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HomeMy WebLinkAbout331228 10/17/18 �%�c,A,,R� CITY OF CARMEL, INDIANA VENDOR: 366869 ONE CIVIC SQUARE QUALITY INTERIORS INC CHECK AMOUNT: $*****8,730.00* 49� /+' CARMEL, INDIANA 46032 3745 N KITLEY AVENUE CHECK NUMBER: 331228 �,�roN�. INDIANAPOLIS IN 46226 CHECK DATE: 10/17/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 109295 8,730.00 OTHER EXPENSES VOUCHER NO. 183007 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor # 366869 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER QUALITY INTERIORS INC CITY OF CARMEL 3745 N KITLEY AVENUE An invoice or bill to be properly itemized must show: kind of service,where performed, INDIANAPOLIS, IN 46226 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit,etc. Payee $8,730.00 366869 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR QUALITY INTERIORS INC Terms Carmel Water Utility 3745 N IQTLEY AVENUE Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), INDIANAPOLIS, IN 46226 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 charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 109295 01-6360-04 $8,730.00 and received except 10/9/2018 109295 $8,730.00 1 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 QUALITY INTERIORS,INC. INVOICE A SPECIALTY CONTRACTOR 3745 N.Killey Avenue Indianapolis,IN 46226 Ph:317-713-7050 Fax:317-713-7055 To: City of Carmel(Water Operations) Invoice No. 109295 3450 W. 131st Street Date 9/20/201.8 Carmel,Indiana 46074 Application 001 Purchase Order No. ' 'JM082118-B i 3 Qualitykb No. 1176 Carmel WTP Security Containment Floor 1 - Original Contract Value 8,730.00 1 i Change Orders . '0.00 Adjusted Contract Value 8,730.00 Work Completed To Date. 8,73U.00 Less Retainage To, 0,00 Total Net Payment Application To Date 8,730:00 } Less Total of Previous Applications 0.00 i Amount Due This Application $8,730.00 This-P_YaPP a lication calculation _ ----- _r 0__ ;Gross � 8,730.00 Retained/held _ .or billed _ Received , !Net 8,730.00 ' Date : PO # : .__i "noSZi� S?�� ACCT # : Use : Q`a � ao�i A9 © � Q AIA Type Document Application and Certification for Payment Page.1 of'2 TO(OWNER);City of Carmel Utilities PROJECT:Carmel WTP Seo.Containment Fi APPLICATION NO: 1 DISTRIBUTION 301 W.136th Street 361 W.136th Street TO: Carmel,IN 46074 Carmel,IN 46074 PERIOD TO:9120/2018 _OWNER _ARCHITECT —CONTRACTOR FROM(CONTRACTOR):QualityInteriors,Inc. VIA(ARCHITECT): ARCHITECTs 3745 N.Kltley Ave PROJECT NO: Indianapolis,IN 46226 CONTRACT FOR:.PO#JM082118-B CONTRACT DATE: The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and CONTRACTOR'S APPLICATION FOR PAYMENT belief the work,covered bythis<application for Payment has been completed in accordance with the Application is made for Payment,as shown below,in connection with the Contract. Contract,Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Type Document is attached. Certificates for Pa ent were sued and payments received from the owner,and that current paymen her ' is now due. 1.ORIGINAL CONTRACT SUM ,,,,,•,.,•..........$ 8,730.00 2.Net Change by Change Orders .................$ 0.00 CONTRA OR: teri rs,I 7 Indianapolis,IN 46226 3.CONTRACT SUM TO DATE (Line 1 +2)........... $ 8,730.00 4.TOTAL COMPLETED AND STORED TO DATE ......$ 8,730.00 By: Date: 9/20/18 fles M.M s,IV// Vice President S.RETAINAGE: State of:IN a. 0.00%of Completed Work $ 0.00 County of:Marion b. 0.00%of Stored Material $ 0.00 Subscribed and$worn to before me this 20th Day of Sept gjjl?per Total retains a Line 5a+5b $ 0.00 Notary Public:Nicole E Frank ��� E�� FR 9 ( ).......... YExpires: 7/11/2A2:4s fJ1fJ1;_J i fJ �O a}til 2 ao���i'� M Commission 6.TOTAL EARNED LESS RETAINAGE.............. S 8,730.00 $. ,,.►�q RY PUBLIC (Line 4 less Line 5 Total) ARCHITECTS CERTIF ATETOR PAl€M IyP ARY SEAL 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT in Accordance with the Contract Documents.based on on-site observatio.%a the dat caom� Line 6 from rior Certificate ..$ 0.00 prising the above application, the Architect certifies to owner that to the�*f i •Afz$r ( p )''"'''''''''''''''' knowledge;information and belief the Work has progressed as indicatedlfij 8.CURRENT PAYMENT DUE ..... ................$ 8,730.00 is inaccordance wi{h the Contract Documents, and the Contractor is enti �� m "«�i)rrliil+��� 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED. (Line 3 less Line 6) $ 0.00 AMOUNT CERTIFIED...............................$ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount ceded differs from the amount applied.Initial all figures on this Application and on.the Continuation Sheet that are changed to conform to the amount certified.) Total changes approved in ARCHITECT: previous months by Owner 0.00 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 0.00 0.00 rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order 0.00 AIA Type Document Application and Certification for Payment Page 2 of 2 TO(OWNER):City of Carmel Utilities PROJECT Carmel WTP Sec.Containment FI APPLICATION NO: 1 DISTRIBUTION 301 W.136th Street 301 W.136th Street TO: Carmel,IN 46074 Carmel,IN 46074 PERIOD TO:9/20/2018 _OWNER —ARCHITECT —CONTRACTOR FROM(CONTRACTOR):Quality Interiors,Inc. VIA(ARCHITECT): ARCHITECTS 3745 N.Ktley Ave PROJECT NO: Indianapolis,IN 46226 CONTRACT FOR:PO#JM082118-B CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE 1 Secondary Containment Coatings 8,730.00 0.00 8,730.00 0.00 8,730.00 100.00 0.00 0.00 REPORT TOTALS $8,730.00 $0.00 $8,730.00 $0.00 $8,730.00 100.00 $0.00 $0.00