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Home My WebLink About162851 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 361523 Page 1 of 1 0 ONE CIVIC SQUARE LINCOLN BANK CHECK AMOUNT: $25,150.00 CARMEL, INDIANA 46032 ATTN MAX C HANK 905 SOUTHFIELD DR CHECK NUMBER: 162851 PLAINFIELDIN 46168 CHECK DATE: 8/2012008 DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION 1•.06 5023990 18807 APP #2 25,150.00 FOUNDERS PARKS INTRAS i sooz i o gnd APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT aaAl TO (OWNER): PROJECT: Founders Park Infrastructure Phase 1 APPLICATION NO. 2 DISTRIBUTION TO: Carmel/ Clay Board of Parks and Recreation OWNER XX Attn.: Mark Westermeler 1411 East 116th Street VIA (ARCHITECT): PERIOD TO: 712512008 Carmel, IN 46032 FROM: Central Engineering Construction Associates, Inc. ARCHITECTS C v 3862 N. Commercial Parkway PROJECT NO: AUG o 1 2008 Greenfield, IN 46140 CONTRACT FOR: SITE IMPROVEMENTS CONTRACT DATE: 22 -May -08 p 3y: _L_ Z__L 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 ($16,100.00) previous months by owner 3. CONTRACT SUM TO DATE $999,618.00 TOTAL 4. TOTAL COMPLETED STORED TO DATE $5D9,091.00 Approved this Month (Column G) No. Date Approved 5. RETAINAGE: 1 16,100.00 a. 10.00% of Completed Work $50,909.10 (Column D +E) b. 10.00% of Stored Material (Column F) U n(olr) $0.00 TOTALS 16,100.00 Total Retainage (Line 5a +5b) or 2., K $50,909.10 Net Change by Change Orders (Total in Column 1) LJ� 25 ($16,100.00) 6. TOTAL EARNED L ESS RETAINAGE $458,181.90 The undersigned Contractor certifies that to the best of the Cantractor's (Line 4 less Line 5 Total) knowledge, information, and belief the Work covered by this Application 7. LESS PREVIOUS CERTIFICATES FOR $231,831.90 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 C F_ I YW<Y. $226,350.00 for which previous Certificates for Payment were Issued and payments 9. BALANCE TO FINISH, PLUS RETAINAGE $541,436.10 received from the Owner, and that current payment shown herein is (Line 3 less Line 6) now due. CONTRACTOR: CENTRAL ENGINEERING CONSTRUCTION ASSOC., INC. Stale of Indiana County of: Hancock BY: p j- DATE: 7! 2_'Q 08 Subscribed and m to before me this 2 s i'` day of July 2008 Karen Horth Powers, President Notary Public: ran^ My Commission Expires: April 21, 2016 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 on on -site observa- ARCHITECT: tions 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, agOWtractor Is payable only to the Contractor named herein. Issuance, pay entitled to payment of the AMOUNT CERTIFIEDDe3cription EQ ment and acceptance of payment are without prejudice to any P.O. 16 F�07 right Uwner or Contractor under this contract. G.L. I n(0 5,oQ t Central E% neeri n9 2:2(,;a)350,00 Line Li 6'1 col n V) 2 5. 1 5 O 00 c_�e, .r��s Z Date CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 OF 2 PAGES PROJECT: FOUNDERS PARK INFRASTRUCTURE PHASE 1 APPLICATION NO.: 2 Job: 437 APPLICATION DATE: 25- Jul -08 PERIOD TO: 25-Jul-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 Construction Staking 14,086.00 7,000.00 6,000.00 13,000.00 92% 1086.00 1300.00 3 Clearing 55,307.00 55,307.00 55,307.00 100% 0.00 5530.70 4 Earthwork 289,035.00 65,500.00 150,000.00 215,500.00 75% 73535.00 21550.00 5 Eroslon Control 38,151.00 24,000.00 24,000.00 63% 14151.00 2400.00 6 Sanitary Sewer 35,110.00 34;110.00 34,110.001 97% 1000.00 3411.00 7 Storm Sewer 104,921.00 7,240.00 95,500.00 102,740.00 98% 2181.00 10274.00 8 Concrete Curbs/Sidewalk 177,447.00 0.00 0.00 0%1 177447.00 0.00 9 Asphalt Paving 138.189.001 0.00 0.00 0% 138189.00 0.00 10 Seeding 82,038.00 0.00 0.00 0% 82038.00 0.00 11 Bonds Insurance 40,628.00 40,628.00 40,628.00 100% 0.00 4062.80 12 Change Order #i: Asphalt 7,100.00 0.00 0% 7100.00 0.00 Concrete Curti /Sidewalks 9,000.00 0.00 0% 9000.00 0.00 TOTALS: $999,618.001 $257,591.00 $251,500.00 $0.00 $509,091.00 51% $400,527.00 $50,909.10 PERCENT: 25.T7%1 25.16% 0.00%1 50.93% 49.07% CEIVED AUG 0 1 2008 BY: r" AFFIDAVIT AND WAIVER OF LIEN Final Partial Payment to Follow STATE OF INDIANA County of HANCOCK Karen Horth Powers being duly sworn states that she/he is the President of Central Engineering Construction Associates, Inc. having contracted with the Carmel/Clay Board of Parks and Recreation to furnish certain materials and/or labor as follows Site Improvement for a Project known as Founders Park Infrastructure Phase I, located in Carmel, IN 46032 and owned by the Carmel /Clay Board of Parks and Recreation and does further state PARTIAL WAIVER: that the final balance due from the owner is the sum of Two Hundred Twenty -Six Thousand Three Hundred Fifty and 00 /100 Dollars ($226,350.00) receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for said amount, effective upon receipt of such payment; FINAL WAIVER: that the final balance due from the owner is the sum of Dollars receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all lien or claim whatsoever on the above described property and improvements thereon on account of labor or material or both, finished by the undersigned thereto, and fin certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. �enorth Powers President Title Witness My Hand and Notarial Seal, this ZS4 da of 2008. u R--- Notary Public Li -Ching Wu Notary Public Printed Signature My Commission Expires April 21, 2016 County of Residence Hamilton AUG 0 1 2008 BY: 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. 18807 Lincoln Bank Terms ATTN: max C Hank 905 Southfield Drive Plainfield, IN 46168 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/25/08 App 2 Founders park Infrastructure Phase I Escrow Pmt 25,150.00 Total 25,150.00 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. Lincoln Bank Allowed 20 ATTN: max C Hank 905 Southfield Drive Plainfield, IN 46168 In Sum of 4/ 25,150.00 ON ACCOUNT OF APPROPRIATION FOR 106 Park Impact Fee Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 18807 App#2 5023990 25,150.00 1 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 i 4 -Aug 2008 CO Y'\ Signature 25,150.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund