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HomeMy WebLinkAbout330832 10/09/18 y a._C�Nb �/ ,� CITY OF CARMEL, INDIANA VENDOR: 372449 j ONE CIVIC SQUARE WESTERN SPECIALTY CONTRACTORS CHECK AMOUNT: $****26,177.00* 9, ��; CARMEL, INDIANA 46032 4143 KINGMAN DRIVE CHECK NUMBER: 330832 '''ZFON�°' INDIANAPOLIS IN 46226 CHECK DATE: 10/09/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4350900 . 54604 8,300.00 OTHER CONT SERVICES 2201 4350900 101679 54604 17,877.00 IDC SIDEWALK CAULKING VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 372449 WESTERN SPECIALTY CONTRACTORS IN SUM OF$ CITY OF CARMEL 4143 KI NGMAN DRIVE 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 per unit,etc. INDIANAPOLIS, IN 46226 Payee $8,300.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Terms Street Department Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board"Members DEPT# FUND.# (or note attached invoice(s)or bill(s)) AMOUNT 54604 43-509.00 $8,300.00 1 hereby certify that the attached invoice(s),or 9/4/18 54604 Sidewalk Caulking $8,300.00 2201 2201 2201 2201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, October 01,2018 Huffman, Dave Director 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 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Western Specialty Contractors QWESTERN' 4143 Kingman Drive SPECIALTY CONTRACTORS Indianapolis-,IN 46226 Phone:(317)377-6040 Fax:(317)377-6050 INVOICE i TO: CARMEL STREET DEPARTMENT Invoice#: 54604 3400 W 131ST Date: 09/04/18 CARMEL,IN 46074 Application#: 1 r Invoice Due Date: 09/04/18 Contract 01718.5019 Indiana Arts and Design Building Payment Terms: Due Upon Receipt 30 WEST MAIN STREET CARMEL,IN 46032 DUE UPON RECEIPT Contract Contract Previous Current Balance Total Item Amount Amount Amount To Finish Retainer j 010 Cove Joint Sealant 16,687.00 0.00 16,687.00 0.00 0.00 i 020 General Conditions Indy 1,190.00 0.00 1,190.00 0.00 0.00 030 Cove Joint Sealant r 5,700.00 0.00 5;700.00 0.00 0.00 040 Partial-Depth Repairs 2,600.00 0.00 .2,600.00 0.00. 0.00 f _ 1 Totals: 26,.177.00 0.00 . 26,177.00 0.00 0.00 I i 1 I I I I i I _ I 1 I 1 i i i i Subtotal this Invoice 26,177.00 Less Retainer this Invoice 0.00 Sales Tax 0.00 Total Due this Invoice 0912018 -428 Page 1 of.1 . i i AFFIDAVIT AND WAIVER OF LIEN [x] Final [] Partial [x] Payment to Follow State of Indiana, County of Marion, SS: Mark Antoskiewicz being duly sworn states that he is the Branch Manager of Western Waterproofing Co., Inc. having contracted with Carmel Street Department to furnish certain materials and/or labor as follows: Repair Work for a project known as Indiana Arts and Design Building located in Carmel,. Indiana and does hereby further state on behalf of the aforementioned contractor: i (PARTIAL WAIVER) that there is due from the Owner the sum of t Dollars (0.00.) a [ ] 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: t (FINAL WAIVER) that the final balance due from the Owner is. the sum of Twenty-Six Thousand One Hundred Seventy-Seven and 00/100 Dollars ($ 26,177.00) t [ ] receipt of which is hereby acknowledged; or [x] The payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment } F THEREFORE, the undersigned waives and releases unto the Owner of said j premises, any and all lien or claim whatsoever on the above-described property and improvements thereon on account of LABOR or material or both, furnished by j 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 or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. i Western Waterproofing-Co., Inc. dba Waterproofing .Specialty Contractors i (Firm) p By . L Branch Manager (Authorized Repsentative) (Title) i WITNESS MY HAND AND NOTARY SEAL, this 4th day of September, 2018 f tary Public) M Commission Expires: October 2150;- 201 il!1 s�I9t Glynda M. Day y � Residing in Marion County �+ ��-�°o)' es�A (Printed Name) ,�. ` e r/ w ri e Y <C Z f d g)4� t ��✓ °e�° 1012`0° \'��"�' ro oyes o�o{6 0 9hAa� VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 372449 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER WESTERN SPECIALTY CONTRACTORS IN SUM OF$ CITY OF CARMEL 4143 KI NGMAN DRIVE 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 per unit,etc. INDIANAPOLIS, IN 46226 Payee $17,877.00 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Street Department 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 101679 54604 43-509.00 $17,877.00 1 hereby certify that the attached invoice(s),or 9/4/18 54604 Sidewalk Caulking $17,877.00 2201 2201 2201 2201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, October 01,2018 Huffman, Dave Director 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 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Q`WESTERN'" Western Specialty Contractors 4143 Kingman Drive SPECIALTY CONTRACTORS Indianapolis,IN 46226 Phone:(317)377-6040 Fax:(317)377-6050 INVOICE To: CARMEL STREET DEPARTMENT Invoice Date: 54604 54 09!04/11818 3400 W 131ST CARMEL,IN 46074 Application#: 1 Invoice Due Date: 09104/18 Contract 01718.5019 Indiana Arts and Design Building Payment Terms: Due Upon Receipt 30 WEST MAIN STREET CARMEL,IN 46032 DUE UPON RECEIPT Contract Contract Previous Current Balance Total Item Amount Amount Amount To Finish Retainer 010 Cove Joint Sealant 16,687.00 0.00 16,687.00 0.00 0.00 020 General Conditions Indy 1,190.00 0.00 1,190.00 0.00 0.00 030 Cove Joint Sealant 5,700.00 0.00 5,700.00. 0.00 0.00 040 Partial Depth Repairs 2,600.00 0.00 2,600.00 0.00 0.00 Totals 26,.177.00 0.00 26,177.00 0.00 0.00 PO l�I(�`"I l 1���1�• o© i i Subtotal this Invoice 26,177.00 j Less Retainer this Invoice 0.00 Sales Tax 0.00 { Total Due this Invoice l~�,81-1,DO i 0812018 -428 Page 1 of 1 AFFIDAVIT AND WAIVER OF LIEN [x] Final [] Partial [x] Payment to Follow State of Indiana, County of Marion, SS: Mark Antoskiewicz being duly sworn states that he is the Branch Manager of Western Waterproofing Co. , Inc. having contracted with Carmel Street Department to furnish certain materials and/or labor as follows: Repair Work for a project known as Indiana Arts and Design Building located in Carmel, Indiana and does hereby further state on behalf of the aforementioned contractor: .(PARTIAL WAIVER) that there is due from the Owner the sum of Dollars (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 Twenty-Six Thousand One Hundred Seventy-Seven and 00/100 Dollars ($ 26,177.00) [ ] receipt of which is hereby acknowledged; or [x] The payment of which has been promised as the sole consideration for 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 thereonon account of LABOR or material or both, 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 or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Western Waterproofing Co., Inc. dba Waterproofing Specialty Contractors (Firm) By Branch Manager (Authorized Repr sentative) (Title) WITNESS MY HAND AND NOTARY SEAL, this 4th day of September, 2018 tary Public) My Commission Expires: October 2150, 201-h Glynda M. Day Residing in Marion County ��•p...A� TPd� (Printed Name) EXPIRCS oo��o C� 001 r V B o� ,•�,` o r.00 \ dip