HomeMy WebLinkAbout181459 01/19/2010 7:::;:"., CITY OF CARMEL, INDIANA VENDOR: 363791 Page 1 of 1
ONE CIVIC SQUARE DIVERSIFIED PAINTING CO INC
CHECK AMOUNT: $18,315.00
CARMEL, INDIANA 46032 1681 EXPO LANE
INDIANAPOLIS IN 46214 CHECK NUMBER: 181459
CHECK DATE: 1/19/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460807 3 18,315.00 PERFORMING ARTS CENTE
SL Subcontract Billing Report
For Work Invoiced From 11/01/09 to 11/30/09
'Subcontra .2695 51 5 160.Paint Wallcoverings r
Job: 2695 Carmel RPAC Construction Vendor: 2507 DIVERSIFIED PAINTING CO., INC.
777 3rd Ave. SW
Carmel, IN 46032
Item Units UM Unit Cost Amount Units//o Amount Units Amount
1 5160 Paint Wallcoverings LS 2,100,000.0C 6.19% 129,925.00 0.97 20,350.00
Total Contract Items 2,100,000.00 129,925.00 20,350.00
Subcontract Totals: 2,100,000.00 129,925.00 20,350.00
Total Billings: 129,925.00 20,350.00
Unpaid Retainage: 12,992.50 2,035.00
Discounts: 0.00 0.00
Net Billings: 116,932.50 18,315.00
98 SSC CMa Projects Page 1 11/19/09 11:59:00 AM
Date Format MM /DD /YY SLSubSiitingReport .rpt
,c" Document G702 /CMa —1992 t is
Application and Certificate' for Payment Construction Manager Adviser Edition 3
TO OWNWI Redevelopment Co PROJE CWARCEL 7A, Regional Performing Arts Center
g g APPL ICATION NO: Distribution to:
One Civic Square Interior Finish Package P5 11!10109
Carmel, IN 46032. Bid Pack #5160; Painting PERIOD TO OWNER
Diversified. Painting Company Envoy Febuary 24, 2009 CONSTRUCTION MANAGER
F ROM 3IN C3iQR: VIA CONSTRUCTIOICEMP11 ERts CONTRACT DATE: 2695 ARCHITECT
Indianapolis, IN 46214 280 E. 96th Street, Suite 100
Indianapolis, IN 46240 PROJECT NOS: CONTRACTOR
Bid Pack 5160;Painting VIA ARCHITECTIndianapolis, IN 46260 FIELD
CONTRACT FOR: 0
CONTRACTOR'S APPLICATION FOR PAYMENT
The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and
Application is made for payment, as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the
Continuation Sheet, AIA Document G703, is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous
2,100,000.00 Certificates for Payment were issued and payments received from the Owner, and that current
1. ORIGINAL CONTRACT SUM payment shown herein i i5 w o' e {11111/
2. Net change by Change Orders 2 100 000
CON TRACTOR: 1t Y lEF� 1 r ft
�p
3. CONTRACT SUM TO DATE Lme 1 2 179 975 Qil B Y INDIANi"
mo
I
4. TOTAL COMPLETED STORED TO DATE (Column G on G703) State of MARION i
vel
5. RETAINAGE County of g NptP
a. 10 i5f Completed Work 12,992.50 Subscribed and sworn to before 11/10/09 Q158
(ColvltD E on 0703) me this day o HRIS FOLEY L %it'�- S �d'
b. of Stored Material Notary Public: 2/21/14 J �rB
61 (Column F on 0703) My Commission expires: A? h`.�
Total R (Lines 5a 5b or Total in Column I of 0703) 12,992.50 CERTIFICATE FOR P AYMENT i te s of ti
116,932.3'0 I accordance with the Contract Documents, based on on site observations and the data comprising
6. TOTAL EARNED LESS RETAINAGE this application, the Construction Manager and Architect certify to the Owner that to the best of their
(Line 4 Less Line 5 Total) 98,617.50 knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 0 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT
(Line 6 from prior Certificate) 1}j 315 00 CERTIFIED. lc� Glr
8. CURRENT PAYMENT DUE AMOUNT CERTIFIED tt
13 t
9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amoun;,applied. Initial all figures on this
1,983,067.50 Application and on t e Continuation Sheet tha hanged to conform with the amount certified.)
(Line 3 less Line 6) CONST .CTIO w
B i l %��a
ADDITIONS DEDUCTIONS Date: ///e4/0,
CHANGE ORDER SUMMARY ARCH! T•,
Total changes a pproved in previous months by Owner By 1 Date:
Total approved this`Month This Certificate is not :negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order t Owner or Contractor under this Contract.
CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
AIA Document G702JCMa 1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties.
Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law.
Purchasers are permitted to reproduce ten (10) copies of this d ocument when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright @aia.org
Document G703 -1992 pagel
i.
Continuation Sheet
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION'NO: 3
containing Contractor's signed certification is attached. APPLICATION DATE; 40127
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 11/10/2009
ARCHITECT'S PROJECT NO:
A 13 C D E F 0
H I
WORK COMPLETED
MATERIALS TOTAL
BALANCE
PRESENTLY COMPLETED RETAINAGE
SCHEDULED FROM PREVIOUS TO
ITEM DESCRIPTION OF WORK STORED AND STORED (IF VARIABLE
NO VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G C) FINISH RATE)
(D +E) C G)
D OR E) (D +E +F)
1 Bonds 73,500.00 /.i,b00.0U 0.00 73,508700 100% 0.00 3,675.00
2 Moblilization 5,000.00 500.00 750.00 1,250.00 25% 3,750.00 62.50
3 Insurance /Hazcom /Safety 4,000.00 4,000 00 0.00 4,000.00 100% 0.00 200.00
4 Submittals 4 ,800.00 4,000 00 800.00 4,800.00 100% 0.00 240.00
5 09 72 00; WALLCOVERING
Labor 18,750.00 0.00 0% 18,750.00 0.00
Material 37,000.00 0.00 0% 37,000.00 0.00
6 09- 84 -00 ACOUSTICAL
WALL PANELS
Labor' 51,500,00 0 0% 51,500.00 0.00
Material 580,000 00 5,800.00 5,800.00 1% 574,200.00 290.00
7 :09- 91. -00; PAINTING
Labor 860,300.00 22,150.00 10,000.00 32,150.00 4% 828,150.00 1,607.50
Material 208,500.00 5,425.00 2,500.00 7,925.00 4% 200,575.00 396.25
8 09- 97 -23; STAINS, SEALERS
Labor 24,700.00 0.00 0% 24,700.00 0.00
Material 13,300.00 0.00 0% 13,300.00 0.00
9 DAILY CLEAN UP 15,000.00 0.00 0% 15,000.00 0.00
10 GENERAL ALLOWANCE 100,000.00 0.00 0% 100,000.00 0.00
11 SUPPLIES ALLOWANCE 15,000.00 0.00 0% 15,000.00 0.00
12 LABOR ALLOWANCE 75,000.00 0.00 0% 75,000.00 0.00
13 CAD ALLOWANCE 5,000.00 0.00 0% 5,000.00 0.00
14 PROGRESS MEETINGS 5,200.00 500.00 500.00 10% 4,700.00 25.00
15 CLOSE -OUTS 3,450.00 0.00. 0% 3,450.00 0.00
Page 1 TvtaIs 2,100,000.00 109,575.00 20,350.00 000' t79,97S nn h 1 970 075 00 6 496 25
CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
AIA Document G703TM 1992. Copyright() 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright
Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent
possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal
counsel, copyrightC57aia org.
D. P. Co. Inc.
AFFIDAVIT AND WAIVER OF LIEN
Payment 2
STATE: INDIANA FINAL XX PARTIAL PAYMENT TO FOLLOW
COUNTY OF: MARION
_kevin M. Blume_. Being duly sworn that he is the Secretary of Diversified Painting Co. Inc_ being in
contract with Carmel Redevelopment Commission to furnish certain materials
and /or labor as follows: Painting Wallcovering for a project known as:
Parcel 7A; Regional Performing Arts Center located in: Carmel, IN
and owned by City of Carmel Redevelopment Commission and does hereby further state
on behalf of the aforementioned subcontractor supplier:
(PARTIAL WAIVER) That there is due from the contractor the sum of
Ninety -Eight Thousand Six Hundred Seventeen and 50/100 DOLLARS: 98,617.50
XXXX receipt of which is hereby acknowledged or
the payment of which has been promised as the sole consideration of the 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 there is due from the contractor the sum of
DOLLARS:
receipt of which is hereby acknowledged or
the payment of which has been promised as the sole consideration of the affidavit
and Final Waiver of Lien which is shall become effective upon receipt of such
payment.
THEREFO 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 or material or both, furnished by the undersigned thereto, subject to limitations or
conditions expressed herein, in any, and further certified that no other party has any claim or right
to lien on account of any work performed or material furnished to undersigned for said project
and within the scope of this affidavit and r.
Diversified Painting Co. Inc._ By: President
Kev4 M. Blume
WITNESS MY HAND AND NOTARIAL SEAL THIS: 11/10/09 Zk4�! i���
MY COMMISSION EXPIRES: 02-21-2014 C., gx4
COUNTY OF RESIDENCE: Hancock /GILL r NO tt ,Xy
Chris Foley PUBLIC
SEAL I
V.\ e 21 2 o1 A
,'4", O I e ND
1 7
CI
Dale 1 b (b) WHERE FRINGE BENEFITS ARE PAID IN CASH
KEVIN BLUME PRESIDENT
Each laborer or mechanic listed in the above referenced payroll has been paid,
(Name of Signatory Party) (Title) as indicated on the payroll, an amount not less than the sum of the applicable
do hereby statel basic hourly wage rate plus the amount of the required fringe benefits as listed
in the contract, except as noted in Section 4(c) below.
(1) That I pay or supervise the payment of the persons employed by (c) EXCEPTIONS
DIVERSIFIED PAINTING CO on the
(Contractor or Subcontractor) EXCEPTION (CRAFT) EXPLANATION
REGIONAL PERFORMING ARTS CENTER that during the payroll period commencing on the
Building or Work) c
I 1 day of d h I r 0 and ending the day of f/ Y 0
all persons employed on said project have been paid the full weekly wages earned, that no rebates have
been or will be made either directly or indirectly to or on behalf of said
DIVERSIFIED PAINTING CO from the full
(Contractor or Subcontractor)
weekly wages earned by any person and that no deductions have been made either directly or indirectly
from the full wages earned by any person, other than permissible deductions as defined in Regulations, Part
3 (29 CFR Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948,
63 Start. 108, 72 Stat. 967; 76 Stat_ 357; 40 U.S.C. 276c), and described below:
REMARKS
(2) That any payrolls otherwise under this contract required to be submitted for the above period are
correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the
applicable wage rates contained in any wage determination Incorporated into the contract; that the
classifications set forth therein for each laborer or mechanic conform with the work he performed.
(3) That any apprentices employed in the above period are duly registered in a bona fide
apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of
Apprenticeship and Training, United States Department of Labor, of if no such recognized agency exists in a
State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.
(4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS NAME AND TITLE SIGN-
KEVIN BLUME, PRESIDENT
in addition to the basic hourly wage rates paid to each laborer or mechanic listed in
the above referenced payroll, payments of fringe benefits as listed in the contract THE WILLFUL FALSIFICATION OF ANY OF THE A: 1VE STA r MENTS MAY SUBJECT THE CONTRACTOR OR
have been or will be made to appropriate programs for the benefit of such SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE CTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE
employees, except as noted in Section 4(c) below. 31 OF THE UNITED STATES CODE.
U S- G.7.0..1997 519.561
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
n �i
,(/1(Pys." ��,7 p7,9 Cc 7p," Purchase Order No.
Terms
q,-? a /7z. 1 2/7 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
/3/4 3 3 a17 l (F 5 1 -'D'c)
Y
Total lc, 3 ✓S C
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. =r'
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
'7! `77 (171'?"---17,.,,,`" IN SUM OF
/e -e l
r 3 /S d
ON ACCOUNT OF APPROPRIATION FOR
9e? 2
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT hereby certify
DEPT. I hereb certif that the attached invoice(s), or
K6c F07 /,315 rxr bill(s) is (are) true and correct and that the
materials or services itemized thereon for
Q. which charge is made were ordered and
received except
-/y 20 �G
Director 9 orations
Cost distribution ledger classification if
claim paid motor vehicle highway fund