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Home My WebLink About197189 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 364048 Page 1 of 1 ONE CIVIC SQUARE GIBRALTAR CONSTRUCTION CORP CARMEL, INDIANA 46032 2932 N. WEBSTER AVENUE CHECK AMOUNT: $36,510.00 INDIANAPOLIS IN 46219 owe CHECK NUMBER: 197189 CHECK DATE: 5/11/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 R4462401 27459 3 36,510.00 7A STREETSCAPE— PALLAD Document G7021CMa TM -1992 Application and Certificate for Payment Construction Manager- Adviser Edition TO OWNER: PROJECT: APPLICATION NO Distribution to: City of Carmel Carmel Parcel 7A Streetscape 3 One Civic Square PERIOD TO:. 4130111 OWNER Carmel, IN 46032 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT Gibraltar Construction. Corp 10/28/10 2932 N. Webster Ave. PROJECT NOS: 1 1 CONTRACTOR Indianapolis, IN 46219 VIA ARCHITECT: 8 *k 29-k FIELD �l CONTRACT FOR: Carmel Parcel 7A Streetscape CSO Architects, Inc. CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor cc ifies 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 thi pplicadon for Payment has been completed in accordance with the Continuation Sheet, AIA Document G703,, is attached. Contract Documents, that al a unts have been paid by the Contractor for Work for which previous Certificates for Payment issued and payments received from the Owner, and that current 1, ORIGINAL CONTRACT SUM 206.200.00 payment shown herein is n e. 2. Net change by Change Orders 0.00 CONTRACTOR: Gibralta struction Corp 3. CONTRACT SUM TO DATE (Line 1 2) 206,200.00 By: Date: 4 l f 4. TOTAL COMPLETED STORED TO DATE.(Column G on G703) 182,086.88 State of:�I� 5. RETAINAGE; County of: A 2 a. %o of completed W ork Subscribed and s n to be r BRIAN R M C B R! D E 10,310.00 ReS. Vi haiiCock COUrr (Column I1+ E on 6703) me this p daof ty b of Stored Material Nota My COMM, EXP. 11 -29 -2017 (Column F on G703) My Commission expires: �li C 'SS10 1 61 186 Total Retainage (Lines 5a 5b or Total in Column I of G703) CERTIFICATE FOR PAYMENT 171 776 88 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. LES 135,266.88 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT PR 6 f prior e R PAYENT CERTIFIED. 8. CURRENT PAYMENT DUE 36 510.00 AMOUNT CERTIF Q .��C�:' 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach expl ati n i f amount certified differs froin the am"Ount,applied. Initial cAlfigures on this Applicat' n and n t Cn mation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) 83,923.00 CONS UCTIO M E By: Date: Ij CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: CSO Architects Inc Total changes approved in previous months by Owner Date: Total approved this Month This Certiticate is notnegotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS named herein. Issuance; "payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order the Owner or Contractor under this Contract. CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured. AIA Document 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. *A1A Document G 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 A2011CMa, 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 G702/CMa 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 G7021CMa, have it notarized and submit it, together with G703, to the Construction Manager and Architect. The Construction Manager and Architect should review G702JCMa 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 G7021CMa 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. D. 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 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 appligafion). 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 stared 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 shot idle incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 /CMa. i E. Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager anprchitect on �IA 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. g'. 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. CONTINUATION SHEET Page 2of2 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION NO.: 3 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where APPLICATION DATE: 4/30/2011 variable retainage for line items may apply. PERIOD TO: 4/30/2011 ARCHITECT'S PROJECT NO.: A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND BALANCE TO IF VARIABLE NO. APPLICATION THES PERIOD STORED (NOT IN STORED TO DATE (G C) (C G) RATE) (D +E) DORE) (D +E +F) 1 Supervision $2,500.00 $2,175.00 $125.00 $2,300.00 92% 200.00 2 Allowance $20,000.00 $0.00 $0.00 0% 20,000.00 3 Bonds $2,576.00 $2,576.00 $2,576.00 100% 4 Misc. General Conditions $5,024.00 $4,370.88 $251.00 $4,621.88 92% 402.12 5 Earthwork $30,000.00 $28,800.00 $28,800.00 96% 1,200.00 10,310.00 6 Asphalt Paving $9,700.00 $1,455.00 $8,245.00 $9,700.00 100% 7 Concrete Curbs $15,600.00 $15,600.00 $15,600.00 100% 8 Concrete Walks $13,000.00 $13,000.00 $13,000.00 100% 9 Joint Sealants $300.00 $0.00 $0.00 D %u 300.00 10 Limestone Retaining Wall $90,000.00 $76,500.00 $10,500.00 $87,000.00 97% 3,000.00 11 Landscaping $12,000.00 $0.00 $10,200.00 $10,200.00 85% 1,800.00 12 Irrigation $5,500.00 $1,100.00 $3,575.00 $4,675.00 85% 825.00 13 Change Order #1 $4,818.00 $3,614.00 $3,614.00 75% 1,204.00 $211,018.00 $145,576.88 $36,510.00 $0.00 $182,086.88 86% $28,931.12 $10,310.00 ISA Form 1 -402 Aldhk AFFIDAVIT AND WAIVER OF LIEN FINAL PARTIAL PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and or labor for a project known as Carmel Parcel 7A- Streetscape and owned by City of Carmel and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER) that there is due from the Owner the sum of Thirty Six Thousand Five Hundred Ten and No /100--- Dollars ($36,510.00) receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration of this 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 the final balance due from the Owner is the sum of Dollars receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto the Dwner of said premises, any and all lien or claim whatsoever on the above- described property and improvements thereon account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions Vxpr ssed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work oimed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By Title President WITNESS MY HAND AND NOTORIAL SEA 42h y of April, 2011. (Notary Public) BRIAN R. MCBRIDE SEAT ,t Ra- c Hancock county '0 ,979 9NDIAkA SUBCONTRACTORS ASS 00 ATION INCOp4QpAIM My GCmrr, EXJ, 11 -29 -2017 Clnauin(re,�bd� P+rtxEraC!1�4� drrCtl1L1 YOGI -A�' COTf!��'SS10� 61 Rev 10'n 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. Gibraltar Constructi &�Mrp 2 932 N. Webster Mira Purchase Order No. I ndianapolis 46219 Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 4/ 8/11 3 Parcel 7A Streetsca e r. 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 Gibraltar Construction Cor1 IN SUM OF 2932 N. Webster Ave. Indianapolis, IN 46219 $36,510.00 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members P09 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 27459 3 2200- R4462401 $36,510.00 which charge is made were ordered and received except 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund