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186227 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 363990 Page 1 of 1 ONE CIVIC SQUARE CADENCE MIT LLC CHECK AMOUNT: $38,435.35 a CARMEL, INDIANA 46032 2535 REAVEST SOUTH DRIVE INDIANAPOLIS IN 46203 CHECK NUMBER: 186227 CHECK DATE: 6/9/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 103 4460705 20535 0035408005 44.18 INLOW PARK REPAIRS 103 4466705 23313 0035408005 38,391.17 INLOW PARK REPAIRS .:y APPLICATION and CERTIFICATE for PAYMENT To: Carmel Clay Parks and Project: Inlow Park Repairs and Application No: 003- 5408.005 Distribution to: Recreation Improvements Project 1411 E 116th St 6310 E 131st St. App. Date: May 26, 2010 OWNER r iii ecno� Carmel IN 46032 CONSTRUCTION MGR. ARCHITECT From: Cadence MTC LLC Period to: May 26, 2010 0 CONTRACTOR 2535 Reavest Dr. S. Project Nos: 5408.005 OTHER Indianapolis, IN 46203 Contract Date: March 9, 2010 Contract For: Via Architect: Schneider Corporation CONTRACTOR APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, payment, as Shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been completed Application is made for Continuation Sheet, or pa is attached. in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments 1. ORIGINAL CONTRACT SUM 78 received from the Owner and that current payment shown herein is now due. ,960.40 2. Net Change By Change Orders 16,300.71 CONTRACTOR: Cadence MTC LLC 3. CONTRACT SUM TO DATE 95,261.1 By: a C Date: May 26, 2010 4. TOTAL COMPLETED AND STORED TO DATE 87, 782,8 Roxanne Bell 5. RETAINAGE: State of: Indiana County of: Marion a. 10% of Completed Work 8,778.2 Subscribed and sworn before me this 26th day of May 2010 b. of Stored Material Roxanne Bell personally appeared before me, the undersigned notary public, and provided 0.00 satisfactory evidence of identification to be the person who signed this document in my TOTAL RETAINAGE presence and swore or affirmed to me that the contents of this document are truthful and 8,778.29 accurate to the best hislher knowled a and elief. 6. TOTAL EARNED LESS RETAINAGE 79, ©04.58 Notary Publi 7 y Commission expires: 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 40 ,569.23 ARCHITEers CERTIFICATE OR PAYMENT 8. CURRENT PAYMENT DUE 38,435.3 in accordance with the Contract Documents based on on site observations and the data comprising this application, the Architect certifies to the Owner that to the best of the 9. BALANCE TO FINISH, INCLUDING RETAINAGE 16,256.5 Architect's 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 CERTIFIED. -�QQ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AMOUNT CERTIFIED sZ✓� 3 J Total changes approved in 16,300.75 0.00 (Attach explanation if amount certified differs from the amount applied for. Initial all figures previous months by Owner on this Application and the Continuation Sheet that are changed to conform to the amount Total approval this Month 0.00 0.00 certified.) TOTALS 16,300.75 0,00 ARCHITECT: GES by Change Order _1 6.3 00.75 By: I Date: Qs. �DfC Description �NL.OW PA��I< �PAt1� D JUN P.O. a� 1 7 J� 2 o�OJ 3`�� P or F p9 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the G.L. !Q J' ��33 Q5 2 2010 Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. Bu ie e escr 4 11v ow k BY. P x3313 1 l` 3g, 3q 1,17 i W hL p Purcha� at r De TQRGB 6 2DOB 1tttRt@M95 RESERVED `f 0 3 S, 435.35 CONTINUATION SHEET G703 PROJECT: Inlow Park Repairs and Improvements Project Cadence MTC LLC Page 1 of 1 Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 003 5408.005 Contractor's signed Certification is attached. APPLICATION DATE: May 26, 2010 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: May 26, 2010 PROJECT NUMBER: 5408.005 A B C D E F G H I Item Description of Work Scheduled Work Completed Materials Total Completed Balance Retainage Value From Previous This Stored Used and Stored to Finish Application(s) Period Prior Current To Date 1 Performance Bond 2,000.00 2,000.00 0.00 2,000.00 100.00 0.00 200.0 2 Start up Mobilization 3,800.00 3,800.00 0.00 3,800.00 100.00 0.00 380.00 3 Demo 8,000.00 8,000.00 0.00 8,000.00 100.00 0.00 800.00 4 Masonry Labor 20,000.00 5,000.00 15,000.00 20,000.00 100.00 0.00 2,000.00 5 Concrete 6,369.00 6,369.00 0.0 6,369.00 100.00 0.00 636.9 6 Roofing 3,580.00 0.00 0.00 0.00 0.00 3,580.00 0.0 7 Carpentry 4,680.00 0.00 4,680.00 4,680.00 100.00 0.00 468.0 8 Spray Features 14,170.00 11,120,99 3,049.01 14,170.00 100.00 0.00 1,417.0 9 Door Hardware 2,600.00 1,920.00 680.00 2,600.00 1 00.0 0 0.00 260.0 10 Excavation 1,090.0 654.00 436.00 1,090.00 100.00 400 109.0 11 Electric 3,491.40 0.00 2,793.12 2,793,12 80.00 698.28 279.31 12 Plumbing 2,180.00 0.00 2,180.00 2,180.00 100.00 0.00 218.00 13 Painting 7,000.00 0.00 6,300.00 6,300.00 90.00 700.00 630.00 14 CO #1 #1 Remove replace concrete 1,386.00 1,386.00 0.00 1,386.00 100.00 0,00 138.60 15 CO #1 #2 Remove glazed block below 975.00 975.00 0.00 975.00 100.00 0.00 97.5 16 CO #1 #3 Drill Epoxy 4' Dowels where 600.00 600.00 0.00 600.00 100.00 0.00 60.0 17 1CO#1 #4 Excavate form constrcut 2 piers 10,839.75 3,251.93 7,587.82 1 0,839.751 100.00 0.00 1,083.98 18 1CO#1 #5 Contingency for damage caused 2,500.00 0.00 0.00 0.001 0.00 2,500.00 0.0 fl U JUN 022010 BY GRAND TOTAL: 95,261.1 45,076.921 42,705.95 1 .11 7,478.281 8,778.29 A =Line Item Number B =Brief Item Description C =Total Value of Item D =Total of D and E From Previous Application(s) (If Any) E =Total Work Completed For This Application F =Materials Purchased and Stored for Project G =Total of All Work Completed and Materials Stored for Project H= Remaining Balance of Amount to Finish 1= Amount Withheld from G TORGO SOFTWARE http: /twww.torgo.net 01986-2008 ALL RIGHTS RESERVED JUN 0 z 2010 B7. The Schneider Corporation c n i r Historic Fort Harrison 8901 Otis Avenue Indianapolis, IN 46216 -1037 Phone: 317.826.7100 Fax: 317.826.7200 TRANSMITTAL TO: Audrey Kostrzewa DATE: 2010.05.28 Carmel -Clay Board of Parks JOB 7628.001 1411 E 116 Street PROJECT: Inlow Park Carmel, IN 46032 RE: Pay Application #3 FROM: Michael Krosschell FAX FAX: NUMBER OF PAGES: DIRECT DIAL: 826.7189 TELEPHONE WE ARE SENDING YOU: Attached Via: Mail Fed Ex UPS Courier Pick Up Other Fax Copies Date Description 1 2010.05.28 Certified Copy of Pay Application #3 THE ABOVE ARE TRANSMITTED as checked below: For approval As requested FOR BIDS DUE For your use For review and comment Other REMARKS: Audrey: please call me if you have any questions. Thanks COPY TO: File If enclosures are not as noted, kindly notify us at once. U 111 111 1:1 7k1 762810011docs%transmitlalst2010 .05.28 kostrzewa inlow pay application #3.docx ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 F Purchase Order No. t 363990 Cadence MTC, LLC Date Due 2535 Reavest Dr. S. Indianapolis, IN 46203 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 5/26/10 003 5408.005 Inlow Park Repairs Improvements 23313 38,391.17 5126/10 003- 5408.005 Inlow Park Repairs Improvements 20535 44.18 Total 38 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 363990 Cadence MTC, LLC 2535 Reavest Dr. S. Indianapolis, IN 46203 In Sum of i 38,435.35 ON ACCOUNT OF APPROPRIATION FOR 103 PARKS CAPITAL FUND PO# or INVOICE NO. kCCT#1TITLI AMOUNT Board Members Dept 23313 F 003 5408.005 4460705 38,391.17 1 hereby certify that the attached invoice(s), or 20535 003 5408.005 4460705 44.18 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 3 -Jun 2010 Signature 38,435.35 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I