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189645 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 363789 Page 1 of 1 ONE CIVIC SQUARE CIRCLE B COMPANY, INC CHECK AMOUNT: $141,991.88 CARMEL, INDIANA 46032 5636 S MERIDIAN ST FON INDIANAPOLIS IN 46217 CHECK NUMBER: 189645 CHECK DATE: 911412010 DEPARTMEN A CCOUNT PO NUMBER INV OICE NUMB AMO DESCRIPTION 902 4460807 APP 1 17,244.00 PAC JUNE 902 4460807 APP 21 124,747.88 PAC APRIL TM AI A Document G702CCMa -1992 ,application and Certificate for Payment Construction Manager- Adviser Edition TO OWNER: PROJECT: APPLICATION NO 1 Distribution to: CARMEL REDEVELOPMENT "COMMISSION CARMEL PERFORMING ARTS CENTER pERI0DT0. 6/15/2010 OWNER ONE CIVIC.SQUARE CARMEL, ;IN 46032 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT El CIRCLE B CONSTRUCTION SYSTEMS SHIEL SEXTON COMPANY PROJECT NOS: 1 L CONTRACTOR 5636 S. MERIDIAN ST: INDIANAPOLIS, IN 46217 VIA ARCHITECT: #2695 -3090 FIELD CO NTRA C T F OR; CSO ARCHITECTS PLASTER" 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 Contract Documents, h t all amounts have been paid by the Contractor for Work for which previous Continuation Sheet, AIA Document G703, is attached. Certificates Pa t were issued and payments received from the Owner, and that current 1. ORIGINAL CONTRACT SUM 137,860.00 Payment ow is now due. 2. Net change by Change Orders CONT CT�(1 RCLE B CONSTRUCTION SYSTEMS 3. CONTRACT SUM TO DATE (Line 1 2) 137,86 B nttmunty Date: 6/18/2010 4. TOTAL COMPLETED 8 STORED TO DATE (Column G on 6703) 19,160.0 State of: IANA /p�',, 5. RETAINAGE County f: P ION r P Subsc ibed an swo�n.t efor r s CATHY GINDER a. °lo of Coin leted Work s NOTARY PUBLIC STATE OF INDIANA (Column D E on G703) 1 me this b. of Stored Material Notary OHNSON COUNTY y Pub c MY pOMM3SSION EXP. F03.1,2017 (Column F on G703) My Commis n exp res: t Total Retaina e Lines 5a 5b or Total in Column I of G703 CERTIFICATE FOR g 1,916.00 �Q►" In accordance with the Contract Doc n on -site observations and the data comprising 6. TOTAL EARNED LESS RETAINAGE 1 7 244 o 0 this application, the Construction Manager an Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge, information and belief the Work progressed as indicated, the quality of the Work is in 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 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 17,244. 00 AMOUNT CERTIFIED t 2. q Iw (Attach explanation if amount certified differs fro the aniqunt,applied. Initial all figures on this 9. BALANCE TO FINISH, INCLUDING RETAINAGE Application and on Continuation She e hat re' cha ged to conform with the amount certified.) (Line 3 less Line 6) 120,616.00 CONS 7rC By: Date: Q CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT Total changes approved th previous months by Owner B Date: 0� J I Total approved this Month This C t negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS named nce,'payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order the Owractor under this Contract. a CAUTI ON: 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 AIO 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 Document G702/CMa -1992 Instructions Application and Certificate for Payment Construction Manager- Adviser Edition A. General Information AIA Document G702 /CMa, 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 A201 /CMa, 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 G702 /CMa, 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 G702 /CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The Contractor should sign G702/CMa, 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 G702 /CMa. 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 G702 /CMa and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 /CMa and G703 should be forwarded to the Owner. 0. Completing the G703 Form Heading: This information should be completed to be consistent with similar information on AIA Document G702 /CMa, 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 paym 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 colurri (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is 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 forni.•s 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 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 Contractor. Payment should not be made to any other party unless specifically indicated on G702 /CMa. 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 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. 1 TM AIA Document 0703 ®1992 Continuation Sheet AIA Document 6702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached. APPLICATION DATE: 1 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 06/18/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 06/18/2010 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED TO RETAINAGE NO FROM PREVIOUS STORED AND STORED (IF VARIABLE VALUE APPLICATION THIS PERIOD (G C) FINISH (NOT IN TO DATE (C G) RATE) (D E) D OR E) (D +E +F) 100 MATERIAL 15,160.00 7,580.00 7,580.00 50.00 7,580.00 758.00 101 CARPENTER LABOR 57,900.00 11,580.00 11,580.00 20.00 46,320.00 1,158.00 102 PLASTERER LABOR 64,800.00 64,800.00 CAUTION: You should sign an original AIA Contract Doc ument, 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 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. =4 1A Document G703% 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, 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 A201, General Conditions of the Contract for Construction. Use olZurrent 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, copyrightgaia.org. COMPLETING THE G703 FORM 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 shou .be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule ofvalues submitted to the Architect at the 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 at1he 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 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 Gt Enter here the'total of columns 0, 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 the 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 the own G703 form or at the end of the basic schedule. The amount of the original contract adjusted Change Orders is to 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. The following is,an example of a Continuation 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 F G H 1 WORK COMPLETED MATERIALS 'I OPAL BALANCE ITEM SCHEDULED FROM PRESENTLY COMNLE "FED TO RETAINACE DESCRIPTION OF WORK V ALUE PREVIOUS STORED AND SCORED (G C) FINISH VARIABLE APPLICATION THIS PERIOD (NOT IN TO DATE RATE) (D +E) DORE) (D +E +1:) (C -G} I MOBILIZATION 5.000 5.000 0 0 5.000 100 0 2 STUMP REMOVAL 5.000 5.000 0 0 5.000 100 0 5 EARTH WORK 15.000 10.000 5.000 0 15.000 100 O a LOWER RETAINING WALL, 10.000 0 5.000 0 5.000 50 5.000 5 CUR55 d MI5G. GONG. 5.000 0 0 0 0 0 5.000 6 PAVING: UPPER DRIVE 20.000 0 0 0 0 O 20 -000 7 PAVING LOADER DRIVE 20.000 O 0 0 0 0 20,000 a PAVERS 20.000 0 0 10,000 10.000 50 10.000 6RICK WORK 5.000 0 O O 0 O 5.000 10 AIA Document G703TM -1992. Copyright ©1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 h The American Institute of Architects. All rights reserved. WARNING: Y 9 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, copyrighi(�aia.orig. �1a� Document G702 /CMaTM -1992 Application and Certificate for Payment Construction Manager Adviser Edition TO OWNER: PROJECT: APPLICATION N0: 21 Distribution to: CARMEL REDEVELOPMENT' COMMISSION CARMEL PERFORMING ARTS CENTER CENTER PERIOD TO ,.Q 15./ 2010 OWNER ONE CIVIC CARMEL,:; IN 46032 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 4/22/08 ARCHITECT El CIRCLE B CONSTRUCTION SYSTEMS SHIEL SEXTON COMPANY PROJECT NOS: I 1 CONTRACTOR 5636 S. MERIDIAN ST. INDIANAPOLIS, IN 46217 VIA ARCHITECT: #2695 -4090 FIELD CONTRACTFOR: INT /EXT FINISHES CSO ARCHITECTS El 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 P ere issued and payments om the Owner, and that current 1. ORIGINAL CONTRACT SUM 6, 394, 50o ocPayment s her due. 0 T 2. Net change by Change Orders (19,569. OO )CONT B CONSTRUCTi N 3. CONTRACT SUM TO DATE (Line 1 2) 6. 374, 931 OOBY- 59 4. TOTAL COMPLETED 8 STORED TO'DATE (Column G on G703) 5 769 575 51State of: D ANA r t+ 5, RETAINAGE. County MARION A- GINDER a. of Completed Work Subs ed d wo t be e N p C STATE OF INDIANA (Column D E on G703) 318, 746.55 met is S013 COUNTY Oid EXP. FEB.1. X17 b. °Io of Stored Material Notary SSI (Column F on G703) My Commission pines: mntnttti Total Retainage (Lines 5a 5b or Total in Column I of G703) 318,7A6.55 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents based on on -site observations and the data comprising 6. TOTAL EARNED LESS RETAINAGE 5. 450 828. 96 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 5, 326,081.08 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. ,t 8. CURRENT PAYMENT DUE Zt7 AMOUNT CERTIFIED �t _IY 7 9. BALANCE TO FINISH, INCLUDING RETAINAGE f (Attach explanation if amount certified differs from t mount applied. Initial all figures on this Application and on the Continuation She that ar ahq _gM to conform with the mnount c rtified.) (Line 3 less Line 6) 924, 102.04 CONS RUCTI G By: Date: t7 ADDITIONS DEDUCTIONS CI IANGE ORDER SUMMARY A ARC Total changes approved to previous months by Owner By: Date: Total approved this'Month This Certificate i not negot4l he AMOUNT CERTIFIED is payable onl to th Contractor TOTALS named herein. I uance, pay ii and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order the Owner or ntractor er 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 /CMaTM" —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• e StsovAIA Document 0703 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached. APPLICATION DATE: 21 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 06122/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 06/22/2010 A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL ITEM BALANCE PRE DESCRIPTION OF WORK SCHEDULED PRESENTLY COMPLETED TO RETAINAGE NO. FROM PREVIOUS STORED AND STORED (IF VARIABLE VALUE APPLICATION THIS PERIOD (G C) FINISH (NOT IN TO DATE (C 6 RATE) (D E) D OR E) (D +E +F) 100 BASEMENT FRAME MATL 107,259.00 107,259.00 107,259.00 100.00 101 BASEMENT FRAME LABOR 85,992.00 85,992.00 85,992.00 100.00 102 BASEMENT HANG MATL 125,006.00 125,006.00 125,006.00 100.00 103 BASEMENT HANG LABOR 133,158.00 133,158.00 133,158.00 100.00 104 ORCHESTRA FRAME MATL 118,670.00 118,670.00 118,670.00 100.00 105 ORCHESTRA FRAME LAB 100,713.00 95,677.35 3,021.39 98,698.74 98.00 2,014.26 106 ORCHESTRA HANG MATL 124,796.00 124,796.00 124,796.00 100.00 1.07 ORCHESTRA HANG LAB 141,631.00 120,386.35 7,081.55 127,467.90 90.00 14,163 -10 108 BALCONY FRAME MATL 108,051.00 108,051.00 108,051.00 100.00 109 BALCONY FRAME LABOR 92,419.00 78,556.15 2,77257 81,328.72 88.00 11,090.28 1.10 BALCONY HANG MATL 115,731.00 115,731.00 1 t5,731.00 100.00 111 BALCONY HANG LABOR 129,223.00 64,611.50 6,461.15 71,072.65 55.00 58,150.35 112 BOX TIER FRAME MATL 135,171.00 135,171.00 135,171.00 100.00 113 BOX TIER FRAME LABOR 113,521.00 113,521.00 113,521.00 100.00 114 BOX TIER HANG MATL 140,350.00 140,350.00 140,350.00 100.00 115 BOX TIER HANG LABOR 178,584.00 142,867.20 8,929.20 151,796.40 85.00 26,787.60 116 ATTIC FRAME MATL 102,176.00 102,176.00 102,176.00 100.00 117 ATTIC FRAME LABOR 87,922.00 87,922.00 87,922.00 100.00 1.18 ATTIC HANG MATL 90,226.00 90,226.00 90,216.00 100.00 119 ATTIC HANG LABOR 110,889.00 110,889.00 110,889.00 100.00 120 ACOUS CEILING MATL 52,941.00 39,705.75 39,705.75 75.00 13,235.25 PAGE 'TOTALS 2,394,429.00 2,240.722.30 28,265.86 .00 2.268,98S. 16 125,440.84 .00 CAUTION: You should sign an original AIA Contract Doc ument, on which this text appears in RED. An original assu 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 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. ADocument TM G703 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached. APPLICATION DATE: 21 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 06/22/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 06/22/2010 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE ITEM PRESENTLY COMPLETED RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS To STORED AND STORED (IF VARIABLE VALUE APPLICATION THIS PERIOD (G C) FINISH (NOT IN TO DATE C G) RATE) (D E) D OR E) (D +E +F) 121 ACOUS CEILING LABOR 40,759.00 8,151.80 8,151.80 20.00 32.607.20 122 INSULATION MAIL 82,670.00 82,670.00 82,670.00 100.00 123 INSULATION LABOR 117,330.00 105,597.00 105,597.00 90.00 11,733.00 200 N/S ELIP CLG METAL M 51,331.00 51,331.00 51,331.00 100.00 201 N/S ELIP CLG METAL L 201,384.00 201,384.00 201,384.00 100.00 202 N/S ELIP CLG PLAS M 74,360.00 74,360.00 74,360.00 100.00 203 N/S ELIP CLG PLAS L 438,153.00 438,153.00 438,153.00 100.00 204 MAIN ELIP CLG METL M 52,412.00 52,412.00 52,41100 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 430,314.00 430,314.00 430,31.4.00 100.00 208 UP /LOW BALCNY METL M 15,304.00 15,304.00 15,304.00 100.00 209 UP /LOW BALCNY METL L 143,518.00 143,518.00 143,518.00 100.00 210 UP /LOW BALCNY PLAS M 37,975.00 37,975.00 37,975.00 100.00 211 UP /LOW 13ALCNY PLAS L 633,522.00 570,169.80 31,676.10 601,845.90 95.00 31,676.10 212 BOX TIER/COL METAL M 10,245.00 10,245.00 10,245.00 100.00 213 BOX TIER/COL METAL L 118,363.00 118,363.00 118,363.00 100.00 214 BOX TIER/COL PLAS M 70,300.00 70,300.00 70,300.00 100.00 215 BOX TIER/COL PLAS L 319,455.00 255,564.00 15,972.75 271,536.75 85.00 47,918.25 216 ORCH H/L METAL M 5,317.00 5,317.00 5,317.00 100.00 217 ORCI-I H/L METAL L 112,967.00 112,967.00 112,967.00 100.00 218 ORCH H/L PLAS M 15,260.00 15,260.00 15,260.00 100.00 PAGE TOTALS 3,210,915.00 3,039,331.60 47,648.85 .00 3,086,980.45 123,934.55 .00 CAUTION: You should sign an original AIA Contract D 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 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 (1 o) 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 G703 TM -1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and. Related Documents. AIA Document G702, 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 A201, 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`A1A.'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, copyrightQaia.org. COMPLETING THE G703 FORM 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 Subcoritractors,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 he 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 the column G (Total Completed and Stored to Date). Column I: This column is normally used only f or 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 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 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 Amounts retraining indispute'should be dealt with according to Section 7.3 in A201. The following is,an example of a`Continuafion 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 I- F G H WORK COMPLETED ,MATERIALS TOTAL BALANCE ITEM SCHEDULED FROM PRESENTLY CONU'LETED RETAINAGE NO; DESCRIPTION OF WORK VALUE PREVIOUS STORED ANDSTORED (G +C) FINISH (IFVARiABLE APPLICATION THIS PERIOD (NOTIN TO DATE RATE) (D +E) DOREI (D +E +F) (C -G) 1 'MOBILIZATION 5.000 5.000 0 0 5.000 100 0 2 5TUMPREMOVAL 5,000 5.000 0 0 5.000 100 O 3 EARTH WORK 15,000 10.000 5,000 0 15.000 100 O A LOWER RETAINING WALL 10,000 0 5000 0 5.000 50 5.000 5 CURBS M15C. CONC: 5.000 0 0 0 O O 5.000 6 PAVING. UPPER DRIVE% 20.000 0 O 0 O 0 20.000 7 PgVING, LOWER DRIVE 20.000 0 0 0 O 0 20.000 8 PAVERS 20.000 0 0 10.000 10.000 50 10.000 5RIC:<WORK 5.000 0 0 0 O 0 5.000 in P n. 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 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 Copynght®aia.ong. Document G703 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: containing Contractor's signed certification is attached. APPLICATION DATE: 21 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 06/22/2010 Use Column I on Contracts where variable retainage, for line items may apply. ARCHITECT'S PROJECT NO: 06/22/2010 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM PRESENTLY COMPLETED BALANCE RETAINAGE DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS TO STORED AND STORED (IF VARIABLE NO. VALUE APPLICATION THIS PERIOD (G C) FINISH (NOT IN TO DATE RATE) (D E) D OR E) (D +E +F) (C G) 219 ORCII H/L PLAS L 315,844.00 157,922.00 157,922.00 50.00 157,922.00 220 4090A GEN. ALLOWANCE 225,000.00 158,534.25 1,885.62 160,419.87 71.30 64,580.13 221 4090B CAD ALLOWANCE 5,000.00 5,000.00 5..000.00 100.00 222 4100A GEN ALLOWANCE 175,000.00 105,134.48 15,017.55 120A5103 68.66 54,847.97 223 4100B CAD ALLOWANCE 5,000.00 5,000.00 5,000.00 100.00 300 BOND PREMIUM 63,312.00 63,312.00 63,312.00 100.00 301 C.O. #I /CCR 41008 60,100.00 42,070.00 42,070.00 70.00 18,030.00 302 C.O. #2 /CCR #1011 27,970.00 27,970.00 27,970.00 100.00 303 C.O. #3 /CCR #1012 1,200.00 1,200.00 304 C.O. #4 /CCR #1014 19,800.00 3,960.00 990.00 4,950.00 25.00 14,850.00 305 C.O. #5 /CCR #10]5 31,680.00 6,336.00 1,584.00 7,920.00 25.00 23,760.00 306 C.Q. #6 /CCR #1016 27,720.00 5,544.00 1,386.00 6,930.00 25.00 20,790.00 308 CO #8 /PAC006(CO7 0) 20,490.00 20,490.00 20,490.00 100.00 309 CO 9 /ALLOWANCE ADJ 226,269.00 226,269.00 226,269.00 100.00 310 CO #I 1/HIGH RAILING 17,740.00 17,740.00 1.7,740.00 100.00 CAUTION: You should sign an original AIA Contrac Docu ment, on which this text appears in RED. An original assures that changes will riot be obscured. AIA Document G703 TM —1992. Copyright ©1963, 1965, 19661967, 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. 1 1 2 AIA Document G703TM 1992 Instructions Continuation Sheet GENERAL,INFORMATION Purpose and Related Documents. AIA Document G702, 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 A201, 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 verity 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. COMPLETING THE G703 FORM 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 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) front 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. More 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 the 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 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 Fisted 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 t6 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 indispu4should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet 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 F_ F G H 1 WORK COMPLETED MA1FRIALS TOTAL BALANCE I'TEN4 SCHEDULED FROM PRESENTLY COMPLETED TO RETAINAGE NO. DESCRIPTION OF WORK VALUE PREVIOUS THIS PERIOD s,rORED (G C) FINISH ANDSTORED (IF VARIABLE APPI- ICA'rION (NOT IN TO DA'PE (C G) RAZE) (D +E) 1)ORE) (D +E +F) 1 MODILIZATION. 5.000 5,000 0 0 5.000 100 0 2 5TUMPREMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 0,000 5,000 0 15,000 00 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5.000 5 CUR55 M15C. CONC, 5,000 0 0 0 0 0 5,000 6 PAVING, UVVER. DRIVE 20.000 0 0 0 0 0 20.000 7 PAVING-, LO6VEP, DRIVE 20.000 0 0 0 0 0 20,000 8 PAVE.:5 20.000 0 0 10.000 10,000 50 10,000 5 vICK WORK 5.000 0 0 0 0 0 5.000 10 AIA Document G703 -1992. Copyright OO 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' legai counsel, copyright @aia.ong. 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 ��fcrP �o�s��� -1,h �f 5���� Purchase Order No. 6 3� s., �pr. "�v� �T Terms �71��� rrra�ocg�s, �G �f 7 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 2 2/ f 7 CPC /2�f 7� 7..�0 lei 9:9 Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF 5 ON ACCOUNT OF APPROPRIATION FOR Tj/ /e" AV Gs 7 Board Members PT I NVOICE NO. ACCT #/TITLE AMOUNT 1 hereby certify that the attached invoice(s), or 7 1 ZZWoo bill(s) is (are) true and correct and that the 9 d 2 21 4IY6-o �o 7 12y, 7g7W materials or services itemized thereon for which charge is made were ordered and received except —9 20 ignature Director of Hedwelopment Cost distribution ledger classification if Title claim paid motor vehicle highway fund