1.6
. .
,20
Cost distribution ledger classification if claim paid motor vehicle highway fund.. Clerk-Treasurer
AIA Type Document
Application and Certification for Payment Page 1 of 2
TO(OWNER):CARMEL REDEVELOPMENT COMM. PROJECT.BLDG&LOT DEMO FOR CRC APPLICATION NO: 2 DISTRIBUTION
30 W.MAIN ST. PERIOD 70:11/30/2017 TO:
SUITE 220 _OWNER
CARMEL, IN 46032 _ARCHITECT
FROM(CONTRACTOR): Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S —CONTRACTOR
2910 W.Minnesota Street PROJECT NO:
Indianapolis, IN 46241
CONTRACT FOR: CONTRACT DATE:
The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and
CONTRACTORS APPLICATION FOR PAYMENT belief the work covered by this application for Payment has been completed in accordance with the
Application is made for Payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous
Continuation Sheet,AIA Type Document is attached. Certificates for Payment were issued and payments received from the owner, ( 10Po�tllllllllijp�
current payment shown herein is now due. ��0 �` RY Pi/ u�46J�
1.ORIGINAL CONTRACT SUM ...... . .. ... . .. . . . ..$ 135,675.00 \\\\�o``��O�P •--•. e�, i/may
Corporation
2.Net Change by Change Orders ... . . . . .. .. . . ...$ 9,840.00 CONTRACTOR: Smock Fansler Cor P
2910 W.Minnesota Street Indianapolis, IN 46241
3.CONTRACT SUM TO DATE (Line 1 +2)... ........ $ 145,515.00 �f * SEAL . -
4.TOTAL COMPLETED AND STORED TO DATE . . . . . . $ 145,515.00 By: ` ` ` Date: �{
5.RETAINAGE: T.M.FANSLER / CEO ��SJ' , •P
a. 0:00%of Completed Work $ 0.00 State of:IN
County of: MORGAN
b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before me this Day of20
Total retainage(Line 5a+5b). . .. ... .. . . .... ... . . $ 0.00
Notary Public:
44
My Commission Expires: 1
6.TOTAL EARNED LESS RETAINAGE. . .. . . .. ... . . . $ 145,515.00
(Line 4 less Line 5 Total) ARCHITECT'S CERTIFICATE FOR PAYMENT
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,based on on-site observations and the data com-
Line 6 from prior Certificate prising the above application, the Architect certifies to owner that to the best of the Architect's
( p' ). . ..... . .... . .. . . . ...$ 122,714.25 knowledge,information and belief the Work has progressed as indicated,the quality of the work
8.CURRENT PAYMENT DUE ... .. . ... . . .. ...... ..$ 22,800.75 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the
9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED.
(Line 3 less Line 6) $ 0.00 AMOUNT CERTIFIED. . . . .. ....... ........ . . ........ $
(Attach explanation if amount certified differs from the amount applied.Initial all figures on this
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Application and on the Continuation Sheet that are changed to conform to the amount certified.)
Total changes approved in ARCHITECT:
previous months by Owner 9,840.00 0.00 By. Date:
Total approved this Month 0.00 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
named herein.Issuance,Payment and acceptance of payment are without prejudice to any
TOTALS 9,840.00 0.00 rights of the Owner or Contractor under this Contract.
NET CHANGES by Change Order 9,840.00
m, m
AIA Type Document
Application and Certification for Payment Page 2 of 2
TO(OWNER):CARMEL REDEVELOPMENT COMM. PROJECT: BLDG&LOT DEMO FOR CRC APPLICATION NO: 2 DISTRIBUTION
30 W.MAIN ST. TO:
SUITE 220 PERIOD TO:11/30/2017 _OWNER
CARMEL, IN 46032 _ARCHITECT
—CONTRACTOR
FROM(CONTRACTOR): Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S
2910 W.Minnesota Street PROJECT NO:
Indianapolis, IN 46241
CONTRACT FOR: CONTRACT DATE:
SCHEDULE PREVIOUS COMPLETED STORED COMPLETED
ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE
1 BLDG&UTILITY DEMOLITION 39,650.00 39,650.00 0.00 0.00 39,650.00 100.00 0.00 0.00
2 SITE DEMO,HARDSCAPE, 67,165.00 57,090.25 10,074.75 0.00 67,165.00 100.00 0.00 0.00
LANDSCAPE
3 PARKING LOT PAVING& 28,860.00 25,974.00 2,886.00 0.00 28,860.00 100.00 0.00 0.00
SIGNAGE
4 CHANGE ORDER#1 9,840.00 0.00 9,840.00 0.00 9,840.00 100.00 0.00 0.00
REPORT TOTALS $145,515.00 $122,714.25 $22,800.75 $0.00 $145,515.00 100.00 $0.00 $0.00
AFFIDAVIT AND WAIVER OF LIEN
[X] Final [ ] Partial [ ] Payment to Follow
State of Indiana
County of Marion
T.M.Fansler' being duly sworn states that he is the CEO of SMOCK FANSLER CORP.having
contracted with: Carmel Redevelopment Commission to furnish certain labor, materials, and/or
services as follows: Mise. Construction for a project known as: SFC#17-066 Building & Lot Demo
located at Carmel,IN and does hereby state on behalf of the aforementioned contractor:
(PARTIAL WAIVER)that there is due from the owner the sum of: $0.00
[ ] receipt of which is hereby acknowledged; or
[ ] the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of
Lien which is given solely with respect to said amount,and which waiver shall be effective only upon
receipt of payment thereof by the undersigned;
(FINAL WAIVER)that the final balance due from the owner is the sum of($22,800.75)
Twenty Two Thousand Eight Hundred Dollars and 75/100
[ ] receipt of which is hereby acknowledged; or
[X] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of
Lien which shall become effective upon receipt of such payment.
THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or
claim whatsoever on the above-described property and improvements thereon on account of Labor,
Materials, and/or Services, furnished by the undersigned thereto, subject to limitations or conditions
expressed herein, if any; and further certifies that no other party has any claim or right to a lien on
account of any work performed, materials, or services furnished to the undersigned for said project, and
within the scope of this affidavit and waiver. �J
SMOCK FANSLER CORP. By�/��i- a CEO
T.M. Fansler
WITNESS MY HAND AND NOTARIAL SEAL,this 2711 day of February,2018. Yullpula
Melissa J. Laue otary Public W ; _
SEAE
My commission expires eOctober 23, 2024_ Residing in Morgan County %�,.•'• ,.�Q
F41�10\P���\\\�
Prescribed by State Board of Accounts City Form No,201(Rev.1995)
VOUCHER, NO: WARRANT NO. .
ALLOWED 20 ACCOUNTS .PAYABLE VOUCHER
Vendor#. 00350511:
IN'SUM OF$ CITY_OF.CARMEL
SMOCK FANSLER CORP. .
2910 W MINNESOTA STAn 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 perhour,number of units;.price per unit,etc.,
INDIANAPOLIS, IN 46241 .
Payee .
$12,960.75
Purchase Order# .
ON ACCOUNT OF:APPROPRIATION FOR
Terms
Redevelopment Commission : .
Date Due
PO#- ACCT# :DATE: INVOICE# DESCRIPTION:
DEPT.# INVOICE# Fund#. . AMOUNT- Board Members : DEPT# FUND# (or note attached invoice(s).or bill(s)) AMOUNT
100530 2 - 44-608.41 '$12,960.75 I:hereby certify that the attached invoice(s),or 11/30/17 2 retainage for 1151stAve demo and construction,.'. $12,960.75
902. Encumbered. . . 902 Prior Year'• 902 . 902
bills)is(are)true and'correct and.that the
materials or services itemized
:thereon for
which charge is.made were ordered and
received except
Tuesday. March 27,-2018
Mestetsky; Henry.
I hereby certify that.the attached invoice(s),or bill(s),'is.(are)true-and correct and I have .
audit-d.same.in accordance,with.IC 5'-1.1-10'-1.6
20, .
Cost distribution ledger classification if claim.paid motor vehicle highway fund.:
-. .
C erk Treasurer .
AIA Type Document
Application and Certification for Payment Page 1 of 2
TO(OWNER):CARMEL REDEVELOPMENT COMM. PROJECT:BLDG&LOT DEMO FOR CRC APPLICATION NO: 2 DISTRIBUTION
30 W.MAIN ST. PERIOD TO:11/30/2017 TO:
SUITE 220 _OWNER
CARMEL, IN 46032 _ARCHITECT
—CONTRACTOR
FROM(CONTRACTOR): Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S
2910 W.Minnesota Street PROJECT NO:
Indianapolis, IN 46241
CONTRACT FOR: CONTRACT DATE:
The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and
CONTRACTOR'S APPLICATION FOR PAYMENT
belief the work covered by this application for Payment has been completed in accordance with the
Application is made for Payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous
Continuation Sheet,AIA Type Document is attached. Certificates
for shown were
herein is now due.
received from the owne\\\ RYlit� �//�/
payment \�o� 0 Ue ' i/�i
1.ORIGINAL CONTRACT SUM ... . . . ..... .. ... ....$ 135,675.00 \\� •• ' •���iy�i
2.Net Change by Change Orders ... . . . ... .. . . . ..$ 9,840.00 CONTRACTOR: Smock Fansler Corporation _
2910 W.Minnesota Street Indianapolis,IN 46241
3.CONTRACT SUM TO DATE (Line 1 +2). . . . . .... . . $ 145,515.00 = SEAL
4.TOTAL COMPLETED AND STORED TO DATE .... . . $ 145,515.00 By: Date:
i. • \
T.M.FANSLER / CEO //��i ST'•• ' P o��\
5.RETAINAGE: State of:IN %iO'FN�\P�a�"`Q\\
a. 0.00%of Completed Work $ 0.00 County of: MORGAN
b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before me this Day of FEJOAl�&Q 120
Total retainage Line 5a+5b 0.00 Notary Public: �'�"U�
My Commission Expires: 3
6.TOTAL EARNED LESS RETAINAGE.. . . . . .. ... . . . $ 145,515.00
(Line 4 less Line 5 Total) ARCHITECT'S CERTIFICATE FOR PAYMENT
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,based on on-site observations and the data com-
Line 6 from prior Certificate $ 122,714.25 prising the above application, the Architect certifies to owner that to the best of the Architect's
( P ) knowledge,information and belief the Work has progressed as indicated,the quality of the work
8.CURRENT PAYMENT DUE .. . . . . . ... . . . . ..... . .$ 22,800.75 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the
AMOUNT CERTIFIED.
9.BALANCE TO FINISH,INCLUDING RETAINAGE
(Line 3 less Line 6) $ 0.00 AMOUNT CERTIFIED. .. . . . . . .. .... ... .......... .. .. $
(Attach explanation if amount certified differs from the amount applied.Initial all figures on this
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Application and on the Continuation Sheet that are changed to conform to the amount certified.)
Total changes approved in ARCHITECT:
previous months by Owner 9,840.00 0.00 By. Date:
Total approved this Month0.00 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
named herein. Issuance,Payment and acceptance of payment are without prejudice to any
TOTALS 9,840.00 0.00 rights of the Owner or Contractor under this Contract.
NET CHANGES by Change Order 9,840.00
AIA Type Document
Application and Certification for Payment Page 2 of 2
TO(OWNER):CARMEL REDEVELOPMENT COMM. PROJECT: BLDG&LOT DEMO FOR CRC APPLICATION NO: 2 DISTRIBUTION
30 W.MAIN ST. TO:
SUITE 220 PERIOD 70:11/30/2017 _OWNER
CARMEL,IN 46032 _ARCHITECT
CONTRACTOR
FROM(CONTRACTOR): Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S
2910 W.Minnesota Street PROJECT NO:
Indianapolis, IN 46241
CONTRACT FOR: CONTRACT DATE:
SCHEDULE PREVIOUS COMPLETED STORED COMPLETED
ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED �a BALANCE RETAINAGE
1 BLDG&UTILITY DEMOLITION 39,650.00 39,650.00 0.00 0.00 39,650.00 100.00 0.00 0.00
2 SITE DEMO,HARDSCAPE, 67,165.00 57,090.25 10,074.75 0.00 67,165.00 100.00 0.00 0.00
LANDSCAPE
3 PARKING LOT PAVING& 28,860.00 25,974.00 2,886.00 0.00 28,860.00 100.00 0.00 0.00
SIGNAGE
4 CHANGE ORDER#1 9,840.00 0.00 9,840.00 0.00 9,840.00 100.00 0.00 0.00
REPORT TOTALS $145,515.00 $122,714.25 $22,800.75 $0.00 $145,515.00 100.00 $0.00 $0.00
AFFIDAVIT AND WAIVER OF LIEN
[X] Final [ ] Partial ] Payment to Follow
State of Indiana
County of Marion
T.M. Fansler, being duly sworn states that he is the CEO of SMOCK FANSLER CORP.having
contracted with: Carmel Redevelopment Commission to ftirnish certain labor, materials, and/or
services as follows: Misc. Construction for a project known as: SFC#17-066 Building & Lot Demo
located at Carmel,IN and does hereby state on behalf of the aforementioned contractor:
(PARTIAL WAIVER)that there is due from the owner the sum of. ($0.00)
receipt of which is hereby acknowledged; or
the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of
Lien which is given solely with respect to said amount, and which waiver shall be effective only upon
receipt of payment thereof by the undersigned',
(FINAL WAIVER)that the final balance due from the owner is the sum of(jZ!,L00._75J
Twenty Two Thousand Eight Hundred Dollars and 75/100
receipt of which is hereby acknowledged;or
[X] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of
Lien which shall become effective upon receipt of such payment.
TBEREFORE, the undersigned waives and releases unto the Owner of said premise's, any and all lien or
claim whatsoever on the above-described property and improvements thereon on account of Labor,
Materials, and/or Services, furnished by the undersigned thereto, subject to limitations or conditions
expressed herein, if any; and further certifies that no other party has any claim or right to a lien on
account oil any work performed, mat terials, or services furnished to the undersigned for said project, and
within the scope of this affidavit and waiver.
SMOCK FANSLER CORP. By z,–X4 e CEO
T,M.Fansler
1h
WITNESS MY HAND AND NOTARIAL SEAL,this 27 day of February,2018.
Ry PUS
'40,6�N
�_V_az 1-k-L
Melissa J.Laue /f,�otary PA—ic kL
SEi
%
t�k
My commission expires October 23, 2024 Residing in Morgan County
IR,
6F 1W �0*0*\\