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Home My WebLink About155815 01/23/2008 CITY OF CARMEL, INDIANA VENDOR 00351429 Page 1 of 1 ONE CIVIC SQUARE M.K. BETTS ENGINEERING INC CARMEL, INDIANA 46032 PO Box 2533 CHECK AMOUNT: $54,083.70 ANDERSON IN 46018 CHECK NUMBER: 155815 CHECK DATE: 1/23/2008 DEP ARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 6'54 R5023990 S10655 6 5 SOLAR DRYING I I j I i ry APPLICATION AND CER TIFICATE FOR PAYMENT AIA DOCU 0 702 (Instructions on reverse side) PAGE ONE Of PAGES TO (OWNER): City of Carmel PROJECT: Solar Drying APPLICATION NO: Six (6) Distribution to: One Civic Square Contract 65 t✓ OWNER Carmel, IN 46032 Carmel, IN PERIOD TO: 12 -31 -07 C ARCHITECT G CONTRACTOR FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C M. K. Betts Engineering Jones Henry Engineers, Ltd. PROJECT NO: C Contracting, Inc. CONTRACT FOR: Invoice No. 07 -232. 06 CONTRACT DATE: Application is made for Payment, as shown below, in connection with the ContracT. CONTRACTORS APPLICATION FOR PAYMENT Continuation Sheet, AIA Document G703, is attached. CHANGE ORDER SUMMARY j 1. ORIGINAL CONTRACT SUM 5 696 ,450.00 Change Orders approved -in I ADDITIONS DEDUCTIONS 2• Net change by Change Orders 5 previous months by Owner 3. CONTRACT SUM TO DATE (line 1 2) 5 69 5 0. 00 TOTAL 4. TOTAL COMPLETED STORED TO DATE 643 ,385.00 Approved this Month (Column G on 6703) 5. RETAINAGE: Number Date Approved a. of Completed Work S (Column D E on G703) b. of Stored Material (Column F on G703) Total Retainage (Line 5a 5b or TOTALS Total in Column I of G703) S 34 ,822.50 D LESS RETAINAGE 5 608,562.50 Net change by Change Orders .TOAL The undersigned Contractor certifies that 'to (Line 4 (less Line 5 Total) the best of the Contractor's knowledge, 7 LESS PREVIOUS CERTIFICATES FOR information and belief the Work covered thiApplicar ion for Payment has been 554 478.80 completed in accordance with the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Certificate) S paid b, the Contractor o fo which previous Ce t ficates for Payment were 8. CURRENT PAYMENT DUE g 54,083.70 issued and payments received from the Owner, and that current payment shown 9 BALANCE TO FINISH, PLUS RETAINAGE 5 87 887 herein is now due. (Line 3 less Line 6) CONTRACTOR: M. K. Betts Engineering Contracting, Inc. State of: Indiana Countv of: Madison Subscribed and sworn to before me this 31st day of Dec. 2007 Notary Public OC I-Y7 By: Date: December 31, 200 My Commission expires: October 28, 2015 AMOUNT CERTI if d iffers s ARCHITECT'S CERTIFICATE FOR PAYMENT PP (Attach ex planati on ii amount terrified differs from the amount applied tor.; 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 the Architect's knowledge, information and belief the Work has progressed as Bv: Date: indicated, the quality of the Work is in accordance with the Contract Documents, and This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only To the c� the Contractor is entitled to payment of the AMOUNT CERTIFIED. Contractcr named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. DOrUMFNT r.7b^ rtFTltir- T! rrlo n.N\.,;\'1 .w ,r frlTin._ a i CONTINUATION SHEET AIA DOCUMENT C/o C a rm el WW Solar' Drying Contract 65 OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Six (6 Contractor's signed Certification is attached. APPLICATION DATE: December 31 2007 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 12 -01 07 Use Column I on Contracts where variable retainage for line may'apply. TO: 1 1 2 2-31 07 ARCHITECT'S PROJECT NO; ,j A B C D E F G H I WORK COMPLETED i TOTAL COMPLETED 1. 1 ITEM DESCRIPTION OF WORK SCHEDULED BALANCE. RETAINAGE This Application, AND STORED ^:o. VALUE TO F!NISH Previous Sto ed Materials TO DATE (C C) (C —G) Applications Work in Place (not';in D or E) (D +E+F) F' 1. Mobilization, Bond .1 Insurance 20,000.00 19,000.00 1,000.0 —0— 20,000.0 100 —0— 2. Topsoil Embankment 850 cy $15.66/cy 1.3,311.00 13;311.00 13,311.00 100 3. Removal of Biosolids 1 1.1.00 cy $6.48/cy 7,128.00 7,128.00 —0— —0— 7,128.00 100 —0— i 4. Excavation, fill embankment 5900 cy $6.48/cy 38,232.00 38,232.00 —0— —0— 38,232.00 100 —0— 5. Site Demo, Piping, Etc. 79,000.00 65,435.00 12,000.00 -0- 77,435.00 98 1,565.00 6. Building Exc. Backfill 45,000.00 41,000.00 4,000.00 -0- 45,000.00 100 -0- 7. Concrete Drying Bldg and.Control 237,000.00 236.,000.00 1,000.00 -0- 237,000.00 100 -0- '.`'.j 8. Dock Extension 6,250.00 5;000'.00 1,250.00 -0- 6,250.00 100 -0- 9. Building Erection 84,200.00 80,000.00 4,200.00 -0- 84,200.00 100 -0- I 10. Hot Water Piping 33,800.00 33,800.00 -0- -0- 33,800.00 100 -0- 1.1.. Waterlines 1.3,450.0 0 7,195.30 6,254.70 I -0- 13,450.00 100 -0- 1.2. Miscellaneous 7,579.00 7,200:00 379.00 -0- 7,579.00 100 -0- 1.3. Asphalt Paving 24,000.00 -0- 24,000.00 -0 24,000.00 100 -0- 14. Electrical 87,500.00 36,000.00 -07'. -0- 36,000.00 42 51,500.00 �i 696,450.00 589;301.30 54,083.70 0 643,385.00 93 53,065.00 34,822.50 AIA DOCUMENT 0703 CONTINUATION SHEET APRIL 1978 EDITION AIAa CJ 1978 THE A.ti1ERICAN' INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE(. N,W.. WASHINGTON 0 .C. -nnnr, Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER Form No. 301 -5 (Rev. 1995) TO ADDRESS 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 1 19 Signature Title I hereby certify that the attached invoice(s), or bill(s), is (are) true and corre and I have audited same in accordance with IC 5- 11- 10 -1.6. 19 er Title 'Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS a SANITATION DEPARTMENT ANO. fi ya CARMEL, INDIANA Favor Of Total Amount of Voucher Deductions Amount of Warrant az� a Month of 19 Acct. VOUCHER RECORD No. Collection System Operation Plant J' Commercial General Undistributed t Construction_ Depre ai& Rese _e__: "Y I Stock Accounts Merchandise Total Allowed Board Members Filed BOYCE FORMS SYSTEMS 1- 800 382 -8702 325