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166659 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 358653 Page 1 of 1 0 ONE CIVIC SQUARE ENGLEDOW, INC CHECK AMOUNT: $4,649.97 ,o CARMEL, INDIANA 46032 1100 E 116TH ST CARMEL IN 46032 CHECK NUMBER: 166659 CHECK DATE: 12110/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 R4462401 15966 7 4,641.97 CARMEL STREETSCAPE s5 4? TM Document G702 -1992 Application and Certifi6t6 for Payment TO OWNER: PROJECT: APPLICATION NO Distribution to: City of Carmel College to Rangeline Rd. 10/17/08 PERIOD T0:_ OWNER Landscape Irrigation CONTRACT FOR: ARCHITECT FROM CONTRACTOR: VIA ARCHITECT: CONTRACT DATE: 1/10/07 CONTRACTOR Engledow Inc. Rundell Errlstberger PROJECT NOS: 15966 FIELD OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment, as shown below, in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for Continuation Sheet, AIA Document G703, is attached. 237,864.85 which previous Certificates for Payment were issued and payments received from the Owner, and 1. ORIGINAL CONTRACT SUM that current payment shown herein is now due. 2. Net change by Change Orders C TOR: Engle Inc. 3. CONTRACT SUM TO DATE Line 1'`t 2 S y Date: 4. TOTAL COMPLETED STORED TO DATE (Column G on G703) State o ovx (G 5. RET�I6AGE: County of: a. of Complefed Work 24,270.64 Subscribed and sworn: to before (Column D E on G703) me this aSt—` dayof b. %'of Stored Material 0.00 �ICk[_ L n (Column F on G703) Notary Public 1 Total Retainage (Lines Sa 5b or Total in Column I of G703) 24 270.64 My Commission expires: `��1 T" 6. TOTAL EARNED LESS RETAINAGE 35.71 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 Less Line 5 Total) In accordance with the Contract Documents, based on on site observations and the data comprising 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT. 213 this application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8. CURRENT PAYMENT DUE AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED into 4 'l, 24,270.64 (Line 3 less Line 6) (Attach explanation if amount certified differsirorm the amount applied. Initial all figures on this Application and on the Corrtiuivatioii.Slzeet that are changed to conform with the am:ouizt certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved m previous months by Owner B h Date: 0$ Total approved this Month This Certificate 1s not negotiable. The AMOU T 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 chang will not be obscured. AIA Document G702TM 1992. Copyright 1953, 1963, 1965, 1971, 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 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, copyrightOa aia.org. SIM Document G702"- 1992 Instructions Application and Certificate for Payment 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 to be used on a Project where a 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 G702, 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 G702 FORM After the Contractor has completed AiA Document G703, Continuation Sheet, summary information should be transferred to AIA Document 6702, Application and Certificate for Payment. The Contractor should sign G702, have it notarized, and submit it, together with G703, to the Architect. The Architect should review G702 and G703 and, if they are acceptable, complete the Architect's Certificate for Payment on 6702. The Architect may certify a different amount than that applied for, pursuant to Sections 9.5 and 9.6 of A201. The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and 6703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document 6702, Application and Certificate for Payment. 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. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting (i.e., president, secretary, partner, etc.) and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. AIA Document G702TM 1992. Copyright 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. Alf rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA' 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. 8AIA TM Document G703 -1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 7 containing Contractor's signed certification is attached. APPLICATION DATE: 10/17/08 In tabulations below; amounts are stated to the nearest dollar. 10/17/08 Use Colunun 1 on Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO: 15966 A C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE PRESENTLY COMPLETED RETAINAGE SCHEDULED FROM PREVIOUS TO ITEM DESCRIPTION OF WORK STORED AND STORED (IF VARIABLE NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G C) FINISH RATE) (D E) D OR E) (D +E +F) (C G) 1 Topsoil $68,371.50 $68,371.50 $0.00 $0.00 $68,371.50 1)0% $0.00 6,837.1.5 2 Sodding, Nursery $4,801.80 $4,801.80 $0.00 $0.00 $4,801.80 1)0% $0.00 $480.18 3 Mulch, Hardwood Shredded Bark $8,385.00 $8,385.00 $0.00 $0.00 $8,385.00 1 0 0 /0 $0.00 $838.50 4 Plant, Evergreen shrub 3 gal. $6,669.00 $5,954.00 $715.00 $0.00 $6,669.00 1 0% $0.00 $666.90 5 Plant, Deciduous 2.5 -3" $47,922.00 $45,314.00 $2,608.00 $0.00 $47,922 00 100% $0.00 $4,792.20 6 Plant Deciduous Tree, 2 -2.5" $18,249.00 $18,249.00 $0.00 $0.00 $1$,249.00 100% $0.00 1,824.90 7 Plant, Perennial, I gal. $27,702.00 $26,154.00 $1,548.00 $0.00 $27,702.00 100% $0.00 $2,770.20 8 Plant, Ornamental Grass I gal. $10,175.75 $9,889.00 $286.75 $0.00 $10,1.75.75 100% $0.00 1,017.58 9 Spade Edge $724.80 $724.80 $0.00 $0.00 $724.80 100% $0.00 $72.48 10 Mobilization /Demobilization $500.00 $500.00 $0.00 $0.00 $500.00 100% $0.00 $50.00 11 Maintenance of Traffic $750.00 $750.00 $0.00 $0.00 $75C.00 100% $0.00 $75.00 12 Jrrigation System $43,614.00 $43,614.00 $0.00 $0.00 $43,614.00 100% $0.00 4,361.40 13 Charge Order 1 $313.00 $313.00 $0.00 $0.00 $313.00 100% $0.00 $31.30 14 Charge Order #2 :,$4,528.50 $4,528.50 $0.00 $0.00 $4,528.50 100% $0.00 $452.85 Total $242,706.35 237,548.60 $5,157.75 $0 00 242,706.35 00% $0.00 4,270.64 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 G703TM- 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This A10 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, PJrchasers 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, copyrighl@aia.org. AIA Document G703 -1992 instructions i 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 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 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. Initiaily, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed Work covered by the previous application (columns D E from the previous application). Values from column F, (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored (column F). Column F: Enter here the value of Materials Presently Stored for which payment is sought- The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed -This Period.) Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column is This column is normally used only for contracts where variable retainage is permitted on a line -item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress. Please note that dollar amounts shown below are for illustrative purposes only, and are not intended to reflect actual construction costs. A B C 1) I; P O H WORK COMPLF'I'1?D ,MATENALS For FAL BALANCE PRLSLN'I'LY CO�I]'I -I�n>D RPTAIN'AOF n'9:N1 SCHI:DULI:D FROM 1'RI:�`IO US 'K� "I'O NO. DESCKII''LION OFSVORIt VALUI'. APPI C'A'1'1ON IRIS PERIOD STORED A�'D SI ORLD (C +C) IINI511 fIF VARIABLE f1) +F) (NO'I'IN 'CU DA "r L: (c C,) RATE) U OR I:] ID +1.tl� 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 57UMP REMOVAL 5,000 5,D00 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS d MISC. CONIC, 5,000 0 0 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 a PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 ii 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA Document, or any portion of it, may result in severe civil and criminal penatties, 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. t 1100 East 116th Street Phone: (317) 575 1100 EN Carmel, IN 46032 Fax: 317 573 7339 GR. INVOICE 311988 INVOICE DATE 10/20/2008 BILL TO PROPERTY ADDRESS City of Carmel 116th Street College to Rangeline Board of Public Works Safety 116th St. College to Rangeline One Civic Square Carmel, IN 46032 Carmel, IN 46032 Telephone: INVOICE DATE TERMS PO SALES REP 10/20/2008 Net 30 Days Dale Morris DESCRIPTION PRICE 0612012008: WORK ORDER: 2784 $4,641.98 Streetscape: 116th St. College to Rangeline Rd. Application 7. INVOICE TOTAL $4;641.98 PROPERTY AMOUNT INVOICE INVOICE DATE 1173 $4,641.98 311988 10/20/2008 1100 East 116th Street NGLT W Carmel, IN 46032 VR 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. r Payee IFngledow, Inc. Purchase Order No. 1100 East 116th Street Terms Carmel, IN 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10/17/08 App 7 Landscape and Irrigation $4,641.97 ree scape 116th C-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 E.ngledQw IPG IN SUM OF 1100 East 116th Street Carmel, IN 46032 $4,641.97 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering r Board Members 2DEPT. j jP VOIC N ACCT #/TITLE AMOUNT O 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 200 $4,641.97 which charge is made were ordered and received except Z Z 20c7g Signs ure Cost distribution ledger classification if Title claim paid motor vehicle highway fund