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Home My WebLink About166792 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00351429 Page 1 of 1 ONE CIVIC SQUARE M.K. BETTS ENGINEERING INC a 0 CHECK AMOUNT: $119,584.00 CARMEL, INDIANA 46032 PO BOX 2533 a� ao ANDERSON IN 46018 CHECK NUMBER: 166792 CHECK DATE: 12/10/2008 D= PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 654 R5023990 S10726 12 119,584.00 CONSTRUCTION i APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) PAGE ON OF PAGES TO (OWNER): City of Carmel PROJECT: Blower /Electrical Modification APPLICATION NO: Twelve(12)Distribution to: One Civic Square Contract 60 OWNER Carmel, IN 46032 PERIOD TO: 10 31" =08 ARCHITECT CONTRACTOR FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C M. K. Betts Engineering PROJECT NO: C Contracting,.Inc. CONTRACT FOR: Invoice No. 07 -262. 12 CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT Applic n Sh et,fAIA Document G703, a c"hedcDnnection with the Contract. CHANGE ORDER SUMMARY 1. ORIGINAL CONTRACT SUM 5 2,349 ,000.00 Change Orders approved in I ADDITIONS DEDUCTIONS 2. Net change by Change Orders 295 ,205.00 previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 2) S 2, TOTAL 4. TOTAL COMPLETED STORED TO DATE 2,016 Approved this Month (Column G on G703) Number Date Approved S. RETAINAGE: a. of Completed Work CO#1 $302,815.00 7,610.00 (Column D E on G703) b. of Stored Material (Column F on G703) Total Retainage (Line 5a 5b or TOTALS $302 7,610.00 Total in Column I of G703) S 132,210.25 6. TOTAL EARNED RETAINAGE 1,884 vet Chan e by Change Orders $295, 205.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, (Line 4 less Line 5 Total) information and belief the Work covered by this Application for Payment has been 7. LESS PREVIOUS CERTIFICATES FOR completed in accordance with the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Certificate)......... S 1 paid by the Contractor for Work for which previous Certificates for Payment were 8. CURRENT PAYMENT DUE g 119,584.00 issued and payments received from the Owner, and that current payment shown 9 BALANCE TO FINISH, PLUS RETAINAGE 5 759,830.72 herein is now due. (Line 3 less Line 6) CONTRACTOR: M. K. Betts Engineering Contracting, Inc.. State of: Indiana County of: 1Iadison Subscribed and sworn to before me this 31st day of Oct. 2008 Notary Public: e" By: Date: October 31, ,2008 My Commission expires: October 28 201.5 ARCHITECT'S CERTIFICATE FOR PAYMENT AMOUNT CERTIFIED S pP (Attach exp lanation If amount certified differs from the amount a fora 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: 1a�� indicated, the quality of the Work is in accordance with the Contract Documents, and This Certificate is not negotiable. The AvtOUNT CERTIFIED is payable only to the the Contractor is entitled to payment or the AMOUNT CERTIFIED. Contractcr named herein. Issuance, payment and acceptance of payment are without prejud to any rights of th Ow n e r o r COnrraCTor under this Contract. AIA DOCUMENT 0702 APPLIC?,TIC u AND CERTIFICATE FOR PAY.VE.VT MAY 19ti EDITION AIA' 1981 CONTINUATION SHEET AIA DOCUh1ENT 0703 Car Cont ract 60 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Twelve 12 Contractor's signed Certification is attached. APPLICATION DATE: October 31, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 10 -01 -08 Use Column I on Contracts where variable retainage for line items may apply. TO: 10 31 -08 ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED —TOTAL COMPLETED ITEM DESCRIPTION OF WORK SCHEDULED This Application AND STORED a o BALANCE RETAINAGE `:o. VALUE TO FINISH Previous Stored Materials TO DATE (G =C) (C —G) Applications Work in Place (not in D or E) fD +E) F) 1. Mobilization, Bond Insurance 75,000.00 55,000.00 7,000.00: -0- 62,000.00 83 13,000.00 2. Generator Pad Platfor .40,000.00 40,000.00 -0- -0- 40,000.00 1100 -0- 3. Generator 272,000.00 261,000.00 11,000.00 -0- 272,000.00 100 -0- 4. Launder Covers 160,000.00 160,000.00 -0- -0- 160,000.00 100 -0- 5. Switch Gear Building 39,000.00 39,000.00 -0- -0- 39,000.00 100 -0- 6. Masonry 78,000.00 61,800.00 -0- -0- 61,800.00 80 16,200.00 7. Roofing Sheetmetal 14,000.00 14,000.00 -0- -0- 14,000.00 100 -0- 8. Doors, Frames Hardware 16,000.00 16,000.00 -0- -0- 16,000.00 100 -0- 9. Aeration Tank work 40,000.00 39,000.00 1,000.00 -0- 40,000.00 100 -0- 1.0. Valves 10,000.00 9,600.00 400.00 -0- 10,000.00 100 -0- 11. Blower Bldg Phase.I 90,000.00 77,800.00 7,700.00 -0- 85,500.00 95 4,500.00 1.2. Blower Bldg Phase 11 35,000.00 6,128.26 -0- -0- 6,128.26 18 28,871.74 1.3. Pipe Insulation 5,400.00 -0- -0- -0- -0- 00 5,400.00 14. Acoustical Ceilings! 21,000.00 -0- -0- -0- -0- 00 21,000.00 1.5. Roll Up Doors 7,100.00 -0- -0- -0- -0= 00 7,100.00 16. Signs Fire Extinguishers 1,500.00 -0- -0- -0- -0- 00 1,500.00 17. Instrumentation 90,000.00 19,621.30 -0- -0- 19,621.30 22 70,378.70 AIA DOCUMENT 6703 CONTINUATION SHEET APRIL 1978 EDITION AIA'- U 1978 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON'. D.C. 20006 G703 1978 Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show, kind of service, where performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 351429 M.K. BETTS ENGINEERING CONTR Purchase Order No. P.O. Box 2533 Terms Anderson, IN 46018 Due Date 12/8/2008 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/8/2008 12 $119,584.00 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 Date er VOUCHER 086864 WARRANT ALLOWED 351429 IN SUM OF M. K. BETTS ENGINEERING CONTR P.O. Box 2533 Anderson, IN 46018 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 12 07- 1050 -61 $119,584.00 P �t CPS Voucher Total $119,584.00 Cost distribution ledger classification if claim paid under vehicle highway fund C ONTINUATION S AIA DOCUMENT 0703 Carmel Contract 60 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Twelve (12) Contractor's signed Certification is attached. APPLICATION DATE: October 31, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD-FROM: 10 01 08 Use Column I on Contracts where variable retainage for line items may apply. TO: 10 -31 -08 ARCHITECT'S PROJECT NO: A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED TOTAL COMPLETED BALANCE RETAINAGE This Application AND STORED °o `;o. VALUE Previous TO DATE (G =C TO FINISH Applications Work in Place Stored Materials (not in D or E) (D +E +F) (C G) 1.8. Control Commissioning 56,000.00 -0- -0- -0- -0- 00 56,000.00 19. Software Allowance 25,000.00 -0- -0- -0- -0- 00 25,000.00 20. HVAC 92,000.00 77,833.0 2,500.0 -0- 80,333.00 88 11,667.00 21.. Electrical 11.24,000.00 899,353.97 71,600.0 -0- 970,953.97 87 153,046.03 22. Painting 13,000.00 -0- 8,684.00 -0- 8,684.00 67 4,316.00 23. Miscellaneous 45,000.00 20,300.00 5,200.00 -0- 25,500.00 57 19,500.00 CO #1 Change Order No. 1 1. Eliminate EUH04,5,6 7,610.00 7,610.00 -0- -0- 7 100 -0- 2. Suspended Solids Meter #10 4,992.00 -0- 4,500.00 -0- 4,500.00 91 492.00 3. PMQII Meter Plant Feed 7,357.00 7,357.00 -0- -0- 7,357.00 100 -0- 4. Addition PMQII Metering 3,445.00 3,445.00 -0- -0- 3,445.00 100 -0- 5. Misc. Electrical Blower Building 508.00 508.00 -0- -0- 508.00 100 -0- 6. Solar Drying Supplemental Heat 282,955.00 93,500.00 -0- -0- 93,500.00 33 189,455.00 7. Electrical Prat to Aeartion 1,679.00 1,485.00 -0- -0- 1,485.00 89 194.00 AIA DOCUMENT G703 CONTINUATION SHEET APRIL 3978 EDITION AIA' U 1978 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON. D.C. 70006 G703 1978 CONTINUATION SHEET AIA DOCUMENT G703 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Twelve (12 Contractor's signed Certification is attached. APPLICATION DATE: October 31, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 10 -01 -08 Use Column I on Contracts where variable retainage for line items may apply. TO: 10 -31 -08 ARCHITECT'S PROJECT NO: A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED VALUE This Application TOTAL COMPLETED BALANCE RETAINAGE PP AND STORED TO FINISH Previous Stored Materials TO DATE (G -C) (C —G) Applications Work in Place (not in D or E) (D +E +F) 8. Remove Concrete Lining Aeration Tank #10 500.00 500.00 -0= 0 500.00 100 0- 9. Condenser Support Trenwa 1,185.00 1,185.00 -0- -0- 1,185.00 100 -0- 10. Metal Halide Lights Fixture ••C•' 194.00 194.00 -0- -0- 194.00 100 -0- 2644,205.00 1897,000.53 119,584.00 -0- 2016,584.53 77 627,620.47 132,210.2 AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA't CU 1978 THE Ah ",'RICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.. WASHINGTON. D.C. 20006 G703 1978