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CITY OF CARMEL, INDIANA VENDOR: 356231 Page 1 of 1
ONE CIVIC SQUARE YARDBERRY LANDSCAPING EXCAV 1M�
CARMEL, INDIANA 46032 9940 SOUTH 100 WEST HECK AMOUNT: $17,654.41
y <Fori a�. ANDERSON IN 46017 CHECK NUMBER: 160139
CHECK DATE: 5/28/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 R4462300 16845 6 17,654.41 DRAINAGE PROJECT
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 0702 (Instructions on reverse side) rr.Ct ONE Or
TO (OWNER). PPO)ECT: PPU _ATION NO: 4, Distr1 to
C I OG Cr iz rn��, I^� \Jt�� L� IIJAC,� ��h1°, c��� Ma'JTS D OWNER
C,{k IA el— PERIOD TO 4-11-09 DARCHITI
clvli A r
O CONTRA
FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECF•S O
Yardberry Landscape Excavating PROJECT NO.: 0
9940 S. 1000 W. CROSS �+�a 'vEEizS
CONTRACT F0 �p derson, IN. 46017 ONTRACT DATE.
oes
Application is made for Payment, as shown below, in connection with the Co
CONTRACTOR'S APPLICATION FOR PAYMENT Continuation Sheet, AIA Document G703, is attached.
CHANGE ORDER SUMMARY 1 ORIGINAL CONTRACT SUM S /93,5 oo
2. Nct change by Changc Ordcrs S �L, f (09 zq t
Change Orders approved in ADDITIONS DEDUCTIONS
previous months by Owner 3. CONTRACT SUM TO DI,TE (Line 1 2) S a t9, '7/ y. 0'/
TOTAL 4. TOTAL COMPLETED &STORED TO DATE............ S l "lfr 7y4. Dy
(Column G on G703)
Approved this Month
3 0 S. RETAINAGE:
Number Date Approved
a. 1 X of Completed Work S I0, fg• I
�Sco' 0o (Column D E on 6703)
b. D X of Stored Material S
(Column F on G703)
Total Retainage (Line 5a +5b or
TOTALS 1> Total in Column 1 of 6703) S 10,81`6.(0
Net than r by c Orders q 6. TOTAL EARNED LESS RETAINAGE S 6y.7� 4.
The undersigned Contractor certifies that to the best of the Contractor's knowledge, 1 (Line 4 less Line S Total)
information and belief the Work covered by this Application (or Payment has been 7. LESS PREVIOUS CERTIFICATTS FOR
completed in accordance with the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Cenifcate) S
paid by the Contractor for Work for which previous Certificates for Payment were. b. CURRENT PAYMENT DUE S
issued and payments received from the Owner, and that current payment shown 9. BALANCE TO FINISH, PLUS RETAINAGE S 33,7 XG•l0
herein is now due. (Line 3 less Line 6)
CONTRACTOR:
Statcof: A County of 1k)Pz'
Subscribe and sworn to before me this /1,w day of
Notary Pu lie: iSed,Gf
By: Date: 11 My Commission expires:
AMOUNT CERTIFIED S� 5
ARCHITECT'S CERTIFICATE FOR PAYMENT. (Attach explanation if amount certified differs from the amount applied fora
In accordance with the Contract Documents, based on on -site observations-and the ARCHITECT:
'data comprising the above application, the Architect certifies to the Owner that to the
best of theArehiteet's knowledge, information and,belief the Work has progressed as B PP41OVE Date:
Indicated, the quality of the Work is in accordance with the Contract Documents, and This Certi irate is no negotiable. The AMOUNT CERTIFIED is payable onh
the Contractor is entitled to payment of the AMOUNT CERTIFIED. Contractor named h rein. issuance, payment and acceptance of payment are
prejudice to any rights of the Owner or Contractor under this Contract.
AIA nOCUMtNT C7r2 A"tICATION AND CFRTIFICATT FOR PAYMtNT MAY 1 FDITION ALA' C. 1933
CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 OF
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER:
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. ARCHITECTS PROJECT NO:
Use Column I on Contracts where variable retainage for line items may apply.
ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED THIS PERIOD MATERIALS TOTAL (G C) BALANCE RETAINAGE
NO. VALUE FROM PREVIOUS PRESENTLY COMPLETED 100% TO FINISH
APPLICATION STORED AND STORED (C G)
(D E) NOT IN TO DATE
DORE D +E +F
1 Construction Engineering $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00
2 Mobilization Demobilization $8,000.00 $8,000.00 $1,000.00 $0.00 $8,000.00 100% $0.00
3 Maintenance of Traffic $5,000.00 $5,000.00 $1,000.00 $0.00 $5,000.00 100% $0.00
4 Clearing Right of Way $7,800.00 $7,800.00 $800.00 $0.00 $7,800.00 100% $0.00
5 Utility Exploration and Relocation $3,000.00 $3,000.00 $0.00 $0.00 $3,000.00 100% $0.00
6 Ditch Grading $20,052.00 $19,140.00 $2,616.00 $0.00 $19,140.00 95% $912.00
7 Drive Culvert Cleaning $1,075.00 $1,075.00 $0.00 $0.00 $1,075.00 100% $0.00
8 Core Existing Structure $750.00 $750.00 $0.00 $0.00 $750.00 100% $0.00
9 12" CMP $44,039.00 $44,039.00 $0.00 $0.00 $44,039.00 100% $0.00
10 12" 22.5 deg. CMP Bend $1,100.00 $1,100.00 $0.00 $0.00 $1,100.00 100% $0.00
11 18" RCP $4,680.00 $4,680.00 $0.00 $0.00 $4,680.00 100% $0.00
12 21" RCP $5,184.00 $1,728.00 $0.00 $0.00 $1,728.00 30% $3,456.00
13 18" Concrete Pipe End Section $5 $2,520.00 $0.00 $0.00 $2,520.00 50% $2,520.00
14 21" Concrete Pipe End Section $5,880.00 $1,960.00 $0.00 $0.00 $1,960.00 30% $3,920.00
15 Inlet, E -7 $24750.00 $24,750.00 $0.00 $0.00 $24,750.00 100% $0.00
16 B- Borrow for Structure Backfill $4,320.00 $4,320.00 $0.00 $0.00 $4,320.00 100% $0.00
17 Paved Side Ditch $5,520.00 $5,250.00 $5,250.00 $0.00 $5,250.00 100% $0.00
18 HMA Surface, 9.5 mm $1,690.00 $1,690.00 $0.00 $0.00 $1,690.00 100% $0.00
19 HMA Intermediate, 19.0 mm $2,160.00 $1,160.00 $0.00 $0.00 $1,160.00 55% $1,000.00
20 PCCP for Driveways 6" $770.00 $770.00 $0.00 $0.00 $770.00 100% $0.00
21 Concrete for Street Cut Repair, Depth 12" $4,500.00 $4,150.00 $0.00 $0.00 $4,150.00 95% $350.00
22 Flowable Fill for Street Cut Repair $4,400.00 $1,430.00 $0.00 $0.00 $1,430.00 32% $2,970.00
23 Compacted Aggregate, No 53 Base $1,820.00 $1,820.00 $0.00 $0.00 $1,820.00 100% $0.00
24 Rip Rap, Revetment $5,250.00 $5,250.00 $0.00 $0.00 $5,250.00 100% $0.00
25 Drop Fabric Inlet Protection $2,250.00 $2,250.00 $0.00 $0.00 $2,250.00 100% $0.00
26 Temporary Rock Check Dam $1,400.00 $0.00 $0.00 $0.00 $0.00 0% $1,400.00
27 Temporary Silt Fence $1,440.00 $0.00 $0.00 $0.00 $0.00 0% $1,400.00
28 Erosion Control Blanket w/ Mulched Seeding $12,045.00 $12,045.00 $1,250.00 $0.00 $12,045.00 100% $0.00
29 Sidewalk Repair, Concrete 4" (Undistributed) $4,770.00 $0.00 $0.00 $0.00 $0.00 0% $4,770.00
30 Tree Removal, 3 in. (Undistributed) $400.00 $400.00 $400.00 $0.00 $400.00 100% $0.00
31 Tree Removal, 12 in. (Undistributed) $1,500.00 $1,500.00 $1,500.00 $0.00 $1,500.00 100% $0.00
32 Tree Removal, 24 in. Undistributed $3,000.00 $3,000.00 $3,000.00 $0.00 $3 000.00 100% $0.00
$193,545.001 $170,577.001 $16,816.00 $0.00 $170,577.00 $22
AIA DOCUMENT G703'APPLICATION AND CERTIFICATE FOR PAYMENT'MAY 1983 EDITION'AIA' 1983
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W.,WASHINGTON, D.C. 2006 G703 -1983
CONTINUATION INUA►T'ION SHEET AIA DOCUMENT G703 PAGE 3 OF 3 PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER:
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar•. ARCHITECTS PROJECT NO:
Use Column I on Contracts where variable retainage for line items may apply.
ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED THIS PERIOD MATERIALS TOTAL (G C) BALANCE RETAINAGE
NO. VALUE FROM PREVIOUS PRESENTLY COMPLETED 100% TO FINISH
APPLICATION STORED AND STORED (C G)
(D E) NOT IN TO DATE
DORE D +E +F
33 19 "x30" Oval RCP Pipe $4,991.04 $4,991.04 $0.00 $0.00 $4,991.04 100% $0.00
✓34 Extra 18" RCP Pipe $2,470.00 $2,470.00 $0.00 $0.00 $2,470.00 100% $0.00
✓35 19 "x30" Concrete End Sections 6 $10,800.00 $10,800.00 $0.00 $0.00 $10,800.00 100% $0.00
L e Ex s et aoo "0 -------$O-OE)- ---$271-130-00 On'r
T'"'� ✓37 Extra 64' of 12" CMP $3,008.00 $3,008.00 $0.00 $0.00 $3,008.00 100% $0.00
✓38 Keystone Wall $2,800.00 $2,800.00 $2,800.00 $0.00 $2,800.00 100% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$0.00 $0.00 $0.00 $0.00 0% $0.00
$26 $26 $2,800.00 $0.00 $26,169.04 0% $0.00
$219,714.041 $196 $19,616.00 $0.00 $196,746.04 $22,698.00
AIA DOCUMENT G703 APPLICATION AND CERTIFICATE FOR PAYMENT MAY 1983 EDITION 1983
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,N.W.,WASHINGTON, D.C. 2006 G703 -1983
Y arctberry Landscape Excavating invoice
9940 South 1000 West
Anderson, IN 46017 Date Invoice
4/11/2008 6358 -AA
Bill To
CITY OP CARMEL CARMEL VIEW DRAINAGE IMP
Description Amount
APPLICATION FOR PAYMENT #6 17.654.41
THANK YOU FOR YOUR BUSINESS
Total $17,654.41
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.
Payee
Yardberry Landscape Excavating
Purchase Order No.
9940 South 1000 West
Terms
Anderson, IN 46017
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/16/08 Pay App #6 Carmel View Drainage Project (07 -05) $17,654.41
Tota
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
-Yard Lanilcnane Exray ti
IN SUM OF
9940 South 1000 West
Anderson, IN 46017
$17,654.41
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
IN54b Pay App 96 206 R4462300 P79 .41 materials or services itemized thereon for
which charge is made were ordered and
received except
A -3 20
C
Signat re
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund