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Home My WebLink About331391 10/19/18 4�p,C�g3R J® CITY OF CARMEL, INDIANA VENDOR: 00350511 ONE CIVIC SQUARE SMOCK FANSLER CORP CHECK AMOUNT: $****59,793.00* CARMEL, INDIANA 46032 2910 W MINNESOTA ST CHECK NUMBER: 331391 9M,�ioN INDIANAPOLIS IN 46241 CHECK DATE: 10/19/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460805 101988 73093018 59,793.00 BALDWIN CHAMBERS SITE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350511 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER SMOCK FANSLER CORP IN SUM OF$ CITY OF CARMEL 2910 W MINNESOTA ST 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 46241 Payee $59,793.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 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 101988 73093018 44-608.05 $59,793.00 1 hereby certify that the attached invoice(s),or 9/30/18 73093018 Baldwin Chambers eastern Sitework $59,793.00 902 902 902 902 bill(s)is(are)true and correct and that the iT� materials or services itemized thereon for which charge is made were ordered and received except Thursday, October 18,2018 Henry Mestetsky I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer AIA Type Document Application and Certification for Payment Page 1 of 2 TO(OWNER):CARMEL REDEVELOPMENT COMM. PROJECT:BALDWIN CHAMBERS E.ENTRY APPLICATION NO: 1 DISTRIBUTION 30 W.MAIN STREET PERIOD TO:9/30/2018 TO: SUITE 220 _OWNER CARMEL, IN 46032 _ARCHITECT _CONTRACTOR FROM(CONTRACTOR): Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S 2910 W.Minnesota Street PROJECT NO: Indianapolis,IN 46241 CONTRACT FOR: CONTRACT DATE: The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and CONTRACTOR'S APPLICATION FOR PAYMENT belief the work covered by this application for Payment has been completed in accordance with the Application is made for Payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Type Document is attached. Certificates for Payment were issued and payments received from the owne4��tt►Nf��igdfU�fNirriip��y�� current payment shown herein is now due. \\\��OO�Q,FtY•PUP4 V%%'��// 1.ORIGINAL CONTRACT SUM . . .. . . . . .. . . ....... .$ 147,300.00 2.Net Change by Change Orders ... . .. . .. . .. . . . .$ 0.00 CONTRACTOR: Smock Fansler Corporation _ 2910 W.Minnesota Street Indianapolis,IN 46241- L _*13.CONTRACT SUM TO DATE (Line 1 +2).. . .... .... $ 147,300.00 = n p� 4.TOTAL COMPLETED AND STORED TO DATE . . . .. . $ 62,940.00 By: Date:A T.M.FANSLER / CEO ��i S,'•.••.• .••�P\\�o 5.RETAINAGE: State of:INrOIF" ppQ`��\\ a. 5.00%of Completed Work $ 3,147.00 County of: MORGAN b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before me this Day of 0 20 Total retainage(Line 5a.+5b). ... . . . . . . . . ..... . . . $ 3,147.00 Notary Public: A�� My Commission Expires: M Al kod- 6.TOTAL EARNED LESS RETAINAGE. . ... . ... .... . $ 59,793.00 (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- 0.00 prising the above application, the Architect certifies to owner that to the best of the Architect's (Line 6 from prior Certificate). . . .. . . . . . . . . . . ......$ knowledge,information and belief the Work has progressed as indicated,the quality of the work 8.CURRENT PAYMENT DUE . . . . . . . . . . . . . . . ......$ 59,793.00 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) $ 87,507.00 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 ARCHITE&T previous months by Owner 0.00 0.00 By. Date: ! �S Total approved this Month 0.00 0.00 This Certificate is not negotiable. The- OU T 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):CARMEL REDEVELOPMENT COMM. PROJECT: BALDWIN CHAMBERS E.ENTRY APPLICATION NO: 1 DISTRIBUTION 30 W.MAIN STREET TO: SUITE 220 PERIOD TO:9/30/2018 _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 �o BALANCE RETAINAGE 1 SITE 16,500.00 0.00 13,200.00 0.00 13,200.00 80.00 3,300.00 660.00 CLEARING/EARTHWORK/UTI LITII 2 CONC.WALLS,MODULAR 55,000.00 0.00 44,000.00 0.00 44,000.00 80.00 11,000.00 2,200.00 WALLS,STAIRS 3 PAVERS AND WALKS 28,700.00 0.00 5,740.00 0.00 5,740.00 20.00 22,960.00 287.00 4 METAL RAILINGS 10,700.00 0.00 0.00 0.00 0.00 0.00 10,700.00 0.00 5 MASONRY CLADDING 20,400.00 0.00 0.00 0.00 0.00 0.00 20,400.00 0.00 6 LANDSCAPING/IRRIGATION 12,500.00 0.00 0.00 0.00 0.00 0.00 12,500.00 0.00 7 LIGHTING 3,500.00 0.00 0.00 0.00 0.00 0.00 3,500.00 0.00 REPORT TOTALS $147,300.00 $0.00 $62,940.00 $0.00 $62,940.00 42.73 $84,360.00 $3,147.00 AFFIDAVIT AND WAIVER OF LIEN [ ] Final [X] 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: Misc. Construction for a project known as: SFC#17-130 Baldwin Chambers East Entry 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: ($59,793.00) Fifty Nine Thousand Seven Hundred Ninety Three Dollars and No/100 [ ] receipt of which is hereby acknowledged; or [X] 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 $( 0.00) [ ] receipt of which is hereby acknowledged;or [ ] 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. SMOCK FANSLER CORP. ByTitle CEO .M.Fansler oA4. WITNESS MY HAND AND NOTARIAL SEAL, this 24" day of September ,2018. \��\v�" YpUe % �. Melissa J. Lau Notary Public •' SEAQ My commission expires_October 23, 2024 Residing in Morgan County EOII�FI�