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161305 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 358944 Page 1 of 1 ONE CIVIC SQUARE CENTRAL ENGINEERING CONSTRUC�RYCK AMOUNT: $231,831.90 CARMEL, INDIANA 46032 38(32 N COMMERCIAL PARKWAY GREENFIELD IN, 46140 CHECK NUMBER: 161305 CHECK DATE: 7/11/2008 DEPAR AC PO NUMBER INVOICE NUMBER AMOUNT DE SCRIPTION 106 R5023990 16093 APP #1 221,78.0.98 FOUNDERS PARK DEVELOP 853 R5023990 16093 APP #1 10,050.92 FOUNDERS PARK DEVELOP A APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT TO (OWNER): PROJECT: Founders Park Infrastructure Phase 1 APPLICATION NO. 1 DISTRIBUTION TO: Carmel/ Clay Board of Parks and Recreation OWNER XX Attn.: Mark Westermeler 1411 East 116th Street VIA (ARCHITECT): PERIOD TO: 6/3012008 Cannel, IN 46032 FROM: Central Engineering 8 Constriction Associates, Inc. ARCHITECTS 3862 N. Commercial Parkway PROJECT NO: Greenfield, IN 40140 CONTRACT FOR: SITE IMPROVEMENTS CONTRACT DATE: 22 -May -08 Application made for Payment, as shown below, In connection CONTRACTOR'S APPLICATION FOR PAYMENT with the contract. Continuation Sheet Is attached. CHANGE ORDER SUMMARY 1. ORIGINAL CONTRACT SUM $1,015,718.00 Change Orders approved In ADDITIONS DEDUCTIONS 2. Net Change by Change Orders $0.00 previous months by owner 3. CONTRACT SUM TO DATE $1,015,718,00 TOTAL 4. TOTAL COMPLETED STORED TO DATE $257,591.00 Approved this Month (Column G) No. Date Approved S. RETAINAGE: a. 10.00% of Completed Work $25,035,10 (Column D +E) b. 10.00% of Stored Material (Column F) $724.00 TOTALS1 0.001 Total Retainage (Line Sa +5b) or $25,759,10 Net Change by Change Orders (Total in Column 1) $0,00 6. TOTAL EARNED LESS RETAINAGE $231,831.90 The undersigned Contractor certifies that to the best of the Contractor's (Line 4 less Line 5 Total) knowledge, Information, and bellef the Work covered by this Application 7. LESS PREVIOUS CERTIFICATES FOR $0.00 for Payment has been completed in accordance with the Contract Docu- PAYMENT (Line 6 from prior Certificate) ments, that all amounts have been paid by the Contractor for Work for 8. CURRENT PAYMENT DUE $231,831.90 for which previous Certificates for Payment were Issued and payments 9. BALANCE TO FINISH, PLUS RETAINAGE $763,885.10 received from the Owner, and that current payment shown herein is (Line 3 less Line 6) now due. CONTRACTOR: CENTRAL ENGINEERING CONSTRUCTION ASSOC., INC. Slate of Indiana County of: Hancock BY: DATE: rO 1 1 2SIO6 Subscribed and om to before me this' I day of June ,2008 Karen Horih Powers, President Notary Public. G�M+i it Lx My Commission Expires: April 21, 201r�.J AMOUNT CERTIFIED ARCHITECT'S CERTIFICATE FOR PAYMENT (Attached explanation If amount certified differs from the amount applied for.) In accordance with the Contract Documents, based an on -site observa- ARCHITECT: dons and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, By; Date: and belief the Work has progressed as indicated, the quality of the Work is This Certificate In not negotiable. The AMOUNT CERTIFIED is Is In accordance with the Contract Documents, and the Contractor is payable only to the Contractor named herein. Issuance, pay entitled to payment of the AMOUNT CERTIFIED. Po-i /4 ment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this contract. 9 .3 CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 OF 2 PAGES PROJECT: FOUNDERS PARK INFRASTRUCTURE PHASE I APPLICATION NO.: 1 Job: 437 APPLICATION DATE: 25 3 uv1 O PERIOD TO: 30-Jun-08 ENGINEER'S PROJECT NO.: A B C D E F G H I WORK COMPLETED MATERIALS TOTAL FROM PRESENTLY COMPLETED BALANCE RETAINAGE ITEM DESCRIPTION OF WORK SCHEDULED PREVIOUS THIS STORED AND STORED TO (IF VARIABLE) NO. VALUE APPLICATION PERIOD (NOT IN TO DATE (G C) FINISH RATE (D E) D OR E) (D +E +F) (C G) 1 Mobilization 40,806.00 23,806.00 23,806.00 58% 17000.00 2380.60 2 ConstrucUon Staking 14,086.00 7,000.00 7,000.00 50% 7086.001 700.00 3 Clearing 55,307.00 55,307.00 55,307.00 100% 0.00 5530.70 4 Earthwork 289,035.00 65,500.00 65,500.00 23% 223535.00 6550.00 5 Erosion Control 36,151.00 24,000.00 24,000.00 63% 14151.00 2400.00 6 Sanitary Sewer 35,110.00 34,110.00 34,110.00 97% 1000.00 341700 7 Storm Sewer 104,921.00 7,240.00 7,240.00 7% 97681.00 724.00 8 Concrete Curbs /Sidewalk 177,447.00 0.00 0% 177447.00 0.00 9 Asphalt Paving 138,169.00 0.00 0% 138189.00 0.00 10 Seeding 82,038.00 0.00 0% 82038.00 0.00 11 Bonds Insurance 40,628.00 40,628.00 40,628.00 100% 0.00 4082.80 TOTALS: $1,015,718.00 $250,351.00 $7,240.00 $257,591.001 25% $758,127.001 $25,759.10 PERCENT: 0.00% 24.65% 0.71% 25,3B%j 74.64% ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 Purchase Order No. Central Engineering Construction Assoc., In.c Terms 3862 N. Commercial Parkway Date Due Greenfield, IN 46140 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) 6/30/08 ApLj 1 Founders Park Infrastructure Phase 1 Amount 6/30/08 App. 1 Founders Park Infrastructure Phase 1 10,050.92 221,780.98 W 1 831.90 1 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. Central Engineering Construction Assoc., In-c Allowed 20 3862 N. Commercial Parkway Greenfield, IN 46140 In Sum of 231,831.90 ON ACCOUNT OF APPROPRIATION FOR 853 Gift Fund 106 Park Impact PO# or INVOICE NO. ACCT#rrITLE AMOUNT Board Members Dept P.O. 16093 1 hereby certify that the attached invoice(s), or 853 App. 1 5023990 10,050.92 bill(s) is (are) true and correct and that the P.O. 16093 1 materials or services itemized thereon for 106 App. 1 5023990 221,780.98 which charge is made were ordered and received except ITI i s I a- Su.b CGnf Gr a I �(leClse, po' 7 Co*6d 7 -Jul 2008 t no Pow 1 (00g3 Signature 231,831.90 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund