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Home My WebLink About163293 09/03/2008 F 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: $210,239.78 ANDERSON IN 46018 CHECK NUMBER: 163293 CHECK DATE: 9/3/2008 DEPA RTMENT ACCOUNT PO NUMB INVOICE NUMBE AMOUNT DESC RIPTION 654 R5023990 S10726 9 210,239.78 CONSTRUCTION f APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 670 (Instructions on reverse side) PAGE ONE OF P.XGES TO (OWNER): City of Carmel PROJECT: Blower/ Electrical Modification APPLICATION NO: Nine (9) Distribution to: One Civic Square Contract 60 L OWNER Carmel, IN 46032 PERIOD TO: 07 31 -08 C ARCHITECT El CONTRACTOR FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C M. K. Betts Engineering PROJECT NO: C Contracting, Inc. CONTRACT FOR: Invoice No. 07- 262.09 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 1. ORIGINAL CONTRACT SUM S 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 1,478 Approved this Month (Column G on G703) Number Date Approved 5. 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 $302,815.00 7,610.00 Total in Column I of G703) 132,210.25 Net thane by Change Orders $295,205 6. TOTAL EARNED, LESS RETAINAGE 1 ,346,335 .98 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 1 136 096.20 completed in accordance with the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Certificate) paid by the Contractor for Work for which previous Certificates for Payment were 8. CURRENT PAYMENT DUE 210, 239.78 issued and payments received from the Owner, and that current payment shown 9, BALANCE TO FINISH, PLUS RETAINAGE 1 ,297 ,869 .02 herein is now due. (Line 3 less Line 6) CONTRA OR: M. K. Betts Engineering Contracting, Inc.. State of: Indiana County of: Madison Subscribed and sworn to before me this 31st day of July 2008 Notary Public: 117 Bv: Date: July 31, 2008 My Commission expires: October 28 2015 AMOUNT CERTIFIED ARCHITECT'S CERTIFICATE FOR PAYMENT (Attach explanation if amount certified differs from the amount applied 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 BY: Date: i7 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 of the AMOUNT CERTIFIE Contractcr named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G7U2 ?PLICATIC AND CERTIFIC.' FOR PAl•ntE\.T MAY Iy8I EDITION *AIA" a c 19tl1 THE A-.,rIr n i rI nr r .�:r Hiivr'rc i ?r v�kv v. ^�ui. w"I �r W :,_��C..MN iii Ini,�u. (,702 -19fi3 C SHEE AIA DOCUMENT 0703 Carmel Contra 6 0 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Nine (9) Contractor's signed Certification is attached. APPLICATION DATE: July 31, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 07 01 08 Use Column I on Contracts where variable retainage for line items may apply. TO: 07 -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 VALUE Previous Stored Materials TO DATE (G =C) TO FINISH Applications Work in Place (D +E +F) (not in D or E) 1. Mobilization, Bond Insurance 75,000.00 40,500.00 4,500.00 -0- 45,000.00 60 30,000.00 2. Generator Pad Platfori 40,000.00 38,750.00 1,250.00 -0- 40,000.00 100 -0- 3. Generator 272,000.00 255,000.00 6,000.00 -0- 261,000.00 96 11,000.00 4. Launder Covers 160,000.00 160,000.00 -0- -0- 160,000.00 100 -0- 5. Switch Gear Building 39,000.00 38,500.00 -0- -0- 38,500.00 99 500.00 6• Masonry 78,000.00 42,000.00 -0- -0 42,000.00 54 36,000.00 7. Roofing Sheetmetal 14,000.00 -0- 14,000.00 -0- 14,000.00 100 -0- 8. Doors, Frames Hardware 16,000.00 -0- 16,000.00 -0- 16,000.00 100 -0- 9. Aeration Tank Work 40,000,00 19,100.43 19,899.57 -0- 39,000.00 99 1,000.00 10. Valves 10,000.00 7,715.00 1,085.00 -0- 8,800.00 88 1,200.00 11• Blower. Bldg Phase 1 90,000.00 35,315.92 8,300.00 -0- 43,615.92 48 .46,384.08 12. Blower Bldg Phase II 35,000.00 5,128.26 -0- -0- 5,128.26 15 29,871.74 13. Pipe Insulation 5,400.00 -0- -0- -0- -0- 00 5,400.00 14. Acoustical Ceilings 21,000.00 -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 ALA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA' RU 1978 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK: AVE., N.W., WASHINGTON, D.C. 20006 G703 1978 gyLE ENTRAL SUPPLY COMPANY, INC. t t �r .>tir t5 d c DUPL ICATE tf ii ii$�a 'i :$r lLr e^::, 7; Y��f j t z, }a r' I `r`r t 7 r I f t t 5 r t h I 1, I. I. F I q i I I �f L 2.59 55 I II( J m Q) 1 r -t °!.r f•"S'�¢ec -r t a�'�`- .atr f t'SF 11�i>!�_j "rF.d ry�y jf1�J'te' "�+"�e+7c. f tv _I y x t 2 Per month Service Charge will be made on st Pa 3 u W e certify tr th o s QU Due Accounts. e her ify, ha g od were produced in complianced 1 wi of tth all applicable TAXI41��; of section an h Fan Lab it �h w a I and of regu lations and F.REIQ".7h6T i s the Unit r d States Department of Labo t Standa d o0 I ......;.r •s: i r t �*I t o rders under Section 14 thereof. I L. EXCLUSION OF WARRANTIES The lactar warranty constitutes the only warranty with respect to these goods. Seller and Purchaser hereby agree that the implied ^O ^'T� ^f htn m a narticular purpose and all other warranties (except lot the factory warranty), express or implied, including any Board Form Prescribed No. ibe 301-S St e Rev.199 ot Accounts 5) ACCOUNTS PAYABLE VOUCHER Form 301 (v. 199 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 19 Signature Title I 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- 1 -1.6. Officer Title Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS SANITATION DEPARTMENT ACCT CARMEL; INDIANA e ,r Favor Of Total Amount of Voucher Deductions 1. b 0.6 104 fr 7X Amount of Warrant Month of 19 VOUCHER RECORD Not Collection System Operation Plant C- Commercial General Undistributed Construction Depreciation Reserve Stock Accounts Merchandise Total Allowed Board Members Filed BOYCE FORMS SYSTEMS 1- 800- 382 -8702 325 CONTINUATION SHEET AIA DOCUMENT 0703 Carmel Contract 6 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Nine (9) Contractor's signed Certification is attached, APPLICATION DATE: July 31, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 07 01 08 Use Column I on Contracts where variable retainage for line items may apply. TO: 07 31 -08 ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED ITE,�t DESCRIPTION OF WORK SCHEDULED COMPLETED BALANCE RETAIN AGE VALUE This Application AND STORED Previous (G =C) TO FINISH TO DATE Applications Work in Place Stored Materials O DATE (C—G) (not in'!,D or E) 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 50,733.00 11,100.00 —0— 61,833.00 67 30,167.00 21. Electrical 11.24,000.00 514,417.42 99,080.00 2,593.55 616,090.97 55 507,909.03 22. Painting 13,000.00 —0— —0— —0— —0— 00 13,000.00 23. Miscellaneous 45,000.00 9,200.00 4,500.00 —0— 13 ;700.00 30 31,300.00 CO#1 Change Order No. 1 1. Eliminate EUH04,5,6 7,610.00 —0— 3,300.00 —0— 3,300.00 43 4,310.00 2. Suspended Solids Meter #10 .4,992.00 —0— —0— —0— —0— 00 4,992.00 3. PMQII Meter Plant Feed 7,357.00 —0— 7,357.00 —0— 7,357.00 100 —0- 4. Addition PMQII Metering 3,445:00 —0— 3,445.00 —0— 3,445.00 100 —0- 5. Misc. Electrical Blower Building 508.00 —0— 508.00 =0— 508.00 100 —0- 6. Solar Drying Supplemental Heat 282,955.00 24,662.78 18,220.00 —0— 42,882.78 15 F240,072.22 7. Electrical Prat to Aeartion 1,679.00 —0— 1,485.00 —0— f 1,485.00 88 194.00 AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA'b U 1978 THE A,ti'.ERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK: AVE_ N.W.. WASHINGTON, D.C. 20006 G703 1978 CONTINUATION SHEET AIA DOCUMENT G703 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Nine (9) Contractor's signed Certification is attached. APPLICATION DATE: July 31, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 07 -01 -08 Use Column I on Contracts where variable retainage for line items may apply. TO: 07 -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 ^'o. VALUE This Application AND STORED u� o Previous TO DATE (G -C) TO FINISH Stored Materials (C—G) Applications Work in Place (not in D or E) (D+E +F) 8. Remove Concrete Lining Aeration Tank 110 500.00 500.00 —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 -0- 194.00 -0 194.00 100 -0- 2644,205.00 1262,329.11 213,623.57 2,593.55 1478,546.23 56 165,658,77 132,210. AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA' U 1978 G703 1 978 THE A. INSTITUTE OF ARCHITECTS, 1735 NEW YORK. AVE., N.W.. WASHINGTON. D.C. 20006