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Home My WebLink About327012 07/03/18 (9, CITY OF CARMEL, INDIANA VENDOR: 371894 ONE CIVIC SQUARE BO-MAR INDUSTRIES, INC. CHECKAMOUNT: $*****2,917.28* CARMEL, INDIANA 46032 3838 S.ARLINGTON AVE. CHECK NUMBER: 327012 INDIANAPOLIS IN 46203 CHECK DATE: 07/03/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 101723 5 2,917.28 SIGN TYPE 20 VOUCHER NO. WARRANT NO. Prescribed by"State Board of Accounts City Form No.201(Rev.1995) ALLOWED owED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 371894 IN`SUM OF$ BO-MAR INDUSTRIES, INC. CITY OF- CARMEL 3838-S.ARLINGTON:AVE. An invoice or bill to be property itemized must show:kind of service,where performed,dates service rendered;by whom,rates per day,numberof hours,rate per hour,number of units,price per unit,etc. INDIANAPOLIS, IN 46203 Payee $2,917.28 Purchase Orde ON ACCOUNT OF APPROPRIATION FOR r # Redevelopment Commission Terms • Date Due PO# ACCT# DATE INVOICE# DESCRIPTION. DEPT# INVOICE# Fund#" AMOUNT Board Members ' DEPT# FUND# " (or note attached invoice(s)or bill(s)) AMOUNT 101723 5 44-608.07. $2,917.28 I:hereby certify that the attached invoice(s),or 5/31/18 5 Center Green signage $2,917.28 902 902 902 902 bill(s)is(are)true and correct and,that-the.. materials or services itemiied:thereon for which charge is made were ordered and" received except Monday,June 25,.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 accordancewiih.IC 5-11-1071".6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer . APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE 1 OF 1 TO GC: Carmel Redevelopment Commission APPLICATION NO.: 5 Disfibution to: PERIOD TO: 5/31/18 OWNER FROM CONTRACTOR: j � L-J Bomar Industries,Inc. PROJECT NO.: ARCHITECT CONTRACTOR 3838 S.Arlington Ave. Indianapolis,IN 46203 CONTRACT FOR: Carmel Center Green Signage CONTRACT DATE: 9/19/2017 The undersigned Contractor eertiges that to the best of the contractor's knowledge.Infarrnation end belief CONTRACTOR'S APPLICATION FOR PAYMENT the work covered bythis Appllcdon for Payment has been completed in accordance with the Applicadon is made for payment as shown below In connection with the Coprdraet Documents,that all amounts have been paid by the Contractor for Work for which previous Contract Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were Issued and payments received from the owner,and that current 1 ORIGINAL CONTRACT SUM $ 174,354.00 payment shown herein is now due. 2 Net change by Change Orders $ 2,917.28 3 CONTRACT SUM TO DATE(line 1+2) $ 177,271.28 CONTRACTOR: Bo-mar Industries, Inc 4 TOTAL COMPLETED&STORED TO DATE $ 177,271.28 (Column G on G703) 5 RETAINAGE: By: a.10 %of Completed Work - Robert BuchInan,President (Columns D+E on G703) b. Stored Material % 10 _ (Columns F on G703) State of: Indiana Total Retainage(line 5a+5b or County of: Marion Total in Column I of G703) $ - Subscribed and sworn to before 6 TOTAL EARNED LESS RETAINAGE $ 177,271.28 me this )�,�_day of 2018 (Line 4 less Line 5 Total) 7 LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) $ 159,544.15 8 CURRENT PAYMENT DUE $ 17,727.13 2a NOTAgy 9 9 BALANCE TO FINISH,INCLUDING RETAINAGE Notary Public: (Line 3 less Line 6) $ _ PUBLIC SS My commission expires:Dq/Z,y j•V 25 %y ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on-stte obs"allons and the date comprising this application,the Architect certifies to the Owner that to the best of the ArchRecrs knowledge,tnfor- motion and bellef the Work has progressed as Indicated,the quality of the Work Is In aocordance CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS with the Contract Documents,and the contractor Is entitledOU to payment of the AMOUNT CERMIED.Total changes approved AMourrrcEtrlFtED previous months by Owner 2,917.28 (Attach explanetlon ff amount certified differs from the amount applied for. Total approved this Month _ �-t r � ��, �' (� . ��TOTALS 2,917.28By: Date: 05 1 ?_-SNET CHANGES b Chan a Order 2,917.28 - This Certlfleate is negotiable.The AMOUNT CERTIFIED Is payable only to the Contractor named herein.Issuance,payment and acceptance of payment arewithout pm)WI a to any NgMs of the of the Owner or Contractor under this contract G703 CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 of 2 PAGES AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NUMBER: 5 Contractor's signed Certification is attached. APPLICATION DATE: 5/18/18 In tabulations below,amounts are stated to the nearest dollar. PERIOD FROM: 9/19/17 Use Column I on Contracts where variable retainage for line items may apply. TO: 5/31/18 GC's PROJ NO: A B C D E F G H I ITEIV DESCRIPTION of WORK Scheduled Previous THIS APPLICATION Total Completed % BALANCE RETAINAGE NO. VALUE Application Work in Place Stored Material and Stored (GIC) TO FINISH 1 Sign Type 30 90,454.00 90,454.00 - 90,454.00 100% - - 2 Installation of Sign Type 30 3,000.00 3,000.00 - 3,000.00 100% - - 3 Sign Type 20 14,400.00 14,400.00 - 14,400.00 100% - - 4 Sign Type 10/15 60,000.00 60,000.00 - 60,000.00 100% - 5 Installation of Sign Type 10/15 3,000.00 3,000.00 - 3,000.00 100% - 6 Bond 3,500.00 3,500:00 - 3,500.00 100% - 7 C/O-Sign Type 20 2,917.28 2,917.28 - 2,917.28 100% - - TOTAL 177,271.28 177,271.28 - - 177,271.28 G702 AND G703 BILLING Pay App 5 5-18-18 Page 1 CONTRACTOR'S AND SUPPLIER'S AFFIDAVIT AND WAIVER OF LIEN +( nal (martial (payment to Follow The undersigned,being first duly sworn on his oath or affirming,states that: 1 Robert Buchanan (Name) is the President (Title) of Bo-Mar Industries (Company),(hereinafter called"Company') of and is familiar with the facts herein stated and makes this affidavit for and on behalf of himself and the Company,being duly authorized to bind the Company by the statements herein contained 2 The Company,having contracted with Carmel Redevelopment Commission has performed work and labor or famished materials supplies'or equipment in the construction of certain improvements on the real estate commonly known as Carmel Center Green Signage located at Carmel Center Green in, Carmel (City), IN (State),which real estate is owned by Carmel Redevelopment Commission (hereinafter called"Owner"). 3 Company has,orwill within 10 days of receipt of payment due from Carmel Redevelopment Commission noted in Item 4, paid for all work,labor,materials,equipment,and suppliers performed or furnished 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 alien 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 NONE 4 The amount due to Company from Carmel Redevelopment Commission PARTIAL WAVIER that the balance due is the sum of ❑ 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: Seventeen Thousand Seven Hundred Twenty-Seven and 13/100 ( $ 17,727.13 ) ❑ receipt of which is hereby acknowledged,or ❑� 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 improvements thereon account of LABOR or material or both,famished by the undersigned thereto,and further certifies that no other party has any claim or right to a lien on account of any work performed or material famished to the undersigned for said project,except as noted above,and within the scope of this affidavit and waiver. Bo-Mar Industries,Inc. (Com y me) Title: President (sign tare of officer Su scribed and sworn before me this 18th day of May 2018 County of Residence: Marion (Notary Publi 4/24/2025 (My Commission Expires) ``�11111I1f////j 4 i A NOTA r 9 Z SE U9LIC ST1\%;%