HomeMy WebLinkAbout187176 07/06/2010 CITY OF CARMEL, INDIANA VENDOR: 363791 Page 1 of 1
ONE CIVIC SQUARE DIVERSIFIED PAINTING CO INC CHECK AMOUNT: $141,939.00
CARMEL, INDIANA 46032 1681 EXPO LANE
`o INDIANAPOLIS IN 46214 CHECK NUMBER: 187176
CHECK DATE: 7/6/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460807 APP 6 141,939.00 PERFORMING ARTS CENTE
s -1 9.9
.i
A pplication and, for -ay m ent Const Ma nager- Adviser Edition 3
IAA
TO OWNER:
PROJECT: APPLICATION NO: 6: y Distribution to: z
Cm nYe1 fLedevelopme lit r Coanmissioai PARCEL 7A Regiaird Performing Arts Center
0116 Cis %ic Sc u e PERIOD TO OWNE=R F
i iish 0ackage P5 4/1 5110
I a Inteaaoa 1 S
Bid Pack' 160; Painting CONSTRUCTION MANAGEFZ Ll
Carmel, 'EN 46032
FLiONI CON inting Company VIA CONSTRUCTION MANAGER: CONTRACT DATE: Febuary 24, 2009
ARCHITECT F
168.1 Expo Lane; CSO;A rc h itects PROJECT NOS: l 2695 1 CONTRACTOR -I
Indianapolis; iN 46214 280 E 96th Street, Suite 100
:VIA ARCHITECT ',',Indianapolis, IN 46240' 1 1E1_U
CONTR FOWid Pack 5160;Paint:in9
.CONTRACTORI-S APPLICATION ;FOR PiAYMENT ig b
The undei'si lied Contractor l.haY to the best of the Contractor's lutowlecf��c, inforntalioa and
A >>licatiolt is ntatle far �a merit as shown I w i hellef tile 'Work. covered by this Application lair Piiymenl has hccn completed in accordance with Ilia.
I I 1 y be o, .n coliiu c txaii;witli' the Contract:
Continuation Sleet, AIA 10geinnertt G703; is attached, contract Docirinents that all amounts have bccil ptlid by the Contr;rclor fol Wurl< Iur «liicli previous
Ccitlflcates for�.Paymcnt, wevc issued and payments do eivecl from the Owner, and that current
1. ORIGINAL CONTRACT SUM paymcnlL,sh6wn licicin is no %t chic.
2. Ne 3. CONTRACT SUM TO BATE hers100,OO�OQ
t.change b Chan a Ord CONTR ,P co"
Y 9 ACTO he.
(Lined I r 2).. 2 94x;909 -98— i3 y:
i) TO DATE (Coluintti G'on t,703) State`(? NDIANA
4. TOTAL COMPLETED STORE
5 5 0 -7 35-U0
5. RETAINAGE: C punt} of Boone
a• (I ColnI)l ctcd Worlc SuhSCa rnd sworn to b03r&6 Th011iSS E• HI��
(Ck�2fiun,J) T on 6703 36 me this da} pC... 4!15!10 "r, Notary Pudic State of Indiana
Nolan 1'ublrc Boone County
b• °lo ctf Stored M !feria! y
-�8 /a Thomas E Hdl. �r� 2( 7
(Column 17 dn:G703) 1t9y Coniii isslvn ex
Expires I�o� 8
18,i�0.D8
'I'ota1 Retainage (Lilies 5a +51) cii Tow I iit Column .I of (j703):: CERTIFICATE:FOR.PAYMENT
55,073.50 :[n coidaiice vvilh the Con tracCDocumenls, l7aSCd on on -sill oliscrvations and the clntn cginpritiin
6. TOTAL EARNED LESS RETAINAGE 66 fie l is pliciiiion, the Cons(IUcLion Manager anti Architect cci til'y to Ile O%\ ncr that In Iho best of !heir
(Line 4 Less Line 5 Total) kllwviedge, ininrrimlion and holier the Work ho-as progrc:aed as iHdicaE.ccl, tic (ILIA iIV Of (hc VV01 k is in
7. LESS PR i p rior
IOUS CERTIFICATES R PAYMENT h accordance with ll e Contract l)ocunacn a
ts, nd t h n t
e Coil is entitled 1p I7avun o
icC f •1
the ANdOUN
333�1z -50 CI [Z7'1F113D: t)O
8. CURRENT PAYMENT DUE AMOUNT CERTIFIED
:14} 9.39 -eo
9. BALANCE TO FINISH, INCLUDING RETAINAGE: (Anach e,tplanution if amount <crti ie dr/ /er•c i the rimorria rrllplied. Irr::lial al! %i,�ru cti on iliis
Applieliiion, ond ori- /W. Conthii alioll sheel tl it li `challgr.e fu coofm ni inith (li(: allionnl cei libel!.)
Line 3 less Li 6 CONST UCTION AG
Line 1 54938 -5
I3 Date:
0
CI-IANGI3ORDLR SUMN Y ADD1;,C[QNS' DE10[JC'1'IONS ARCH
r
Tutat ch urges, rppipvetl n1 previous months by Ownci h 13y: Date. r i
Total ippaoved titrsiv3bnth 1'Itis Cerfihc2tc 15 negotiable. 'the AMOUNT CLIZ'i'lFIiD is payable only tv the Cc;ntractn�'
'I'O 'I 4. named` her m lssatancc Eiaylatcltt grid acceptance of payment <Irc widlow pi lice lei ally iit;ht.� of
NI <•T CI IANGL'S by Changa Order the Owiier of Contr ;tWtor under (his 1 7010 IC1.
1S t1'd'ii3V\l_
You a'rrr?ulcd ;iz r'i _t¢t nrrd�'srt.ti AiP Gvillvact Docr•nxlettz, art Which tfri t ._i al Ft aids so ?3. An ciai_11aa a6 .;?t as }it j: r Ct3rt 1 c,e it
4 AIA Document G7021CMal- 1992. Copyright 1992 by The American Institute 61 Archilerts.'All rights reserved. P!C.11ti +.t tL;: Ei, <<111 Qooi omvnt; ts
?r e•iagilU riZrJd reprra furl CSl Jii UI' ili`ill'i klni,t4711 !lt i11E5 /;tf1 y 11o ::rirn ^_i'ii., pl' i:iny t33 r1.1411 Oi It; ma'!; ,fSS II? in �,eV ei'�� CI'lii Hilt.t'A if371rf rl tarRi'F2t {7e7., "t lfl irolil ';a
Purchasers are permilled to reproduce ten (10) copkes of this dooumcmt when completed: To report copyright violations of AIA Contract uacuments, e -mail The American Institute of Ai chite(;Is' legal counsel, copyrlgiv rr lia org.
TM
All Docum 70 A2 199,
page 1
Continuation Sheet
AIA Docomew 6702 APPL.ICA ION AND CERTIPICATIONJ OIt1?AYMT N'[', APPLICATION 0.
containing Conlaac[ot 5 st;ltcd callficaLion 1s atl<tchetl. APPLICATION DATE: 6
In l: +halation~ helc w uno(tnLs Luc stated tai (ITC nearest dollar. 40283
Use Column I ononti'acts where variable ielams +ge for line hems m`ty ap}11y. PER {ODTO: r
4/15/2010
ARCHITECT'S PROJECT NO:
A_ [I C D
WORKCnliV_t.I_LELIED Mn1IIt[AI_s 'YO AL
WVLA NCI.i
SCFILDULI.I) s' R[ SLN "fLY COMPLETFI) RI tAINA(
FEZOM 1121 VIOUS ['O (11' ARIAIII,E
f'Il3Nl DI�SCRlP I'{ON OF WORK S LOR]3D AND S "I'ORI�D
NO VALUE APPLICA110N l'EIfS PERIOD (C C) HN1S11
D
(NOT IN TO DA "I'E (t_ G) IZA'I N.)
D Olt 1-3) (D i;u -I')
I Bonds 7S,500.00:. 73,500.00 73,500.00 100% 0.00 7,350.00
2 MoblilizaliaT 5;000.00 2,750.00 2,250:00 5,000A0 100% 0.00 500.00
3 /Hazconi /Safety 4,000.00 4,000,00 4,000.00 1 -00% 0.00 400.00
4 Sulimit.fals 4,800.00 4,800.00 4,800.00 100% 0.00 480,00
5 09-72-00; WALLCOVLRING
LaUOr .18,750.00 0.00 0 18,750.00 0.00
Mateztal 37,000.00 0`00 0 37,000.00 0.00
6 09, -84 00 ACOOSTICAL
WAI L PANELS
I,aUor, 51,500.00 4:00 4% 51,500.00 0.00
Material 580 5,800.00 181500.00 187,300.00 32%, 392,700.00 18,730.00
7 09- 91 -00; PAIN'T'ING
BASE MECI-T Labor 36,680.00 34,150.00 1,530.00 35,680.00 97% 1,000.00 3,568.00
13ASE MECI -I Material 9,000,00 i :8,925:00 0.00 8,925.00 99% 75.00 89250
13ASE ELECT LABOR I0,680.00.,: 8,000.00 2,080.00 10,080:00 100% 0.00 1,008.00
BASIS ELECT' MAZER 2,500.00 1 1,000.00 2,500.00 100% 0.00 250.00
SI
INT CON BASE LA13: 10,880,00 2,200.00 1,100.00 3,300.00 30% 7,580.00 330.00
IN r CONSTI BASE MAT 2,500.00 560.00 250.00 750.00 30% 1,750.00 75.00
PLEM LABOR 8,480 00 5,000:00 5,000.00 59% 3,480.00 500.00
PLEIvI MATE RAIL 2,500 00 1,250.00 1,250.00 50%., 1,250.00 125.00
CON HALL N WALL LABOR 69,120 00 0-00 0% 69,120 00 0.00
CON HALL N.WALL'MATLRIAL 12,500.00:1: 0.00 0 %i 12,500.00 0.00
CON HALL N DOME.LABOR 45,920 00 5,000.00 25,000.00 30,000 00 65% 15,920.00 3,000.00
CON HALL IV DOMI MATERIAL 15,000,00;. ,1,800.00 9,000.00 19 800 00 72% 4,200.00 1,080.04
CON HALL BALY WALL LAB 122i240.00 4,004.00 4 3% 118,240.00 400,.00
CON, HA1 LIBALY WALL MA'r 24,000 00 2,004.00 2,000.00 8% 22,000.00 200.00
SUBTOTAL PAGE 1 1,145,950 152,925.00 54,460.00
181,500-00; 388,685.00 11.47 757,065.00 38,888.50
('f1U1l0N- You shot.11d siyli art: original AM Coil tract,t7ocrl ct1 uulilclt this t6xi: TaPpears in REF). An orl!jillal assures that chaar luo "nfill I na
AIA Document G703TM 1992. Capyright 1963,1965.161313,'1967,100, 197b 198)3 and:1992 by The American Institute of Architects. All rights reserved. WAGt;•li dt= 'E "i,i .,?n' i" rtr..ta n r:. +.c:, r ;h6;
I_aw and. International Treaties. Onauthor'i<ed reprarluclioii or disrrihuliori ai iaais niA�:Docurner:, nr any poriion of it, may result in severe civil :and ci irninai henalii: c, as c. iii es :w to x' r,
vwi dale 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' fegai
counsel, copyright@aia.org.
;71 TIM ez�,
i auzr�`�
oc i 19
Continuation Sheet
pa 2
AIA Document GM2 APPI ICASION AND CER I`iriCATIONFOR PA) nIEN'r, APPLICATION :NO`.
containing ConLt�ctor s sagncd;'c�ttlfication is.altached. APPLI,CATIONDATE:
In kabul a ions helo uutS Wre AULc(I to the nearestdol]21. 6
Use Coll LIMIt I tin COit tfacts where variable rcfaainage for line ItemS, nn ay apply. PERIOD TO:
Et ARCHITECT'S PROJECT NO: 40283
4/15/2010
t3 C IJ L f' G FI I
WOIZKCO MAILIZIALS TOTAL
IiAI.ANCF
PRLSEN'11:Y
SCIILDUI 11`131, I lZONI PRE COMPLLt IiD VIOUS TO O k1�1 AINA(;!'z,
CL'LM D>✓SCRIPT[ON OF WORK STORED AND b70R1',D (I1 VARIAIILG
VALUI APPLICATION TI IIS Pl3RIOD (C. C) FINISH
N0. (NOT IN f0 DA 1 Is RATF)
D OR. L)- (D +E +F) G)
CON HALL DOME LABOR 1,00,260.00 15,500.00 54,000.00 69,500.00 69% 30,760.00 6,950.00
CON HALL DOME MATERAL 35,000.00 6,000.00 18,000.00 24,000.00 69% 11,000.00 2,400.00
CON HALL S WALL I ABORT; 45,120.00> 0 00 0% 45,120.00 000
CON I IALL S WALL, MAT,CRIAL 9,500.00 0 00 0% 9,500.00 0.00
CON I4ALL,S I)OML LABOR 45,920.00, 10,000.00 22,000.00 32,0001)(1 70% 13,920.40 3,200.00
CON IIALL:S MOME,MATERIAL 15,000.00:.., 2,000.00 8,500.00 10 500.00 70% 4,500.00 1,050.00
N JJER M30R 28,000,0d-,. 0.00 0% 28,000.00 0.00
&-TIRR MATERIAL 6,500.00 0.00 0% 6,500.00 0.00
N OItCH LABOR 28,000.00 0.00 0% 28,000.00 0.00
N ORCII 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 MATERIAL 6,500.00 0.00 0% 6,500.00 0.00
W LOBB COIL LABOR 28,000.00 0.00 0% 28,000.00 0.00
W LOBB CLILMTI RAIL 6,500.00 0.00 0% 6,500.00 0.00
E LOBBY LABOR' 28,000:00 0.00 0% 28,000.00 000
E LOBBY MATERIAL 7,000.00 0.00 0 7,000.00 0.00
L LOB13Y CC IL 38,800.00_ 0.00 0% 38,800.00 0 -00
E L013BY MA`I'I✓IRIAL 9,300.00 0.00 0% 9,300.00 0,0()
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.ORCI-I LOB,STR WAIT LAB 48,000.00 3,500.00 0.00 3,500.00. 7% 44,500.00 350.00
SW ORCII L OB S7R WAI, VAT 8,700.00 750.00 0.00 X50 DO. 9% 7,95D.00 75,0(1
SE ORCH LOB SIk W'AL LAB 48,006M a" 3,500.00 0.00 3 500.00 7% 44,500.00 350.00
SE ORCII,lidB STR'WAL MAT 8,700.00 750:00 0.00 i 750.00 9% 7,950.00 75.00
SLJ13 TOTAL I'AGl 2 642,11 01 �3D�7� 3- 09 7,60I1�0
s3AU 1 You _,l'auulel.�igor.`an orlg €n pltp Got11ract r n wNch this tc 'tL a
t '�lae3rs in LILW10. All urt�•n:a! �asstarGs i4aet clt. aa.:te. ar�ilP itrat P?
AIA Document G703 1992. Copyright 1963, 1985, 1966;..1.967, -1970 i978, 1983'wid 1992 by The American Institute of Architects. All rights reserved. VfAilwllrA� i r i,
z +nr t ru] Internation %a! Treaties. Unauihorizecf rehrarh?k tine nr cr€strihution uI this,Al/♦ tJoc €rau�nt; ur any po {'kicn of it, may rescrkl rn sr. ue! a civil aucl t.ri� rain �i i' .u: k1s: xi!l
;iossibie a.rr der Ili( law. Purchasers are permitted to reproduce ten (i D) copies,ok this document when completed. To report copyright violations of AIA Contract DOCUments, e mail The American Insfilule of Arch4ecls' legal
counsel copyright@aia,o.rg.
1�q4
1 A-1A Document-:G703T" 1992
Continuation' -Sheet page 3
Aln D6ctnrlcnl G702 APPJ IQATI AND C'rRTlF),CATIOtVTOR PAYMENT, APPLICIaTION N0.
containing Contraclot 5 signed ectliftcaLion is attached. APPLICATION DATE:
In tabulations below Imuw is ate staled to t to dearest dollar' 40283
Use C olunatt I ota onlracCS'Miele variable helainagc•for line ttaus nt ty ahj�ly. PERIOD TO:
ARCHITECTS PROJECT NO:
4/15/2010
A B C D G I
WORK CO MPLET1.1)
MATERIALS K_IALS IOFAI
I,nl.n�cr.
SCIILDULLD PRESENTLY NTI Y COMPI I LED 121;1 A1 NA( i
FROM E REMOUS 1O
1'1'LM I)I7SCRIP'i'IONOFWORIC SIORIsb ANIISTORSD (IF VARIAl31�1
NO. IALUf.? APL'ACKI]ON 1'111.5'E'RRIOD (G -C) i[NISt!
(l� 4- G) (N0T IN I'O.DA7'L'^ RA'I'L',)
'D OR E) (DA
BAL L/H LABOR 28,000.00 0.00 0% 28,000.00 0.00
B11L L /II MATERAIL` 6,800.00. 0.00 0%
G, 800.00 0.00
IN'I' CON ATTIC LABOR :::17,004.60 0.00 :!0 17,000.00 0.00
INT CON A' ic MIITERTAL; 3,500.00 0.00 0 3,500.00 0.00
8 09- 97 -23; S'T'AINS, SEALERS
BASEMENT' Laboa 7,700.00 5,500:00 0.00 5,500 00::" 71% 2,200.00 550.00
BASEMENT'Mat6 al 5,800.00 5,500:00 0.00 5,500:00 95% 300.00 550.00
BASE MLCH RM,LABOR 2,500.00 1,250.00 0.00 1;250.40 50% 1,250,00 125.00
BASE.MLCH RM:MATGR 1,500.00. 750.00 0.40 750.00 50% 750.00 75.00
PLI M LABOR 2,500.00 1 0.00 1,250.00 50% 1,250.00 125.00
PLEM MATERAIL 1,504.00' 750.00 0.00 750.00 50% 750.00 75.00
CON HALL BALCONY LAP 4,504.00 0.00 0% 4,500.00 0.00
CON HALL BALCONY MAT 1 0.00 0% 1,500.00 0.00
ORCH LOB, STR LA13' 7,500.00 0.00 0% 7,500.00 0.00
ORCH LOB, STR MAT 3,000.00. 0.00 0 3,000.00 0.00
9 DAILY CLEAN UP 15 500.00 0.00 500.00 3% 14,500.00 50.00
10 GENERAL ALLOWANCE 140;000:00 0.00 0% 100,000.00 0.00
1 -I SUPPLIES ALLOWANCE 15,000.00 0.00 0% 15,000.00 0.00
12 LABOR ALLOWANCE 75,000.00 0.00 0% 75,000.00 0.00
1:3 CAD ALLOWANCE 5,000.00 0.00 0% 5,000.00 0.00
14 PROGRESS MEETINGS l'' 5,200.00 1 750.00 1,850.00 3G% 3,350.00 185.00
1.5 CLOSL OUTS' 3,450.04 0 00 D% 3,450.00 0.00
CO 1 DED AI LOW.ANCIs -55,000.00
CO 7_ 0.00
3113T07r1L PAGE, 256950 .16,600.00 750.00 0.40 17.,,350,00 4.05 7.94,600.00 1,735.00
SUB 10LALi'PAGL' 1 1 00 152,925.00 54,460.00 181,500.00 388,885.00 11.47 757,065.00 38,888.50
U.D_LOl`AL'.PAGE 2 642 1000 92,000.00 102,500.00 0 144,500.00 3.09 497,600.00 14,450.00
CAUTION: I': N: Y��_1��I� C�� ��<iii ctriciitlal f11f1 0tarlt2to��?QQ� �A nt, can wai�lri r,I�e�aa Iota or,ic;L�t Q�1e_t tit: l c t{r+I k �8 G2 �f ,5192
Al Document G 70 'M 1992. Copyright 1963, 1965, 1966; 1967 1970, 1976,1983 and 1992 by The American InstiIuIe'of Architects. All rights reserved. W Al",,1ti11`1U, AIA D :rs:+
t_acnr atui !n`rrnaiinnal 'I reaties- I_fnauthorized repo adurlian.or distrilwtion of tads !1111 Dacuaa i�'i., or any portion of it, may result in severe civil and criminal I Ia, oui vifli
pos ibie under the 1a W. 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, copyrfght@)aia.org.
D. P. Co. Inc.
AFFIDAVIT AND WAIVER OF LIEN
Payment 4
STATE: INDIANA FINAL XX PARTIAL PAYMENT TO FOLLOW
COUNTY OF: MARION
_kevin M. Blume_ Being duly sworn that he is the Secretary of Diversified Painting Co. Inc_ being in
contract with Carmel Redevelopment Commission to furnish certain materials
and /or labor as follows: Painting Wallcovering for a project known as:
Parcel 7A; Regional Performing Arts Center located in: Carmel, IN
and owned by _City of Carmel Redevelopment Commission and does hereby further state
on behalf of the aforementioned subcontractor supplier:
(PARTIAL WAIVER) That there is due from the contractor the sum of:
THIRTY -FIVE THOUSAND ONE HUNDRED AND 00 10 0----------------------------- DOLLARS: 35,100.00
XXXX receipt of which is hereby acknowledged or
the payment of which has been promised as the sole consideration of the affidavit
and Partial Waiver of Lien which is given solely with respect to said amount and
which waiver shall be effective only upon receipt of payment thereof by the
undersigned.
(FINAL WAIVER) That there is due from the contractor the sum of
receipt of which is hereby acknowledged or DOLLARS:
the payment of which has been promised as the sole consideration of the affidavit
and Final Waiver of Lien which is shall become effective upon receipt of such
payment.
THEREFO the undersigned waives and releases unto the Owner of said premises, any and
all lien or claim whatsoever on the above described property and improvements thereon on
account of labor or material or both, furnished by the undersigned thereto, subject to limitations or
conditions expressed herein, in any, and further certified that no other party has any claim or right
to lien on account of any work performed or material furnished to undersigned for said project
and within the scope of this affidavit and wavier.
_Diversified Painting Co. Inc._ 13..E President
K n M. Blume
WITNESS MY HAND AND NOTA AL SEAL THIS: 04/15/10
MY COMMISSION EXPIRES: 11 -08 -2017
COUNTY OF RESIDENCE: Boone NOTARY
homas E. Hill
u
Thomas E. Hill
Notary Public State of Indiana
Boone County
Expires Nov 8, 2017
D. F. CO., INC.
DIVERSIFIED PAINTING CO., INC.
1681 Expo Lane, Indianapolis, IN 46214 (317) 209 -9899 fax (317)209 -9886
i
April 22, 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.
Furthermore, pursuant to the Indiana Public Access Counselor, this information is not
disclosable under the Indiana Open Records Act.
r
If you have any questions on this matter, please contact me. r.
F
Very truly yours,
F
E
ti
Y
f
t.
evin Blume
President
a
e
k
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
r°�5 f "41, ��7 Purchase Order No.
L 0i 7 Terms
1 �,r�irfhw�o�f 5 /�Il Date Due
Invoice Invoice Description Amount
Date Number 1 (or note attached invoices) or bill(s))
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
IN SUM OF
lql 9 9'06
ON ACCOUNT OF APPROPRIATION FOR
Pay from TIF d
Board Members
PO# or DEPT INVOICE NO. ACCT #/TITLE AMOUNT 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
-7 20/o
Signature
Director of Redevelopment
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund