HomeMy WebLinkAbout324252 04/18/18 oAA,,f. CITY OF CARMEL, INDIANA VENDOR: 365399
d ONE CIVIC SQUARE INSITUFORM TECHNOLOGIES USA INC CHECK AMOUNT: $....18,111.87*
CARMEL, INDIANA 46032 1088 VICTORY DRIVE CHECK NUMBER: 324252
HOWELL MI. 48843 CHECK DATE: 04/18/18
r.
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
660 5023990 3 18,111.87 OTHER EXPENSES
VOUCHER NO. 185311 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor # 365399 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
INSITUFORM TECHNOLOGIES CITY OF CARMEL
1088 VICTORY DR An invoice or bill to be properly itemized must show: kind of service, where performed,
HOWELL, MI 48843 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
$18,111.87 365399 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR INSITUFORM TECHNOLOGIES Terms
Carmel Wasterwater Utility 1088 VICTORY DR Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), HOWELL, MI 48843
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which char a is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
3 OC�F050=97� e87 sand;received except 4/16/2018 3 $18,111.87
vailability T
f
�ell
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited
same in accordance with IC 5-11-10-1.6
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20
Clerk-Treasurer
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 0702 Page 1 of 2
To: Jones&Henry Engineers,Ltd. Project: City of Carmel,IN.Concord Village Lining Contract 91,2017 Application No.: 3
1980 E.116th St.Ste.260 j
Carmel,IN 46032 Period From: 03/01/18 I
Attn: Tom Schreiber Owner/Engineer: Period To: 03/31/18
http://ecomm.easternengineering.comNiewNiewJob.aspx?JoblD=2922
From: Insituform Technologies USA,LLC. Job# 126591
1088 Victory Dr. Prime Contractor: Contract 91
Howell,MI 48843
Contract For: City of Carmel,IN.Concord Village Lining Contract 91,2017 j
Application is made for Payment,as shown below,in connection with the Contract.
CON'TRACTOR'S APPLICATION FOR PAYMENT Continuation Sheet,ATA DOelllllent 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 $2,677.50
previous months by Owner 3. CONTRACT SUM TO DATE(Line I+2) $317,771.40 {
TOTAL $0.00 $0.00 4. TOTAL COMPLETED&SPORED TO DATE $162,708.90
Approved this Month 5. RETAINAGE:
Number Date Approved a. 10 %of Completed Work $16,270.89 I
FD1 $2,677.50 b. %of Stored Material $0.00
TOTAL RETAINAGE $16,270.89
6. TOTAL EARNED LESS RETAINAGE $146,438.01
(Line 4 less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $128,326.14
TOTALS $2,677.50 $0.00 fl. l lLf ti 1. a_1 tP+1 I'
Net Change by Change Orders $2,677.50 9. BALANCE TO FINISH,PLUS RETAINAGE $152,385.00
The undersigned Contractor certifies that to the best ofthe Contractors knowledge, information and belief,the work covered State of. n'llelligan Coullty of: Wayne
by this Application for Payment has been completed in accordance with the Contract Documents,that all amounts have been
Owner,and that cwrent payment shown herein is now due. +
i
Notary Public:
CONTRACTOR: Insituform Technologies USA, Inc.
i
My commission expires:
Amount Certified:
liy: Date; 03/31/18
Duane(lln)e1Sl' ,Project Manager (Allached exphatallon fainowtr(I%%fer5f•On the alaonlrrr%J%lhedf l)
ARCHITECT'S CERTIFICATE FOR PAYMENT Owner/Engineer: j
In accordance with the Contract Documents,based on on-site observations and the data comprising By' r v Date:
c
the above application,the Architect ceniries to the Owner that to the best of the Architect's knowledge This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor named herein.
information,and belief,the work his progressed as indicated,the quality of the work is in accordance Issuance,payment,and acceptance of payments are without prejudice to any rights of the owner or contractor
with the contract documents,and the Contractor is entitled to payment of AMOUNT CERTIFIED under this cottmct.
CONTINUATION SHEET AIA DOCUMENT 0702(Revised) Page 2 oP2
AIA Document 0702,APPLICA'T'ION AND CERTIFICATE FOR PAYMENT,containing
Contractors signed Certification is attached. i
In tabulations below,amounts are stated to the nearest dollar. Use C01umn I on Contracts Period From: 03/01/18
where variable retainage f'or line items may apply. Perio(I 1b: 03/31/18
1
City of Carmel,IN.Concord Village Lining Contract 91,2017
I
Itcm Contract Information Work Completed Previous/rhis Period Total to Date Completed % Balance To
No. Description of Work Quanlily U/M Unit Price Contract Previous Qty. Qry.Wts r.rt°a This Period Total Qty. To Date Comp. Finish i
$Amount $Amount
$Amount ($) $Amount
i
Mobilization 1.00 LS $2,293.90 $2,293.90 1:00;` .
0.00 ;1'.00'; 2,293.90 100%
_ 0.00
2A SMH 36-80 TO 36-82 78 LF $26.80 $2,090.40 0.00 : 78:00; 2,090.40 100% 0.00
2A SMH 36-82 TO 36-85 144 LF $26.80 $3,859.20 144:00; ,. 0.00 144.00;- 3,859.20 100% 0.00
2A SMH 36-85 TO 36-88 364 LF $26.80 $9,755.20 355'00'; 9,540.80 ::3N 00. 9,540.80 98% 0.00
2A SMI-I 36-88 TO 36-103 287 LF $26.80 $7.691.60 „295 00' 7,906.00 .295,00; 7,906.00 103% 0.00 i
2A SMH 36-103 TO 36-102 151 LF $26.80 $4,046.80 1.51:00 0.00 151;00. 4,046.80 100% 0.00 i
2A SMH 36-34 TO 36-126 166 LF $26.80 $4,448.80166:00`] y 0.00 .166.00' 4,448.80 100% 0.00 j
2A SMH 36-76 TO 36-73 210 LF $26.80 $5,628.00 210:00;1, 0.00 =.210,00 5,628.00 100% 0.00 i
2A SMH 36-48 TO 36-49 402 LF $26.80 $10,773.60 " :'.402:00`; 0.00 . 402:00: 10,773.60 100% 0.00 t
2A SMH 36-56 TO 36-36 204 LF $26.80 $5,467.20 '104:00:; ) 0.00 _ 204.00` 5,467.20 100% 0.00
2A SMH 36-47 TO 36-46 420 LF $26.80 $11,256.00 :'•'g20;00:7. ,` 0.00 ;420,0.0 11,256.00 100% 0.00
2A SMH 36-101 TO 36-35 LF $26.80 190100 i' 0.00 190:00; 5,092.00 100% 0.00
2A SMH 36-35 TO 36-34 LF $26.80 ;53100']F " -•^, "" 0.00 53.00: 1,420.40 100% 0.00
2A SMH 36-91 TO 36-94 LF $26.80 250;00 0.00 '250=00` 6,700.00 100% 0.00
2A SMH 36-94 TO 36-97 LF $26.80 1,36?OO:I 5`'3 0.00 136:00; 3,644.80 100% 0.00
2A SMH 36-97 TO 36-35 LF $26.80 27A:00, 0.00 271.00: 7,262.80 100% 0.00
2A I SMH 36-33 TO 36-34 LF $26.80 j 0.00 At00'; 0.00 100% 0.00
2A ISMH 36-104 TO 36-105 LF $26.80 "154:00;' t. 0.00 : .-: 154:00'. 4,127.20 100% 0.00 j
t- 0.00 0.00 100% 0.00 i
2b SMH 36-73 TO 36-2 240 LF $25.90 $6,216.00 ""':2401001 0.00 240;00` 6,216.00 100% 0.00
2b SMH 36-2 TO 36-1 301 LF $25.90 $7,795.90 301:00`; 0.00 . 301;00'. 7,795.90 100% 0.00
2b SMH 36-1 TO 36-96 303 LF $25.90 $7,847.70 ti_ 303.1 joj :` 0.00 303:00 7,847.70 100% 0.00 j
2b SMH 36-96 TO 36-98 288 LF $25.90 $7,459.20 °
0.00 , ' '-286 , 7,459.20 100% 0.00
2b SMH 36-92 TO 36-93 355 LF $25.90 $9,194.50 3565.00` , 0.00 356:00', 9,194.50 100% 0.00 1
2b SMH 40-99 TO 40-98 160 LF $25.90 $4,14400 0.00 4,144.00 100/
0.00A0 1
2b SMH 36-97 TO 36-96 260 LF $25.90 $6,734 00260:00 0.00 260:00] 6,734.00 100% 0.00
4 Work Allowance 1 LS I
$15,082.20 $15,082 20 1:00 0.00 ;1;00'' 15,082,20 100% 0.00 I
FD1 Field Directive-1 Cleaning 1 LS 2,677.50 $2,677.50 1:00 ' X1:00' 2,677.50 ;1';00- 2,677,50 100% 0.00
19 gi al Cont t al $3r1�"A33 90 20, 24. 0 5 ,637 0 0
CTra g t9r�ll-[�.�t ,6fi7 50 �3,fi0 0 00
1�av1` C• a- TW-al 7 . 001y14 30 162 108 96 ° 0.0
EXHIBIT D
CONTRACTOR'S AFFIDAVIT AND WAIVER OF LIENS AND CLAIMS
(_) FINAL (X) PARTIAL (_) PAYMENT TO FOLLOW
OWNER: City of Carmel, Indiana Department PROJECT: Concord Village, Contract 91
of Public Works.
CONTRACTOR: Insituform Technologies USA, LLCCONTRACT DATE: June 22, 2017
Duane Ginderske
being duly sworn states that he or she Is the Proj ect Manager of
CONTRACTOR,which was awarded Contract No, 91 with the OWNER In accordance with the
contract terms and conditions to Install and/or furnish certain materials and labor as follows:
CIPP Lining ('Work°)for the Project,
DOES HEREBY STATE,WARRANT AND REPRESENT ON BEHALF OF THE CONTRACTOR the following:
PARTIAL WAIVER That the balance due from OWNER Is the sum of($-18,111.87
( )
Receipt of which Is hereby acknowledged;or
(X) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF
LIENS AND CLAIMS and which is given to and for said amount effective upon receipt of such payment.
FINAL WAIVER That the final balance due from OWNER Is the sum of($ ).
( )
Receipt of which Is hereby acknowledged;or
( ) Payment of which has been promised as the sole consideration for this AFFIDAVIT AND WAIVER OF
LIENS AND CLAIMS which Is given to and for said amount effective upon receipt of such payment.
THEREFORE,through the date hereof,Contractor waives and releases the Owner and Project of all liens or claims,
Including, but not limited to, claims for materials, equipment, labor, superintendence and other services or Work
performed or furnished by Contractor and further affirms that no other party has any claim or right to lien on account
of any materials, equipment, labor, superintendence and other services or Work performed or furnished to or for
Contractor for the Project. Contractor agrees to indemnify, defend and hold the Owner and Project harmtess,
Including costs and attorneys'fees, from and against any and all claims or liens for any subcontractors,materials,
supplies, equipment or labor furnished for, in connection with or Incorporated Into the Project by,through or under
Contractor through the date hereof. This Affidavit and Waiver of Liens Is given to Induce Owner to pay the amount
Indicated above. Contractor represents that all employees,subcontractors or materialmen have been paid or will be
paid from these funds.
That through the date hereof, all Affidavits and Waiver of Liens and Claims are true,correct and unconditional and
that there is no claim either legal or equitable to defeat the validity of said Affidavits and Waiver of Liens and Claims.
That the following are the names of all parties who have furnished material or labor,or bath, for said Work and all
parties having contracts or subcontracts for specific portions of said Work or for material used In the construction
thereof and the amount due or to become due to each,and that the Items mentioned Include all labor and material
required to complete said Work according to Project plans and specifications:
1 2 3 4 5 6 7
CONTRACTOR TYPE OF AMOUNT OF TOTAL NET NET BALANCE
WORK CONTRACT RETAINED PREVIOUSLY AMOUNT TO
PAID THIS BECOME
PAYMENT DUE
Insituform CIPP Lining 16,270.69 102,903.66 43,534.35 16,270.89
TOTAL
AMOUNT OF ORIGINAL CONTRACT 315,093.90 WORK COMPLETED TO DATE 162,706.90
EXTRAS TO CONTRACT 2677.S0 LESS RETAINAGE
TOTAL CONTRACT&EXTRAS NET AMOUNT EARNED 146,436.01
CREDITS TO CONTRACT NET PREVIOUSLY PAID 102,903.66
ADJUSTED TOTAL CONTRACT '16 2,708..9 0 NET AMOUNT OF THIS PAYMENT 11,134:35
BALANCE TO BECOME DUE 16,270.89
C-91 Concord Sewer Lining/451-7236 A-22 CITY OF CARMEL
Contractor's Waiver Final
This Instrument has been executed as of the 31st day of March .1 20 1e
CONTRACTOR. Insituforn Tecnologies USA, LLC
By:
Name: Duane Ginderske
Title: Project Manager
STATE OF INDIANA
COUNTY
OF Hamilton
Sworn to and subscribed before me the undersigned authority on this 31st day of
March 1 20 19
Notary Fffiblic, State
of Michigan
Printed Name of Janice Mortimer
Notary
[SEAL]
My Commission Expires:
!� D9/05/2022
I
I
Ei
I
G
{I
I
t
I
0-91 Concord Sewer Lining/461-7236 A-22 CITY OF CARMEL
Contractors Waiver Final
i
I
i
i,