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182713 03/02/2010 CITY OF CARMEL, INDIANA VENDOR: 363790 Page 1 of 1 ONE CIVIC SQUARE J R CLANCY, INC CARMEL, INDIANA 46032 7041 INTERSTATE ISLAND ROAD CHECK AMOUNT: $148,613.58 SYRACUSE NY 13209 CHECK NUMBER: 182713 CHECK DATE: 3/2/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 8 148,613.58 PERFORMING ARTS CENTE SL Subcontract Billing Report For Work Invoiced From 12101/09 to 12/31109 S6bcontract.2695 =5170; ,5170 Theatre Equip Package #1, Job: 2695- Carmel RPAC Construction Vendor: 9932 JR CLANCY, INC. 777 3rd Ave. SIN Carmel, IN 46032 Contract' To Date This Period .I Item Units UM Unit Cost Amount Units/% Amount Units/% Amount 1 5170 Theatre Equip Package LS 7,515,800.00 9.49% 713,252,80 2.20% 165,126.20 #1 Total Contract Items 7,515,800.00 713,252.80 165,126.20 Change Orders 2 ASI PAC -077 Delete LS 194,000.00 0.00% 0,00 0.00% 0.00 Orchestra Risers 3 RFI PAC -0686 Slack Line LS -12,548.00 0.00% 0.00 0,00% 0.00 Deletion 4 5170 Theatre Equip Package LS 2,654.31 0.00% 0.00 0.00% 0.00 #1 5 5170 Theatre Equip Package LS 2,610.00 0.00% 0.00 0.00% 0.00 #1 7 RFI PAC -0686 Bond LS -106.66 0.00% 0.00 0.00% 0.00 Reduction 8 ASI PAC -077 Band LS -1,649.00 0.00% 0.00 0.00% 0.00 Reduction 9 Allowance Reductions for LS -156,317.50 0.00% 0,00 0,00% 0.00 5170 10 Allowance Reductions for LS -156,317.50 0.00% 0.00 0.00% 0.00 5180 11 Allowance Reductions for LS -10,085.00 0.00% 0.00 0.00% 0.00 5190 Total Change Order Items 525,759.3 0.00 0.00 Subcontract Totals: 6,990,040.65 713,252.80 165,126.20 Total Billings: 713,252.80 165,126.20 Unpaid Retainage: 71,325.28 16,512.62 Discounts: 0.00 0.00 Net Billings: 641,927.52 148,613.58 98 SSC CMa Projects Page 1 12/17/09 02:43:11 PM Date Format MM /DD /YY SLSubBillingReport .rpt APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER ADVISER EDITION AIA DOCUMENT G702 /CMa (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER: Carmel QJ ��}mQ Commifs) PROJECT: ZC D Q I APPLICATION NO.: gj Distribution to: p w Ci V)C U 0,7t C oy met IPA-C- PERIOD TO: iz J-3 F `1 OWNER C -7�� 3r4 INMu e- SW PROJECT NOS.: (7 [I CONSTRUCTION bO -g Z MANAGER FROM CON"T"RACTOR: +0 anC�l, _2� CONTRACT' DATE:2)1 -1 ARCHITECT �off l S new sfat Z SfQ►�(it d CON'T'RACTOR S ro 6we► *1 'IS2'1 n VIA CONSTRUCTION MANAGER:ShjeA _e)(�`()� CONTRACT FOR: kr{e_ 9- 6 �t `N7,�'(lr f b&r �JA(q(&,& CHITECT: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation and belief the Work covered by this Application for Payment has been completed Application is made for payment, as shown below, in connection with the Contract_ in accordance with the Contract Documents, that all amounts have been paid by the Continuation Sheet, AIA Document G703, is attached. Contractor for Work for which previous Certificates for Payment were issued and pay I merits received from the Owner, and that current payment shown herein is now due. I. ORIGINAL CONTRACT SUM CONTRACTOR: 3• k- 0 OAY) C JY)c 2. Net Change By Change Orders g 2 p S 1� 60 J t lP D y fay: Date: 3. CONTRACT SUM TO DATE (Line 1 2) t t 04 0 4. TOTAL COMPLETED STORED TO DATE S_ State of: (Column G on G702) County of: Crm"da:yz Subscribed and sworn to before 5. RETAINAGE: ^I I 32 me this 57 clay of 6 e�L 2 BR,ADLEY R. RIVERS a. of Completed Work f V Notary Pt;biic, State of i4evrYork (Columns D E on G703) Qualified In Oc.onda, Co�lnty Notary Public f Io. U1 Pi30i 8349 of Stored Material S My Commission expires: Commission Expires Sepiernber 27, (Column F on G703) Total Retainage (Line 5a 5b or Q� Total in Column I of G703) t 32S .Z CERTIFICATE FOR PAYMENT b TOTAL EARNED LESS RETAINAGE `f 1 9 2 1 '6 6Z In accordance with the Contract Documents, based on on -site observations and the data (Line 4 less Line 5 Total) comprising this application, the Constriction Manager and Architect certify to the Owner 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 1 that to the best of their knowledge, information and belief the Work has progressed as (Line 6 from prior Certificate) indicated, the quality of the Wo is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIE 8. CURRENT PAYMENT DUE f �7j (p� 3 AMOUNT CERTIFIED S 9. BALANCE TO FINISH, INCLUDING RETAINAG (Attach eltilanation if amount certified differs from the amount applied lnr Initial (Line 3 less Line 6) S I i Z all figures on this Application and on e Continuution Sheet th. at changed to coazJornz to the amount certified.) C NSTRUC71 N ANAGE CHANGE ORDER SUMMARY ADDrlTONS DEDUCTIONS Total changes approved in ��77 $y C H Date: tog previous months by Owner ().00 C�L�► T 6 0. 0 d) Bv Total approved this Month 0, 0 D(3 TOTALS d U b L7 V By` Date: This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con NET CHANGES by Change Order b Oh3 tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702JCMa APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRI3(_TION MANAGER- ADVISER EDITION 1992 EDITION AIA ©1992 THL AMERICAN INSTITUTE OF ARCFIITECI'S. t735 NEW YORK AVENUE, N.W., vASI- UNGI'ON. D.C. 2040( 7292 WARNING: Unlicensed photocopying violates U.S, copyright laws and will subject the violator to legal prosecution. G702 /CMa-1992 CAUTION: You should use an original AIA document which has this Caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. U��lF �����ET INSTRUCTION SHEET FO�&l/\_I���[}�/[��T(�7U2���. /\P9i)CATlO�08NU C2KT|F|CA1IFDK PAYK4E}4I C(��TBl�TIO� A(ld"R-A31 2DlTlDN ij A. GENERAL, INFORMATION :\TA Documcn/G7U-1/CNIx, ApyhnuooxnuCuuhm/,k`,puymcnl� i�di,i.m. Ismbcuscdill n^4unaioo vrkh uJa Docuzuu`� 6�}�. Comnuudm� 5h�cc ]�b�r Uoo/mcnu xc ��^�n�J m hc ox,J Ott x Pnic', Wh,o [,m^nucb'm muno&r/ i�cmpk/?�Uvxxoud,ioc/u.,h, 0vnr, hu/ on' x^uc"uymcm,. uod nhcz mokip|� u�oo�u"� ba`r d/vr'Am-c,n,nts with rbc pv/oxun� for them vpru,cvo"cod it) A[ADocunuucu-'n| 6cnnm|Condxinovof ,boCouccu,u.rCoommcdun. ['un/mmon N�uouwcrAd'Lurbdi/ioo. 1992 [cbci0m, B. COMPLETING THE G702/CMa FORM: a0c,/hcCoo/,umnhuycomp}uc0 a|A oocvmror ('1703, Clwni/`uox,n shot. »ummu1-y ink`mnuduo ^houW be x/ gAU^.comun 6702/C%lx for Px?ox,ocCoommuiou muoxH,,6d,isc,udidon, rhcCv:rmcm,xhovW,wnGn)�/C�o. ha,cx uou,/zu/xnUxohmil it nogrrhcrmdh 6703. x`,h, uod�nNnco lFh� Cnvp/m��ou rumx�,, ,u� ��hiuz� xkoo/U ori�� �7V2�Cwx und 6�U} xod Urh,y xo u'ccpnh\c. nomp\o, (h, Cc' uhmu for yu;mznrouG`o- [hc(�xoovoiom8u/x �grruod^r bjtC xx, yvrsouo/ In Px*grnyh» 9.� uod 0.8 "f»2o|ICMx. Should [l`'o `omu| ux fi"vrc~ nn 0 xod 6n` rhzz bu,c bccocb^ogc| wo»n[hxn w /hcumountccruOrdxod xruxhxncxnbnuboo The cnmplc[cdC702/Ci%u und 07of dmo|dhr horoa/UcdmdicOwner. C. COMPLETING THE G703 FORM: Heading: lhis`o Fort nx ion xhouWh0000pkZCdmhcoonoi,uu'mtb,imi|a,mf`nnuxm`onx|xDo'mn'n'(,7;o2/Cux, Ap|dkx/xn` und CcoiUcu»c br Punncoc [o/uxuc/km Edition, Co A.B&C: cn|umnxxhou|d1 tile ,xuovuportions "f [brpn`i/'lunJdm,,cxcdo|rJ `a|vCuvuiStcmwhhrhcSCbe(]o|ro(,u|u, svhmutu1nochoaohiuzI ,it chcu,mmco,onc^/o[mcPn`icrLoruxxvh�cqorod> aJjvoud The hozkdn^o mzy hcU� v**iooxo[ ,hc nurk or by 5uhumtmc om all(] 1 rcm:in cond`wn/ lh^.1ji1II0vr /k, Pru|uc %Iu]dy1C �Uou|d bc usu| W-bco oqoiod C*|un`nC should h:mhmul*1 'al tochoouo`vhoomon'hxvonc page is wed and rmxlcdonrhc|ump�lgc,Ioi/W(\.'hi�!mm| Should cquJ du mi.pinx| Cucouu �um. ]]c /mxi of co}umo C muy bc w4vurd h� Cbung~ 0n|ce Jvnng, /b, ,"pi,cc Co|umn D: uu^, m `hj,� c it)(' xn`ouoz o[con`pkurd 1,vo'k /ovcncd by d`c |.ncr|oo"xpp|iCuuo^ (^`k/mos D s k(n tile prev \�ihu from ooivmoF(Nxteriu|.syrcuudvSoi,d fr tile pr,iooyup[x:cirion s not h«mu^d x) Uhi, o`ivmo, Co E: Enter kcodurx|ucu/vvoux C /,rhcomco/Whupp|xn^uu. including /b,ru|ucn[mxocnu|,/oco,ponuV iou. /hc project �xhicb v,n U,»cd on rhc p'c,iovn application voup mx,n,iv|^ pu/cor|" Sm,cJ <cnk000 F/. Column F: cnur xc,c mc nduC ofNou,il prczcudv 6'o,cd hr Which Fw?mcn/ i^ unu"I/', 1hc wu| o[/ho nJvm* o/wv h� uz,|m|x/ui z/ Lhr cod "/cu�-h puv p,,ioJ. This ,oh/, co'cr,� both for which in� is soopht xo(I xuodab pn%-iouo|y xvorcd *xidh MV oor VC.t. inuvpnu»cd iom the Pvnic/t �%Ic* puymon by the Onnrr k., nond mxohuk does no' /rw|/ ill u dcdochoo h,,m 'N^ m!u/uo, Oo|y u» mu/«iu|^ x,r ioo,,p"nod in'n O`, p,o/o/ IS /bdr vx|vc dcduocd from thi.s u`ivmu xod ioto n`|uo`n p (v/u,k P,rioU Column G:cou,,hc,c,b^mulo/cok"nnsD.x and F,Cx|m|u»:d`'pcv,ouw'u`myk:/cdkydi:diuxov!omo6�!odvmnc Co H:uov;,hcrx'hcchffc,cocoUccwccoov|vmn[(Schuk,|eU V Ind u.!umnCOiuu{:(n|),wd,uJ�'"/n]mnu,') Column 1: '1 his is "0onvU%7 uycdoo\N' W,c^o/mcrs v/hcoc ,vnxWorcwo:wcis, ycnnun,d on uonium bu`i/, It occd xot hcc*mp|ctco on pu,|c'ts *huz xu`onxm `s °dcbbdd h^/o /h�:c^cmU u^xuv/ amoun,- ChmnQeOrderm:^hhou�hChuugrOucm,ou|dbcm"o,P^*ndbrdmo8|oxrhc,cb,,hJco(rxiumcorlcio`e vCxxugcO,do is,ddcd t"'hcpu`iuu. this ix^wuvmuU, uou,. nnul[y. Cbuog« Orders arc listed o,px,xu|v dtbu oil rhcirown O703 h,rm o,nr1hecudol'tfiQ Tbcamounro[Gbcmigna|ox imctzd|valedb/CbxngcO^1=nismb,,uulvJiuib,uppn+ pduo: |nvuhoo ou tile. 6702/[mxI Construction Change Directives: ^momvx not i" Uiapm' 1hu havc been ioduckdm [nn^nuomu Di^xur,^xhouW h� iocmlx`nted inmooc cx more Cbuoge Orders. /nn`ono 1 ill dj,"yo/* `b"uN he J,xb with *zv,d/^g m r:o�mpb 7! in A D. MAKING PAYMENT T],c Owner abnvW m,xc p,ymc,n dircr1'y to chc Couv,cm,buxcd on dhe:mouut ccn|Ucd by ch,("oom/ucg.m klxoupr/xod Ark:bie.00uA(�LXxomcm .xpo\icodonuod Codxouu 6`,Puywcn', Cuo^/m(Ai^n muooXrpau,i,c, aumnn ,bx oomy(ctu|kvmo)mxiIlS [lie numco,dudd*` o[/bc[oxcmuocv�N iud'n,*Jon6702/C�, CONTINUA PAGE Page 2 of 4 PROJECT: 2695 APPLICATION 8 Carmel PAC DATE OF APPLICATION: 12/1512009 Payment Application containing Contractor's signature is attached. PERIOD THRU: 12/31/2009 PROJECT #s: 2695 A B C D E F G H I COMPLETED WORK STORED TOTAL BALANCE ITEM WORK DESCRIPTION SCHEDULED AMOUNT AMOUNT MATERIALS COMPLETED AND COMP. TO RETAINAGE AMOUNT PREVIOUS THIS PERIOD (NOT IN D OR E) STORED (G C) COMPLETION (If Variable) PERIODS (D L F) (C -G) 1 Bond $47,266.00 $47,266.00 $0.00 $0.00 $47,266.00 100% $0.00 2 Engineering /Project $415,534.00 $166,213.60 $20,776.70 $0.00 $186,990.30 45% $228,543.70 Management/Mobilization 3 Master Control System $238,100.00 $0.00 $0.00 $0.00 $0.00 0% $238,100.00 4 Control System Electrical Work $33,750.00 $0.00 $3,375.00 $0.00 $3,375.00 10% $30,375.00 5 Control System Turn on and $68,900.00 $0.00 $0.00 $0.00 $0.00 0% $68,900.00 Testing 6 CYC, FOH, Lighting Truss $1,356,800.00 $0.00 $0.00 $0.00 $0.00 0% $1,356,800.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $0.00 $0.00 $0.00 $0.00 0% $514,200.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,301,000.00 9 Canopy Rigging and Reel $348,800.00 $0.00 $0.00 $0.00 $0.00 0% $348,800.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $0.00 $0.00 $0.00 $0.00 0% $316,200.00 11 Loudspeaker Rigging Installation $55,800.00 $0.00 $0.00 $0.00 $0.00 0% $55,800.00 12 Variable Acoustic Curtains $118,000.00 $0.00 $0.00 $0.00 $0.00 0% $118,000.00 13 Curtain Installation $17,700.00 $0.00 $0.00 $0.00 $0.00 0% $17,700.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $255,600.00 $127,800.00 $0.00 $383,400.00 90 $42,600.00 Actuators 15 Track Actuator Installation $131,745.00 $79,047.00 $13,174.50 $0.00 $92,221.50 70% $39,523.50 16 Extension Lift Railings $607,521.00 $0.00 $0.00 $0.00 $0.00 0% $607,521.00 SUB- TOTALS $5,997,316.00 $548,126.60 $165,126.20 $0.00 $713,252.80 12% $5,284,063.20 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 3 of 4 PROJECT: 2695 APPLICATION 8 Carmel PAC DATE OF APPLICATION: 12/15/2009 Payment Application containing Contractor's signature is attached. PERIOD THRU: 12/31/2009 PROJECT #s: 2695 A B C D E F G H I COMPLETED WORK STORED TOTAL BALANCE ITEM WORK DESCRIPTION SCHEDULED AMOUNT AMOUNT MATERIALS COMPLETED AND COMP. TO RETAINAGE AMOUNT PREVIOUS THIS PERIOD (NOT IN D OR E) STORED (G C) COMPLETION (If Variable) PERIODS (D E F) (C -G) 17 Lift Installation $90,000.00 $0.00 $0.00 $0.00 $0.00 0% $90,000.00 18 Extension Lift Wagons $111,300.00 $0.00 $0.00 $0.00 $0.00 0% $111,300.00 19 Extension Lift Wagon Installation $18,000.00 $0.00 $0.00 $0.00 $0.00 0% $18,000.00 20 House Mix Lift Railings $248,000.00 $0.00 $0.00 $0.00 $0.00 0% $248,000.00 21 House Mix Lift Installation $60,000.00 $0.00 $0.00 $0.00 $0.00 0% $60,000.00 22 House Mix Lift Wagons $70,000.00 $0.00 $0.00 $0.00 $0.00 0% $70,000.00 23 House Mix Lift Wagon Installation $16,000.00 $0.00 $0.00 $0.00 $0.00 0% $16,000.00 24 Loudspeaker Wagon $35,384.00 $0.00 $0.00 $0.00 $0.00 0% $35,384.00 25 Loudspearker Wagon Installation $7,000.00 $0.00 $0.00 $0.00 $0.00 0% S7,000.00 26 Demountable Risers $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 27 Demountable Riser Installation $4,800.00 $0.00 $0.00 $0.00 $0.00 0% $4,800.00 28 Chorus Wagons $189,000.00 $0.00 $0.00 $0.00 $0.00 0% $189,000.00 29 Package 5170 Allowance $200,000.00 $0.00 $0.00 $0.00 $0 -00 0% $200,000.00 30 Package 5180 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 31 Package 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 32 CAD As- Builts 5170 5180 $20,000.00 $0.00 $0.00 $0.00 $0.00 0% $20,000.00 Allowance 5UB- TOTALS $7,316,800.00 $548,126.60 $165,126.20 $0.00 $713,252.80 10% $6,603,547.20 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 4 of 4 PROJECT: 2695 APPLICATION 8 Carmel PAC DATE OF APPLICATION: 12115/2009 Payment Application containing Contractor's signature is attached. PERIOD THRU: 12/31/2009 PROJECT #s: 2695 A B C D E F G H I COMPLETED WORK o SCHEDULED STORED TOTAL /o BALANCE RETAINAGE ITEM WORK DESCRIPTION AMOUNT AMOUNT AMOUNT MATERIALS COMPLETED AND COMP. TO (If Variable) PREVIOUS THIS PERIOD (NOT IN D OR E) STORED (G 1 C) COMPLETION PERIODS (D E F) (C -G) 33 CAD As- Builts 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 34 Orchestra Risers $194,000.00 $0.00 $0.00 $0.00 $0.00 0% $194,000.00 35 C/O #1 Orchestra riser /slack line ($203,040.00) $0.00 $0.00 $0.00 $0.00 0% ($203,040.00) deletions, chairwagon bronze, 37 C/O #2 Allowance Reductions ($322,720.00) $0.00 $0.00 $0.00 $0.00 0% ($322,720.00) 38 CIO #3 Work Directive $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $6,990,040.00 $548,126.60 $165,126.20 $0.00 $713,252.80 10% $6,276,787.20 CONTINUATION PAGE Quantum Software Solutions, Inc. Document UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT The undersigned has been paid and has received a progress payment in the sum of $21 for labor, services, equipment, or material furnished to (Your Customer) an the 'ob of Un& 0 9- (owner) located at 7173 rQAV StV —Vi 40 (Jab Description) and does hereby release any mechanics lien, stop notice, or bond right that the undersigned has on the above referenced job to the following extent. This release co ers a ro ress payment for labor, services, equipment, or materials fumish�t to 2 (Your Customer) through Ql- (Date) only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; extras or items fumished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the Contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that furnished labor, services, equipment, or material was not compensated by the progress payment. Dated: aoulu. ML COMPANY NAM B ft (Print Name and Title) nr- r 7 a Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 )A n p C Purchase Order No. 7 0 q l lr t P r l& 1 ,0 4 d N, Terms SM t, C 13 2 0 9 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12 -2.54 8 P e �er '^e47 R PX C lq4 ss Total 6 3,59 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 J, .Sn IN SUM OF 70q l S\jra(use IVY I� j4 60, 59 ON ACCOUN. OF APPROPRIATION FOR J_ l)l0 2 Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 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 20 j ,��000- DirectoA eTevelopment Title Cost distribution ledger classification if claim paid motor vehicle highway fund