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HomeMy WebLinkAbout161970 07/23/2008 i CITY OF CARMEL, INDIANA VENDOR: 359953 Page 1 of 1 ONE CIVIC SQUARE NATGUN CORPORATION CHECK AMOUNT: $148,379.53 CARMEL, INDIANA 46032 PO BOX 847140 BOSTON MA 02284 -7140 CHECK NUMBER: 161970 CHECK DATE: 7/23/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 609 5023990 07C36 -6 148,379.53 1051.80 i I j i I q APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions nn reverse side) PAGE ONE OF 1a G ES 1 TO OWNER: PRO PRO JECT: APPLICATION NO.: 07C36 -6 Distribution to: lo) Carmel Utilites J' WTP No. 4 Clearwell 760 3rd Ave, SW, STE 110 Contract 68A PERIOD TO: 4/30/08 El OWNER PROJECT NOS.: ARCHITECT Carmel, IN 46032 CONTRACTOR FROM CONTRACTOR: Natgun Corporation VIA ARCHITECT: CONTRACT DATE: P.O. Box 847140 CONTRACT FOR: Boston, MA 02284 -7140 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation and belief the Work covered by this Application for Payment has been completed Application is made for payment, as shown below, in connection with the Contract. in accordance with the Contract Documents, that all amounts have been paid by the Continuation Sheet, AIA Document G703, is attached. Contractor for Work for which previous Certificates for Payment were issued and pay 1 ments re ved from the Owner, and that current payment shown herein is now due. I. ORIGINAL CONTRACT SUM 2 Net change by Change Orders 95,410.35 C TRACTO 3 CONTRACT SUM TO DATE (Line I 2) 1,472 ,610.35 By: Date: 4129108 4. TOTAL COMPLETED STORED TO DATE.. 1, 459,610.35 state of: Massachusetts (Column G on G703) County Of: Middlesex 5,. RETAINAGE: Subscribed and sworn to before a. of Completed Work 7,000.00 me this 29th day Of April 2008 (Columns D E on G703) b. of Stored Material (Column F on G703) Notary Public: 2014 Total Retainage (Line 5a 5b or My Commission expire MyCOmm isSion Total in Column I of G703) 7,000.00 6. TOTAL EARNED LESS RETAINAGE 1,452,610.35 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data (Line 6 from prior Certificate) 1,304,230.82 comprising 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 8. CURRENT PAYMENT DUE 148 ,379.53 quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) 20,000.00 AMOUNT CERTIFIED (Attach explanation if amount certified differs from the amount applied for Initial CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS all figures on this Application and on the Continuation Sheet that are changed to Total changes approved in conform to the amount certified.) previous months by Owner ARCHITECT: Total approved this Month By: Date: TOTALS This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con NET CHANGES by Change Order tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AIA° ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK a 1 1��2 AVENUE, NW, WASHINGTON, D.C. 20006 -5292 WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 -1992 CAUTION: You should use an nrininal GIG rineiimPnt whirh has this rrantinn nrintnri in rcrl in z� CONTRACTOR'S PERIODIC ESTIMATE FOR PAYMENT NO: 07C36 -6 .0 PJW"� S =1 ENGINEER: Jones Henry Engineers LTD PROJECT: 1.50 MG Water Storage Tank 2420 North Coliseum Blvd, STE 214 Carmel, IN Fort Wayne, IN 46805 07C36 CONTRACTOR: Natgun Corporation Remit to: FROM: 04/01/08 11 Teal Road Natgun Corporation TO: 4/30/2008 Wakefield, MA 01880 P.O. Box 847140 Boston, MA 02284 -7140 TERMS: 30 Days CONTRACT AMOUNT: $1,377,200.00 TOTAL WORK COMPLETED TOTAL PERCENT/ ITEM UNIT SCHEDULED FROM PREV. COMPLETED QTY BALANCE NO. DESCRIPTION OF WORK QTY. PRICE VALUE APPLICATION THIS PERIOD TO DATE TO DATE TO FINISH a TANK WORK Engineering, Design Drawings, 1 Calculations, Bonds and Insurance LS 41,000.00 41,000.00 0.00 41,000.00 100% 0.00 2 Footing and Floor Complete LS 145,000.00 145,000.00 0.00 145,000.00 100% 0.00 3 Casting Wall Panels LS 120,000.00 120,000.00 0.00 120,000.00 100% 0.00 4 Casting Dome Panels LS 90,000.00 90,000.00 0.00 90,000.00 100% 0.00 5 Erect Dome Shoring and Forms LS 30,000.00 30,000.00 0.00 30,000.00 100% 0.00 6 Erect Wall Panels LS 90,000.00 90,000.00 0.00 90,000.00 100% 0.00 7 Erect Dome Panels LS 67,000.00 67,000.00 0.00 67,000.00 100% 0.00 8 Form and Pour Wall Slots LS 20,000.00 20,000.00 0.00 20,000.00 100% 0.00 Form Reinforce and Pour Dome Ring 9 and Slots LS 28,000.00 28,000.00 0.00 28,000.00 100% 0.00 10 Core Wall Shotcrete LS 15,000.00 15,000.00 0.00 15,000.00 100% 0.00 11 Prestressing LS 135,000.00 135,000.00 0.00 135,000.00 100% 0.00 12 Covercoat LS 30,000.00 30,000.00 0.00 30,000.00 100% 0.00 13 Coating system LS 16,000.00 16,000.00 0.00 16,000.00 100% 0.00 14 Strip and Remove Dome Shoring and Forms LS 5,000.00 5,000.00 0.00 5,000.00 100% 0.00 15 Inlet riser and Pipe LS 28,200.00 28,200.00 0.00 28,200.00 100% 0.00 16 Manway LS 7,300.00 7,300.00 0.00 7,300.00 100% 0.00 17 Ladders LS 12,700.00 12,700.00 0.00 12,700.00 100% 0.00 1 ,s CONTRACTOR'S PERIODIC ESTIMATE FOR PAYMENT NO: 07C36 -6 PJM S =1 WORK COMPLETED TOTAL PERCENT/ ITEM UNIT SCHEDULED FROM PREV. COMPLETED QTY BALANCE NO. DESCRIPTION OF WORK QTY. PRICE VALUE APPLICATION THIS PERIOD TO DATE TO DATE TO FIN ISH 18 Sensor Sleeves LS 1,000.00 1,000.00 0.00 1,000.00 100% 0.00 19 Handrails LS 2,100.00 2,100.00 0.00 2,100.00 100% 0.00 20 Casting Precast Baffle Wall Panels LS 69,300.00 69,300.00 0.00 69,300.00 100% 0.00 21 Erecting Precast Bafffle Walls LS 35,700.00 35,700.00 0.00 35,700.00 100% 0.00 22 Precast Pilasters LS 24,500.00 24,500.00 0.00 24,500.00 100% 0.00 23 Hatch Vent and Overflow LS 18,000.00 18,000.00 0.00 18,000.00 100% 0.00 Subtotal Tank Work 1,030,800.00 1,030,800.00 0.00 1,030,800.00 0.00 c SITE WORK A Layout and Survey LS 9,000.00 9,000.00 0.00 9,000.00 100% 0.00 B Clear and Grub Site LS 18,000.00 18,000.00 0.00 18,000.00 100% 0.00 C General Site Prep LS 7,000.00 7,000.00 0.00 7,000.00 100% 0.00 D Erosion Sedimentation Control LS 6,500.00 6,175.00 325.00 6,500.00 100% 0.00 E Temporary Access Road LS 13,000.00 13,000.00 0.00 13,000.00 100% 0.00 F Excavation for the Proposed Tank LS 55,000.00 55,000.00 0.00 55,000.00 100% 0.00 G Dewatering LS 4,000.00 4,000.00 0.00 4,000.00 100% 0.00 H Sheet Piling LS 46,200.00 46,200.00 0.00 46,200.00 100% 0.00 1 3/4" Crushed Stone Leveling Base Material LS 24,000.00 24,000.00 0.00 24,000.00 100% 0.00 J Stabilized Winding Track, Road Etc. LS 25,000.00 25,000.00 0.00 25,000.00 100% 0.00 K Water and Drain Pipe, Concrete Structures LS 75,000.00 75,000.00 0.00 75,000.00 100% 0.00 L Final Backfill and Site Restoration LS 50,700.00 40,560.00 10,140.00 50,700.00 100% 0.00 M Chain Link Fence LS 13,000.00 0.00 0.00 0.00 0% 13,000.00 Subtotal Site Work 346,400.00 322,935.00 10,465.00 333,400.00 13,000.00 TOTAL ORIGINAL CONTRACT 1,377,200.00 1,353,735.00 10,465.00 1,364,200.00 13,000.00 2 CONTRACTOR'S PERIODIC ESTIMATE FOR PAYMENT NO: 07C36 -6 PJM S =1 WORK COMPLETED TOTAL PERCENT/ ITEM UNIT SCHEDULED FROM PREV. COMPLETED QTY BALANCE NO. DESCRIPTION OF WORK QTY. PRICE VALUE APPLICATION THIS PERIOD TO DATE TO DATE TO FINISH CHANGE ORDERS C.O 1 Piping Changes LS 95,410.35 95,410.35 0.00 95,410.35 100% 0.00 TOTAL CHANGE ORDERS 95,410.35 95,410.35 95,410.35 TOTAL CONTRACT 1,472,610.35 1,449,145.35 10,465.00 1,459,610.35 13,000.00 ORIGINAL CONTRACT SUM: 1,377,200.00 We Certify That This Estimate Is Correct Net Change By Change Orders: 95,410.35 NATGUN CORPORATION CONTRACT SUM TO DATE: 1,472,610.35 TOTAL COMPLETED TO DATE: 1,459,610.35 RETAINAGE: 7,000.00 TOTAL EARNED LESS RETAINAGE: 1,452,610.35 LESS PREVIOUS BILLINGS: 1,304,230.82 We Have Checked This Estimate and Recommend Payment CURRENT PAYMENT DUE: 148,379.53 BALANCE TO FINISH INCLUDING RETAINAGE: 20,000.00 BY: 3 't 7rescribed by State Board of Accounts Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER TO ADD Invoice Date Invoice Number Item Amount 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 orrect and I have audited same in accordance with IC 5 11 10 1.6. ljvelz Mo. Day Yr. icer Title Voucher No. Warran No. ACCOUNTS PAYA BLE DETAILED ACCOUNTS MUNICIPAL WATER DEPT. ACCT. NO. CARMEL, INDIANA Favor Of 111A f Gum <��P Total Amount of Voucher Deductions 6 Amount of Warrant Month of Yr VOUCHER RECORD Acct. No. Source of Suppl Water Treatment Transmission and Dist. Customer Accounts Administrative and General operation- Maintenance Utility Plant in Ser io Constr. Work in Pro ess, Materials and Supplies Customers Deposits Total Allowed Board of Control Filed Official Title ROYCE FORMS SYSTEMS 1 -800- 382 -8702 325