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CITY OF CARMEL, INDIANA VENDOR: 363789 Page 1 of 1 ONE CIVIC SQUARE CIRCLE B COMPANY, INC CHECK AMOUNT: $564,356.5D o CARMEL, INDIANA 46032 5636 S MERIDIAN ST INDIANAPOLIS IN 46217 CHECK NUMBER: 182701 CHECK DATE: 3/212010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 9,778.60 29043 902 4460807 1,490.44 29046 902 4460807 11 6,318.80 PERFORMING ARTS CENTE 902 4460807 15 546,768.66 PERFORMING ARTS CENTE SL Subcontract Billing Report For Work invoiced From 12/01109 to 12131/09 Subco;ntract.•. 2695- 4090 4090 FraminglGWt3lP.laster Job: 2695- Carmel RPAC Construction Vendor: 1981 CIRCLE B COMPANY, INC 777 3rd Ave. SW Carmel, IN 46032 Contract Ta Date This Period �s.... s IP Item Units UM Unit Cost Amount Units/% Amount Units Amount 1 4090 Framing /GWB /Plaster LS 6,394,500.00 52.41% 3,351,525.50 13.04% 833,789.74 Total Contract Items 6,394,500.0 3,351,525.50 833,789.74 Change Orders 2 CCR #1008 Oculus Alternate LS 60,100.00 0.00% 0.00 0,00% 0.00 3 CCR 1014 East Lobbies LS 19,800.00 0.00% 0.00 0,00% 0.00 Level 5 Finish Alternate 4 CCR 1011 Domed Ceiling LS 27,970.00 0.00% 0.00 0.00 0.00 East Lobby Alternate 5 CCR 1012 Barrel Vaulted LS 1,200.00 0.00% 0.00 0.00% 0.00 Ceiling Balcony Alternate 6 CCR 1015 West Lobbies LS 31,680.00 0.00% 0.00 0.00% 0.00 Level 5 Finish Altnerate 7 CCR 1016 South Lobbies LS 27,720.00 0.00% 0,00 0.00% 0.00 Level 5 Finish Altenate 9 RCP PAC -006 LS 20,490.00 0.00% 0.00 0,00% 0.00 10 Allowance Reductions LS 226,269.0 100.00% 226,269.00 100,00% 226,269.00 Total Change Order Items 37,309.0 226,269.00 226,269.00 Subcontract Totals: 6,357,191.00 3,125,256.50 607,520.74 Total Billings: 3,125,256.50 607,520.74 Unpaid Retainage: 312,525.65 60,752.08 Discounts: 0.00 0.00 Net Billings: 2,812,730.85 546,768.66 98 SSC CMa Projects Page 1 12/17109 02:41:39 PM Date Format MM /DD /YY SLSubBilling Report. rpt =111'1 Document G702/CMa -1992 Application and Certificate for Payment Construction Manager Adviser Edition TO OWNER: PROJECT: APPLICATION NO 15 Distribution to: CARMEL REDEVELOPMENT COMMISSION CARMEL PERFORMING ARTS CENTER pER10DT0 12/15/09 OWNER El ONE CIVIC:, SQUARE CARMEL,N 46032 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA. CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT EI CIRCLE B CONSTRUCTION SYSTEMS 4/22/08 SHIEL SEXTON COMPANY PROJECT NOS: 1 CONTRACTOR 5636 S. MERIDIAN ST. INDIANAPOLIS, IN 46217 VIA ARCHITECT: FIELD CONTRACTFOR: FINISHES CSO ARCHITECTS, INC. CONTRACTOR'S APPLICATION FOR PAYMENT Th e 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 6703, is attached. Contract Documents, that 411 amounts_have'been paid by the Contractor for Work for which previous Certiticates for aymen were issued- and payments received 1. ORIGINAL CONTRACT SUM 'from the Owner, and that current 6 394 500. Payment sh er i ow due. 2. Net change by Change Orders (37 309.0 CONT TO B CONSTRUCTION .SYSTEMS f 3. CONTRACT SUM TO DATE (Line. 6. 357, 191. 00 By Da(e: ,.f I J 4. TOTAL COMPLETED &STOR ED TO DATE (Column G on G703) 3 125, 256. State of: 5. RETAINAGE Count of. MARIO a• of Completed Work Sub ribed sw o 6 0 CAT1�Y A GINDER' (Column D E on G703) 312 525.65 m this d� f AAY PUBLIC STATE OF INDIANA OHN N b. of Stored Material Notary Public: 00 10 JSOrCC�QUEN� 1,,1T GrC� ssN tit (Column F on G703) My Commissio ires: Total Retainage (Lines 5a 5b or Total in Column I of G703). 312,525.65 CERTIFICATE FO AYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising 8. TOTAL EARNED LESS RETAINAGE 2,812,730.85 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 s 2,265,962.19 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. a �Qfp�. 8. CURRENT PAYMENT DUE 546 768.66 AMOUNT CERTIFIED (Attach explanation if amount certified dill fr the anto,ilttt Initial all figures on this 9. BALANCE TO FINISH, INCLUDING RETAINAGE Application and on. Continuation She eJ that ,e :changed to conform with the amount certified.) (Line 3 less Line 6) 3,544,460.1 CONS UCTION By: Date: l 2 1 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCH ECT: Total changes approved; in previous months by Owner By: Date: Va Total approved this Month This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the ontractor TOTALS named herein. Issuance payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order the 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 G702 /CMalm 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 Al a 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. TM 1 AIA Document G703 992 Page 1 of 3 Continuation Sheet 15 AIA Document 6702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 12/15/2009 containing Contractor's signed certification is attached. APPLICATION DATE: 12/15/2009 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT N0: A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM PRESENTLY COMPLETED RETAINAGE DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS TO NO. VALUE STORED AND STORED (G C) FINISH (IF VARIABLE APPLICATION THIS PERIOD (NOT IN TO DATE RATE) (D E) D OR E) (D +E +F) (C G) 100 BASEM ENT P RAM F MA 7 r- 107,259.00 10 7759.0u 1 0 7,259.00 i00.00 101 BASEMENT FRAME LABOR 85,992.00 84,272.16 84,272.16 98.00 1,719.84 102 BASEMENT HANG MATL 125,006.00 125,006.00 125,006.00 100.00 103 BASEMENT HANG LABOR 133,158.00 79,894.80 79,894.80 60.00 53,263.20 104 ORCHESTRA FRAME MATL 118,670.00 89,002.50 29,667.50 118,670.00 100.00 105 ORCHESTRA FRAME LAB 100,713.00 50,356.50 25,178.25 75,534.75 75.00 25,178.25 106 ORCHESTRA HANG MATL 124,796.00 24,959.20 12,479.60 37,438.80 30.00 87,357.20 107 ORCHESTRA HANG LAB 141,631.00 14,163.10 14,163.10 10.00 127,46790 108 BALCONY FRAME MATL 108,051.00 81,038.25 27,012.75 108,051.00 100.00 109 BALCONY FRAME LABOR 92,419.00 9,241.90 9,241.90 10.00 83,177.10 110 BALCONY HANG MAIL 115,731.00 28,932.75 28,932.75 25.00 86,798.25 Ill BALCONY HANG LABOR 129,223.00 129,223.00 112 BOX TIER FRAME MATL 135,171.00 135,171.00 135,171.00 100.00 113 BOX TIER FRAME LABOR 113,521.00 34,056.30 22,704.20 56,760.50 50.00 56,760.50 114 BOX TIER HANG MATL 140,350.00 35,087.50 35,087.50 70,175.00 50.00 70,175.00 115 BOX TIER HANG LABOR 178,584.00 26,787.60 17,858.40 44,646.00 25.00 133,938.00 116 ATTIC FRAME MATL 102,176.00 102,176.00 102,176.00 100.00 117 ATTIC FRAME LABOR 87,922.00 87,922.00 118 ATTIC HANG MATL 90,226.00 90,226.00 90,226.00 100.00 119 ATTIC HANG LABOR 1.10,889.00 110,889.00 120 ACOUS CEILING MATL 52,941.00 52,941.00 121 ACOUS CEILING LABOR 40,759.00 40,759.00 122 INSULATION MATL 82,670.00 41,335.00 41,335.00 50.00 41,335.00 PAGE TOTALS: 2,517,858.00 1,106,627.81 222,325.95 .00 1,328,953.76 1,188,904.24 .00 CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that chang wi ll not be obscured. AIA Document G703 -1992. Copyright 01963, 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, copyright@aia.org. Document G703TM 1992 Page 2 of 3 Continuation Sheet 15 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 12/15/2009 containing Contractor's signed certification is attached. APPLICATION DATE: 12/15/2009 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT N0: A B C D E F G H 1 WORK. COMPLETED MATERIALS TOTAL BALANCE DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED TO IF VA I AGE ITEM FROM PREVIOUS STORED AND STORED (IF VARIABLE NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G C) FINISH RATE) 123 INSULATION LABOR 117,330.00 409n.00 D OR E) g0aj q 0 40.00 7630.00 NIS ELIP CLG METAL M 51,331.00 51,331.00 201 NIS ELIP CLG METAL L 201,384.00 161,107.20 20,138.40 181,245.60 90.00 20,138.40 202 NIS ELIP CLG PLAS M 74,360.00 52,052.00 22,308.00 74;360.00 100.00 203 N/S ELIP CLG PLAS L 438,153.00 175,261.20 153,353.55 328,614.75 75.00 109,538.25 204 MAIN ELIP CLG METL M 52,412.00 52,412.00 52,41.2.00 100.00 205 MAIN ELIP CLG METL L 168,703.00 168,703.00 168,703.00 100.00 206 MAIN ELIP CLG PLAS M 71,273.00 71,273.00 71,273.00 100.00 207 MAIN ELIP CLG PLAS L 430,314.00 301,219.80 64,547.1.0 365,766.90 85.00 64,547.1.0 208 UP /LOW BALCNY METL M 15,304.00 3,060.80 4,591.20 7,652.00 50.00 7,652.00 209 UP /LOW BALCNY METL L 143,518.00 7,1.75.90 14,351.80 21,527.70 15.00 121,990.30 210 UP /LOW BALCNY PLAS M 37,975.00 18,987.50 18,987.50 50.00 18,987.50 21.1 UP /LOW BALCNY PLAS L 633,522.00 63,352.20 63,352.20 10.00 570,169.80 212 BOX TILR/COL METAL M 10,245.00 8,196.00 2,049.00 10,245.00 100.00 213 BOX TIER/COL METAL L 118,363.00 29,590.75 59,181.50 88,772.25 75.00 29,590.75 214 BOX TIER/COL PLAS M 70,300.00 31,635.00 17,575.00 49,210.00 70.00 21,090.00 215 BOX TIER/COL PLAS L 319,455.00 47,918.25 47,918.25 15.00 271,536.75 216 ORCH H/L METAL M 5,317.00 5,317.00 217 ORCH H/L METAL L 112,967.00 112,967.00 218 ORCH H/L PLAS M 15,260.00 1,526.00 1,526.00 10.00 13,734.00 219 ORCH H/L PLAS L 315,844.00 31,584.40 31,584.40 10.00 284,259.60 220 4090A GEN. ALLOWANCE 225,000.00 173,632.40 173,632.40 77.17 51,367.60 221 40908 CAD ALLOWANCE 5,000.00 5,000.00 5,000.00 100.00 222 4100A GEN ALLOWANCE 175,000.00 24,477.95 69,735.84 94,213.79 53.84 80,786.21 PAGE TOTALS: 3,808,330.00 1,347,795.95 606,463.79 .00 1,954,259.74 1,854,070.26 .00 CAUTION: You should sign an original AIA Contract Do cumen t, on which this text appears in RED. An original assures that ch anges will n ot be obscured. AIA Document G703T'" —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, copyright@aia.org. AIA Document rm 1 6703 992 Pap-e 3 of 3 Continuation Sheet 15 AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 12/15/2009 containing Contractor's signed certification is attached. APPLICATION DATE: 12/15/2009 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED RETAINAGE FROM PREVIOUS (G C) FISH STORED AND STORED N (IF VARIABLE (NOT IN TO VALUE APPLICATION THIS PERIOD NO. SH DATE RATE) 223 410013 CAD ALLOWANCE 5,000.00 (D E) 5,000.00 D OR E) p0 100.00 (C G) 300 BUND PREMIUM 63,312MU 63,312.00 6T312.00 100AO 301 C.O. #1 /CCR #1008 60,100.00 60,100.00 302 C.O. #2 /CCR #1011 27,970.00 27,970.00 303 C.O. #3 /CCR #1012 1,200.00 1,200.00 304 CO. #4 /CCR #1014 19,800.00 19,800.00 305 C.O. #5 /CCR #1015 31,680.00 31,680.00 306 C.O. #6 /CCR #1016 27,720.00 27,720.00 308 CO #8 /PAC006(CO7 0) 20,490.00 20,490.00 309 CO 9 /ALLOWANCE ADJ 226,269.00 226,269.00 226,269.00 100.00 CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that change w ill 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 AIAO 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. AFFIDAVIT AND WAIVER OF LIEN FINAL PARTIAL PAYMENT TO FOLLOW STATE OF INDIANA COUNTY OF MARION SS: JOHN M. ABBOTT BEING DULY SWORN THAT TIE IS THE PRESIDENT OF CIRCLE B CONSTR. SYSTEMS, LLC HAVING CONTRACTED WITH CARMEL REDEVELOPMENT COMMISSION TO FURNISH CERTAIN MATERIALS AND /OR LABOR AS FOLLOWS: INTERIOR FINISHES FOR A PROJECT KNOWN AS: CARMEL, PERFORMING ARTS CENTER AND OWNED BY: CARMEL PERFORMING ARTS CENTER DOES HEREBY FURTHER STATE OF BEHALF OF THE AFOREMENTIONED SUBCONTRACTOR/SUPPLIER: PARTIAL WAIVER) THAT THE BALANCE DUE FROM THE CONTRACTOR IS THE SUM. OF ONE MILLION THREE HUNDRED NINETY THREE THOUSAND EIGHT HUNDRED NINE DOLLARS AND .63 /100 ($1,393,809.63) XX RECEIPT OF WHICH IS HEREBY ACKNOWLEDGED: OR THE PAYMENT OF WHICH HAS BEEN PROMISED AS THE SOLE CONSIDERATION FOR THIS AFFIDAVIT AND PARTIAL WAIVER OF LIEN, WHICH IS GIVEN TO AND FOR SAID AMOUNT, EFFECTIVE UPON RECEIPT OF PAYMENT; (FINAL WAIVER) THAT THIS FINAL BALANCE DUE IS THE SUM OF: RECEIPT OF WHICH IS HEREBY ACKNOWLEDGED: OR THE PAYMENT OF WHICH HAS BEEN PROMISED AS THE SOLE CONSIDERATION FOR THIS AFFIDAVIT AND WAIVER OF LIEN WHICH SHALL BECOME EFFECTIVE UPON RECEIPT OF SUCH PAYMENT. THEREFORE THE UNDERSIGNED WAIVES AND RELEASES UNTO THE OWNER OF SAID PREMISED, ANY AND ALL LIEN OF CLAIM WHATSOEVER ON THE ABOVE DESCRIBED PROPERTY AND IMPROVEMENTS ON ACCOUNT OF LABOR OR MATERIAL OR BOTH, FURNISHED BY THE UNDERSIGNED THERETO, AND FURTHER THAT NO OTHER PARTY HAS ANY CLAIM OR RIGHT TO A LIEN ON ACCOUNT OF WORK PERFORMED OR MATERIAL FURNISHED TO THE UNDERSIGNED FOR SA R J T AND WITHIN THE SCOPE OF THIS AFFIDAVIT AND WAIVER. CIRCLE B CONSTR. SYSTEMS, LLC BY: TITLE: PRESIDENT 'ESS Y HAl\ AN TARIAL SEAL THIS 23RD DAY OF NOVEMBER, 2009 C HY A. G ER, TARY PUBLIC MY COMMIS .ON EXPIRES: 02/01 /2017 RESIDENT OF JOHNSON COUNTY Prescribed by State Board of Accounts City Form Nc. 291 (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. I Q Payee Co S wcf/ �y 5te Purchase Order No. 5� �6 S.erld��I►� 5�. Terms n J i c1 n !l p h i s, '11217 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12 09 I 5 1 rwi x Ic eY' P 5y ti 66 Total 546 9. 66 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 1 IN SUM OF �6 S cr�d �idlh i n J �r c �i,.a, b' 1 ON ACCOUNT OF APPROPRIATION FOR 02/ 0V Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 1 hereby certify that the attached invoice(s), or j S' 7 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 20/0 erector oNer�eyelopmer�4 Title Cost distribution ledger classification if claim paid motor vehicle highway fund SL Subcontract Billing Report For Work Invoiced From 12/01/09 to 12/31/09 Sulic'ontract: .2695, -3060 3060 Fireproofing Job: 2695- Carmel RPAC Construction Vendor: 1981 CIRCLE B COMPANY, INC 777 3rd Ave. SW Carmel, IN 46032 Y§ a r COntraG E n W, TO Qat@ thlS Period 1. Item Units UM Unit Cost Amount Units/% Amount Units Amount Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored (column F). Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result In a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed This Period). Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line -item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. ti Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or-6t the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 /CMa•forrr. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 /CMa. E. Making Payment The Owner should make payment directly to the Contractor based on the amount certified bythd Construction Manager and Architect on AIA Document G7021CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The cormpleted,fbrm contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G7021CMa.? AIA Document G7021CMaM 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 document when completed. To report copyright violations of AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright @aia.org. O CQ fJ Q o N Q o H o Z C� rf] cJ t U C� +I 0 0 w u- E m a c M o a CD n J act C D x_ Q Z o j o U.Q Ey v o Iti E N w O CC v� w U t CV U E o 7- O w O a cli N o v t: G4 H H. d H o oe p c o c rn o o zy O o 0 E+ H F4 0" U ca o rn c o ff S lu U v m �a 7 F YO Ga Q iJ OH o' W° U a W c o T G U a H o w H w U i� o a, rn z a t. c3 a UO f4 H a v Z w p u w p m W a s m o E V fs7 �a O E O rn a o o p v [iJ a m O w U a> o o c 5 z —1 w a O -2 0.' o 0 a Gd H Z Fq F4 H Q t U O (D Q w H w O an p Z c o 3„ c o c c a� v c w v m V W O, U' p Q ra U Z o o PG w c c z t� c W ro c d Z LIZ N n Z F ua z s ag r a w z t7 a x c Q f~ CJ H I— Z z I— F— H cf) Z U o a �I a Q O H� �a p 0 o O Z ce a V E Q U ca x F— V Q V LL C.) u) H V U Q U c%J c•i a Lo 1.6 r= ov of z U¢ a undijge uruLrs. iumugil Ldldrlge UfUe15 UUUIu UG IIIL:UlpUIdlCu Uy GIIdllyllly LIIC SLIMULIIC UI VdILIC75 CdLll LIIIIG d U11011yC LIIUCI IJ dUUCU W UB5 r1UJULL, LIIIJ IJ IIUL normally done. Usually Change Orders are listed separately, either on the own G703 form or at the end of the basic schedule. The amount of the original contract adjusted °by Change Orders is to be- entered in the appropriate location of the G702 form. Construction Change Directives: Amounts:not in dispute that have been included in Construction Change Directives should be incorporated into one or more 'Change Orders: Amounts remaining indispute,should be dealt with according to Section 7.3 in A201. t The following r's.an example of a'Gontinuation Sheet for work in progress. Please note that dollar amounts shown are for illustrative purposes only, and are not intended to reflect actual construction costs. A B C D E J' G 1-1 1 WORK COMPLETED MATERIALS TOTAL_ BALANCE rEM SCHEDULED FROM PRESENTLY COMPLETED To RF'TAINAGE NO. DFSCRIVI70N OF WORK VALUF PREVIOUS STORED ANDSTORBD (G_ FINISH (IF VARIABLE 'PHIS PER [OD APYLICA'rION 1) OR H) '1'O DA'dT (C G RATE) (D E) D OR EI (U +E +F) 1 M051LIZATION 5.000 5,000 0 0 5.000 100 O 2 5TUMP.REMOVAL` 5,000 5.000 0 0 5.000 100 0 3 EARTH WOR{ 15.000 10.000 5.000 0 15.000 100 0 A LOWER RETAINING WALL 10,000 0 5,000 0 5.000 50 5.000 5 CURB5 M15C. CONG. 5.000 0 0 0 O 0 5.000 6 PAVING, UPPER DRIVE 20.000 0 0 O O 0 20.000 7 PAVING, LO4VER UM[VE 20.000 0 0 0 O 0 20,000 8 fAVER5 20.000 O C 10000 10,000 50 10.000 9 5R1C:., WORK 5.000 0 0 0 O 0 5.000 10 n c 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 on 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, copyright4aia.erig. z 3 w r la y �t :t c CL c E2 GO 0 v: c °U �ww�pps �"�C7C7C7 L Mo L) IX0 mc� o Q C7 U o O ��c�/l�!] Z¢QE E O�rT x air c m N N W FQ Q U U U V Z E e o O Q Q W O'I O O N M in c �5 1 1 1, 4 20 oo �Z 000000QOO 000o a31n' Q r- 00 oc o0 00 U d M 0 C L 0 1 AFFIDAVIT AND WAIVER OF LIEN FINAL PARTIAL PAYMENT TO FOLLOW STATE OF INDIANA COUNTY OF MARION SS: JOHN M. ABBOTT BEING DULY SWORN THAT HE IS THE PRESIDENT OF CIRCLE B CONSTR. SYSTEMS, LLC HAVING CONTRACTF.D WITH CARMEL REDEVELOPMENT COMMISSION TO FURNISH CERTAIN MATERIALS AND /OR LABOR AS FOLLOWS: 1:�rornvnr_nU'rnic 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 Purchase Order No. S� 3� S fie vim, S Terms /�J• Giyr�i�o /i 5 `���32 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) i a 34 �a a Total Z> 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 '*ate VOUCHER NO. WARRANT NO. ALLOWED 20 C V t' /c" /J 6r, .3� C��-�..o� ✓fj SJ� °1x,73 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR a 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 2 -�26 20/0 Signature Cost distribution ledger classification if T itle claim paid motor vehicle highway fund December 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 Circle B :Invoice No. 29043REVIS 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 ($9,778.60). Sincerely, Warren David Brewer Project Manager cc: Don Cleveland Mike Anderson Tony Eisenhut File C B Invoice Number 29043REVIS Invoice Date 1.2/03/2009 Construction Systems Customer Number 001110 INVOICE Job Numbcr F08002 Due Date 01/02/2010 CARMEL REDEVELOPMENT COM CARMEL PERFORMING ART -FP ONE CIVIC SQUARE F08002 CARMEL, IN 46032 PATCH REINFORCED STEEL IN ATTIC FIREPROOFER 160.00 HR 581600 9,305.60 MATERIAL E 473.00 GROSS BILLINGS: 9,778.60 NET BILLINGS 9,778.60 REMIT TO: (317) 787 -5746 fax (317) 780 -2654 5636 South Meridian Street Indianapolis, Indiana 46217 Equal Opportunity Employer T E AND MATERIAL AGREEMENT I" Construction Systems 111 Job Invoice Number 5636 South Meridian Street 19 6854 Indianapolis, IN 46217 Work Performed for: l Phone: 317-787-5746 L_ Fax: 317- 780 -2654 Project Name: L .fl iYrt 0 r l�d r !Y/ In DATE:! �9 6 Q Circle B Job No.: f7 Grey areas are for office use only Straight Time Time 112 DBL. Time DESCRIPTION OF WORK:I.�,,.,,. LABOR =s� Extension HR Rate HR Rate HR Rate Carpenter Carpenter Foreman Finisher Finisher Foreman Plasterer Plaster Foreman Laborer Fireproofer Superintendent Tr uck Driver Other LABOR TOTALS LJVi Overtime will be charged in accordance with union agreements. MATERIALS; Qty Rate Extension SUPPLIES' '.EQUIPMENT Description Qty Rate /Day Extension MATERIAL TOTALS I v „.EQUIPMENT TOTALS .A Due to the cost of mobilization of equipment and crew there is a 2 MATERIAL TOTAL hour minimum on all charges. EQUIPMENT TOTAL Traver Extension SUBTOTAL SALES TAX LABOR TOTAL TRAVELTOTAL TRRIJEL'TOTALS ��a SUBTOTAL I hereby agree to the quantities and details above and agree BOND to pay pursuant to the ntract payment terms and conditions. GRAND TOTAL r -s 6 OWNE WNER REP. S ATURE DATE CIRCLE B SIGNATURE DATE IME AND MATERIAL AGREEMENT L1 Construction Systems Jab invoice Number 5636 South Meridian Street Z Indianapolis, IN 46217 Work Performed for: C J J Phone: 317 787 -5746 Fax: 317 780 -2654 Project Name: a k t� DATE: (j a Circle B Job No.: Grey areas are for office use only Straight Time Time 112 DBL. Time DESCRIPTION OFWORK:. 'LABOR Extension HR Rate HR Rate HR Rate ir Carpenter f Carpenter Foreman Finisher Finisher Foreman Plasterer Plaster Foreman Laborer Fireproofer,� Superintendent Truck Driver Other a LABOR TOTAL`S 1 S Overtime will be charged in accordance with union agreements. MATERIALS °Ak :SUPPLIES Qty Rate Extension E QUIPMENT, Description Qty RatelDay Extension MATERIAL ,TOTALS 11' `iEQUIPMENT TOTALS Due to the cost of mobilization of equipment and crew there is a 2 MATERIAL TOTAL` hour minimum on all charges. EQUIPMENT TOTAL Travel Extension SUBTOTAL SALES TAX LABOR TOTAL TRAVELTOTAL TRAVEL TOTALS SUBTOTAL 1 hereby agree to the quantities and details above and agree BOND to pay pursuant to th ntract payment terms and conditions. GRAND TOTAL OWNS WNER REP. NATURE DATE CIRCLE B SIGNATURE DATE TIME AND 'MATERIAL AGREEMENT Construction Systems Job Invoice Number 5636 South Meridian Street 7755 Indianapolis, IN 46217 Work Performed for: bhtA Phone: 317- 787 -5746 Fax: 317 780 -2654 Project Name: DATE: Circle B Job No.: t} I Grey areas are for office use only Straight Time Time 112 DBL. Time DESCRIPTION OF WORK: LABOR 9 Extension HR Rate HR Rate HR Rate OQ Carpenter` Carpenter Foreman Finisher 7 9 Finisher Foreman Plasterer Plaster Foreman Laborer Fireproofer� Superintendent Truck Driver Other LABOR TOTALS `r, f Overtime will be charged in accordance with union agreements. MATERIALS I s Qty Rate Extension SUPPLIES Inv i Oaa EQUIPMENT Description Qty Rate /Day Extension MATERIAL TOTALS_e' EQUIPMENTJOTALS 7-57W 14 4? Due to the cost of mobilization of equipment and crew there is a 2 MATERIAL TOTAL hour minimum on all charges. EQUIPMENT TOTAL Travel Extension SUBTOTAL SALES TAX LABOR TOTAL 2>fi6, TRAVELTOTAL .TRAVEL TOTALS SUBTOTAL t hereby agree to the quantities and details above and agree BOND p ursuant to the contract payment terms and conditions. GRAND TOTAL I I Y l OWNERIOWNE EP. SIGNATURE DATE CIRCLE B SIGNATURE DATE TIME AND MATERIAL AGREEMENT Construction Syster ns Job Invoice Number 5636 South Meridian Street t Indianapolis, IN 46217 Work Performed for: 7756 Phone: 317- 787.5746 Fax: 317 780 -2654 Project Name: DATE: 2 Circle B Job No.: Grey areas for office use only BO Straight Time Time 112 DBL. Time DE CRIPTION ©F WORK: LABOR Extension HR Rate HR Rate HR Rate F ir Carpenter Carpenter Foreman Finisher Finisher Foreman Plasterer A I Plaster Foreman Laborer Fireproofer Superintendent Truck Driver Other r u., LABOR TOTALS S T'- Overtime wilt be charged in accordance with union agreements. MATERIALS Qty Rate Extension SUPPLIES,.. 6 S tt f EQUIPMENT` Description Qty RatelDay Extension M, a MATERIAL TOTALS EQUIPMENT TOTALS Due to the cost of mobilization of equipment and crew there is a 2 MATERIAL TOTAL hour minimum on all charges. EQUIPMENT TOTAL Travel Extension SUBTOTAL �.a SALES TAX LABOR TOTAL TRAVELTOTAL agree to the q uantities an TOTALS SUBTOTAL I hereby q nd details above and agree BOND y to pay pursuant to the contract payment terms and conditions. GRAND TOTAL 9�WNERiOWNil REP. SIGNATURE DATE CIRCLE B SIGNATURE DATE V TIME AND MATERIAL AGREEMENT Construction Systems Job Invoice Number 5636 South Meridian Street. 7 7 Indianapolis, IN 46217 Work Performed for: J Q Phone: 317- 787 -5746 qq Fax: 317 780 -2654 Project Name: V� i I 7 Circle B Job No.: Grgy areas are for office use DESCRIPTION OF WORK: r Straight Time Time 112 DBL. Time LABOR Extension 0 HR Rate HR Rate HR Rate r Carpenter T Carpenter Foreman Finisher: Finisher Foreman' Mr�r Plasterer Plaster Foreman Laborer Fireproofer 95 Superintendent Truck Driver Other LABOR,TOTALS /i;�5� Overtime will be charged in accordance with union agreements. MATERIALS Qty Rate Extension SUPPLIES ,s nJ cry EQUIPMENT Description Qty RatelDay Extension MA ERIAL TOTALS 27 1 EQUIPMENT;TOTALS Due to the cost of mobilization of equipment and crew there is a 2 MATERIAL TOTAL "7 hour minimum on all charges. EQUIPMENT TOTAL,< Travel! Extension SUBTOTAL ''s SALES TAX LABOR TOTAL�,> TRAVELTOTAL TRAVEL TOTALS. SUBTOTAL thereby agree to the quantities and details above and agree BOND to pay pursuant to the contract payment terms and conditions. GRAND TOTAL R WNERIOW R REP. SIGNATURE DATE CIRCLE B SIGNATURE DATE TIME AND MATERIAL AGREEMENT n Construction Systems Job Invoice Number 5636 South Meridian Street 7 758 Indianapolis, IN 46217 Work Performed for: Phone: 317 -787- 5746 Fax: 317 780 -2654 Project Name: 9- r �J DATE: Circle B Job No.: Grey areas are for office use only Straight Time Time 112 DBL. Time DESCRIPTION OF,WORK:.,. a LABOR Extension HR Rate HR Rate HR Rate J Carpenter -ri no Carpenter Foreman Finisher Finisher Foreman Plasterer Plaster Foreman s Laborer A (S. Fireproofer Superinte Truck Driver Other LABOR TOTALS �v.a37v Overtime will be charged in accordance with union agreements. MATERIALS r Qty Rate Extension SUPPLIES r -►mot, EQUIPMENT Description Qty Rate /Day Extension MATERIAL TOTALS, EQUIPMENT TOTALS Due to the cost of mobilization of equipment and crew there is a 2 MATERIAL TOTAL hour minimum on ail charges. EQUIPMENT TOTAL Travel Extension SUBTOTAL SALES TAX LABOR TOTAL TRAVELTOTAL 'TRAVEL TOTALS1 SUBTOTAL 1 hereby agree to the quantities and details above and agree BOND to pay pursu the contract payment terms and conditions. GRAND TOTAL j 1 ,�WNERJOWIKR REP. SIGNATURE DATE CIRCLE B SIGNATURE DATE TIME AND MATERIAL AGREEMENT Construction Systems Job Invoice Number South Meridian Street Indianapolis, IN 46217 Work Performed for: Phone: 317- 787 -5746 a Fax: 317 -780 -2654 Project Name: SDATE: Circle B Job No.: Grey'areas are for office` "Fuse only Straig Time Time 112 DBL. Time DESCRIPTION OF WORK:, 9 LABOft,n Extension HR Rate HR Rate HR Rate Carpenter Carpenter Foreman Finisher Finisher Foreman Plasterer Plaster Foreman Laborer Fireprooferr Superintendent Truck Driver Other 41 4'. LABOR TOTALS /3* S Overtime will be charged in accordance with union agreements. MATERIALS Qty Rate Extension SUPPLIES C i Y EQUIPMENT:. Description Qty I Rate /Day Extension F; MATERIAL TOTALS s EQUIPMENT TOTALS �F Due to the cost of mobilization of equipment and crew there is a 2 MATERIAL TOTAL hour minimum on all charges. EQUIPMENT TOTAL Travel Extension SUBTOTAL SALES TAX LABOR TOTAL` TRAVELTOTAL t T RAVEL TOTALS SUBTOTAL 1 hereby agree to the quantities and details above and agree BOND to pay pursuant to the contract payment terms and conditions. GRAND TOTAL 2 ,la Le� OWNERIOWNERXEP. SIGNATURE DATE CIRCLE B SIGNATURE DATE Ce IRCLE 13 Job Invoice Number Construction Systems TIME AND MATERIAL AGREEMENT ID 5636 South Meridian Street Work Performed k*: Indianapolis, IN 46217 Phone: 317 -787 -5746 Project Name: DATE: LQ C7� Fax: 317- 780 -2654 Circle B Job No.: Grey areas are for oifj e DESCRIPTtC1N{7F yd(yRK,A Straight Time Time 112 DBL- Time C Extension HR Rate HR Rate HR Rate Carpenter %re Finisher Laborer V.•. �e Plasterer 2' tea, a Fire Proofer Foreman Superintendent�:w Truck Drive Operator z R� sa, LABOR TOTALS ^i Overtime will be charged in accordance with union agreements. E{tIJfF?Nt CfpEtATClR.NOt ItLl3DED` Oty Rate Extension Description Oty Rate /Day Extension StJpPL1ES x c g a T' t �b� 3 r EQUIPMENT;TOTALS MATERIALTOTALS Due to the cost of mobilization of equipment and crew there is a 2 hour minimum on all charges. TraVa1 Extension MATERIAL TOTAL EQUIPMENT TOTALd SUBTOTAL SALES TAX TRAVELTOTALS LABOR TOTAL TRAVELTOTAL SUBTOTAL 0 OVERHEAD &PROFIT hereby the quantities and details above and agree SUBTOTAL to p pursua to the contract payment terms and conditions. BOND GRAND TOTAL i�,�7r� e r 7 NER/OWNE EP. SIGNATURE DATE CIRCLE. B SIGNATURE DATE C B Invoice Number 29046 Construction Systems Invoice Date 12/31/2009 Customer Number 001110 i NVO I C E .fob Number F08002 Due Date 01/30/2010 CARMEL REDEVELOPMENT COM CARMEL PERFORMING ART -FP ONE CIVIC SQUARE F08002 CARMEL, IN 46032 HAND PATCH FIREPROOFING REINFORCED STEEL IN ATTIC FIREPROOFER 24.00 HR 58.1600 1,395.84 MATERIAL E 94.60 GROSS BILLINGS: 1,490.44 NET BILLINGS: 1,490.44 REMIT TO: (317) 787 -5746 fax (317) 780 -2654 5636 South Meridian Street Indianapolis, Indiana 46217 Equal Opportunity Employer 90 0qv eIRCLE Job Invoice Number Construction Systems TIME AND MATERIAL AGREEMENT 5636 South Meridian Street Work Performed: 19 Indianapolis, IN 46217 Phone: 317-787-5746 Project Name: t DATE: 2-31 Fax: 317 780 -2654 �0 Circle B Job No.: Grey areas are for office use only;;. Straight ht Rate RR Rate HR BL. Time CsESCRIPTfO N F W Cii EiKT� 9 e Extension ate Carpenter Finisher 'F Laborer 63 Plasterer p �a Fire Procter Foreman Superintendents Truck Drive Operator Y ?G LABOR TOTALS. Overtime will be charged in accordance with union agreements. i =EG1F71VlENT tpiA7(7R N lNLt)DE�t ,a T EN y��t,�, ��n �O`Z Rate Extension ham Qry Description Oty Rate /Day Extension 5UPP41E5 y;' 1 k r EQU P,MENT TOTALS e s,,,, MATERIAL�TOTALS Due the cost of mobilization of equipment and crew there is a 2 hour minimum on all charges. TdV@I Extension MATERIAL TOTAL Z7 EQUIPMENT TOTAL SUBTOTAL SALES TAX °d. R TRAVEL°TOTALS LABOR TOTAL TRAVEL TOTAL SUBTOTAL OVERHEAD PROFIT I hereby agree to the quantities and details above and agree SUBTOTAL to pay ursuant to the contract payment rms and conditions. BOND GRAND TOTAL Gl�.°J Sj�' 7 WNER/OWNER P 8 P. SIGNATURE DATE CIRCLE B SIGNATURE DATE "e B Job Invoice Number Construction Systems TIME AND MATERIAL AGREEMENT 0 563 South Meridian Street Work Performed by: s g Indianapolis, IN 46217 Phone: 317 787 -5746 Project Name: DATE: Fax: 317- 780 -265 4 Circle B Job No.: Grey areas are for office use only', a Straight Time Time 1/2 DBL. Time s LABUR� Extension t k I: HR Rate HR Rate HR Rate AGba?. Carpenter� r;a Finisher r Laborers. Plasterer l Fire ProoferJ "gd' A Foreman yam', Superintendent �9� Truck Drive Operator', T LABOR TOTALS r!' Overtime will be charged in accordance with union agreements. 'EGtUI'lAENT< F€I#i[ E P1gT (t lilt A HO" TEFiI p' 4 Qty Rate Extension Description Oty Rate /Day Extension :5iJPPLfES 4AX n f t. ri n9 EE i MATERIALTOTALS t f J „EUUIPMENT:.T.OTALS Due to the cost of mobilization of equipment and crew there is a 2 hour minimum on all charges. Travel Extension MATERIAL TOTAL �7 ;Y Is EQUIPMENT TOTAL SUBTOTAL SALES TAX TRAVEL TOTALS LABOR TOTAL j f vs 'Y TRAVEL TOTAL SUBTOTAL OVERHEAD &PROFIT I hereby agree to the quantities and details above and agree SUBTOTAL to pay pursuan th contract payment terms and conditions" BOND 1i GRAND TOTAL OWNER/O ER REP. SI ATURE DATE AT CIRCLE B SIGNATURE DATE Cleveland, Don. H From: Dave Brewer [dbrewer @shielsexton.com] Sent: Thursday, January 14, 2010 7:52 AM To: Cleveland, Don H Subject: RE: Ermco Payment Yes. It was required once the structural modification were complete. Thanks, W. David Brewer Shiel Sexton Company, Inc. office (317) 688 -6853 mobile (317) 281 -0743 dbrewer @shielsexton.com From: Cleveland, Don H [mailto:dcleveland @carmel.in.gov] Sent: Thursday, January 14, 2010 5:59 AM To: Dave Brewer Subject: RE: Ermco Payment Is this emergency work? Don Cleveland, Finance Manager Carmel Redevelopment Commission 30 West Main Street, Suite 220 Carmel, IN 46032 dcleveland @carmel.in.gov 317 -571 -2795 to desk 317 -571 -2789 fax 317 796 -9061 cell From: Dave Brewer [mailto :dbrewer @shielsexton.com] Sent: Wednesday, January 13, 2010 3:58 PM To: Cleveland, Don H Cc: Mike Anderson; Ryan Anderson Subject: FW: Ermco Payment Don, This was not previously billed but I really want to keep all of this coming through us so we can track. I would like to recommend that we pass this through with the January pay app and will let Circle B know. If you have any questions, please let me know. Thanks, W. David Brewer Shiel Sexton Company, Inc. office (317) 688 -6853 1 C 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 Cohs4ro+,uh Systems Purchase Order No. 500 S S `T. Terms n I co k. 6s,, T IV 62 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9--0-01 RFV_7S In/ in t� 5 99778, 6b f N. a 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 r CdP B �oi1.S'�p S�IS`�e MS IN SUM OF 5 02 St 462 ON ACCOUNT OF APPROPRIATION FOR 902 14qW07 Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 902 2 R E ViS 46007 q 1 6� bill(s) is (are) true and correct and that the "102 2q �}6 b D$0 M materials or services itemized thereon for which charge is made were ordered and received except f 20 /0 Si nature Director oY Redevelop nW Title Cost distribution ledger classification if claim paid motor vehicle highway fund