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181473 01/19/2010 CITY OF CARMEL, INDIANA VENDOR: 363792 Page 1 of 1 j s ONE CIVIC SQUARE W R DUNKIN SON, INC CARMEL, INDIANA 46032 PO BOX 2247 CHECK AMOUNT: $396,923.50 ,,4 ANDERSON IN 46018 CHECK NUMBER: 181473 CHECK DATE: 1/19/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 009 10,561.50 PERFORMING ARTS CENTE 902 4460807 0835 1509 -2 20,524.00 PERFORMING ARTS CENTE 902 4460807 19 365,838.00 PERFORMING ARTS CENTE ,i D l i I l ,,i November 23, 2009 Mr. Les Olds Carmel Redevelopment Commission One Civic Square Carmel, IN 46032 RE: Carmel City Center Performing Arts Center Shiel Sexton Project #2695 EMERGENCY WORK W. R. Dunkin Sons Invoice No. 08- 385 1509 -2 Dear Mr. Olds: Based upon on -site observations and the data comprised in the billings, Shiel Sexton Company (Construction. Manager) certifies to the owner that, to the best of their knowledge, information and belief, the Work has progressed as indicated, the quality of Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the amount requested ($20,524.00). Sincerely, Warren David Brewer Project Manager cc: Don Cleveland Mike Anderson Tony Eisenhut File �a f R J lY :.`jIM ii '.1.1T,.. General Contractors Construction Managers Established 1915 P.O. Box 2247 PHONE: (765) 643 -3321 ANDERSON, IN 46018 FAX: (765) 778 -2970 INVOICE NO. 08 -385 -1509 -2 DATE: 10/30/09 TO: City of Carmel Redevelopment Commission One Civic Square Carmel, IN 46032 RE: Project: Parcel 7A, Carmel Regional Performing Arts Center Additional Cost for T &M Work Related to Project Shut -Down APPLICATION NO. 2 T &M for Bulletin #40 Cleaning Water Control to Mitigate Delay Impact Partial 20,524.00 TOTAL AMOUNT DUE 20,524.00 W. BULLETIN #40 o Y: Son,, 14110. Gen erai Contractors &Construction Managers- F ;ti4a1r!ished1 1.915 November 17, 2009 Shiel Sexton Company, Inc. 902 North Capitol Avenue Indianapolis, IN 46204 ATTN: Dave Brewer PROJECT: Carmel Performing Arts Center RE: Bulletin #40 Cleaning and Water Control to Mitigate Delay Impact Partial Dave, As requested we have completed additional work to assist with cleaning and containing water inside the building so construction can continue following the shut -down. This change request includes the T &M work completed per Work Orders #455, 479, 487, and 511. A breakdown with supporting detail is attached for your reference. Total investment for completed work 20,524 Thank you for the opportunity to complete the additional work noted. Please call if you have any questions. Yours very truly, W. R. DUNKIN SON, INC. Bradley Tyler'- Project M ,fit fkxl 2409 WEST I8 STREET PO BOX 2247 ANDERSON, IN 46018 -2247 765- 643 -3321 FAX 765- 642 -7679 Bulletin 40 Estimate Page 1 Carmel Regional Performing Arts Center Material 1 Equipment Quoted Labor Subcontract Description Quantity Unit Unit Cost Total Cost Material Cast Unit MH Total MH Rate Total Cost Unit Cost Total Cost Total Cost T &M WORK FOR WATER CONTROL (PARTIAL} REQUIRED TO MITIGATE SHUT -DOWN DELAY includes Work Orders 4455, 479, 487, 511 0.000 $0.00 MATERIAL 0.000 $0.00 Lowe's Invoice 1 Ticket 1 Sum 130.97 0.000 $0.00 131 kAce Hardware 4 Tickets 1 Sum 267.97 0.000 80.00 266 SESCO 3 Ticket 1 Sum 809.04 0.000 $0.00 809 0.000 $0.00 LABOR 0.000 $0.00 Superintendent 2 MH 1.000 2.00 $63.00 126 126 Carpenter Straight Time 83.5 MH 1.000 83.50 $51.53 4,303 4,303 Carpenters Time and One Haif 53 MH 1.000 53.00 $77.30 4,097 4,097 Laborers Straight Time 233 MH 1.000 233.00 $35.46 8,262 8,262 Cement Finisher MH 1.000 $47.54 Truck Driver (Pick -up Barrels) HR 45.00 1.000 $51.53 Project Manager MH 1.000 $82.00 Estimator MH 1.000 $54.50 0.000 $0.00 SUBCONTRACTOR 0.000 $0.00 Poynter Sheet Metal 1 Sum 0.000 50.00 423.00 423 423 0.000 $0.00 0.000 $0.00 Account Subtotal 8 1,208 371.50 16,788 423 18,419 Tax @0% Account Total 1,208 16,788 423 18,419 Estimated Material Quoted Material 1,208 Estimated Labor 16,788 Subtotal Material Labor 17,996 Quoted Subcontracts 423 Subcontract Insurance 0 Subtotal Quoted Work 423 Project Subtotal 18,419 Overhead Profit -Mat'I Labor 10.0% 1,800 Overhead Profit- Subcontracts 10.0% 42 SUB TOTAL 20,261 Bond 1.3% 263 TOTAL 20,524 Printed 11/17/2009 Page 1 x Saw', inc, NO. d General Contractors Construction Managers Established 1915 P.O. Box 2247 Anderson, IN 46018 Telephone (765) 643 -3321 Fax (765) 778 -2970 Date iti-Z7 Job No. 3i4c DESCRIPTION OF WORK: C y GAP /"8niv1 UP? uR J D Job Name C4e/t f_ •f� C.. Cost Code 1 5/1 IGAMS 4 .SL A$ 00 4 66 -0 o Extra ime Material 2 T// A TT .Zc_ o Backcharge o Other This work has has not been completed. LABOR TRADE HOURS ST OT RATE TOTAL }'A u J Atcp&iti rA Z A fit F dLPE t/TE/c.. #6.5 i/ QTY MATERIAL (Note where purchased or from stock) EQUIPMENT HOURS 2" Tier- or IL.K Small Tools t ZO Roi-LS a F ,e_ Ron W.R.D. Truck UN -I 1 Ke-e7 n 5 WORK AUTHORIZED BY: ACKNOWLEDGEMENT: Company W.R.Q. Repr ntative Not1, By Title White W.R.D. File Yellow Customer Pink Job File A -e-t- I a r 5' B L ic a 0-4 iph Fur:bit-4Ft FZ a f\t„ 7 .a 1 F ar L FR Et [1e=ii R M li._ 7 I NI 7 2Z3 1 1 f v -',t,Aritintk.ACrio i 11•CiCti E OPE' •N c .034BER• -44- i BILL TO SHIP TO: W. R DUNKIN SON, INC. W. R DUNKIN SON, INC. P. O. BOX 2247 P.O. BOX 2247 r-gy•7:reyVV DT:',S 9 "4"A't7A-) '7 t II"' 7;1-47 EV .474 :IN r 7, 7 3 ....4, ..,..4%..-0 7, 4 ,:s4f, .7 v.., TA- ..vgmkr.5 -0' w..... ....t. Tr' %.:7 el.....-.m .■i ---,3V 4 •"e c ME DES ka' 14 Wmouictir l' 4., ,L'-.4......67........A. '''''4 ■M",.....7-k Y ,:',1-+7 A 1, ;;I: '.,..,..iii7._ =t '''''s="" 2.. 12 10207 ACE CONCRETE -moRTnk CART 4.490 53.88 4 5131396 CAULK SAVER 5/8X20' 5.460 21.84 r 7 I e F fl, TAXABLE 1 HOUSE 81. 75. 7 2 11111111111 A 1 1 NON-TAXABLE .00 81.02 73 7—jf,\ IMIIIIIIIIIIIIIII X „IL,414z...., :•-srw-.2-r-T •-4, i rt 4 L.', t41-1 1 1 G Ft IC H R Di WI Fl R L A LL- iN3 Di .0 S4 RIN1LL X" N '::ieciL la 62:11 2 Y 7 7 1 R NG A-11\A a re. s. -..-.;,a,a 1 1 vedv 6A ACCT UMBER i N BILL TO HIP TO: W. R DUNK IN SON, INC. R DUNK IN SON, INC. L.••Lr P. O. BOX 2247 :P. O. BOX 2247 ANDERSON IN 46018 :ANDERSON IN 46018 "URCHASER .C.A r....m.. R PG„, TERMS -SALESMAN r.. ,L,-,.• R DUNKIN SON 9 IN MINI 00ANTnY ITEM NUMBER DESCRIPTION 1 1 PRICE/UNIT AMOUNT .:Ti,:-._,' ,"_...--:i r n ``413,XTVg."-c,'`..s::::;', .-L: :57!, gei'VKli?,,; 1; :1'.- --Y)''', V9'1 f 1 4 ••;+••94. 4: L.. r. 114n: ';',i 'L 4 1' 4 1;?-0 .-1.A J CH::: ,Ci4i R l!'),:. '-3r+- ,%j--->V3':'.;.',',.:.: ,:e,gife.i',;.', ..q.:,,1-?-:..i=p,iy;,, i: -L `.,-,7::?,,#:, "f-f-0--A-:".- 4 f. -:1:1.17.•:„: i ,..,1-_-... ,t-•,,an.- --:,4-wf,-.. ft. ,11.(tc:',.,;- W1 ,,:.:i.i. 4'^ :::Z11-:., 4 A vfiq:7;i;::-:'::: .T_ 1 4 Vtqs k :'-f WiT...k: .5'.., -q fol''''.-rk'''''' Y-1/4-; Vif:-if.**AkT ;Y, --tot-W'' :.1: 01 kti ..,i: ?=0 4 rvr,,, .6 Wn 't. 4 24 .:i. .-f 7:• 4 17 I 'Mgle X -A- k L 1:- V 1 44:4i 1 4it...''Z: it altAiVri:F N „._..i4e::::'::: '.:-7 I. yr „.....7,-,vitr,: ,,„.„,„,,....:4;:*.:_..:::-,..2 .,,,e,-;,;: 04,,,..40.i4.' A ;„.,,,L., ;:„„...tek fy.. 4 Y.4:: .::-.4 -c.47.11.74,- 1 ,,..F. Mi.N5.titii F.,..t si.t.e..,: 4,- ::.N. V i I ..E '4.' '40-1.10::::• k .4*4 "V;P:014; ,,P1: ":6 4 W4_;cXfAiki 1. 4* 2- 4 Zr''' 1 4,-, %C,. .`"'"--■*::=:v::_••..,. If 4 74 K7**A0" 40- 70 4:1 0 .05 24 karig.. I.44- h 7-;,' 7 -F Y-::' t• HOUSE 64.07 TAXABLE W.,.,,,.--•A ..:.-r.-.•.... -,'"-P'-''''..•Vc*:'..V:.,. 3 14 :.:-0-:::, ,v,:-; ;•:4: :-1 TAX 0;i•:-I9 114 NON-TAXABLE Al:', 7i'•'- -r,"-•'' SUB-TOTAL 7 4 ....,7..-..,,.=, 441.1e4etlt:Ag -::.,.i- --.'=',•..7 r of RECEIVE THE ABOVE IN GOOD CONDITION alag ',R.,0#, a rwA-1.-'-` -a A 2.:-.4-4 07 I T ..„T 7,- ..,..v.f.... ,0A,4,4:-.. y...., .,:s....L.,'...,,,--- 1 V E III NO. Son. Inc. General Contractors Construction Blanagers Established 1915 P.O. Box 2247 Anderson, IN 46018 z C Telephone (765) 643-3321 Fax (765) 778 -2970 Date (D 15 fG 1 Job No. �GJ J DESCRIPTION OF WORK: J; G' 1� liki iL 1:4,1/11 il�(i� jZ,n�� Job Name L fli�1�?' t-/DS c .S .5_s" jr7i..�C l 0 �7f p Cost Code 4 o Extra o Time Material �1 i4- cy. Fi- /Z �'C )6 CL) o Backcharge dOther //1A44 f °'i i- re' at'Ai Ply-IAN-0 /AO This work has has not 1)1,4 Ti[_. been completed. LABOR TRADE HOURS CI OT RATE TOTAL ININ111FI Tilt/ vi k),,J L. 0 0 0r d' V' I n I 1 10 ic1 111111111111191111E111111111111111 1 ...4 to 136 tD Jat( I *MIN O 11111111_ IIIIIIIIIIMIIMIIIIIIII IIIIIIIIIIIIIIIIIIIIIMIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIK QTY MATERIAL (Note where purchased or from stock) EQUIPMENT HOURS IMIIIIIII Small Tools IONE 1 I 2; l .8 v iiiiii W.R.D. Truck MN i n li a llill11111111111111111111111111111111111 MIMI 111111111111 INN MIIIIIIIIIIIIIIIIIIIIIII 111111111111111111111111111111111111111111.1111111 11E11 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII WORK AUTHORIZED BY: CK L GEMENT: Company W .D. Representative s? ,47-41, 1 ®e'er 21 VI A Title White W.A.D. File Yellow Customer Pink Job File .4-..r.'"...."'''''''''''''..s...........'''"'"" 1.......T p WOE'S HONE CENTERS, INC. 14598 LOWES NAV CARMEL, IN 46033 A 5 (317)566 -8124 -SALE SALES S15258A1 834883 10 -08 -09 10376 ALL PURPOSE SAND -TUBE 122.40 30 4.08 SUBTOTAL: 122.40 TAX: 8.57 INVOICE 02698 TOTAL: 130.97 BALANCE DUE: 130.97 LAR: 130.97 LAR XXXXXXXXXXXX7984 000812 LAR P0: 4050J ACCOUNT NAME: W 8 DUNKIN SONS INC RUTH BUYER: BROVNING DAVE r AMOUNT: 130.97 ACCOUNT WILL BE BILLED UPON MERCHANDISE RECEIPT OR ND LATER THAN 60 DAYS FROM TRANSACTION GATE FOR STOCK MERCHANDISE AND NO LATER THAN 90 DAYS FROM TRANSACTION DATE FOR SOS OR DIRECT DELIVERY MERCHANDISE. 1525 TERMINAL: 02 10/08/09 13:04:32 it OF ITEMS PURCHASED: 30..._._..._ EXCLUDES FEES, SERVICES AND SPECIAL ORDER ITEMS IIib:IftiiR s THANK YOU FOR SHOPPING LOVE'S i RECEIPT REQUIRED FOR CASH REFUND. f CHECK PURCHASE REFUNDS REQUIRE 15 DAY WAIT PERIOD FOR CASH BACK. STORE H6R: TODD BYCZEK HAU1' A COMMENT OR FEEDBACK? LET US KN011.AT: WWW.LOWES.COH /FEEDBACK W agg SOHO, 111111C.-- NO. 455 General Contractors Construction Managers Established 1915 P.O. Box 2247 a Anderson, IN 46018 Telephone (765) 643 -3321 e Fax (765) 778 -2970 Date_ A(, Z V6 t 07 Job No. JR DESCRIPTION OF WORK: Zahl Wt., 6C-TiR Job Name 4flr? 1�L_ d Si-k -o o 8 /1 Cost Code s o Extra o Time Material C-Aalp re 'ay el-dhc, 21,1)7 f o Backcharge /Other rt<-L SMAILe `This work has has not been completed. y +,+yJ LABOR TRADE HOURS ST OT EMI TOTAL mmuiemiumiwi ,..mmuiriourdonem 111111111111111211111=1111111111111 J ir 111111111111112111111151 NMI oli SI& I a* 111111111 t 1111• .e 111111111 N'N IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII QTY MATERIAL (Note where purchased or from stock) EQUIPMENT HOURS IIIIIIIIIRIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Small Tools MIMI W.R.D. Truck IIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIM M I I II IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIInIIIIIIIIIIIIIIIIIIIIMIIIIIII II I II IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII r r IIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIII I IIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIEIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIr WORK AUTHORIZED BY: e" N i. r, t ENT �o 5\ L s Company W.R.D Representative 1 -1[A1e White W.R.D. File Yellow Customer Plnk Job File Iii k° .4 MATERIAL T ®p p a pp yg S i t; rr t TIME MA Y ERIAL ORK ORDER CUSTOMER: lam aZ"' -t JOB PROJECT: :...n�..�I r/L 4. DATE: '-4:97 DESCRIPTION OF WORK: '1 —O ,m 14 91 LAD OR RECORD: Date Em la ee Re;. Drs. Rate 1 1 -1I2 Rate 2 Rate T.P. Amount ..2:1 111111.111111111111111111114=1 inmill111111111111111111111111111111111111 Mom _MMIIIMIPMIVIA111. I_ IMO Ilrfrali •111111111111111111111111. milloinimm 874. 44, I P .7--, t" l 5 ,a Travel Pay: i Labor Total:! 4 431- MATERIAL USED: Quantl Deseri, Hon Unit Amount 111 i l 11111.111111111 NE II II c Material Total: Sales Tax: Total Material Labor: Signature otPSM ProJect Sopervtsor azure of Customer's kepresents&. uthorizine Work I, r i I) fit FIP. I, l'` Fit 4 t i N 7— Son. Inc- NO. ,.9 3 General Contractors Construction Managers Established 1915 P.O. Box 2247 a Anderson, IN 46018 fi t Telephone (765) 643 -3321 Fax (765) 778 -2970 Date I•101 0✓ f1 Job No. 3W DESCRIPTION OF WORK: b V/Z.- ���1()i4ie Job Name m€ C.A Cost Code 157O7 S 5 1 Z d Z o Extra /Time Material o Backcharge o Other This work has has not been completed. LABOR TRADE HOURS ST OT RATE TOTAL err' Sys Jk i 'ifY 17 1 -2 rig-b VIC_ 4../D. 4,6. 1 I/4 1 7 'TT t S l K.Es144lG 4v lcre-to.- Vy q `ni 8 Q /de Fjl/ r 1 4n l�a 1 t yTt 9 1 /Mt 1414/ 131 S JOkA/ 021/01/4//o 1 73/ 8 3,>✓i 340kfiumi 6 19'3 0 QTY MATER RI IAL (Note where purchased or from s :ock) EQUIPMENT HOURS ,Z D 141 b�,14, 4AiG, {iki;vo ;IA 1 (Sr) ,Small Tools W.R.D. Truck Z A. c i illfl1747 t ace of l y 358013(] 3 S E S 6-r 7 1 e 4E1 717713 71 i3s 7r? I s 7 WORK AUTHORIZED BY: ACK/L a LE»►GEMENT: ompany W. D. Representative 14... ..s' l g.-1 0 V, u. 5 c'4 By Title White W.R.D. File Yellow Customer Pink Job File E3 Pi R 1 1�.. 1 NI za. E. 1 1 1 r0F S r K w ,4„.._. M i e} ,Q S�' CCT il HOUSE 35801368 20 10/31/09 08:45:20 003302 1 W.R DUNKIN SON, INC. W. R DUNKIN SON, INC. P.O. BOX 2247 P.O. BOX 2247 ANDERSON I N 46018 ANDERSON I N 46018 ay 3 °r_+� 4". c Si l -s '�ti '+1�'�` a f m 7 -P tq�� 0?'" S'" .y ,y ,.g, -.r .a�. t -.Z4.4.-- y� I�i.� tea- 7 w^' C• F F.a "%.l C F �4 ^i'' '7 :...:.k4 7'' rZ-Ak44,1 i., u y .ss 1: t kt e .:t.s ilrt 44,s ,h e 4.'P.i .k_ .7 W. R DUNKIN SON, IN TRACI iv 7 3- r te-_ ��'1 3 7 r a G.'� a a x: su"" -Y "t- ti3`s xr 1 DESCR O N 7 C A OU wee fx .U a`'s iS m e t ._.r, as ks^,.. 't v L..;: k a e r i 1 19077 GREATSTUFF FOAM TRPL 120Z S 2.990 2.99"':1 1 19077 GREATSTUFF FOAM TRPL 120Z S 2.990 2. 99 o 1 19077 GREATSTUFF FOAM TRPL 120Z S 2.990 2.99 1 19077 GREATSTUFF FOAM TRPL 120Z S 2.990 2.99: 1 1096189 DAPTEX LATEX FOAM 120Z 4.980 4.98 1 1096189 DAPTEX LATEX FOAM 120Z 4.980 4.98; 1 1308006 FLOOR SQUEEGEE CURVD 36 21.990 21.99;'; 1 1365246 FLOOR SQUEEGEE 24 "ACE AL 16.990 16. 99 1 1308006 FLOOR SQUEEGEE CURVD 36" 21.990 21.9'3:' 3 10546 BROOM HNDL TAPRD 1- 1/8X54 5.990 17.97 HOUSE 107.92 TAXABLE 100.86 TAX MR NONTAXABLE .00 SUB -TOTAL 107.92 X al 31. 4 ��OTAL s 1 7 9 c I i 4) "7 a1 B R 10 a L.INU Rfl TY TRANSAC71ON tl �OCl I(ati6� TRANSACTION DATE PAGE ACCT NUM ER HOUSE 35800514 22 10/29/09 10°09 :18 003302 1 BILL TO SHIP TO W. R DUNKIN SON. INC. W. R DUNKIN SON INC. P.O. BOX 2247 P.O. BOX 2247 z s Y a a 1 -,..,.,.,......,!...-8,-.:,.4 v m ?0, y M 7 r '4 'gE r< ..,.r tt A tr E2A %:�fi :1 3.' 4 y:4. tt Y- E�Rms S q ES .-R DUNK IN 3ON, f VA QUANTRY ITEM NUMBER DESCRIPTION PRICE/UNIT AMOUNT RCK oca �z I9160 E4 PRA" a P PO f200 Z 7:::' 6, 99 ,y'' ra r b. s d 3 ��,'rr -0 Y 7 P' a ,C"'' 3 z k 1, s t a y, TAXABLE HOUSE 14.96 NON TAXABLE 14.1;%-:' SUB -TOTAL 7 1. 2 y4. vb X 3 .1 r. J E THE ABOVE IN GOOD CONDITION r b ra t 1111101V Remit to Address: Southeastern Supply Co., Inc. 4325 Prospect Street Southeastern Supply Co. Indianapolis, IN 46203 4325 Prospect Street Indianapolis, IN 46203 Telephone: 317 -359- 9551 Facsimile: 317-359-0176 RECEIVED OCT 2009 Page 1 of 1 st Dunkin Son inc. Invoice No: 293784 Invoice Date: 10/06/09 Sales Order No: 717713 W.R. Dunkin Son, Inc. Customer No: 6005 P.O. Box 2247 Customer Purchase Order. 40501 Sales Person Name: David Brown Anderson, IN 46018 Order Date: 10/02/09 Ship Date: 10/02/09 Delivery Note No: 717713 Shipping Instructions: SESCO TRUCK 10 Am K ati �sc °s Stock,Code De ption:. UIM �A'plyde Ship 13/0 Unfit Line otal Q QtY atYPr1ce 06C2412 2 x 4 x 12 Const. EA 100 100 0 2.71 271.00 03THORO03 Waterplug 5 -Gal. EA 2 2 0 47.49 94.98 02SCREW003 8 x 3" Coarse Drywall Screw EA 1 1 0 12.65 12.65 #5 +4 ''"�wk.,., �`"�taidt° m -i, ...a -§S� sri'< y -C; r w..- i:;£'.a Gross fiodi Frei Miscellaneotp :u Disco wl r 3zotal,i $.41 e 378.62 0.00 0.00 0.00 0.00 378.62 Remit to Address: Southeastern Supply Co., Inc. Mn====a22=3 4325 Prospect Street Southeastern Supply Co. Indianapolis, IN 46203 4325 Prospect Street Indianapolis, IN 46203 h Telephone: 317-359-9551 Facsimile: 317-359-0176 hi EC, OCT 22D0 Page 1 of I ”kr R Invoice No: 294549 Invoice Date: 10/20109 Sales Order No: 718539 Tati i 61 W.R. Dunkin Son, Inc. Customer No: 6005 P.O. Box 2247 Customer Purchase Order: 4050J Sales Person Name: David Brown Anderson, IN 46018- Order Date: 10/16109 Ship Date: 10/16/09 Delivery Note No: 718 539 Shipping Instructions: SESCO TRUCK 10/19PM Ok 4 1. 7441,fi irSV. c 9 6 ralitga E I n.„0.40ta k ittIEA!‘ VgrrA e itjW,tg'CVIAVMCSN4itt?igt4rga:SS*:taitiiiliaiega,Patkire l aVs i 03THOR003 Waterplug 5-Gal, EA 3 3 0 47.49 14247 06C2412 2 x 4 x 12 Const. EA 50 50 2.71 135.50 FREIGHT CHARGE 1 0.0 0 1 0 00 aliaatrailtlitgageggkeigiterkiifelaifi DiRaticaleMatRiAgA 277.96 10.00 0.00 0.00 0.00 287.96 Remit to Address: Southeastern Supply Co., Inc. 4325 Prospect Street Southeastern Supply Co. Indianapolis, IN 46203 4325 Prospect Street Indianapolis, IN 46203 Telephone: 317 -359 -9551 RECEIVED Facsimile: 317- 359 -0176 NOV ?G09 Page 1 of 1 W.R. SUE akin Soil !"';R' invoice No: 295102 Invoice Date: 10/29/09 Sales Order No: 719157 W.R. Dunkin Son, Inc. Customer No: 6005 P.O. Box 2247 Customer Purchase Order. 4050J Sales Person Name: David Brown Anderson, IN 46018- Order Date: 10/28/09 Ship Date: 10/28/09 Delivery Note No: 719157 Shipping Instructions: Salesperson Deliveryl0 -28 -9 StockCa a i Desc�iptton ti UlIVI kOrtler Shp 81,0 Unity Dine Total F*f�. 03THORO03 Waterplug 5 -Gal. EA 3 3 0 47.49 142.47 9 d Gr s�T al. Frei ht MtscellaneoysJ Dtscqunt O Tax` Total,invoice 142.46 0.00 0.00 1 0.00 0.00 142.46 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 O c'/4/ (yam Purchase Order No. /5 X 2 4 {7 Terms h /74Pr5 //t/ Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) °730 g GS-3 2 s" y��� z SY2.G 0 Total .51 .OD I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same ins accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. .WARRANT NO. ALLOWED 20 ,a/ SO'2 /mac IN SUM OF ,tea ,X 22 5 7 /4/ 4/6 2/ 3 6 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACC AMOUNT hereby certify invoice( s), DEPT. I hereb certi that the attached invoices or Ord i /50 2 �iS bill(s) is (are) true and correct and that the '-/(Zoa materials or services itemized thereon for which charge is made were ordered and received except Direcfo' o Aerations Title Cost distribution ledger classification if claim paid motor vehicle highway fund SL Subcontract Billing Report For Work Invoiced From 11/01/09 to 11/30/09 Subcontract: 2695 -5010 5010 General Trades Job: 2695- Carmel RPAC Construction Vendor: 9279 W.R. DUNKIN SON. INC 777 3rd Ave. SW Carmel, IN 46032 Contract To Date This Period Item Units UM Unit Cost Amount Units/% Amount Units Amount 1 5010 General Trades LS 1,480,000.00 24.38% 360,779.00 0.79 11,735.00 Total Contract Items 1,480,000.00 360,779.00 11,735.00 Subcontract Totals: 1,480,000.00 360,779.00 11,735.00 Total Billings: 360,779.00 11,735.00 Unpaid Retainage: 36,077.90 1,173.50 Discounts: 0.00 0.00 Net Billings: 324,701.10 10,561.50 98 SSC CMa Projects Page 1 11/19/09 12:02:23 PM Date Format MM /DD /YY SLSubBillingReport .rpt �O� C �r� 1992 10 ent 7021 Application and Certificate for Payment Construction Manager Adviser Edition TO OWNER: Carmel Redevelopmt Comm PROJECT: Parcel 7A, #5010 CPA APPLICATION NO: 009 Distribution to: One Civic Square 777 3rd Ave S.W. OWNER: X Carmel, IN 46032 Carmel, IN 46032 PERIOD TO: November 30, 2009 CONSTRUCTION MANAGER: X FROM W.R. Dunkin Son, Inc. VIA CONSTRUCTION Shiel Sexton Co., Inc. CONTRACT DATE: February 23, 2009 ARCHITECT: X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS: 25310H 2695/5010 2695 CONTRACTOR: X Anderson, IN 46018 FIELD: CONTRACT FOR: Bid Pkg #5010 VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and 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 b paid-b5 the Contractor for Work for which previous Continuation Sheet, AIA Document G703, is attached. Certificates for Payment were issued an• l ent /received from the Owner, and that current 1. ORIGINAL CONTRACT SUM 1,480,000.00 payment shown herein ;fir ow du- 2. NET CHANGE BY CHANGE ORDERS 81,040.00 C 1, c w i :-01.„16 INC 3. CONTRACT SUM TO DATE (Line 1 2) 1,398,960.00 I r%�� e Date: November 10, 2009 4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 360,779.00 St,.-- of: Indiana 5. RETAINAGE: County of: Madisq a. 10 of Completed Work Subscribed and sworn to before (Column D +Eon G703) 36,077.90 me this 13th day of November 2009 f� /il b. 0 of Stored Material Notary Public: Martha A. Carpenter e Cr,�L t (Column F on G703) 0.00 My Commission expires: January 08, 2017 7 Total Retainage (Lines 5a 5b or Total in Column 1 of 0703) 36,077.90 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE 324,701.10 In accordance with the Contract Documents, based on on -site observations and the data comprising (Line 4 Less Line 5 Total) this application, the Construction Manager and Architect certify to the Owner that to the best of their 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 314,139.60 knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. S 8. CURRENT PAYMENT DUE 10,561.50 AMOUNT CERTIFIED I 1 1 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial a figures on this Application a,. on the Co tinuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) 1,074,258.90 CONSTRUCT! f N MA i g G 'I/ BY: Date: 2-247 By: ��CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITET Tr- I (y� Total changes approved in previous months by Owner 0.00 0.00 i Date: "yCJ 1 I i l I Total approved this Month 0.00 81,040.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS 0.00 81,040.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order 81,040.00 AIA Document G702/CMa 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 1 under the law. This document was produced by AIA software at 11:34:59 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010, and is not for resale. User Notes: (963920706) -4 Document G7O3TM 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 009 containing Contractor's signed certification is attached. APPLICATION DATE: 11/10/2009 In tabulations below, amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 11/30/2009 ARCHITECT'S PROJECT NO: 25310H A B C D E F G H I. WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G C) FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (C G) RATE) (D E) (D +E +F) 01010 Performance Bond 26,400.00 26,400.00 0.00 0.00 26,400.00 100.00 0.00 2,640.00 Mobilize 01015 Demobilize 8,000.00 4,000.00 0.00 0.00 4,000.00 50.00 4,000.00 400.00 Supervision 01020 Coordination 87,000.00 43,200.00 4,800.00 0.00 48,000.00 55.17 39,000.00 4,800.00 General Conditions 01025 M 30,000.00 14,600.00 1,800.00 0.00 16,400.00 54.67 13,600.00 1,640.00 General Conditions 01026 L 34,000.00 16,100.00 1,900.00 0.00 18,000.00 52.94 16,000.00 1,800.00 1400A Organ Facade Pipes 200,000.00 61,720.00 0.00 0.00 61,720.00 30.86 138,280.00 6,172.00 Carpentry Labor 1400B Hours 32,000.00 32,000.00 0.00 0.00 32,000.00 100.00 0.00 3,200.00 Provide Tie -Off 1400C Points at Balconies 25,000.00 0.00 0.00 0.00 0.00 0.00 25,000.00 0.00 Vertical Partition System Backfold 1400D Doors 15,000.00 0.00 0.00 0.00 0.00 0.00 15,000.00 0.00 16'X16' Temporary 1400E Overhead Door 6,000.00 0.00 0.00 0.00 0.00 0.00 6,000.00 0.00 Temporary OHD Enclosure and 1400F Insulation 10,000.00 1,644.00 0.00 0.00 1,644.00 16.44 8,356.00 164.40 1000 SY of BX 1200 1400G Tensar Geogrid 17,000.00 4,117.00 0.00 0.00 4,117.00 24.22 12,883.00 411.70 1400H 350 CY of #2 Stone 18,200.00 4,183.00 1,535.00 0.00 5,718.00 31.42 12,482.00 571.80 AIA Document G703 1992. Copyright 0 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 1 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 11 17 on 11/13/2009 under Order No.0754240912_1 which expires on 06/10/2010, and is not for resale. User Notes: (791955557) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G C) (C G) RATE) (D E) (NOT IN D OR E) (D +E +F) 1400J 200 CY of #53 Stone 10,000.00 0.00 0.00 0.00 0.00 0.00 10,000.00 0.00 1400K General Allowance 75,000.00 0.00 0.00 0.00 0.00 0.00 75,000.00 0.00 CAD As -Built 1400L Allowance 5,000.00 0.00 0.00 0.00 0.00 0.00 5,000.00 0.00 General Clean Up 01560 M 4,000.00 0.00 300.00 0.00 300.00 7.50 3,700.00 30.00 01561 General Clean Up L 25,000.00 1,400.00 1,400.00 0.00 2,800.00_ 11.20 22,200.00 280.00 Final Cleaning (Items 01562 in BP 5010 10,000.00 0.00 0.00 0.00 0.00 0.00 10,000.00 0.00 Dewatering for 9 02110 Months -M -Eq 18,500.00 18,500.00 0.00 0.00 18,500.00 100.00 0.00 1,850.00 Dewatering for 9 02111 Months L -Eq 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00 0.00 2,800.00 Piping from Tri -Plex 02240 to Lift Station 21,000.00 21,000.00 0.00 0.00 21,000.00 100.00 0.00 2,100.00 Interior Metal Fabrications 05504 Submittals 6,200.00 6,200.00 0.00 0.00 6,200.00 100.00 0.00 620.00 Interior Metal Fabrications 05505 Materials 86,500.00 60,200.00 0.00 0.00 60,200.00 69.60 26,300.00 6,020.00 Interior Metal 05506 Fabrications Erection 24,000.00 2,700.00 0.00 0.00 2,700.00 11.25 21,300.00 270.00 Miscellaneous Metals 05511 M 5,640.00 0.00 0.00 0.00 0.00 0.00 5,640.00 0.00 Miscellaneous Metals 05512 L 2,500.00 0.00 0.00 0.00 0.00 0.00 2,500.00 0.00 Interior Rough 06100 Carpentry M 28,000.00 0.00 0.00 0.00 0.00 0.00 28,000.00 0.00 Interior Rough 06101 Carpentry L 36,500.00 0.00 0.00 0.00 0.00 0.00 36,500.00 0.00 07810 Skylight Shade M 62,000.00 1,240.00 0.00 0.00 1,240.00 2.00 60,760.00 124.00 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 2 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 11:46:17 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010, and is not for resale. User Notes: (791955557) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED DATE (G C) (C G) RATE) APPLICATION (NOT IN D OR E) (Da E +F) (D +E) Skylight Shade 07811 Installation 29,500.00 0.00 0.00 0.00 0.00 0.00 29,500.00 0.00 07910 Joint Sealants M 48,000.00 0.00 0.00 0.00 0.00 0.00 48,000.00 0.00 07911 Joint Sealants L 24,500.00 0.00 0.00 0.00 0.00 0.00 24,500.00 0,00 08810 .interior Glazing 42,000.00 840.00 0.00 0.00 840.00 2.00 41,160.00 84.00 09610 Access Flooring 19,500.00 0.00 0.00 0.00 0.00 0.00 19,500.00 0.00 09710 FRP Wall Panels M 1,000.00 0.00 0.00 0.00 0.00 0.00 1,000.00 0.00 09711 FRP Wall Panels L 2,000.00 0.00 0.00 0.00 0.00 0.00 2,000.00 0.00 Acoustic Fabric 09712 Wrapped Panels 42,500.00 0.00 0.00 0.00 0.00 0.00 42,500.00 0.00 10210 Toilet Compartments 44,000.00 0.00 0.00 0.00 0.00 0.00 44,000.00 0.00 Backfold Door 10220 Tracks M 5,000.00 0.00 0.00 0.00 0.00 0.00 5,000.00 0.00 Backfold Door 10221 Tracks L 4,560.00, 0.00 0.00 0.00 0.00 0.00 4,560.00 0 .00 10222 Operable Partition 21,000.00 0.00 0.00 0.00 0.00 0.00 21,000.00 0.00 10223 Wire Mesh Partitions 9,500.00 0.00 0.00 0.00 0.00 0.00 9,500.00 0.00 Toilet Accessories 10224 M 34,000.00_ 0.00 0.00 0.00 0.00 0.00 34,000.00 0.00 Toilet Accessories 10225 L 28,000.00 1,000.00 0.00 0.00 1,000.00 3.57 27,000.00 100.00 10510 Metal Lockers 16,500.00 0.00 0.00 0.00 0.00 0.00 16,500.00 0.00 10520 Phenolic Lockers M 110,000.00 0.00 0.00 0.00 0.00 0.00 110,000.00 0.00 10521 Phenolic Lockers L 29,000.00 0.00 0.00 0.00 0.00 0.00 29,000.00 0.00 10610 Corner Guards M 9,500.00 0.00 0.00 0.00 0.00 0.00 9,500.00 0.00 10611 Corner Guards L 3,500.00 0.00 0.00 0.00 0.00_ 0.00 3,500.00 0.00 17001 Changr Order No. 01 81,040,00 0.00 0.00 0.00, 0.00 0.00 81,040.00 0.00 GRAND TOTAL $1,398,960.00 $349,044.00 $11,735.00 $0.00 $360,779.00 25.79% 51,038,181.00 $36,077.90 AIA Document G703 -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 3 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 11:46:17 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010, and is not for resale. User Notes: (791955557) AFFIDAVIT AND WAIVER OF LIEN ]FINAL X PARTIAL X PAYMENT TO FOLLOW State of Indiana, County of Madison. SS Bradley Tyler being duly sworn states that he is the Project Manager of W. R. Dunkin Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and /or labor as follows: Bid Package 5010- Interior Finishes for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Application for Payment 06 has been received for work performed through 08/31/09. (PARTIAL WAIVER) that there is due from the contractor the sum of Eight Thousand Ninety -nine dollars and 60 /cents 8,099.60 Application for Payment has been received for work performed through (FINAL WAIVER) that the final balance due from the Owner is the sum of dollars and 00 /cents 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 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 ac t6unt of y work performed or material furnished to the undersigned for said project, an. 't in' the sc. e of t a i avit nd waiver. W. R. Dunkin Son, Inc. B /4'`�/ Title: Project Manager WITNESS MY HAND AND NOTARIAL SEAL, this 13` day of November 2009 Y d/e/ 6 /2 (Notary $ublic) My Commission Expires: January 08, 2017 Printed Martha A. Carpenter Residing in Madison County P Date 11/12/09 Thur C E R T I F I E D PAYROLL R E G I S T E R Page 1 Job: 08 -393 CPA -BP 5010 P5 INTER FINISHES Contractor: W. R. DUNKIN SON, INC. Pay Period 11/04/09 11/10/09 777 3RD AVE. S.W. P.O. BOX 2247 CARMEL, IN 46032 ANDERSON, IN 46018 Employers Id 35- 0280890 Employee 1 Hours Worked This Project I PAY JOB EARN! FED I STATEION DEDI TOT NET Information I WED THDR FRI SAT SON MON TUBS TOTAL' RATE'TOT EAENI FICA LOCAL' MISC I DED 1 PAY BROWN, BRIAN A. 11441 S CR 200 EAST ST 8.00 8.00 28.09 224.72 119.74 43.20 85.33 MUNCIE, IN 47302 OT .00 .00 1123.60 85.96 11.80 .00 346.03 777.57 SS 315 -72 -1198 SEX M Carpenter Journeyman DEP 0 BROWNING, PAUL W. 7330 N 575 WEST ST 8.00 8.00 8.00 8.00 8.00 40.00 30.84 1233.60 110.18 40.63 179.18 FRANKTON, IN 46044 OT .00 .00 1233.60 94.37 14.94 .00 439.30 794.30 SS 309 -88 -5830 SEX M Carpenter- CA- S/3.25 -V DEP 2 KEESLING, ROBERT R. 687 W MILL STREET ST 1.00 1.00 28.09 28.09 117.28 36.89 85.33 MIDDLETOWN, IN 47356 OT .00 .00 1123.60 85.95 13.56 .00 339.01 784.59 S5 310 -96 -4365 SEX M Carpenter- Journeyman DEP 4 MIRANDO, JOHN T 1102 PROGRESS ST. ST 8.00 8.00 28.09 224.72 187.48 38.20 85.33 MIDDLETOWN, IN 47356 OT .00 .00 1123.60 85.95 14.05 .00 411.01 712.59 SS 309 -84 -2916 SEX M Carpenter Journeyman DEP 0 Job T o t a l s: Hours: 57.00 Earnings: 1711.13 S T A T E M E N T O F C O M P L I A N C E DATE: 11/12/09 I, MARTI CARPENTER, EXEC.ASST. PR.CLERK do hereby state: (1) That I pay or supervise the payment of the persons employed by W. R. DUNKIN SON, INC. on the (building or work) CPA -BP 5010 P5 INTER FINISHES ;that during the payroll period 11 /04/09 11/10/09 ;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 (Contractor or Subcontractor) W. R. DUNKIN SON, INC. from the full 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 Stat. 108;72 Stat. 967;76 Stat. 357;40 U.S.C. 276c),and described below: Dues Initiation,Child Support,Vacation Fund,VACATION FUND,Vacation Fund,GARNISHMENT ,Local Prom /Pac,Loans,Union Dues, Market Recovery,INTERNAT'L DUES,United Way (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 and 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 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,or if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Training,United State Department of Labor. (4) That: (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS JO In addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, 111 payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH 12 Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in Section 4(0) below. (c) EXCEPTIONS (CRAFT) EXCEPTION 1 EXPLANATION I I I I I I I I I I I I I I I I I l I I I I 1 I f I I I i I I I Remarks: I I NAME AND TITLE I SIGNATURE MARTI CARPENTER, EXEC.ASST. /PR.CLERK i THE WILLFUL FALSIFICATION OP ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. I I Date 10/29/09 Thur C E R T I F I E D PAYROLL R E G I S T E R Page 1 Job: 08 -393 CPA -BP 5010 P5 INTER FINISHES Contractor: W. R. DUNKIN SON, INC. Pay Period 10/21/09 10/27/09 777 3RD AVE. S.W. P.O. BOX 2247 CARMEL, IN 46032 ANDERSON, IN 46018 Employers Id 35- 0280890 Employee 1 Hours Worked This Project i PAY JOB EARN' FED 1 STATEIUN DEDI TOT I NET Information 1 WED THUR FRI SAT SON MON TUES TOTAL' RATEITOT EARNI PICA LOCAL' MISC I D8D I PAY SOLING, RYAN L 245 N 9TH STREET ST 2.00 2.00 28.09 56.18 123.19 48.36 106.32 MIDDLETOWN, IN 47356 OT .00 .00 1460.69 111.75 17.78 .00 407.40 1053.29 SS 314 -96 -5183 SEX M Carpenter Journeyman DEP 4 BROWN, BRIAN A. 11441 5 CR 200 EAST ST 5.00 5.00 10.00 28.09 280.90 86.03 35.56 68.26 MUNCIE, IN 47302 OT .00 .00 898.88 68.76 9.44 .00 268.05 630.83 SS 315 -72 -1198 SEX M Carpenter- Journeyman DEP 0 BROWNING, PAUL W. 7330 N 575 WEST ST 8.00 8.00 8.00 8.00 8.00 40.00 30.84 1464.90 144.88 48.50 204.27 FRANKTON, IN 46044 OT 5.00 5.00 46.26 1464.90 112.07 17.83 .00 527.55 937.35 SS 309 -88 -5830 SEX M Carpenter- CA- S/3.25 -V DEP 2 FLYNN, AIMEE N. 310 S PEARL ST. ST 2.00 2.00 22.47 44.94 114.61 40.40 79.79 SPICELAND, IN 47385 OT .00 .00 932.52 71.34 11.18 .00 317.32 615.20 SS 317 -96 -1345 SEX F Carpenter -CA -3 Yr. -80.8 DEP 2 KEESLING, ROBERT R. 687 W MILL STREET ST 3.00 3.00 4.00 4.00 14.00 28.09 393.26 201.55 48.36 106.32 MIDDLETOWN, IN 47356 OT .00 .00 1460.68 111.74 17.78 .00 485.75 974.93 SS 310 -96 -4365 SEX M Carpenter- Journeyman DEP 4 MIRANDO, JOHN T 1102 PROGRESS ST. ST 5.00 5.00 28.09 140.45 131.30 30.56 68.26 MIDDLETOWN, IN 47356 OT .00 .00 898.88 68.77 11.24 .00 310.13 588.75 SS 309 -84 -2916 SEX M Carpenter Journeyman DEP 0 Job T o t a l s: Hours: 78.00 Earnings: 2380.63 j S T A T E M E N T O F C O M P L I A N C E DATE: 10/29/09 I, MARTI CARPENTER, EXEC.ASST. /PR CLERK do hereby state: (1) That I pay or supervise the payment of the persons employed by W. R. DUNKIN SON, INC. on the (building or work) CPA -BP 5010 P5 INTER FINISHES that during the payroll period 10/21/09 10/27/09 ;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 (Contractor or Subcontractor) W. R. DUNKIN SON, INC. from the full 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 Stat. 108;72 Stat. 967;76 Stat. 357;40 U.S.C. 270c),and described below: Dues- Initiation,Child Support,Vacation Fund,VACATION FUND,Vacation Fund,GARNISHMENT ,Local Prom /Pac,Loans,Union Dues, Market Recovery,INTERNAT'L DUES,United Way (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 and 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 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,or if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Training,Onited State Department of Labor. (4) That: (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS 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 have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH 1_1 Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable 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. (c) EXCEPTIONS (CRAFT) EXCEPTION 1 EXPLANATION I I I I I I I 1 I 1 I 1 I I I 1 1 I I 1 I Remarks: I NAME AND TITLE I SIGNATURE MARTI CARPENTER, EXEC.ASST./PR CLERK f THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. 1 I i Date 11/04/09 Wed C E R T I F I E D P A Y R O L L R E G I S T E R Page 1 Job: 08 -393 CPA -BP 5010 05 INTER FINISHES Contractor: W. R. DUNKIN SON, INC. Pay Period 10/28/09 11/03/09 777 3RD AVE. S.W. P.O. BOX 2247 CARMEL, IN 46032 ANDERSON, IN 46018 Employers Id 35- 0280890 Employee 1 Hours Worked This Project I PAY IJOB EARN FED STATEIUN DEDI TOT I NET Information I WED THOR FRI SAT SUN MON TOES TOTAL RATEITOT EARN PICA LOCAL MISC I DED I PAY BOLING, RYAN L 245 N 9TH STREET ST 1.00 7.00 8.00 28.09 224.72 123.19 48.36 106.32 MIDDLETOWN, IN 47356 OT .00 .00 1460.68 111.74 17.78 .00 407.39 1053.29 SS 314 -96 -5183 SEX M Carpenter Journeyman DEP 4 BROWNING, PAUL W. 7330 N 575 WEST ST 8.00 8.00 8.00 8.00 8.00 40.00 30.84 1233.60 110.18 40.63 107.51 FRANKTON, IN 46044 OT .00 .00 1233.60 94.37 14.94 .00 367.63 865.97 SS 309 -88 -5830 SEX M Carpenter- CA- S/3.25 -V DEP 2 FLYNN, AIMEE N. 310 S PEARL ST. ST 7.00 7.00 22.47 157.29 173.59 48.42 96.10 SPICELAND, IN 47385 OT .00 .00 1168.44 89.38 14.12 .00 421.61 746.83 S5 317 -96 -1345 SEX F Carpenter -CA -3 Yr. -80e DEP 2 KEESLING, ROBERT R. 687 W MILL STREET ST 1.00 1.00 2.00 28.09 56.18 201.55 48.36 106.32 MIDDLETOWN, IN 47356 OT .00 .00 1460.68 111.74 17.78 .00 485.75 974.93 SS 310 -96 -4365 SEX M Carpenter- Journeyman DEP 4 J o b T o t a l s: Hours: 57.00 Earnings: 1671.79 e f S T A T E M E N T O F C O M P L I A N C E DATE: 11/04/09 I, MARTI CARPENTER, EXEC.ASST./ PR CLERK do hereby state: (1) That I pay or supervise the payment of the persons employed by W. R. DUNKIN SON, INC. on the (building or work) CPA -BP 5010 P5 INTER FINISHES that during the payroll period 10/28/09 11/03/09 ;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 (Contractor or Subcontractor) W. R. DUNKIN SON, INC. from the full 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 Stat. 108;72 Stat. 967;76 Stat. 357;40 U.S.C. 276c),and described below: Dues- Initiation,Child Support,Vacation Fund,VACATION FUND,Vacation Fund,GARNISHMENT ,Local Prom /Pac,Loans,Union Dues, Market Recovery,INTERNAT'L DUES,United Way (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 and 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 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,or if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Training,United State Department of Labor. (4) That (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS I g 1 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 have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH 1_1 Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable 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. (c) EXCEPTIONS (CRAFT) EXCEPTION EXPLANATION 1 1 Remarks: NAME AND TITLE 1 SIGNATURE MARTI CARPENTER, EXEC.ASST./ PR CLERK f G -7 THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SdBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLEE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. Date 10/22/09 Thur C E R T I F I E D PAYROLL R E G I S T E R Page 1 Job: 08 -393 CPA -BP 5010 P5 INTER FINISHES Contractor: W. R. DUNKIN SON, INC. Pay Period 10/14/09 10/20/09 777 3RD AVE. S.W. P.O. BOX 2247 CARMEL, IN 46032 ANDERSON, IN 46018 Employers Id 35- 0280890 Employee 1 Hours Worked This Project 1 PAY JOB EARN, FED 1 STATE1UN DEDI TOT 1 NET Information f WED THOR FRI SAT SUN MON TOES TOTAL RATEjTOT EARN' FICA LOCAL MISC 1 DED 1 PAY BROWNING, PAUL W. 7330 N 575 WEST ST 8.00 8.00 8.00 8.00 8.00 40.00 30.84 1233.60 110.18 40.63 179.18 FRANKTON, IN 46044 OT .00 .00 1233.60 94.36 14.94 .00 439.29 794.31 SS 309 -88 -5830 SEX M Carpenter -CA -S /3.25 -V DEP 2 HOFFMAN, KYLE P. 8707 N 300 WEST ST 4.00 4.00 31.59 126.36 4.4.5 7.94 18.05 ALEXANDRIA, IN 46001 OT .00 .00 252.72 19.34 2.92 .00 52.70 200.02 SS 310 -70 -6575 SEX M Carpenter Superintend DEP 1 KEESLING, ROBERT R. 687 W MILL STREET ST 2.00 2.00 4.00 28.09 112.36 68.91 29.25 68.26 MIDDLETOWN, IN 47356 OT .00 .00 898.88 68.77 10.76 .00 245.95 652.93 SS 310 -96 -4365 SEX M Carpenter Journeyman DEP 4 Job T o t a l s: Hours, 48.00 Earnings: 1472.32 4 S T A T E M E N T O F C O M P L I A N C E DATE: 10/22/09 I, MARTI CARPENTER, EXEC.ASST./ PR CLERK do hereby state: (I) That I pay or supervise the payment of the persons employed by W. R. DUNKIN SON, INC. on the (building or work) CPA -BP 5010 P5 INTER FINISHES ;that during the payroll period 10/14/09 10/20/09 ;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 (Contractor or Subcontractor) W. R. DUNKIN SON, INC. from the full 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 Stat. 108;72 Stat. 967;76 Stat. 357;40 U.S.C. 276c(,and described below: Dues- Initiation,Child Support,Vacation Fund,VACATION FUND,Vacation Fund,GARNISHMENT ,Local Prom /Pac,Loans,Union Dues, Market Recovery,INTERNAT'L DUES,United Way (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 and 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 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,or if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Training,United State Department of Labor. (4) That: (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS I 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 have been or will be made to appropriate programs for the benefit of such employees,except as noted in Section 4(c( below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH I_I Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable 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. (0) EXCEPTIONS (CRAFT) EXCEPTION 1 EXPLANATION I I I 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I Remarks: I I NAME AND TITLE SIGNATURE MARTI CARPENTER, EXEC.ASST./ PR CLERK 1 ✓vim L! v�:,��.,;.GLJ THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. I 1 Prescribed by Stale 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 Purchase Order No. f 2 ?r .Z2 7 Terms G(6' Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) a g 9 ad f ?c 5 r_ s6 Total 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 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF i' gox 22 7 /41 .1- /g ON ACCOUNT OF APPROPRIATION FOR Apir— Board Members Pp or INVOICE NO. ACCT #/TITLE AMOUNT hereby certify invoice( s), DEPT. I hereb certi that the attached invoices or G2 4 6 4 K 6 P7 /5 (o 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 220D 6 S nature 6 Directnr of Operations Title Cost distribution ledger classification if claim paid motor vehicle highway fund SL Subcontract Billing Report For Work Invoiced From 11/01/09 to 11/30/09 Subcontract: 2695 -4050 4050 General Trades Job: 2695- Carmel RPAC Construction Vendor: 9279 W.R. DUNKIN SON, INC 777 3rd Ave. SW Carmel, IN 46032 Contract To Dat This Period Item Units UM Unit Cost Amount Units/% Amount Units!% Amount 1 4050 General Trades LS 12,235,000.00 58.28% 7,130,544.00 2.99 365,838.00 Total Contract Items 12,235,000.00 7,130,544.00 365,838.00 Change Orders 2 CCR 1008 Oculus LS 228,000.00 100,00% 228,000.00 0.00 0.00 Alternate 3 4050 General Trades LS 9,031.00 100.00% 9,031.00 0.00 0.00 5 Opening 167E to Aluminum LS 2,196.00 13.66% 300.00 0.00% 0.00 6 Shear Transfer /Lateral LS 98,741.00 100.00% 98,741.00 0.00 0.00 Support Angle thru 06/05/2009 9 ASI PAC -054 Auditorium LS 17,527.00 100.00% 17,527.00 0.00% 0.00 Supply Air Distribution 10 ASI PAC- 075 Door LS 11,292.00 100.00% 11,292.00 0.00 0.00 Schedule Clarifications 12 4050 General Trades LS 44,936.00 100.00% 44,936.00 0.00% 0.00 13 Shear Transfer /Lateral LS 14,683.00 100.00% 14,683.00 0.00% 0.00 Support Total Change Order Items 426,406.00 424,510.00 0.00 Subcontract Totals: 12,661,406.00 7,555,054.00 365,838.00 Total Billings: 7,555,054.00 365,838.00 Unpaid Retainage: 633,070.30 0.00 Discounts: 0.00 0.00 Net Billings: 6,921,983.70 365,838.00 98 SSC CMa Projects Page 1 11/19/09 12:02:35 PM Date Format MM /DD /YY SLSubBillingReport .rpt \R i s'' ,o. A I A Document G7 ®21 aT" ®1992 Application and Certificate for Payment Construction Manager Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A, 44050 Carmel APPLICATION NO: 019 Distribution to: Commission Performing Arts OWNER: X One Civic Square 777 3rd Ave. S.W. Carmel, IN 46032 Carmel, IN 46032 PERIOD TO: November 30 2009 CONSTRUCTION MANAGER: X ARCHITECT: X FROM W.R. Dunkin Son, Inc. VIA CONSTRUCTION Shiel Sexton Co., Inc. CONTRACT DATE: May 08, 2008 CONTRACTOR: X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS: 2531012695 4050 2695 FIELD: Anderson, IN 46018 OTHER: CONTRACT FOR: 13P- #4050 General Trades VIA ARCHITECT: CSO Architects CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for 'ayrnent 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 bi the Contractor for Work for which previous Continuation Sheet, AIA Document G703, is attached. Certificates for Payment were issued anry.ayments received from the Owner, and that current 1. ORIGINAL CONTRACT SUM 12,235,000.00 payment shown herein, ow due. 2. NET CHANGE BY CHANGE ORDERS 426,406.00 CO Irt /4'' 1 N ',I N C CONTRACT UM TO DATE Line 1 2) 12 661 406.00 Date: November 13, 2009 3. NTRA S d .I 4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 7,555,054.00 St. c Indiana 5. RETAINAGE: County of: Madis• a. 5 of Completed Work Subscribed and sworn to before (Column D E on G703) 633,070.30 me this 13th day of November, 2009 b. 0 of Stored Material Notary Public: Martha A. Carpenter _y 1 J L�/1� 7 a C (Column F on G703) 0.00 My Commission expires: January 08, 0Z 17 Total Retainage (Lines 5a 5b or Total in Column I of 6703) 633,070.30 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE 6,921,983.70 In accordance with the Contract Documents, based on on -site observations and the data comprising (Line 4 Less Line 5 Total) this application, the Construction Manager and Architect certify to the Owner that to the best of their 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 6,556,145.70 knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. O© 8. CURRENT PAYMENT DUE 365,838.00 AMOUNT CERTIFIED 3 1051 a 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified ders from the amount applied. Initial all figures on this Application ant on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) 5,739,422.30 CONSTRUC 19 M G:1,7 By: 4 .�i D ate: /1. 2.4 Zoo CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT 4 r I Total changes approved in previous months by Owner 426,406.00 0.00 By: Date: 11 �j" Total approved this Month 0.00 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS 426,406.00 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order 426,406.00 AIA Document G7021CMaT" —1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This Ale 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 taw. This document was produced by AIA software at 11'30:07 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010, and is not for resale. User Notes: (879589715) AIA 1 ii 1 0 1 Document G703 1992 Continuation Sheet ALA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 019 ii containing Contractor's signed certification is attached. 1 In tabulations below, amounts are in US dollars. APPLICATION DATE. 1 /10/2009 Use Column 1 on Contracts where variable retainage for line items may apply. PERIOD TO: 11/30/2009 ARCHITECT'S PROJECT NO: 25310 A B C D i E F G_ H 1 l WORK COMPLETED TOTAL MATERIALS PRESENTLY ITEM DESCRIPTION OF SCHEDULED FROM AND STORED TO COMPLETED BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED (G C) FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (C G) RATE) D E (D +E +F) 11 PERFORMANCE 01010 _BOND 106,000.00 106,000.00 0.00 0.00 106,000.00 100.00 0.00 10,600.00 '.T MOBILIZE/DEMOB 1 01015 ILIZE 29,000.00 15,000.00 0.00 0.00 15,000.00 51.72 14,000.00 1,500.00 SUPERVISION /CO j 01020 ORDINATION 361,000.00 296,800.00 12,000.00 0.00 308,800.00 85.54 52,200.00 28,480.00 GENERAL 01025 CONDITIONS -M 380,000.00 286,000.00' 16,000.00_ 0.00 302,000.00 79.47 78,000.00 27,000.00 GENERAL 01026 CONDITIONS -L 98,000.00 75,000.00 5,000.00 0.00 80,000.00 81.63 18,000.00 7,000.00 1r, ALLOWANCE- 1 STONE 140A0 WALKWAY 8,500.00 0.00 0.00 0,00 0.00, 0.00 8,500.00 0.00 ALLOWANCE- TEMPORARY i' 140B0 HANDRAIL 38,000.00 27,769.00 0.00 0.00 27,769.00 73.08 10,231.00 2,776.90 ALLOWANCE- TEMPORARY DOORS/FRAMES /H 14000 ARDWARE 10,000.00 0.00 0.00 0.00 0.00 0.00 10,000.00 0.00 14000 ALLOWANCE -ICE 13,500.00 2,289.00 0.00 0.00 2,289.00 16.96 11,211.00 207.10 ALLOWANCE- 140E0 SECURITY 31,000.00 0.00 0.00 0.00 0.00 0.00 31,000.00 0.00 ALLOWANCE- 140F0 ,DUMPSTERS 191,700.00 44,037.00 6,831.00 0.00 50,868.00 26.54% 140,832.00, 3,987.90 140GO ALLOWANCE- 34,000.00 22,170.00 0.00, 0.00 22,170.00, 65.21 11,830.00, 2,200.00, AIA Document G703"" -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 1 Prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912_1 which expires on 06110/2010, and is not for resale. deer Hetea: (1429823795) VOUCHER NO. WARRANT NO._ ALLOWED 20 Dv,74,29! IN SUM OF$ e 7 iro�P�so� /(U c'vg %S S 9 ON ACCOUNT OF APPROPRIATION FOR i1■ Board Members PO# or DEPT. q INVOICE NO ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or 4 d?'? 36s73cf-Ce' 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 S nature Director of perations Cost distribution ledger classification if Title claim naid motor vahirla hiohwav fiend s r" ci' P j *g e -e 4 "i y 7 4 -i- .'1 r �'s 3- 2c'� a h S+ �'�,T T a 4 i R f F 5.. P✓nrJ yc irj� 4� t +l w e 3' w ry x'.sr��tJE r f s la �'r�-� t� ExM s "z �i?+ t s a `1' n r, 7 70 +,y 4,^J 3 �,r j t t y t yam z A t 'ti. t 'R E 1 3 F ,.z V, u' P a` i k 7J�$' v gs u 4yky 3 r v 4. r a a i,1 c z E 4 E "'s -4 a a �3d. t a: �.'�"drt .fs t F t �?..3a� .a'�.�'.; c�`'r. ..card 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 ,c' .0 ,F, -5=2 Purchase Order No. O i dX 2 Terms `i c Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) r Total 36-54 Oa t I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer