186661 06/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364099 Page 1 of 1
ONE CIVIC SQUARE CHANCE BROS MARBLE TILE INC
CARMEL, INDIANA 46032 114 W MCCARTV ST CHECK AMOUNT: $70,740.00
INDIANAPOLIS IN 46225
CHECK NUMBER: 186661
CHECK DATE: 6/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460807 APP 2 70,740.00 PERFORMING ARTS CENTE
J TM
Document G702 /CMa -1992
Application and Certificate for Payment Construction Manager- Adviser Edition
TO OWNER: PROJECT: APPLICATION NO: Distribution to:
CITY OF CARMEL `REDEVELOPMENT COMMISSION
PERIOD TO: OWNER D
1 CIVIC SQUARE TWO
CARMEL, IN 46032 CARMEL PERFORMING ARTS 04/15/10 CONSTRUCTION MANAGER I-]
FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: CERAMIC TILE ARCHITECT
Chance Bros. Marble Tile, Inc. PROJECT NOS: 1 1 CONTRACTOR
114 W. McCarty St., VIA ARCHITECT CSO ARCHETECTS FIELD
CONTRACT 00anapolis, IN 46225
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 G743, is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous
221495.00 Certificates for Payment wee issue nd payments Tlie, Inc. 4/12/2010
ayments received from the Owner, and that current
1.ORIGINAL CONTRACT SUM t. payment ho e re 11 is no ue.
17500.00 Ls. a rble
2. Net change by Change Orders CONTRACT Ch e
203995.00
3. CONTRACT SUM TO DATE (Line, l 2} By: Date:
4. TOTAL COMPLETED STORED TO DATE Column G on G703 87800.00 State o m
5. RETAINAGE County of:
an n
a. 10 of Completed Work 8780.00 Subscribed and sworn to befor y
(Column D E qn G703} me this 12 ay of APRIL 2010
b. of Stored Material 0.00 c
Notary Publi-,�r%
oIumul F on G703) My Commission expires:,
Total Retainage (Lines 5a 5b or Total in Column I of G703): 8780.00 -CERTIFICATE FOR PAY E T
79020.00 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' 8280.00 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT
(Line 6 from prior Certificate) CERTIFIED. _10.0
�j tx
8. CURRENT PAYMENT DUE I s 70740.00 1 AMOUNT CERTIFIED
8. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs f to he amount applied. Initial all figures on this
124975.00 PP g f certified.)
A lication and t e Continuatio heel th ar than ed to conform with. the amount
(Line 3 less Line 6) CONS UCTI
By: Date:
Co
ADDITIONS DEDUCTIONS
CHANGE ORDER SUMMARY ARCHITECT:
Total changes approved in''previous months by Owner 0.00 17500.00 By: y ^Y1� Date: 2—q
Total approved Ihis`Month 0.00 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS 0,00 17500.00 named herein. lssuance; `payment and acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order 17500.00 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.
r AIA Document G7021CMaTM 1992. Copyright pc 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 (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 G702 /CMa -1992 Instructions
i
Application and Certificate for Payment Construction Manager Adviser Edition
A. General information
AIA Document G7021CMa, Application and Certificate for Payment, Construction Manager Adviser Edition, is to be used in conjunction with AIA Document G703,
Continuation Sheet. These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner, but not as a
constructor, and where multiple Contractors have direct Agreements with the Owner. Procedures for their use are covered in AIA Document A201ICMa, General
Conditions of the Contract for Construction, Construction Manager Adviser Edition, 1992 Edition.
B. Reproductions
This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to
reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document.
The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G7021CMa, but only for use in connection with a particular
project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission
from the AIA.
Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA).
To report copyright violations of AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright@aia.org.
C. Completing the G7021CMa Form
After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AIA Document G702ICMa, Application and
Certificate for Payment, Construction Manager- Adviser Edition.
The Contractor should sign G7021CMa, have it notarized and submit it, together with G703, to the Construction Manager and Architect.
The Construction Manager and Architect should review G702 /CMa and G703 and, if they are acceptable, complete the Certificate for Payment on G702lCMa. The
Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201 /CMa. They should then initial all figures
on G7021CMa and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G7021CMa and G703 should be forwarded
to the Owner.
D. Completing the G703 Form
Heading: This information should be completed to be consistent with similar information on AIA Document G7021CMa, Application and Certificate for Payment,
Construction Manager- Adviser Edition.
Columns A, B C: These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of
values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors
and should remain consistent throughout the Project. Multiple pages should be used when required.
Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum.
The total of column C maybe adjusted by Change Orders during the Project.
Column D: Enter in this column the amount of completed work covered by the previous application (columns D E from the previous application). Values from column F
(Materials Presently. Stored) from the previous application should not be entered in this column.
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.
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 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 on the G702 /CMa 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 in dispute should be dealt with according to Section 7.3 in A2011CMa.
E. Making Payment
The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702 /CMa,
Application and Certificate for Payment, Construction Manager- Adviser Edition. The completed form contains the name and address of the.Cdnti ctor. Payment should
not be made to any other party unless specifically indicated on G702ICMa.
i
AIA Document G7021CMaTM 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 porfion 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[?a aia.org,
TIM
:4AIA Document G703 -1992
Continuation Sheet
AIA Document G702T"', Application 'and Certification for Payment, APPLICATION NO:
containing Contractors signed, certification is attached. CARMEL PERFORMING ARTS TWO
APPLICATION DATE:
In tabulations below; amounts are stated to the nearest dollar. 4/12/2010
Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO:
ARCHITECT'S PROJECT N0: a /15/2o1a
A B C D E j F G H I
WORK COMPLETED TOTAL
MATERIALS BALANCE
SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED TO RETAINAGE
ITEM DESCRIPTION OF WORK AND STORED
VALUE APPLICATION THIS PERIOD STORED (C +C) FINISH (Ir variable rate)
NO. (D E) (Not in D or E) TTO DATE (C G)
CERAMIC TILE
MOBILIZATION 500.00 500.00 0.00 0.00 500.00 100% 0.00 50.00
BOND 1ii,800.00 1,800.00 0.00 0.00 1,800.00 100 0.00 180.00
ALLOWANCE 2 7 20,000.00 10,000.00 0.00 0.00 10,000.00 50% 10,000.00 1,000.00
ALLOWANCE fi 5,000.00 5,000.00 0.00 0.00 5,000.00 100% 0.00 500.00
C.O. 1 (2,500.00) 0.00 0.00 0.00 0 00 0% (2,500.00) 0.00
C.O. 2 (15,000.00) (15,000.00) 0.00 0.00 ;.(15,000.00) loo °i° 0.00 (1,500.00)
C O 3 0.00 0.00 0.00 0.00, 0.00 #DIV /O! 0.00 0.00
BASEMENT R.R.S.:
LABOR 3,800.00 1,000.00 2,800.00 0.00 3,800.00 100% 0.00 380.00
MATERIAL 5,900.00 5,900.00 0.00 0.00 5,900.00 100% 0.00 590.00
PLENUM FIRS
LABOR 30,400.00 0.00 15,200.00 0.00 15,200.00 50% 15,200.00 1,520.00
MATERIAL 45,600.00 0.00 45,600.00 0.00 45,600.00 100% 0.00 4,560.00
NORTH BOX TIER
LABOR 17,600.00 0.00 0.00 0.00 0.00 0 17,600.00 0.00
MATERIAL 26,400.00 0.00 0.00 0.00 0.00' D% 26,400.00 0.00
GRAND TOTAL
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.
L 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
>A4 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.
a
TM
Document G703 -1992 Instructions
Continuation Sheet
GENERAL INFORMATION
Purpose and Related Documents. AIA Document G702TM, Application and Certificate for Payment, is to be used in conjunction with AIA
Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the
Owner. Procedures for their use are covered in AIA Document A201TM, General Conditions of the Contract for Construction.
Use of Current Documents. Prior to using any AIA Contract Document, users should consult www,aia.org or a local AIA component to verify
the most recent edition.
Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the
AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further
rights to reproduce this document, The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed
Ci703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction
granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users
of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA
Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright cr aia.org.
COMPLETING G703 1992
Heading. This information should be completed in a manner consistent with similar information on AIA Document G702, Application and
Certificate for Payment.
Columns A, B C. These columns should be completed by identifying the various portions of the Project and their scheduled values consistent
with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by
sections of the Work or by Subcontractors and should remain consistent throughout the Project, Multiple pages should be used when required.
Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the
original Contract Sum. The total of column C may be adjusted by Change Orders during the Project.
Column D. Enter in this column the amount of completed Work covered by the previous application (columns D E from the previous
application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column.
Column E. Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that
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.
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 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 on 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 in dispute should be dealt with according to Section 7.3 in A201.
The following is an example ofa Continuation Sheel for work in progress. Please note that dollar anrounts drown below arefor illustralive proposes only, and are
not intended to reflect actual consiruclron costs.
A B C D E F G H
WORK CC MPL'TFD "rO'PAL
MATIiRIAI,S BALANCE
I'NGM SCHF,DULED FROM PREVIOUS PRF,SENTLY COMPLi =TL'D '1'O RETAMAGI'
N DIiSCKEP'I'16N OF WORK VALpF APPLICATION THIS PERIOD STORED AND tiTORED (G +C) FINISH pJ vnrin5re role}
(Dr F,J r.YUi.,D,�FJ TO DATE; rC- G)
(D +5 +1'1
1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0
2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0
3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0
4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000
5 CUP D5 G MI5C. CONC. 5,000 0 0 0 0 0 5,000
6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000
7 PAVING, LOWER DRIVE 20000 0 0 0 0 0 20,000
B PAVERS 20,000 0 0 10000 10,000 50 10,000
9 BRICK WORK 5,000 0 0 0 0 0 5,000
L
11 GRAND'I'UTAL 105,000 20,000 10 000 10,000 1 40,000 65,000
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 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.
A TM A AIA Document G 199
Continuation Sheet
AIA Document G702' Application'` and Certification for Payment, APPLICATION NO':
containing Contractor's signed certification is attached. CARMEL PERFORMING ARTS PG 2
APPLICATION DATE:
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:
ARCHITECT'S PROJECT NO:
A B C D E F G H
WORK COMPLETED TOTAL
MATERIALS BALANCE
SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED
TO RETAINAGE
ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G Q FINISH (if variable rate)
NO. TO DATE
(D E) (Not n D or E) (D E F) (C G)
NORTH ORCHESTRA LOW
LABOR 10,000.00 0.00 0.00 0.00 0.00 0% 10,000.00 0.00
MATERIAL 15,000.00 0.00 15,000.00 0.00 15,000.00 100% 0.00 1,500.00
BALCONY HIGH
LABOR 16,000.00 0.00 0.00 0.00 0.00, 0% 16,000.00 0.00
MATERIAL 23,495.00 0.00 0.00 0.00 0.00 0% 23,495.00 0.00
TOTAL GRAND TOTAL 203,995.00 9,200.00 78,600.00 0.00 87,800.00 43% 116,195.00 8 780.00
CAUTION: You sho sign a original AIA Co n t ract 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
r( 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 G703" -1992 Instructions
Continuation Sheet
GENERAL INFORMATION
Purpose and Related Documents. AIA Document G702T 1 1 1 Application and Certificate for Payment, is to be used in conjunction with AIA
Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the
Owner. Procedures for their use are covered in AIA Document A201T General Conditions of the Contract for Construction.
Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify
the most recent edition.
Reproductions. This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the
AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further
rights to reproduce this document. The AiA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed
G703, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction
granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users
of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AiA
Contract Documents. e -mail The American Institute of Architects' legal counsel, copyright@aia.org.
aia.org.
COMPLETING G703 -1992
Heading. This information should be completed in a manner consistent with similar information on AIA Document G702, Application and
Certificate for Payment.
Columns A, B C. These columns should be completed by identifying the various portions of the Project and their scheduled values consistent
with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by
sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required.
Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. initially, this total should equal the
original Contract Sum. The total of column C may be adjusted by Change Orders during the Project.
Column D. Enter in this column the amount of completed Work covered by the previous application (columns D E from the previous
application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column.
Column E. Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that
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 1. 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.
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 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 on 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 in dispute should be dealt with according to Section 7.3 in A201.
The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are
not intended to reflect actual Construction Costs.
A R C D C F G 11 I
WORK C 'TOTAL
MATERIALS BALANCE
COMPLETED
ITEM SCHI:DULF.0 FROM P PRIiSI:N Kt h AGE
NO DESCRIPTION OP WORK VALUE APPLICATION THIS PERIOD STORIiU AND STORED (G +C.') FINISH SH /I(coriu rare/
(D 5) (Na 01) E) TO DATF.
(0,E *F) (C G)
1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0
2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0
3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0
4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000
5 CURBS 6 MI5C. CONC. 5,000 0 0 0 0 0 5,000
b PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000
7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000
8 PAVERS 20,000 0 0 10,000 10.000 50 10,000
9 BRICK WORK 5,000 0 0 0 0 0 5,000
10
10
11 GRANDTOTAL 105,000 20,000 10,000 000 40,000 65,000
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 AIO Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Ale 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.
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.
Payee
C 1 t3 r ��1 Purchase Order No.
ll y Gf/ AI 6, 5� Terms
/ti -�G225 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 7G 7y�,GC
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.
1
ALLOWED 20
A-Z IN SUM OF
�o Zit otl)
ON ACCOUNT OF APPROPRIATION FOR
Pay from TIF R�0
Board Members
PO# or INVOICE NO. ACCT #/TITLE I here ereb certi that the attached invoice, or
DEPT. T Y 'Y invoice s),
yy6a�7 7U7y�,Uv 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
S- 7 20/Q
Signature
Director of Redevelopment
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund