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156894 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 356231 G Page 1 of 1 ONE CIVIC SQUARE YARDBERRY LANDSCAPING EXCAVA AMOUNT: $15,369.29 t o CARMEL, INDIANA 46032 9940 SOUTH 100 WEST ANDERSON IN 46017 CHECK NUMBER: 156894 CHECK DATE: 2/21/2008 DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 206 R4462300 16845 4 15,369.29 DRAINAGE PROJECT DOcurrent 6702 1992 Application and Certificate for Payment ow?aR. APPUCAM� Dht CT: r �o- ibOon to: �lT� OF Cazm� �,J 1)RRInIRC1C 1r'1Pz0J -`rnetJtS l..�R -m V PER}DD Ti 0: a 08 0 1 C, vic �S- Qu Acre C a run cDNTRACr troll: ARDUTECT: FRDM VIA CONTRACT GATE: COt1TRACTOR CgKTRACTOR ARCHRICT: PRDJE(CTNOS: ka�B��R� LR"jt)SL.RP� L!�C L G 1! �pAD ��6�n/cE�S FIELD:© gg40 5 ICCO j r=1„ lDe& -;v,J, /-j lN OTHOL o CONTRACTOR'S APPLICATION FOR PAYMENT The undersi Cbn=u= cm that to the bey of the cages knawled ;ufornn ian and behd the Work covered by du s Appbc»on fbr Payment has been completed in moaridmcc Apphcabon is made for Mmxmi. as sho Km below, m ommecdoo voth the ConaacL With the Ccmtraa Dotcroents, that aD ammo hmr- be= paid by tht Conirar I far Work for Shcet., ALA Docmnctd G7(13, is artadx'd. uticb pmirrns CetOifk=es for Payment Rem Caned and pa)mcats rerentd fimm the Owner, and 1.OWG� COMTRACT SUM S 113, 5145.0 o that cunmt payment shown heram c: now dur- 2 Net change by Change Orders S 13 30.Oj CO OR: 3. CONTRACT SUM TO DATE (lip 1 t Z)._---- S I N tl 1`♦ 0q By. D=: v2 -:!5 O S' 4. TOTAL COWL= 6 STORED TO DATE (Ccl=i G rn G703) S 1 130.0 q Stan cf. I i.l n l A rJ A 5. RETAXkGF Ca®ty of (Y14 o i S O IJ !L 10 of ¢d wort Subscribed jMd (c�D r Gr43) S 11 X13.01 �o �E�rz� J ao b. 0 of Sim Material (Cohmm F on 67(13) S 0 0 0 Notary Public Total Rcuinage (hats 5 a 5b or Total in Cafrrn:n 1 of 6703)_ S 13 0 I Kly Commi mion -Firm b TOTAL EARKM LESS RETAIHAGE S 151 ,411- 03 ARCI ffr::c 'S CERTIFY ATE. FOR PAYMENT (L ine 4 Less Lice 5 Total) In aDomdz= vinh the Coan Doc ww- based an an -site obscr%= xis cad the dua oampr Sing 7. LESS PRFVFOUS CERTFICATES FOR PAYMENT S 14 it y '1 .'I q This htpp1kz=n, the Aerhrt of cer ce es to the ORS a that to the best of the Arcbitcu's knaledge, (line b from prim Cerl Scar) t mformabon and bebr -f the Woe} has pragtrsscd as meted, the gaatity of the Wodr ts in accordance oath the Coturaci Do:mneuts, and the Cacrracmr is ecmkd to payment od the LaJRREKTPAYWZh7DLEE 16, 3 q, a`) AbAOUNT CERTIFI>=D_ S. RM ANCE TD FNM� UQITMG RETAKAGE Al�OihfT CSTTrF�D S f .6, 34 Z (Tint 3 loss Line 6) S 54 4 l 01 {Attach tplmra d- if w== cevified drf f fso -the --a ap&cd h—al aU fsgu -j on this Apptic adm and on dic Corr mimon Shea ica arr cfimglad m onrfana wuh r bc amarad cargie) `GE ORDER STIMhiARY ADDITIO.� DIDUC ITDPIS C 12at15 Ra4D Enl4l /j&�R.� ohzl cs swim micas months Ownrt S �;0. 301.Oq S 0.0o By Datr: p ZUD az] apFsvticd this Mom S Op S 0.00 This Certificate is not Degodahle. '(Ise AAAiOUNT CEPTff=) is palrbk only to die Ca¢ltxa TOTALS S �,3 ,3 .ON S 0 Cv` uzmod b=m issnanrre, papmerd atd acoeptance of palmmt err uithvol prcjudke to coy rights of l' CHANGES by Ch., Odor S a 3 3v 1.0`1 me o„mer or ca=acc= trader this +:.'A30trax A!A Doaaarn G702— —1992. Copyri2td O 1832 and 1712 by TTn amadcan kss of Arch AM rV2v rmwwvaL WAfi MML Thus 91A" Doe r:�e:1 ts prtt-Mc ted try US. C�or'ATtgm lea :Td ht n -mal Trea'_es UnrY`mr repro :rciion or dts!- MerOn of II A10 BeanerQ a rry por co of 11, may matt t-) ve%- -e CA. std er=n Imud e's, anti u9 Ira prosectMed to tY r n-3 M r rar,T posst� vc the tat+. 7tYS cbnmteat vas p t xc�d br Al saflaare at US23 t9 on 0.5tLi24C15 u-c>nr DrdH. Nm10o012124ti 2 vdiJdt ei#r3 cn dL12Da5, and is nd for resa5a. timer Not= (f726138;6� 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 $6,500.00 $500.00 $0.00 $7,000.00 90% $1,000.00 3 Maintenance of Traffic $5,000.00 $4,000.00 $0.00 $0.00 $4,000.00 90% $1,000.00 4 Clearing Right of Way $7,800.00 $7,000.00 $0.00 $0.00 $7,000.00 90% $800.00 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 $12,000.00 $4,524.00 $0.00 $16,524.00 75% $3,528.00 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 $5,040.00 $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 $24,750.00 $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 $0.00 $0.00 $0.00 $0.00 0% $5,520.00 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 $0.00 $5,250.00 $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 $7,000.00 $3,795.00 $0.00 $10,795.00 90% $1,250.00 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 $0.00 $0.00 $0.00 $0.00 0% $400.00 31 Tree Removal, 12 in. (Undistributed) $1,500.00 $0.00 $0.00 $0.00 $0.00 0% $1,500.00 32 Tree Removal 24 in. Undistributed $300000 $0.00 $0.00 $0.00 $0.00 0% $3,000.00 $193 545.00 $139 692.00 $14 069.00 $0.00 $153 761.00 $39 784.00 AIA DOCUMENT G703 APPLICATION AND CERTIFICATE FOR PAYMENT'MAY 1983 EDITION "AIA' 1963 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,N.W.,WASHINGTON, D.C. 2006 G703 -1983 CONTINUATION 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 36 Type E Inlet 1 $2,100.00 $2,100.00 $0.00 $0.00 $2,100.00 100% $0.00 37 Extra 64' of 12" CMP $3,008.00 $0.00 $3,008.00 $0.00 $3,008.00 100% $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 $0.00 $0.00 $0.00 $0.00 0% $0.00 $23,369.04 $20 $3,008.001 $0.00 $23,369.04 0% $0.00 $216,914.04 $160 $17 $0.00 $177 130.04 $39 784.00 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 -1883 Yardberry Landscape Excavating Invoice 9940 South 1000 West Date Invoice Anderson, IN 46017 2/5/2008 6345 -AA Bill To CITY OF CARMEL CARMEL VIEW DRAINAGE IMP Description Amount APPLICATION FOR PAYMENT #4 15,369.29 THANK YOU FOR YOUR BUSINESS Total $15,369.29 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)) 2/4/08 Pay App #4 Carmel View Drainage Project (07 -05) $15,369.2 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 andsG c.,,.., g IN SUM OF 9940 South 1000 West Anderson, IN 46017 $15 9 369.29 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 ay pp CCs R4462300 $15,369.29 materials or services itemized thereon for which charge is made were ordered and received except 200 S e Si nat e Cost distribution ledger classification if Title claim paid motor vehicle highway fund