HomeMy WebLinkAbout165859 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 00351429 Page 1 of 1
ONE CIVIC SQUARE M.K. BETTS ENGINEERING INC CHECK AMOUNT: $133,164.08
CARMEL, INDIANA 46032 PO BOX 2533
,off `o ANDERSON IN 46018 CHECK NUMBER: 165859
CHECK DATE: 11/12/2008
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER A MOUNT D ESCRIPTION
654 R5023990 510726 11 133,164.08 CONSTRUCTION
ma_ 1 a
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 6 (Instructlon5 on reverse side) N"GE ONE OF PAGES
TO (OWNER): City of Carmel PROJECT: Blower /Electrical Modification APPLICATION NO: Eleven(l 1 Oistribution to:
One Civic Square Contract 60 G OWNER
Carmel, IN 46032 PERIOD'TO: 09 -30 -08 C ARCHITECT
CONTRACTOR
FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C
M. K. Betts Engineering PROJECT NO: C
Contracting, Inc..
CONTRACT FOR: Invoice No. 07 -262. 11 CONTRACT DATE:
is CONTRACTOR'S APPLICATION FOR PAYMENT Continuation nu Lion Sn et, Document G703,lisaltt ched connection with the Contract.
CHANGE ORDER SUMMARY 1. ORIGINAL CONTRACT SUM 5 2, 349 ,000.00
I 2, Net change by Change Orders 295,205.00
Change Orders approved in ADDITIONS DEDUCTIONS 2,644,205.00
previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 S
TOTAL 4. TOTAL COMPLETED STORED TO DATE S 1,897,000.53
Approved this Month (Column G on G703)
S. RETAINAGE:
Number Date Approved 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
132 210.25
TOTALS $302 815.00 7 610.00 Total in Column I of G703)
6. TOTAL EARNED. LESS RETAINAGE 1,764,796;
vet than e by Change Orders $295 205.00 28
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) 1,631
paid by the Contractor for Work for which previous Certificates for Payment were 8. CURRENT PAYMENT DUE S 133,164.08
issued and payments received from the Owner, and that current payment shown 9 BALANCE TO FINISH, PLUS RETAINAGE 879
herein is now due. (Line 3 less Line 6)
CONTRACTOR: M. K. Betts Engineering Contracting, Inc. State of: Indiana County of: Madison
Subscribed and sworn to before me this 30th day of Sept. 2008
Notary Public:
Bv: a Date; Sept. 30, 2008 My Commission expires: October 28 2015
AMOUNT CERTIFIED S
ARCHITECT'S CERTIFICATE FOR PAYMENT (Attach explanation if amount certified differs from the amount applied for.)
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 B .Date: Z.
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
the Contractor is entitled to payment or the AMOUNT CERTIFIE Contractcr named herein. Issuance, payment and acceptance of payment are withe�ut
prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUtitENT G7V_ .�,PPUCATIr -w AND CERTIFICATE. FOR PAN. %IE.l .CITY Igh4 EDITION .CIA' 198i
-.1 ,-..T1 I Ir 1 1_. 114 11'�Q" :l A t`. Ill '00) C- 17(12 19ft'.l
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 11/10/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/10/200 11 $133,164.08
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
Date 6ffi r
VOUCHER 086648 WARRANT ALLOWED
351429 IN SUM OF
M.K. -BETTS ENGINEERING CONTR
P.O. Box 2533
Aliderson, IN 46018
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
t
'r
Board members
PO INV ACCT AMOUNT Audit Trail Code
11 07- 1050 -61 $133,164.08
C(7_n ✓D N
0
i
i
I Voucher Total $133,164.08
Cost distribution ledger classification if
claim paid under vehicle highway fund
C ONTINUATION SHEET AIA DOCUMENT G703 Carmel Cont ract 60 PAGE OF PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Eleven (11)
Contractor's signed Certification is attached. APPLICATION DATE: Sept. 30, 2008
In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 09 01 -08
Use Column I on Contracts where variable retainage for line items may apply. TO: 09 30 08
ARC;,HITECT'S PROJECT NO:
A B C D E F G H I
ITE,ti1 DESCRIPTION OF WORK SCHEDULED WORK COMPLETED T OTAL COMPLETED BALANCE RETAINAGE
This Application AND STORED
.o. VALUE Previous TO DATE (G o C) TO FINISH
Stored Materials (C —G)
Applications Work in Place (not in D or E) (D+E-{ F)
1. Mobilization, Bond
Insurance 75,000.00 50 5,000.00 —0— 55,000.00 73 20,000.00
2. Generator Pad Platforp 40,000.00 40,000.00 -0- -0- 40,000.00 100 -0-
3. Generator 272,000.00 261,000.00 -0- -0- 261,000.00 96 11,000.00
4. Launder Covers 160,000.00 160,000.00 -0- -0- 160 100 -0-
5. Switch Gear Building 39,000.00 39,000.00 -0- -0- 39,000.00 100 -0-
6. Masonry 78,000.00 42,000.00 19,800.00 -0- 61,800.00 79 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 -0- -0- 16,000.00 100 -0-
9. Aeration Tank Work 40,000,00 39,000.00 -0- -0- 39,000.00 98 1,000.00
10. Valves 10,000.00 9 -0- 0 9 96 400.00
11.. Blower Bldg.- Phase I 90,000.00 68,115.92 9,684.08 -0- 77,800.00 86 12,200.00
12. Blower Bldg Phase II 35,000.00 6,128.26 -0- -0- 6,128.26 18 28,871.74
13. Pipe Insulation 5,400.00 770- -0- -0- -0= 00 5
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
1.7. Instrumentation 90,000.00 19,621.30 -0- -0- 19,62.1.30 22 70,378.70
AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA'� U 1978
THE AM-RICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK: AVE., N.W., WASHINGTO D.C. 20006
Gi�3 197II
i
C O NT INUATION S AIA D OCUMENT G703 Carmel Contrac 60 PACE OF PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Eleven (11
Contractor's signed Certification is attached. APPLICATION DATE: Sept. 30, 2008
In tabulations below, amounts are stated to the nearest dollar, PERIOD FROM: 09- 01 -08
Use Column I on Contracts where variable retains a for line items may a p p l y. g Y PP Y• TO: 09 -30 -08
ARCHITECT'S PROJECT NO:
A B C D E F G H I
WORK COMPLETED
ITE.m DESCRIPTION OF WORK SCHEDULED TOTAL COMPLETED BALANCE RETAIN,�\GE
This Application AND STORED
:o. VALUE Previous TO DATE (G =C) TO FINISH
Stored Materials IC
Applications Work in Place (not iniD or E) (D +E +F)
18. 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 77,833.00 -0- -0- 77,833.00 95 14,167.00
21. Electrical 11.24,000.00 827,763.97 71,590.00 -0- 899,353.97 80 224,646.03
22. Painting 13,000.00 -0- -0- -0- -0= 00 13,000.00
23. Miscellaneous 45,000.00 15,800.00 4;500.00 -0- 20,300.00 45 24,700.00
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- -0- -0- -0- 00 4,992.00
3. PMQII Meter Plant
Feed 7,357.00 7,357.00 -0- -0- 7,35,7.00 100 -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 70,910.00 22,590.00 93,500.00 33 +189,455.00
7. Electrical Prat to
Aeartion 1,679.00 1,485.00 -0- -0- 1,485.00 88 194.00
AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA' Oc 1978
THE A,titERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORE: AVE., N.W.. WASHINGTON, D.C. '_0006 6703 X978
C S AIA DOCUMENT 0703 PAGE OF PAGES
AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Eleven (11
Contractor's signed Certification is attached. APPLICATION DATE: Sept. 30, 2008
In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 09 -01 -08
Use Column I on Contracts where variable retainage for line items may apply. TO: 09 30 08
ARCHITECT'S PROJECT NO:
A B C D E F G H I
WORK COMPLETED TOTAL COMPLETED
ITEM DESCRIPTION OF WORK SCHEDULED This Applic AND STORED BALANCE RETAINAGE
No. VALUE TO FINISH
Previous TO DATE (G -C)
Applications Work in Place Stored Materials (D +E +F) (C —G)
(not in D or E)
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 1763,836.45 133,164.08 —0— 1897,000.53 72 747,204.47 132,210.2
AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA't 1978
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.. WASHINGTON, D.C. 20006 G703 —1978