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Home My WebLink About157566 03/19/2008 CITY OF CARMEL, INDIANA VENDOR: 00361429 Page 1 of 1 ONE CIVIC SQUARE M.K. BETTS ENGINEERING INC CARMEL, INDIANA 46032 PO BOX 2533 CHECK AMOUNT: $12,798.00 «o ANDERSON IN 46018 CHECK NUMBER: 157566 CHECK DATE: 3/19/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 654 5023990 8 12,798.00 OTHER EXPENSES ,j'4 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 0702 tlnstructions on reverse side( +G` o,F of Pu,ES TO (OWNER): City of Carmel PROJECT: Solar Drying APPLICATION NO: Eight (8)Distribution to. One Civic Square Contract 65 0w ER Carmel, IN 46032 Carmel, IN PERIOD TO: 02 29 08 ARCHITECT CONTRACTOR FROM (CONTRACTOR): VIA tARCHITECT): ARCHITECT'S r M. K. Betts Engineering Jones Henry Engineers, Ltd. PROJECT NO: Contracting, Inc. CONTRACT FOR: Invoice No, 07--232.08 CONTRACT DATE: Application CONTRACTOR'S APPLICATION FOR PAYMENT Continuation Sheet, ,f shown AIA Document G703, is attached. l raCl. connect on with the LUn CHANGE ORDER SUMMARY j 1. ORIGINAL CONTRACT SUM S 696,450.00 Change Orders approved in I ADDITIONS DEDUCTIONS 2 Net change by Change Orders S 123,297.00 previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 2) S 819,747.00 TOTAL 4. TOTAL COMPLETED &STORED TO DATE S 801 ,427 .00 Approved this Month (Column G on G703) Number Date Approved 5. RETAINAGE: a. of Completed Work S CO #1 $110,499.00 —0— (Column D +E on G703) CO #2 12,798.00 —0— b. of Stored material 5 (Column F on G703) Total Retainage (Line 5a 5b or 34,822.50 TOTALS, $123 297.00 —0— Total in Column I of G703) S 76 6,604.50 Net change by Change Orders $123,297.00 6. TOTAL EARNED LESS RETAINAGE S 0 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 253,806.50 paid by the Contractor for Work for which previous Certificates for Payment were B. CURRENT PAYMENT DUE S 12,798.00 issued and pavments received from the Owner, and that current payment shown 9. BALANCE TO FINISH, PLUS RETAINAGE S 53 50 herein is now due. (Line 3 less Line 6) CONTRACT M. K. Betts Engineering Contracting, Inc. State of: Indiana County of: 'Iadison Subscribed and sworn to before me this 29th_ day of Feb. 2008 Notary Public:QZQvvco Bv: Date: Feb. 29, 2008 My Commission expires: October 28 201.5 ARCHITECT'S CERTIF ATE FOR PAYMENT AMOUNT CERTIFIED...... t cer tified d iffers he 5 (Attach explanation if amount terrified diiiers irom the amount applred io,:; In accordance with the Contract Documents, based on on -site observations and the ARCHITE 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: indicated, the quality or the Work is in accordance with the Contract Documents, and This Certificate is not negotiable. The AMOUNT CERTIFIED is payable onl to the the Contractor is entitled to payment of the AMOUNT CERTIFIED Contractcr named herein. Issuance, payment and acceptance of payment arc without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT C7Q'? °n•�,�( Alit'.., .:i) _F.Ti� •�c cif 'OP EDiTIOI CONTINUATION SHEET AIA DOCUMENT 0703 Carmel WWTP Solar Drying ConLract 65 P..\GE OF P \GE AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NU`tBER: Eight (8) Contractor's signed Certification is attached. APPLICATION DATE: Feb. 29, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROtiI: 02 -01 -08 Use Column I on Contracts where variable retainage for line items may apply. TO: 02 -29 -08 ARCHITECT'S PROJECT NO' A B C D E F G H WORK COMPLETED TOTAL COMPLETED ITEM DESCRIPTION OF WORK SCHEDULED BALANCE RETAIN: \GE VALUE This Application AND STORED TO FINISH Previous TO DATE iG =C C —G) Stored Materials Applications Work in Place (not in D or E) D *E +F1 1. Mobilization, Bond i Insurance 7.0,000.00 20,000.0 -0- 0- 20,000.00 100 0- i 2. Topsoil Embankment 850 cy $15.66/cy 13,311.00 1.3,311.00 -0- -0- 13,311.00 100 -0- 3. Removal of Biosolids 1.1.00 cy $6.48/cy 7,128.00 7,128.00 -0- -0- 7,128.00 100 -0- 4. Excavation, fill embankment 5900 cy $6.48/cy 38,232.00 38,232.00 -0- -0- 38,232.00 1001 -0- 5. Site Demo, Piping, Etc. 79,000.00 77,435.00 -0- -0- 77,435.00 98 1,565.00 6. Building Exc. Backfill 45,000.00 45,000.00 -0- -0- 45,000.00 100 -0- 7. Concrete Drying Bldg and Control 237,000.00 237,000.00 -0 -0- 237,000.00 100 -0- 8. Dock Extension 6,250.00 6,250.00 -0- -0- 6,250.00 100 -0- 9. Building Erection 84,200.00 84,200.00 -0- -0- 84,200.00 100 -0- 1.0. Hot Water Piping 33,800.00 33,800.00 -0 -0- 33,800.00 100 -0- 11. Waterlines 13,450.00 13,450.00 -0- -0- 13,450.00 100 -0- 1.2. Miscellaneous 7,579.00 7,579.00 -0- -0 7,579.00 100 -0- 13. Asphalt Paving 24,000.00 24,000.00 -0- -0 24,000.00 100 -0- 1.4. Electrical 87,500.00 86,500.00 -0- -0 86,500.00 99 1,000.00 ,s. AIA DOCUMENT 0703 CONTINUATION SHEET APRIL 1978 EDITION AIA 1) 1978 THE INSTITUTE OF ARCHITECTS. 1735 \Evv YORE: vvE .NAV 7) r 1r,.. CCNTINUAT!ON SHEET 4/A DOCUMENT 0703 P A GE ,-sIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER. Eight (8) Contractor's signed Certification is attached. APPLICATION DATE: February 29, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 02 01 08 Use Column I on Contracts where variable retainage for line items may apply. TO: 02 29 08 ARCHITECT'S PROJECT NO. 5 C D F G H WORK CONII'LETED DESCR:PTIO.�' OF WORK SCHEDULED OTAL CO310PLETED BALANCE �ET GL This AcQhcation AN'D STORED TO FINISH VALUE .o. Previous Stored Materials TO DATE iG C1 tC —G) Applications Work in Place (not in D or E) (D +E+F) 15. Change Order No. 1 1. Backflow Preventor piping, found, etc 26,500.00 26,500.00 -0- -0- 26,500.00 100 -0- 2. Dock Lights 5,740.00 5,740.00 -0- -0- 5,740.00 100 -0- 3. Heating lines and Conduit 48,000.00 48,000.00 -0 -O- 48,000.00 100 -0- 4. 40 Amp Breaker 2,755.00 -0- -0- -0- -0- 00 2,755.00 5. MCC Cover at Centri. 748.00 748.00 -0 -0- 748.00 100 -0- i 6. Relocate Fence at firing range 1,256.00 1,256.00 -0- -0- 1,256.00 100 -0- 7. Additional Asphalt 22,780.00 9,780.00 -0- -0- 9,780.00 43 13,000.00 8. Remove Lift Station Structure 1,100.00 1,100.00 -0- -0- 1,100.00 100 -0- I �9. Contour Eorth Edge i of Lagoon 1,620.00 1,620.00 -0- -0- 1,620.00 100 -0- 16. 1. Excavation, fill embankment I 1975 cy $6.48 12,798.00 -0- +12,798.00 -0 12,798.00 100 -0- I 1 I I I 819,747.00 1 788,629. 0 12,798.00 -0- 801,427.00 98 18,320.00 34,822.50 .\I% t)OCt,htfNT G -03 C�.�',IA�:v.ilU' SHEE" P R IL 1973 EDlTlO�' AIDV" 197H T ;35 N Rb >.VE �.v:�SHIV n.. r :;or. iQIfR 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. t Payee 351429 M.K. BETTS ENGINEERING CONTR Purchase Order No. P.O. Box 2533 Terms Anderson, IN 46018 Due Date 3/10/2008 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 3/10/2008 8 $12,798.00 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 j Date +er VOUCHER 085032 WARRANT ALLOWED 351429 IN SUM OF M.K. BETTS ENGINEERING CONTR P.O. Box 2533 Anderson, IN 46018 a] Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 8 09- 1050 -79 $12,798.00 6 �5�P P Voucher Total $12,798.00 Cost distribution ledger classification if claim paid under vehicle highway fund