185009 04/28/2010 CITY OF CARMEL, INDIANA VENDOR: 363791 Page 1 of 1
ONE CIVIC SQUARE DIVERSIFIED PAINTING CO INC CHECK AMOUNT: $201,690.00
CARMEL, INDIANA 46032 1681 EXPO LANE
•w,,. INDIANAPOLIS IN 46214 CHECK NUMBER: 185009
CHECK DATE: 4128/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460807 5 201,690.00 PERFORMING ARTS CENTE
TM
Document G7021CMe -1992 z
Application and Certificate for Payment Construction Manager- Adviser Edition
TO OWNER: PROJECT: APPLICATION NO Distribution to:
Carmel Redevelopment Commission PARCEL 7A, Regional Performing Arts Center
One Civic Square Interior Finish Package P5 PERIOD TO 3 OWNER
Carmel,.IN 46032 Bid Pack #5160; Painting
CONSTRUCTION MANAGER
FROM CONTRA'►1MFPainting Company VIA CONSTRUCTION MANAGER: CONTRACT DATE: Febuary 24, 2009 ARCHITECT
1681 Expo Lane CSO Architects 2695
Indianapolis, IN 46214 280 E. 96th Street Suite 100 PROJECT NOS: 1 CONTRACTOR
VIA ARCHITECT: Indianapolis, IN 46240 FIELD
CONTRACT FOR. id Pack 5160;Painting
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and
Application is made for payment, as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the
Continuation Sheet, AIA Document G703, is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous
Certificates for Payment were issued and payments received from the Owner, and that current
1. ORIGINAL CONTRACT SUM 2,100,000 nn payment shown herein is now due.
2. Net change b Cha Orders CONTRACTOR:
9 Y 9 P. D. P Co. Inc.
3. CONTRACT SUM TO DATE (Line 1 2 2,045,000.00 By: C Date: 3110120
4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 393,025.00 State of: INDIANA
5. RETAINAGE. County of:
Boone
a. of Completed Work Subscribed and sworn to before
(C�oi4n D E on G703) ,152.50 me this of 3
Thornas E. QIndia
b. 10 °7k of Stored Material Notary Publi� Notary t'tlbliG State O (Column F on G703) i�6 ,150.00 My Commission expires: 11108;2017 pone (;cun
Total Retainage (Lines 5a+ 5b or Total in Column of G703) CERTIFICATE FOR PAYMENT Expires N ov 8,
39,302 .69 In accordance with the Contract Documents, based o -s e servations 7=7e data comprising
P g
6. TOTAL EARNED LESS RETAINAGE 353,722.50 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 152 032.50 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT
(Line 6 from prior Certificate) CERTIFIED.
8. CURRENT PAYMENT DUE 201,690.00 AMOUNT CERTIFIED
A licatio and out i
aount certified differs fro tl a mrtount „applied. Initial all tgures an this
9. BALANCE TO FINISH, INCLUDING RETAINAGE Attach exp lanation r
PV Continuation Sheet that re hanged to conform with the aunount certified.)
(Line 3 less Line 6) 1,6 1,277.50 CONST CTION M N E
By: Date: 7 D
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT Air
Total changes .approved in previous months by Owner By:
W Wu k��
Date:
Total approved this'Month This Certificate is n.ot negotiable: The AMOUNT CERTIFIED is payable only to the Contractor
named herein. Issuance, a ment and acceptance of payment are without prejudice to an rights TOTALS p' Y p P” Y P J Y 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 G7021CMaT 1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIO Document is protected by U.S. Copyright Law and International Treaties.
Unauthorized reproduction or d istribution 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, copyrightgaia.org.
d, TM
Document G703 -1992 page
I.
Continuation Sheet
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 5
containing Contractor's signed certification is attached. APPLICATION GATE: 40247
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 3/10/2010
ARCHITECT'S PROJECT NO:
A B 7SCHEDULED PRESENTLY COMPLETED D E F G H I.
WORK COMPLETED MATERIALS TOTAL
BALANCE
FROM PR EVIOUS lo TO RETAINAGE
ITEM DESCRIPTION OF WORK: STORED AND STORED (IF VARIABLE
NO APPLICATION THIS PERIOD (NOT IN TO DATE (G +C) FINISH RATE)
(D E) D OR E) (D +E +F) (C G)
Bonds 73,500.00 73,500.00 73,500.00 100% 0.00 7,350.00
Moblilization 5,000.00 1,750.00 1,000.00 2,750.00 55% 2,250.00 275.00
Insurance/ Hazcom /Safety 4,000.00 4,000.00 4,000.00 100 0.00 400.00
Submittals 4,800.00 4,800.00 4,800.00 100% 0.00 480.00
09- 72 -00; WALLCOVERING
Labor 18,750.00 9.00 0% 18,750.00 0.00
Material 37,000.00 0.00 0% 37,000.00 0.00
09- 84 -00; :ACOUSTICAL
WALL PANELS
Labor 51,500.00 0.00 0% 51,500.00 0.00
Material 580,000.00 5,800.00 181,500.00 187,300.00 32% 392,700.00 18,730.00
09- 91 -00; PAINTING
BASE MECH Labor 36,680.00 24,150.00 10,000.00 34,150.00 93% 2,530.00 3,415.00
BASE MECH Material 9,000.00 6,425.00 2,500.00 8,925.00 99% 75.00 892.50
BASE ELECT LABOR 10,080.00 8,000.00 8,000.00 79% 2,080.00 800.00
BASE ELECT MATER 2,500.00 1,500.00 1,500.00 60% 1,000.00 150.00
INT CONST BASE LAB 10,880.00 2,200.00 2,200.00 20% 8,680.00 220.00
INT CONST BASE MAT 2,500.00 500.00 500.00 20% 2,000.00 50.00
PLEM LABOR 8,480.00 0.00 0% 8,480.00 0.00
PLEM MATERAIL 2,500.00 0.00 0% 2,500.00 '0.00
CON HALL N WALL LABOR 69,120.00 0.00 0% I 69,120.00 0.00
CON HALL N WALL MATERIAL 12,500.00 0.00 0% 12,500.00 0.00
CON HALL N DOME LABOR 45,920.00 5,000.00 5,000.00. 11
40,920.00 500.00
CON HALL N DOME MATERIAL 15,000.00 1,800.00 1,800.00 12% 13,200.00 180.00
CON HALL BALY WALL LAB 122,240.00 0.00 0% 122,240.00 0.00
CON HALL BALY'WALL MAT 24,000.00 0.00 0% 24,000.00 0.00
CAUTION: You should sign an original AIA Contract Document, on Which this text appears in RED. An original assures that changes will not be obscured.
AIA Document G703TM 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This 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 law. Purchasers are permitted to reproduce ten 00) 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 G703 -1992
E
r
Continuation Sheet P a g e 2
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO:
containing Contractors signed certification is attached. APPLICATION "DATE:
In tabulations below; amounts are stated to the nearest dollar. 5
Use Column 1 on Contracts where variable retainage for line items may apply. PERIOD TO: 40247
ARCHITECT'S PROJECT NO: 3/10/2010
A B C D E F G H
WORK COMPLETED MATERIALS TOTAL
BALANCE
SCHEDULED FROM PREVIOUS
PRESENTLY COMPLETED TO RETAINAGE
ITEM DESCRIPTION OF WORK STORED AND STORED (IF VARIABLE
NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G C) FINISH RATE)
(D E) D OR E) (D +E +F) (C G)
CON HALL DOME LABOR 100,260.00 15,500.00 15,500.00 15 84,760.00 1,550.00
CON HALL DOME MATERAIL;' 35,000.00 6,000.00 6,000.00 17% 29,000.00 600.00
CON HALL S WALL LABOR 45,120.00 0.00. 0% 45,120.00 0.00
CON HALL S WALL MATERIAL 9,500.00 0.00 0% 9,500.00 0.00
CON HALL S DOME LABOR 45,920.00 10,000.00 10,000.00 22% 35,920.00 1,000.00
CON HALLS DOME MATERIAL 15,000.00 2,000.00 2 000.00 13% 13,000.00 200.00
N TIER LABOR 28,000.00 0.00 0% 28,000.00 0.00
N TIER`'MATERIAL 6,500.00 0.00 0% 6,500.00 0.00
N ORCH LABOR 28,000.00 0.00 0% 28,000.00 0.00
"N ORCH MATERIAL 6,500.00 0.00 0% 6,500.00 0.00
W LOBB LABOR 28,800.00 0.00 0% 28,800.00 0.00
W LOBB MATERAIL 6,500.00 0.00 0% 6,500.00 0.00
W LOBB CEIL LABOR 28,000.00 0.00 0% 28,000.00 0.00
W LOBB CEIL MTERAIL 6,500.00 0.00 0% 6,500.00 0.00
E LOBBY LABOR 28,000.00 0.00 0% 28,000.00 0.00
E LOBBY MATERIAL 7,000.00 0.00 0% 7,000.00 0.00
E LOBBY CEIL LABOR 38,800.00 0.00 0% 38,800.00 0.00
E LOBBY MATERIAL 9,300.00 0.00 0% 9,300.00 0.00
S LOBB LABOR 45,000.00 0.00 0% 45,000.00 0.00
S LOBB MATERIAL 11,000.00 0.00 0% 11,000.00 0.00
SW ORCH LOB,STR WAL LAB, 48,000.00 3,500.00 3,500 00 7% 44,500.00 350.00
SW ORCH LOB,STR WAL MAT 8,700.00 750.00 750 00 9% 7,950.00 75.00
SE ORCH LOB STR WAL LAB 48,000.00 3,500.00 3,500 00 7% 44,500.00 350.00
SE ORCH LOB',STR 'WAL MAT 8,700.00 750.00 750.00 9% 7,950.00 75.00
4 1.00 60Q.100.00 4,200,00
CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
AIA Document G703TM+ 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright
Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent
possible under the lativ. 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 G703rM 1992
Continuation Sheet pa 3
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO`.
containing Contractot's:signed cei is attached. w 5
APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. 40247
Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0: 3/10/2010
ARCHITECT'S PROJECT NO:
A B C D E F G H
WORK COMPLETED MATERIALS TOTAL
BALANCE
SCHEDULED FROM PREVIOUS
PRESENTLY COMPLETED TO RETAINAGE
ITEM DESCRIPTION OF WORK STORED AND STORED (IF VARIABLE
NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G C} FINISH RATE)
(D E) D OR E) (D+L +F) (C G)
BAL L/H LABOR 28,000.00 0.00 0% 28,000.00 0.00
BAL L/H MATERAIL 6,800.00 0.00 0% 6,800.00 0.00
INT CON ATTIC LABOR 17,000.00 0.00 0% 17,000.00 0.00
INT CON ATTIC MATERIAL 3,500.00 0.00 0% 3,500.00 0.00
09- 97 -23; STAINS, SEALERS
BASEMENT Labor 7,700.00 3,000.00 2,500.00 5,500.00 71% 2,200.00 550.00
BASEMENT Material 5,800.00 1,500.00 4,000.00 5,500, 00 95% 300.00 550.00
BASE MECH RM LABOR 2,500.00 1,250.00 1 50% 1,250.00 125.00
BASE MECH RM MATER 1,500.00 750.00 750.00 50% 750.00 75.00
PLEM LABOR 2,500.00 1,250.00 1,250.00 50% 1,250.00 125.00
PLEM MATERAIL 1,500.00 750.00 750.00 50% 750.00 75.00
CON HALL BALCONY LAB 4,500.00 0.00 0% 4,500.00 0.00
CON HALL BALCONY MAT 1,500.00 0.00 0% 1,500.00 0.00
ORCH LOB, STIR LAB 7,500.00 0.00 0% 7,500.00 0.00
ORCH LOB, STIR MAT 3,000.00 0.00 0% 3,000.00 0.00
DAILY CLEAN UP 15,000.00 500.00 500.00 3% 14,500.00 50.00
0 GENERAL ALLOWANCE 100,000.00 0.00 0% 100,000.00 0.00
1 SUPPLIES ALLOWANCE 15,000.00 0.00 0% 15,000.00 0.00
2 LABOR ALLOWANCE 75,000.00 0.00 0% 75,000.00 0.00
3 CAD ALLOWANCE 5,000.00 0.00 0% 5,000.00 0.00
4 PROGRESS MEETINGS 5,200.00 1,000.00 100.00 1,100 "00 21,%0;; 4,100.00 110.00
5 CLOSE -OUTS 3,450.00 0.00 0 3,450.00 0.00
CO 1 DED ALLOWANCE 55,000.00
CO 2 0.00
SIBTOTAL PAGE.:;_ 256,950.00 5,500.00 11,100.00 0.00 16,60000 3.91 295,350.00 1,660.00
SUB TOTAL PAGE 1 1,145,950.00 129,925.00 23,000.00 181,500.00 334,425.00 7.82 811,525.00 33,442.50
SUB TOTAL PAGE 2 642,100.00 33,500.00 8,500.00 0.00 42,000 "00 1.00 600,100.00 4,200.00
GRAND TOTAL 2,045,000.00 168 925.00 42 600.00 181 500.00 393 025.00 12.72 1 39 302.50
CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
AIA Document G703TM 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright
Law and International Treaties. Unauthorized reproduction or distribution of this A10 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 IaOo. 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, copyrightCa aia.org.
D. P. CO., INC.
DIVERSMED PAINTING CO., INC-.
1681 Expo Lane, Indianapolis, IN 46214 (31.7) 209 -9899 fax (317)209 -9886
March 23 2010
City of Carmel Redevelopment Commission
Re: Trade Secret Notice REGIONAL PERFORMING ARTS CENTER "Project
Dear _City of Carmel Redevelopment Commission
Enclosed is the certified payroll you have requested for the above- referenced project.
Diversified Painting Co., Inc. is supplying this information for the exclusive review of CSO
ARCHITECTS and the City of Carmel Redevelopment Commission_ This
information is not to be shared, copied or passed along to any other parties without the written
permission of Diversified Painting Co., Inc. This information is viewed as confidential
employee information and contains trade secrets. Anyone forwarding or transmitting this
information without written permission by Diversified Painting Co., Inc. will be held
responsible to the fullest extent permitted by Indiana and federal law.
C
Furthermore, pursuant to the Indiana Public Access Counselor, this information is not
disclosable under the Indiana Open Records Act.
If you have any questions on this matter, please contact me.'
E
Very truly yours,
Kevin Blume
President
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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
Ur�P✓y1� r°r/ P 'r %�f:iyc CQ Purchase Order No.
1� �Xwo Zy1/- 1 Terms
l
�r�/4 c��r9,'o 5 i //l� yG2 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 20 1 G fO. CJd
1 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�iyr' -'S �'o� /"q•�f% �c���4�,� IN SUM OF
s
ON ACCOUNT OF APPROPRIATION FOR
Board Members
D PT6# INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
G2 y ea ��7 ,7a(6*Oo 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
y -,E 2010
Signature
Director of Redevelopment
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund