182712 03/02/2010 CITY OF CARMEL, INDIANA VENDOR. 363782 Page 1 of 1
ONE CIVIC SQUARE HORNING ROOFING CHECK AMOUNT: $86,553.00
1: o CARMEL, INDIANA 46032 2340 ENTERPRISE PARK PLACE
INDIANAPOLIS IN 46218 CHECK NUMBER: 182712
CHECK DATE: 3/2/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460807 7 86,553.00 PERFORMING ARTS CENTE
SL Subcontract Billing Report
For Work Invoiced From 12/01/09 to 12/31/09
Subcontract 2695- 3040 '3040•Roofing',
Job: 2695- Carmel RPAC Construction Vendor: 3271 HORNING ROOFING
777 3rd Ave. SW
Carmel, IN 46032
M
contract Tot Date r This Period
:s
Item Units UM Unit Cost Amount Units1% Amount Units/% Amount
1 3040 Roofing LS 1,366,450.00 47.01% 642,430.00 5.31 72,600.00
Total Contract Items 1,366,450,0 642,430.00 72,600.00
Change Orders
2 CCR 1008 Oculus LS 1,430.00 100.00% 1,430.00 100.00% 1,430.00
Alternate
3 CCR 1009 Clay Tile Roof LS 419,400.00 25.99% 109,000.00 5.96 25,000.00
Alternate
Total Change Order Items 417,970.00 107,570.00 23,570.00
Subcontract Totals: 1,784,420.00 750,000.00 96,170.00
Total Billings: 750,000.00 96,170.00
Unpaid Retainage: 75,000.00 9,617.00
Discounts: 0.00 0.00
Net Billings: 675,000.00 86,553.00
98 SSC CMa Projects Page 1 12/17/09 02:35:46 PM
Date Format MMIDD /YY SLSubBilling Report. rpt
TM X992
=j Document G702 /CMa
Application and Certificate for Payment Construction Manager- Adviser Edition
TO OWNER:
PROJECT APPLICATION NO Distribution to:
lU�.�► fm, PERIOD To: X0 OWNER El
CONSTRUCTION MANAGER El
FROM CONTRA TC� ORR- VIA CONSTRUCTION MANAGER:, CONTRACT DATE: ARCHITECT
ft Nin vbd? 0- alai UT L PROJECT NOS: T 1 CONTRACTOR 0
,y6 e
T VIA ARCHITECT: FIELD
ON RAC
CT POR: C�
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowled 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
Contract Documents, that all amounts ve been paid by the Contractor for Work for which previous
Continuation Sheet, AIA Document G703, is attached. Certificates for Payment werp- and payments received from the Owner, and that current
1. ORIGINAL CONTRACT SUM $1 O payment shown herein is no e
2. Net change by 'Change Orders /�J .(}CONTRACT
3. CONTRACT SUM TO DATE (Line 2) y: Date:
4. TOTAL COMPLETED STORED TO DATE Column G on G703 State of:
5.;RETAINAGE County of:
mV
a. �Q of Completed `Work Subscribed and sworn to before
(Column D E on G703) Ij 009 0 me this day of„
b. of Stored Material Notary Public:
(Column F on G703) 0.00 My Commission expires:'
g
Total Retaina a (Lines 5a 5b or Total in Column I of G703) CERTIFICATE FOR PAYMENT
In 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) knowledge, information and belief the Work has progressed as 'indicated, the quality of the Work is in
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT o 00 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT
(Line 6 from prior Certificate) CERTIFIED.
B. CURRENT PAYMENT DUE a AMOUNT CERTIFIED
(Attach explanation if amount certified differs from the amount applied. Initial l figures on this
9: BALANCE TO FINISH, INCLUDING RETAINAGE
Application and of ntinu_ation Sheet that are changed to conform with the amount certified:')
(Line 3 less Line 6) $1 CONSTRU AGER:
By: oor Date: 7 3,0/= ZoD 4
ADDITIONS DEDUCTIONS
CHANGE ORDER. SUMMARY ARC &6 T:
Total changes a roved m previous months b Owner
g p p Y By: Date:. l
Total approved thi s Month This Certificate is not negotiable. The AMOUNT CERTIFIED is payable onO to the Contractor
TOTALS (X} 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
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 G702 /CMaTM 1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This Ate Document is protected by U.S. Copyright Law and International Treaties.
Unauthorized reproduction or distribution'of this AIO 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, copyright @aia.org.
CONTINUATION SHEET AIA DOCUMENT G703
Page 1 of
Application No:
Application Date. 11/24/2009
JOB NAME CARMEL -R PAC CONSTRUCTION Period To 12/01/2009
HORNING JOB 8 -2408 Architect's Project No:
A B C D E F G H I
Work Completed Materials Total Balance Retalnage
From Previous Presently Completed to Finish
Application Stored Stored to Date (G /C)
Item# Description of Work Scheduled Value (D +E) This Period (Not in D or E) (D +E +F)
1 Roofing Labor $107,140.00 $47,430.00 $47,430.00 $59,710.00 $4,743.00
2 Roofing Material $166,980.00 $166,980.00 $166,980.00 $0.00 $16,698.00
3 Nailbase Material $105,300.00 $105,300.00 $105,300.00 $0.00 $10,530.00
4 Nailbase Labor $38,180.00 $30,540.00 $4,000.00 $34,540.00 $3,640.00 $3,454.00
5 Sheet Metal Labor $57,350.00 $11,470.00 $8,600.00 $20,070.00 $37,280.00 $2,007.00
6 Sheet Metal Material $146,390.00 $30,000.00 $60,000.00 $90,000.00 $56,390.00 $9,000.00
7 Tile Dome Material $112,000.00 $112,000.00 $112,000.00 $0.00 $11,200.00
8 Tile Dome Labor $39,800.00 $0.00 $0.00 $39,800.00 $0.00
9 Tile Balance Material $168,000.00 $41,000.00 $41,000.00 $127,000.00 $4,100.00
10 Tile Balance Labor $59,700.00 $0.00 $0.00 $59,700.00 $0,00
11 Paver Material $56,700.00 $0.00 $0.00 $56,700.00 $0.00
12 Paver Labor $18,900.00 $0.00 $0.00 $18,900.00 $0.00
13 Bond $15,010.00 $15,010.00 $15,010.00 $0.00 $1,501.00
14 Subcontractor $250,000.00 $2,100.00 $2,100.00 $247,900.00 $210.00
15 Submittals $5,000.00 $5,000.00 $5,000.00 $0.00 $500.00
16 Safety /Start -up $7,500.00 $3,000.00 $3,000.00 $4,500.00 $300.00
17 Clean-up/Closeout $7,500.00 $0.00 $0.00 $7,500.00 $0.00
18 Change Order #1 ($1,430.00) $0.00 ($1,430.00) ($1,430.00) $0.00 ($143.00)
19 Change Order #2 $419,400.00 $84,000.00 $25;000.00 $109,000.00 $310,400.00 $10,900.00
20 Allowance $5,000.00 $0.00 $0.00 $5,000.00 $0.00
$1,784,420.00 $653,830.00 $96,170.Ofl $0.00 $750,000.00 $1,034,420.00 $75,000.00
HORNING ROOFING SHEET METAL CO, LLC
AFFIDAVIT AND WAIVER OF LIEN
INVOICE 7
STATE: INDIANA FINAL PARTIAL X PAYMENT TO FOLLOW
COUNTY OF: MARION
_RON PHELPS II_ Being duly sworn that he is the President of _Homing Roofing Sheet Metal Company, LLC
contract with Carmel Redevelopment Commission to furnish certain materials
and /or labor as follows: As Per Contract for a project known a� as: Carmel Regional Performing Arts
Center located in. Carmel
and owned by and does hereby further state
on behalf of the aforementioned subcontractor! supplier:
(PARTIAL WAIVER) That there is due from the contractor the sum of
DOLLARS: $77,400.00
X 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.
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, in any, and further certified that no other party has an laim or right
to lien on account of any work performed or material furnished to undersign fo s id project
and within the scope of this affidavit and wavier.
_Horning Roofing Sheet Metal Co.,LLC_ By: President
Ron Ph ps II
WITNESS MY HAND AND NOTARIAL SEAL THIS: 11/17/09
MY COMMISSION EXPIRES: 02 -02 -11
COUNTY OF RESIDENCE: Morgan NOTARY
Kevin L. Moore
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.
�j Payee
A ����;�g x as 7 ii1? Purchase Order No.
2 F �o F�, r� /�N, Ja 4 °�i9 <t- Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7 7 6c;
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
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�y��G7 SsG 5s3 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
2G 20 X
Signature
Dlrja fr r of RadeVe lop mant
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund