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HomeMy WebLinkAbout165009 10/16/2008 *f CITY OF CARMEL, INDIANA VENDOR: 356231 Page 1 of 1 ONE CIVIC SQUARE YARDBERRY LANDSCAPING 8, EXCAV 1N� CARMEL, INDIANA 46032 9940 SOUTH 100 WEST HECK AMOUNT: $146,022.55 ANDERSON IN 46017 CHECK NUMBER: 165009 CHECK DATE: 10/16/2008 �1EPARTMENT A CCOUNT PO N INVO NUMBER AMOUNT DESCRIPTION K `'610 5023990 W08290 146,022.55 WATER MAIN REPLACEMEN r r e b.o[," jai d :b py 4. a DOcum6nt G702' ®1992 Application and Certificate for Payment TO OtiNhIII3:� PROJECT: APMCATM NO: fribttlion ta: e D e e ,,,c D11 CA TLm e. I�P.JC�1ea l j t�trP� �r w rc� e�T C AN ST) PEMODTO: g �,5 o �y OANgt Q Lim �QU AQ Ui T�� 00fR J RUGALe met f CONTRACT F-OR: ARDMCT: Q FROM VIA CONTRACT DATE: COtM=( R: 4UlTMCfOR: ARCHR -67: PROJECT NOS: ou t Ja�uT3� tiny ll�nlascErPe" a rc CPASs�oa,� �r•►C�i+�+�� FiD:Q CONTRACTOR =S APPLICATION FOR PAYMENT The mAersu Cmtm= cettifics that to tht best Of ffie C0=2=eS baO%�� and beW do a'Mt covered by this AgplicDoa for Paymeaf has bem completed m wcordmco Application is made fur pa}=cra, as shovm blow, in im=ccfum vivh the CawvacL v th the Canvas DammccM tha7 all amottau bm-c beta prod by the Co==w for Work for Umirntation Shea. ALA Documzm G703, is auacW etich pmiom C=ftBcales for Payment Qae issued and Mmmts recemned fi= fbe Ow=, and 1.OMNAL CONTRACT SUM S o7. 9 y 0!� that cwarnt payment Shona hmem is now &e- 2Nei tta,tge by Change Orders ti`+ COKTRA�iPO =ft:_ 3. CONTRACT SUFI TO DATE (line Date:$' 4.TOTALCOUPLE M6STOPEOTOOATF(Cfl=GonGM) 4,3 Swc Nt) v 5. PETA2UMF- qty of In A i s c• ej L 1 of Compietrd Wo& Suhur5ed and sworn to bdom U 5 Oc (L ah= D E on G703) S i' p2, me this JSTN &Y b. of Starrd Ma=il] (Column F on GM) S Notary Pubic_ Tota.I R udnMe {lines 5a Sb or Total in Coh=, I of 6703 S tl MY �0m 4 D 09 6. TOTAL EARNED LESS RETAINAGE s a 3 a 0 ARCHITECT'S CERTIFICATE FOR PAYMENT G 4 Less line S TotzI) aocaadzwe. wish the Connmx Doc, based on cn -site obsutiatims and the data aampnsing 7. LESS PREV10US CERTITICATES FOR PAY3�7T S �6 Y 1,4 this flx Arrhhed eafLin is the Gamer that to the best of the AahiteWs knoa (lirx bfrom prlar Crztificar) mformab an nn d belief the Wade has pmgressrd as m&c=d, the quality of the Wcxk is to somr&nae wuh the Contract Doam and the Cocawwr is ersaled to payment of the CURRENT PAYMENT DLI£ 4 AIAOUNT CERTn IFA_ I BALANCE TO FKSK INCL JDKG RETAPL4OE AMOUNT IEnFIE (line 3 less Line 6) S—al. /S r/ 1 (Anach cTlanatim if a=u aorgird drffmfmm the amo=d appke& b=al all frgwu on this App and on rho Cwrmuarnan Sleet drat =r eirtaagaad m aTfons wuh xbe m7x= ae lifia) MA NGE ORDER SU.4iMARY ADDITION DfDUCMINS ARCEIITWP otzi >nd in micars months Oanrr S c� ,lJS S Z .O� By Data: otz] ad ibis >1loa+h S k ed S This Ca>ifi�e is not mgodahlc. The ANIOUNT CERIH ED is pa3 only w die Coavaua' TOTALS S �iv� S Mmod ha xa rm lsm paymaff and accepmcc of payment tte without ptzJ�oe to aaydgbn of NET CHANGES h Change or3Q s a 73y,1%5�, ..R 'me Ovtmer or a >mda this caahma A1A DcumwrAG7Q2- -1- W CWpiqbt 01 s e2 a d 59z by Tho r ---b-- tr=auL- or ant aa� AN 6" m9wvmL WAFUM.W rtt M a D0ur..W:af ter rnr LLS. CoprMg t Law a_->d hnE1m=mad Trues. UrLTj. cwtMd reprodm zon ca dGL19,rrtian of ttds Ate D=r�nwi& cr wry porton o4 it may reudt in s--s crd3. and u1a PWIRftias, and uM ba prosacc led Z the IMT �C art f+o�� cti lzx, This dmar�ci times pen�c: bl' AL4 sage at 11973:19 am [14?3+2DS`S tzzlar tlnfz+ tae.l0ol)12f2:fi 2 expires ca+ fd U2005, avd Ts rsA is rye. User Nobs= (472b88:b3) CA o c T Prescribed by State Board of Accounts Form No. 301 (Re v.1995) ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount •ti 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 which charge is made were ordered and received except Mo. Day Yr. Signature Title 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. Mo. Day Yr. fficer Title Voucher No. Warrant No. p ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WATER DEPT. CARMEL, INDIANA Favor Of Akl �A -d scAp� Total Amount of Voucher Deductions a oso N602 s5 Amount of Warrant Month of Yr Acct. VOUCHER RECORD No. Source of Suppl Water Treatment Transmission and Dist Customer Accounts Administrative and General O eration- Maintenance Utility Plant in Service Constr. Work in Progress Materials and Supplies Customers De osits Total Allowed Board of Control Filed Official Title BOYCE FORMS SYSTEMS 1 -800- 382 -8702 121