155281 01/10/2008 f CITY OF CARMEL, INDIANA VENDOR: 358653 Page 1 of 1
i. ONE CIVIC SQUARE ENGLEDOW, INC
CHECK AMOUNT: $33,019.65
CARMEL, INDIANA 46032
CHECK NUMBER: 155281
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 R4462401 15966 APP 5 8,464.95 CARMEL STREETSCAPE
2200 R4462401 15966 APP 6 24,554.70 CARMEL STREETSCAPE
W
i
i
TM
OCUrnent G702 1992
Application and Certificate for Payment
TO OWNER: PROJECT: Streetscape: 116th St. APPLICATION NOs 6 Distribution to:
City of Carmel College to Rangeline Rd. PERIOD TO 12/31/07 OWNER D
CONTRACT FOR: Landscape Irrigation ARCHITECT El
FROM CONTRACTOR: VIA ARCHITECT: CONTRACT DATE: 1/10/07 CONTRACTOR
Engledow Inc. Rundell Ernstberger PROJECT NOS: 15966 FIELD
OTHER D
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 which previous Certificates for Payment were issued and payments received from the Owner, and
1. ORIGINAL CONTRACT SUM 237,864.85 that current payment shown herein is now due.
2. Net change by Change Orders 4,841.50 CONT nITOR: Engledow 1
3. CONTRACT SUM TO DATE (Line 1-± 2) 242,706.35 By t.a Date:
4. TOTAL COMPLETED STORED TO DATE Column G on G703 PhAt"01
237,548.60 State
5. RETAINAGE: County of: l+o.
a. 10 of Completed Work Subscribed and sworn to before
(Column D +'E on G703) 23,754.86 me this ay of
b of Stored Material
(Column F on G703) 0.00 Notary Public
M Commission expires: d1 tU
Total Retainage (Lines Sa Sb or Total in Column I of G703) 23,754.86 2x� tl a1 a'o14
6. TOTAL EARNED LESS RETAINAGE 213 ,793,74 ARCHITECT'S CERTIFIC 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 189,239.04 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
S. CURRENT PAYMENT DUE 24,554,70 AMOUNT CERTIFIED.
9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED 2-4 5S A- 10
(Line 3 less Line 6) 28 ,91.2.6 1 (Attach explanation if amount certified differs from the amount applied. Initial all figures on this
Application_ and on the Continuation Sheet that sire changed to conform with the amount certified.)
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT:
Total changes approved to previous months by Owner $4,841.50 By: p Date:
Total approved this Month $0.00 a n 1. o i V
This Certificate is not tiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS $4,841.50 named herein.; Issuance payment and acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order 4,841.50 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 G702TM 1992. Copyright O 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 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 N 0) 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.ord'
Document G702"- 1992 Instructions
Application and Certificate for Payment
3
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 G702, 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 G702.
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 to conform to the amount certified
and attach an explanation. The completed G702 and G703 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. All rights reserved.
WARNING: This Ale 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.
I NR AIA -1992
7M
ent 6103
Continuation Shy
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO 6
containing Contractor s sign certification is attached. APPLICATION DATE: 12/26/07
In tabulations below; amounts are stated to the nearest dollar.
Use Column.I on Contracts where variable retainage for line items may apply. PERIOD TO: 12/31/07
ARCHITECT'S PROJECT NO: 15966
A B C D E F G H I.
WORK COMPLETED MATERIALS TOTAL
BALANCE
SCHEDULED FROM PREVIOUS
PRESENTLY COMPLETED TO RETAINAGE
ITEM DESCRIPTION OF WORK STORED AND STORED (IF VARIABLE
NO. VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G C) FINISH RACE)
(D E) D OR E) (D +E +F) (C G)
1 Topsoil $68,371.50 $68,371.50 $0.00 $0.00 $68,371.50 100% $0.00 $6,837.15
2 Sodding, Nursery $4,801.80 $4,801.80 $0.00 $0.00 $4,801.80 100% $0.00 $480.18
3 Mulch, Hardwood Shredded Bark $8,385.00 $7,925.00 $460.00 $0.00 $8,385.00 100% $0.00 $838.50
4 Plant, Evergreen shrub. 3 gal. $6,669.00 $5,954.00 $0.00 $0.00 $5,954.00 89% $715.00 $595.40
5 Plant, Deciduous:: Tree 2.5 -3" $47,922.00 $24,179.00 $21,135.00 $0.00 $45,314.00, 95% $2,608.00 S4,53 1.40
6 Plant, Deciduous Tice, 2 -2.5" $18,249.00 $1.2,561.00 $5,688.00 $0.00 $18,249:00 100% $0.00 S 1,824.90
7 Plant Perennial, 1 gal. $27,702.00 526,154.00 $0.00 $0.00 $26,154.00 94% $1,548.00 S2,615.40
8 Plant, Ornamental Grass, I gal. $1.0,175.75 $9,889.00 $0.00 $0.00' $9,889.00 97% $286.75 $988.90
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 $750.00 100% $0.00 $75.00
12 Irrigation System $43,614.00 $43,614.00 $0.00 $0.00 $43,614.00 100% $0.00 4,361.40
13 Charge Order 41 $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 $242,706.35 210,265.60 $27,283.00 S $237,548.60 98% $5,157.75 $k754.86
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, 1 970, 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 A10 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.-
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 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. 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
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 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 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 casts.
WORK CO.MPLEI F I) MATERIA1 10TH.
L\NCl
PRBI'NI'LY COMPI.EI'F,1? RF; I'AINAGP.
ITEM SC FROM I' Uti I; '1'Cl
DESCRIPTION OF WORK 5'rOREU AND STORED (11; \'ARIANLI3
No. DESCRIPTION VAI.UI: AI'i'I.ICATIO\ THIS PERIOD ((i -C) FINISH
fU +Ei) (NOT IN' 'I'O UA "I'E (C -G) ItATII)
D OR ti) II;W &F1
1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0
2 STUMP REMOVAL 5,000 5,000 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 MISC.. CONC. 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
8 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
11 1 20.000 I0,000 10,000 40,000 65,000
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 AEA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AI4 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.crg.
ENG LED® PVT 1 100 BEAST 1 16T" STREL•T CARMEL, IN DIANA 46032
GR Ur 31 7/575- 1 100 31 7/573 -7339 FAX
l0 -CL 116 12/26/2007 0037087 -IN 1 5966
Job 1026220
Customer: Site Address:
City of Cannel 1 16th Street Project
Board of Public Works Safety College to Ranueline
One Civic Square
Carmel, IN 46032
116th Street Project landscape $24,554.70
Landscape Services
Application Vt
Landscape and hTigation services through
December 31. 2007.
Sales Tax: $0.00
Amount Due: $24,554.70
TERMS NET 30, ACCOUNTS PAST 30 DAYS ARE SUBJECT TO 1.5% PER MONTH FINANCE CHARGE.
CUSTOMERNUMBER i
10 -CL1 16 $24,554.70 0037087 -IN 12/26/2007
ENGLEDI W t 100 EAST 1 16 11, STREET CARMEL, INDIANA 46032
GR U1 317/575 -1100 317/573 -7339 FAX
:AMI
Document G702' -1992
Application and Certificate for Payment
TO OWNER: PROJECT: Streetscape; l 16th St. C_ APPLICATION NOs Distribution to:
City of Cannel College to Rangeline Rd. PEPS O 10/31/07
OWNER
CONTRACT FOR: Landscape &Irrigation ARCHITECT
FROM CONTRACTOR: VIA ARCHITECT: CONTRACT DATE: 1/10/07 CONTRACTOR
Engledow Inc. Rundell Ernstberger PROJECT NOS: 15966
FIELD
OTHER
CONTRACTOR 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. which previous Certificates for Payment were issued and payments received from the Owner, and
1. ORIGINAL CONTRACT SUM 237,864.85 that current P a Y ment shown herein is now due.
2. Net change by Change Orders 4,84 CO OR: EnQledow, Inc.
3. CONTRACT SUM TO DATE Line 1 2 242 706.35
By: (,t�(i Date:
4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 210,265.60 State o
5. RETAINAGE: County of:
a. 10 of Completed Work Subscribed and sworn to e or (Column D +'E on G703) 21,026.56 me this aj �J� day of �o�t
b of Stored Material
(Column F on G703) 0'00 Notary Public:.:
56 My Commission expires: nn D
Total Retainage (Lines Sa Sb or Total in Column I of G703) 21 026.
6. TOTAL EARNED LESS RETAINAGE 189,239.04 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 180,774.09 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 8,464.95 AMOUNT CERTIFIED,
9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED
Line 3 less Line 6 53,467.31 (Attach explanation amount certified dt ers rom.the amotmt a pplied. Initial all figures ures on this
p� f tf f pp fs
Application and on the Continuation Sheet that are changed to conform with the amount certified.)
CHANGE ORDER SUMMARY.: ADDITIONS DEDUCTIONS ARCHITECT:
Total changes approved in previous months by Owner 313.00 B Y Date: k\ 4 1 O" I
Total approved this?Month 4,523.50 This Certificate 1s not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS 4,841.50 named herein Issuance payment and acceptance of payment are without prejudice to any rights of
NET CHANGES b Change Order 4,841.50 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 G702TM 1992. Copyright 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This Ale 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, copyrightgaia.org.
U11 AIA 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, Conti nuation.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 G702, 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 G702.
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 G703 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 G702, 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. All rights reserved.
WARNING: This AIODocument 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.
TM
Document G703 1992
Continuation Sheet
AIA Document G702, APPLICATIOMAND CERTIFICATION FOR PAYMENT APPLICATION NO'` 5
containing Contractor's signed,�cerfiflcation is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. 10/31/07
Use Column I -on Contracts where variable retainage for line items may apply. PERIOD TO: 10/31/07
`t ARCHITECT'S PROJECT NO: 15966
A B C D E F- G H l
WORK COMPLETED MATERIALS TOTAL
PRESENTLY COMPLETED BALANCE RETAINAGE
ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS STORED AND STORED TO (IF VARIABLE
NO (NOT IN TO DATE VALUE APPLICATION THIS PERIOD (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 00% $0.00 $6,837.15
2 Sodding, Nursery $4,801.80 $4,801.80 $0.00 $0.00 $4,801.80 00% $0.00 $480.18
3 Mulch, Hardwood Shredded Bart. $8,385.00 $7,925.00 $0.00 $0:00 $7,925.00 95%
$460.00 $792.50
4 Plant, Evergreen shrub 3 gal. $6,669.00 $5,954.00 $0.00 $0.00 S5 89% $715.00 $595.40
5 Plant, Deciduous Tree, 2.5 -3" $47,922.00 $19,615.00 $4,564.00 $0.00 $24,179 `00 50% $23,743.00 $2,417.90
6 Plant, Deciduous Tree, 2 -2.5" $18,249.00 $12,561.00 $0.00 $0.00 $'12,561.00 69% $5,688.00 $1,256.10
7 Plant, Perennial, 1 gal. $27,702.00 $26 $0.00 $0.00 $26,154.00 94% $1,548.00 S2,615.40
8 Plant, Ornamental Grass, 1 gal. $10,175.75 $9,889.00 $0.00 '$0.00 $9,889.00 97% $286.75 $988.90
9 Spade Edge $724.80 $724.80 $0.00 $0.00 $724.80 00% $0.00 $72.48
10 Mobilization/Demobilization $500.00 $500.00 $0.00 $0.00 $500.00 00% $0.00 $50.00
11 Maintenance of Traffic $750.00 $750.00 $0.00 $0.00 $750.00 00% $0.00 $75.00
12 Irrigation System $43,614.00 $43,614.00 $0.00 $0.00 $43,61.4.00 00% $0.00 b4,361.40
13 Charge Order 41 $313.00 $0.00 $313.00 $0.00 $313.00 00% $0.00 $31.30
14 Charge Order ##2 $4,528.50 $0.00 $4,528.50 $0.00 $4,528.50 00% $0.00 $452.85
Total $242,70635
r$20Q,860,10 $9,405.50 $0.00 210 265.60 87% 32 44 0_75 SL,026 56
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 O 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.-
AIA 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 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
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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
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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. 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
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 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 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 U E F G H
WOKK COMPEL "rGll
MATERIALS TOTAL
BALANCE:
ITEM SCHEDULED PROMPRBVIO(JS 1'RLSEM'LY COMPS -EIIiD RF,TAINAGF
NO DL'SCR[Pr101 OF WORK VALLT APPLICATION TF[IS PERl00 STORED AND STORED T I IF VARIABLE
(NOT IN TO DATYi IG +C) i''LV7S8 RATE)
(D r F.) 1) OR E) (D +E +F] (C G)
1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0
2 5TUMP REMOVAL 5,000 5.000 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. CONC, 5,000 0 0 0 0 0 5,000
b 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
6 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
it 105.000 20000 10,000 10000 40,000 65000
AIA Document G703TU 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 It 0) 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 NGLEDI W 1100 FAST 116T" STREET CARMEL, INDIANA 46032
G R 317/575 -1100 317/573 7339 FAx
INVOICE DATE'
10 -CL 116 10/31/2007 00357 10- IN 15966
Job 1026220
Customer: Site Address:
City of Carmel 116th Street Project
Board of Public Works Safety College to Rangeline
One Civic Square
Carmel, IN 46032
1 16th Street Project landscape $8,464.95
Landscape Services
Application V
Landscape and Irrigation services through
October 31, 2007.
Sales Tax: $0.00
Amount Due: $8,464.95
TERMS NET 30. ACCOUNTS PAST 30 DAYS ARE SUBJECT TO 1.5% PER MONTH FINANCE CHARGE.
INVOICE NUMBER INVOICE
10 -CLI 16 $8,464.95 0035710 -IN 10/31/2007
E NGLEDI W 1 1 00 EAST 1 1 6 T STREET CARMEL, I N DIANA 46032
G R U1 31 7/5 75 1 100 31.7/573 -7339 FAx
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
Engledow, 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))
11/2/07 pp 5 116th Street Streetscape, -K .464.95
Landscape irrigation
112108 4P 6 If $24,554.70
33,019.65
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
FaR l ew, I IN SUM OF
1100 East 116th Street
Carmel, IN 46032
$33,019.65
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or. INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 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
15966 App 5 2200- R44624 31$8,464.95 which charge is made were ordered and
15966 App 6 2200 R44624 31$24,554.7o received except
20 D9
Si nat e
c
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund