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Home My WebLink About161786 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 356511 Page 1 of 1 ONE CIVIC SQUARE DAWSON INC CARMEL, INDIANA 46032 6221 S HARDING ST CHECK AMOUNT: $92,499.04 INDIANAPOLIS IN 4621 CHECK NUMBER: 161786 CHECK DATE: 7123/2008 DEPARTM A CCOU N T PO NUMBER IN VOICE NU MBER AMOUNT DESCRIPTIO •902 4460805 0004R 9,919.01 RETAIL SITE #5 902 4460807 0004R 9,919.01 PERFORMING ARTS CENTE 902 4460805 0007 36,330.51 RETAIL SITE #5 ''902 4460807 0007 36,330.51 PERFORMING ARTS CENTE i I APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 6702 PAGEONEOF PAGES TO OWNER: Carmel Redevelopment Commission PROJECT: CARMEL PARCEL #5 APPLICATION NO: 0007 Distribution to: One Civic Square PERIOD TO: 6/30/2008 OWNER Carmel, IN 46032 Contractor's Project No. 250007 PROJECT NOS.: ARCHITECT FROM CONTRACTOR: Dawson Incorporated ARCHITECT: CSO Architects CONTRACTOR 6221 S. Harding Street 280 E. 96th Street Indianapolis, IN 46217 Indianapolis, IN 46280 CONTRACT DATE: 6/23/2005 CONTRACT FOR: The undersigned Contractor certifies that to the best of the Contractor's knowledge, infornation CONTRACTOR'S APPLICATION FOR PAYMENT and belief the Work covered by this application for Payment has been completed in accordance Application is made for payment, as shown below, in connection with the contract. with the Contract Documents, that all amounts have been paid by the Contractor Continuation Sheet, AIA Document G703, is attached. for Work for which previous Certificates for Payment were issued and payment received 1. ORIGINAL CONTRACT SUM $392,700.00 from the Owner, and that current payment shown herein is now due. CONTRACTOR: Daw, n ncorporated 2. Net change by Change Orders $34,268.00 6/24/2008 By: Date: 3. CONTRACT SUM TO DATE (Line I ±2) $426,968.00 4. TOTAL COMPLETED STORED TO DATE $404,394.48 State of INDIANA (Column G on G703) County of: MARION 5. RETAINAGE: Subscribed and sworn to before a. 5.0 00 %of Completed Work $20,219.72 Inc this 6/24/2008 (Columns D +Eoil G703) Notary Public:, -:.y�` /W 0. o b. 0 of Stored Material $0,00 >��'ze (Columns F on G703) My Commission expires: 7/14/2009 Total Retainagc (Line Sa 56 or $20,219.72 ARCHITECT CERTIFICATE FOR PAYMENT Total in Columns 1 on G703) 6. TOTAL EARNED LESS RETAINAGE $384,174.76 In accordance with the Contract Documents, based on on -site observations and the data (Line 4 less Line 5 Total) comprising this application, the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT Architect's knowledge, information and belief the Work has progressed as indicated, the (Line 6 from prior Certificate) 311,513.74 quality of the Work is to accordance with the Contract Documents, and the Contractor 8. CURRENT PAYMENT DUE $72 661.02 is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $42,793.24 (Attac ncrt amount certified differs from the anyount applied for. Initial all figures this plication and on the Continuation Sheet that are changed to CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS conform o the at ottnt c ed.) Total changes approved in ARCH[ ECT: p revious months by Owner $34,268.00 $0.00 By. Date: &A Total I r hi Month $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the TOTALS $34,268.00 $0.00 Contractor named herein. Issuance, payment and acceptance of payment are without NET CHANGES by Change Order $34 2 68-00 p rejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CER FOR PAYMENT 1992 EDITION AIA01). c')1992 THE AMERICAN INS ITUTE OF ARCHITECTS. 1735 NEW YORK G702 -1992 I� AVENUE. N.W.. WASHINGTON. D.C. 20006 -5292 WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. 'This document has been reproduced electronically with the permission of The American Institute of Architects under License 97003 to Primavera Systems, Inc. Reproduction of this document without project specific information is not permitted. Contact The American Institute of Architects to verify the current version of this document and license status." CONTINUATION SHEET AIA D OCUMENT G703 PAGE I OF I PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 0007 containing Contractor's signed Certification, is attached. APPLICATION DATE: In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 6/30/2008 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL BALANCE RETAINAGE ITEM SCHEDULED PRESENTLY COMPLETED a TO IF VARIABLE) DESCRIPTION OF WORK FROM PREVIOUS /o NO. VALUE APPLICATION THIS PERIOD STORED AND STORED TO FINISH RATE (D+ E) (NOT IN D OR E) DATE (D +E +F) (G C) (C G) 000000001 SANITARY SEWER 000000002 Labor $66,256.00 $22,527.04 $36,440.80 $0.00 $58,967.84 89.000 $7,288.16 000000003 Material $95,344.00 $44,811.68 $40,044.48 $0.00 $84,856.16 89.000 $10,487.84 000000005 MONON TRAIL 000000006 Asphalt $23,000.00 $23,000.00 $0.00 $0.00 $23,000.00 100.000 $0.00 000000007 Labor $27,400.00 $27,400.00 $0.00 $0.00 $27,400.00 100.000 $0.00 000000008 Material $29,900.00 $29,900.00 $0.00 $0.00 $29,900.00 100.000 $0.00 000000010 EXISTING DITCH 000000011 Labor $3,900.00 $3,900.00 $0.00 $0.00 $3,900.00 100.000 $0.00 000000012 Material $6,900.00 $6,900.00 $0.00 $0.00 $6,900.00 100.000 $0.00 000000014 STORM SEWER 000000015 Labor $51,800.00 $51,800.00 $0.00 $0.00 $51,800.00 100.000 $0.00 000000016 Material $88,200.00 $88,200.00 $0.00 $0.00 $88,200.00 100.000 $0.00 000000019 Chan e Order No. 1 1 $34,268.00 II $29,470.48 $0.00 II $0.00 I $29,470.48 86.000 $4,797.52 TOTAL I $426,968.001 $327,909.20 $76,485.28 $0.0 $404,394.41 94.71 %I $22,573.51 AIA DOCUMENT G703• APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AIAttt) 01992 lliE AMERICAN INSTITUTE OP ARClirri- C "1'S. 1735 NEW YORK G703 -1992 AVENUE, N.W.. WASHINGTON, D.C. 20006 -5292 WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. 'This document has been reproduced electronically with the permission of The American Institute of Architects under License 97003 to Primavera Systems, Inc. Reproduction of this document without prepedific information is not tted. Contact The American Institute of Architects to verifv the current version of this document and license status," permi PARTIAL WAVIER OF LIEN STATE OF INDIANA SS: COUNTY OF MARION KNOW ALL MEN BY THESE PRESENTS, That the undersigned: Dawson Incorporated for and in consideration of. APPLICATION NO: 0007 PERIOD TO: 6/30/2008 for payment in the amount o£ $72,661.02 does upon receipt of said payment hereby waive, release and surrender any and all liens or claims or rights to lien, for labor, material and /or services, and further certifies that no other party has any claim or right to a lien, on account of any work performed or material furnished to the undersigned for said project situated in the County of Marion, State of Indiana, described as follows: PROJECT: CARMEL PARCEL #5 PROJECT NO: ARCHITECT: CSO Architects CONTRACT: Dawson Incorporated CONTRACTOR Date: 6/24/2008 �L� c By State of INDIANA County of. MARION Subscribed and sworn to before me on: 6/24/2008 Y' Notary Public: ,2%'. >�GC�e2C My Commission expires: 7/14/2009 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 I D 0.tw� n �Car poee lao' Purchase Order No. (o Z Z I S t-E of ns <1'a. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) P A r-C 0 S�l 36 330 s� 4� s k, g fi Total 7 ?:`(G r I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same inaecordance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 pawSar I..c Z Z IN SUM OF /V 4r.? ?2 (Orel °Z ON ACCOUNT OF APPROPRIATION FOR 7 A Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 267 000 7 4 y( o oFo F 3(o sr bill(s) is (are) true and correct and that the 70 GGG7 y (ao o �7c. rr materials or services itemized thereon for which charge is made were ordered and received except S' n TC, /T C-12 Title Cost distribution ledger classification if claim paid motor vehicle highway fund APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 6702 PAGEONEOF PAGES TO OWNER: Carmel Redevelopment Commission PROJECT: Carmel Parcel #5 Site APPLICATION NO: 0004R Distribution to: One Civic Square PERIOD TO: 12/30/2006 OWNER Carmel, IN 46032 Contractor's Project No. 250007 PROJECT NOS.: ARCHITECT FROM CONTRACTOR: Dawson Incorporated ARCHITECT: CSO Architects CONTRACTOR 6221 S. Harding Street 280 E. 96th Street Indianapolis, IN 46217 Indianapolis, IN 46280 CONTRACT DATE: 6/23 /2005 CONTRACT FOR: The undersigned Contractor certifies that to the best of the Contractor's knowledge, information CONTRACTOR'S APPLICATION FOR PAYMENT and belief the Work covered b this application for Pa has been completed in accordance Application is made for payment, as shown below, in connection with the contract. with the Contract Documents, that all amounts have been paid by the Contractor Continuation Sheet, AIA Document G703, is attached. for Work for which previous Certificates for Payment were issued and payment received 1. ORIGINAL CONTRACT SUM $392,700.00 from the Owner, and that current payment shown herein is now due. CONT C OR: Dawson I ed 2. Net change by Change Orders $34,268.00 4/1/2008 g 71 Date: 3. CONTRACT SUM TO DATE (Line 1 ±2) $426,968.00 4. TOTAL COMPLETED STORED TO DATE $294,054.00 State of INDIANA (Column G on G703) County of: MARION 5. RETAINAGE: Subscribed and sworn to before a. 10.0 %of Completed Work $2 9,405.40 me this 4/1/2008 (Columns D+ E on G703) Notary Public: b. 0 IN, $0.00 G (Columns F on G703) My Commission expires: 8/ 8/2014 Total Rctaina e (Line 5a +5bot $29 405.40 ARCHITECT'S CERTIFICATE FOR PAYMENT Total in Columns 1 on G703) 6. TOTAL EARNED LESS RETAINAGE $264,648.60 In accordance with the Contract Documents, based on on site observations and the data (Line 4 less Line 5 Total) comprising this application, the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT Architect's knowledge, information and belief the Work has progressed as indicated, the (Line 6 from prior Certificate) $244,810.58 quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment ofthc AMOUNT CERTIFIED. 8. CURRENT PAYMENT DUE 19 838.02 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED �i�S_ OZ (Line 3 less Line 6) $162,319.40 (Attach explanation i /onionnl certified di /fers from the amount applied for. Initial all figures on pplication and on the Continuation Sheet that are changed to CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS conform the a ount ce ified.) ARCH C��/ Total changes approved in p revious months by Owner $34,268.00 $0.00 By: Date: r. Total a1212roved this Month $0.00 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the TOTALS $34 268.00 $0.00 1 Contractor named herein. Issuance, payment and acceptance of payment are without NE C by Change Order $34,268-90J p rejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICA'T'ION AND CER'rll'ICATE FOR PAYMENT, 1992 EDITION AIA(k), u: )1992 TIIE AMERICAN INSTITUTE 01' ARCI 1735 NEW YORK I`NI AVENUE. N.W., WASHINGTON, D.C. 20006 -5292 WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 -1992 document has been re I produced electronically with the permission of The American Institute of Architects under License 9700 ver 3 to Primaa Systems, I nc. Reproduction of this document without project specific information is not permitted. Contact The American Institute of Architects to verify the current version of this document and license status." t CONTINUATION SHEET AIA DOCUMENT 6703 PAGE I OF I PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 0004R containing Contractor's signed Certification, is attached. APPLICATION DATE: In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 12/30/2006 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL BALANCE RETAINAGE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED al TO IF VARIABLE) NO. VALUE APPLICATION THIS PERIOD STORED AND STORED TO FINISH RATE (D+ E) (NOT IN D OR E) DATE (D +E +F) (G -C) (C G) 000000001 SANITARY SEWER 000000002 Labor $66,256.00 $0.00 $10,600.96 $0.00 $10,600.96 16.000 $55,655.04 000000003 Material $95,344.00 $11,441.28 $11,441.28 $0.00 $22,882.56 24.000 $72,461.44 000000005 MONON TRAIL 000000006 Asphalt $23,000.00 $23,000.00 $0.00 $0.00 $23,000.00 100.000 $0.00 000000007 Labor $27,400.00 $27,400.00 $0.00 $0.00 $27,400.00 100.000 $0.00 000000008 Material $29,900.00 $29,900.00 $0.00 $0.00 $29,900.00 100.000 $0.00 000000010 EXISTING DITCH 000000011 Labor $3,900.00 $3,900.00 $0.00 $0.00 $3,900.00 100.000 $0.00 000000012 Material $6,900.00 $6,900.00 $0.00 $0.00 $6,900.00 100.000 $0.00 000000014 STORM SEWER 000000015 Labor $51,800.00 $51,800.00 $0.00 $0.00 $51,800.00 100.000 $0.00 000000016 Material $88,200.00 $88,200.00 $0.00 $0.00 $88,200.00 100.000 $0.00 000000019 Change Order No. 1 1 $34,268.00 II $29,470.48 $0.00 II $0.00 I $29,470.48 86.000 $4,797.52 TOTAL $426,968.00 $272,011.761 $22,042.24 $0.0 $294,054.01 68.87 %1 $132,914.0 AIA DOCUMENT G703• APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AIA(R) rA992 TIIE AMERICAN INSTITUTE OF ARCI rS, 1735 NEW YORK G703 -1992 AVENUE. N.W., WASHINGTON. D.C. 20006 -5292 WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. 'This document has been reproduced electronically with the permission of The American Institute of Architects under License 97003 to Primavera Systems, Inc. Reproduction of this document without pra�lific information is not permitted. Contact The American Institute of Architects to verify the current version of this document and license status." PARTIAL WAVIER OF LIEN STATE OF INDIANA SS: COUNTY OF MARION KNOW ALL MEN BY THESE PRESENTS, That the undersigned: Dawson Incorporated for and in consideration of. APPLICATION NO: 0004R PERIOD TO: 12/30/2006 for payment in the amount of: $19,838.02 does upon receipt of said payment hereby waive, release and surrender any and all liens or claims or rights to lien, for labor, material and /or services, and further certifies that no other party has any claim or right to a lien, on account of any work performed or material furnished to the undersigned for said project situated in the County of Marion, State of Indiana, described as follows: PROJECT: Carmel Parcel #5 Site PROJECT NO: ARCHITECT: CSO Architects CONTRACT: Dawson Incorporated CONTRACTOR Date: 4/1/2008 By: State of INDIANA County of. MARION Subscribed and sworn to before jpe on: 4/1/2008 Notary Public: My Commission expires: 8/28/2014 '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 Dt�wto 1A d (O ZZ I S, �t��o't.� Purchase Order No. Sl� g e f C dt a,, lr 1 V x(42 Terms Date Due Invoice Invoice Description Amount t Date Number (or note attached invoice(s) or bill(s)) Q Q I C O d r 6, P, orCG S_ 1 (1 0� y/� d GGG PQ �Ct J( i Total 3 9 °z 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 ��..r Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 G z z i s, IN SUM OF Y 6- ON ACCOUNT OF APPROPRIATION FOR 01 ®z /x Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or q 0 2 f Q 44 4018o5 g1 t. bill(s) is (are) true and correct and that the 4 6 Dpp q R 4 `(&og o 1 1 4 1 1 6 materials or services itemized thereon for which charge is made were ordered and received except Si at Cost distribution ledger classification if tle claim paid motor vehicle highway fund