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Home My WebLink About158638 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 356934 Page 1 o f 1 ONE CIVIC SQUARE SIGNATURE CONSTRUCTION LLC CHECK AMOUNT: $35,033.48 CARMEL, INDIANA 46032 720 3RD AVE SW CARMEL IN 46032 CHECK NUMBER: 158638 CHECK DATE: 4/15/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 .4460805 35,033.48 RETAIL SITE ##5 I 3� G CSO Architects Letter of Transmittal TO: Carmel Redevelopment Commission DATE: March 27, 2008 111 West Main Street PROJECT NO: 26163HC Carmel, Indiana 46032 RE: March Payment Request ATTN: Sherry Mielke CONTACT PHONE: 571 -2787 WE ARE SENDING YOU. COPIES DATE w, P IDESCRIPTION 3 3127108 Payment Request, Parcel 5B. Motor Court, By Signature Construction, 35,033.48 IF ENCLOSURES ARE NOT AS INDICATED, PLEASE NOTIFY US AT ONCE. THESE ARE TRANSMITTED: For approval Reviewed as submitted Resubmit for approval For your use As noted Submit for distribution As requested Revise and Resubmit Return corrected prints For review and comment Rejected Other: REMARKS: Sherry: Attached is the payment request for the month of March 2008. I've approved the request and I'm asking, for payment at the April 2008 CRC meeting. If you have any questions please feel free to call. Thanks, Bob CC: FILE By: Bob Courier Service: 1 -HR 3 -HR Same Day FedEx Services: 8:30 A.M. Delivery 10:30 A.M. Delivery 3:00 P.M. Delivery FedEx Ground Delivery Hand delivery Other Delivery Service: Document2 ARCHITECTURE INTERIOR DESIGN 280 East 96th Street, Suite 100 Indianapolis, Indiana 46240 Main 317.848.7800 Fax 317.574.0957 csoinc.net PARTIAL Payment to Follow AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA SS: COUNTY OF HAMILTON Steve Warne being duly sworn states that he is the Vice President of SIGNATURE CONSTRUCTION, LLC having contracted to furnish certain materials and /or labor as follows: Site Development for a project known as Parcel 5B Phase I Carmel City Center Motor Court located at CARMEL, IN and owned by Carmel Redevelopment Commission and does further state: PARTIAL WAIVER: that the balance due from the owner is the sum of thirty five thousand thirty three dollars and forty eight cents the payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for said amount, effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all lien or claim whatsoever on the above described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has a any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC t Koontz z President Subscribed and sworn to before me this: A( rel_ Notary Public: ;aYP� LINDA BUCHANAN ,....4re noTarav Hancock County 5Ew z= My Commission Expires August 20, 2011 ar APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES TO OWNER: Carmel Redevelopment Commission PROJECT: Parcel 5H APPLICATION NO Draw Number 5 Distribution to: One Civic Square Phase 1 Carmel City Center Signature costs =OWNER Carmel, Indiana 46032 Motor Court =ARCHITECT PERIOD TO 4/21/2008 CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction LLC 720 3rd Avenue S.W. PROJECT NOS: CS Project 21010 Carmel, Indiana 46032 CONTRACT FOR: CONTRACT DATE: 917/2007 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document U703, is attached. completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received Gom the Owner, and that current payment shown herein is now due. ;to`�0�' "Y gh.,. LINDA BUCHANAN Hancock County I. ORIOINAL CON RAC 'I' SUM 2,841,863.UU a SEAL My Commission Expires 2. Net change by Change Orders 0,00 CON "1 RAC'I OR: 9 F ;"O' August 20, 201 3. CONR•RAC "1' SUM'f0 DATE (Line l t 2) 5�, 4. 1OTALCOMPLE'I'ED &51'URED I'O T8TF592F= By: f Date: 5. RE "I•A1NAG E: m Soon[ re51 en /►fpm a. U "U998 of Completed Work 183,358.47 Sub nbed ands om to before me this 25th day of k°etrraarp, 1tAl? TCTi_m D E on 6703) b. of Stored Material TC F on 6703) 1 otal Ketainage (Lines Da JI) or Total in Column I ofG703) 183,358.47 6. 'TOTAL EARNED LESS RE'1'AINAUE fib, 5 226.£Si In accordance with the Contract Documents, based on on -site observations and the data (Line 4 Less Line 5 "Total) comprising the application, the Architect certifies to the Uwner that to the best or the 7. LESS PREVIOUS CERI IFICAfES FOR Architect's knowledge, information and belief the Work has progressed as indicated, PAYMENT (Line 6 from prior Certificate) 1,619,192.77 the quality of the Work is in accordance with the Contract Documents, and the Contractor S. CURRENT PAYMENT DUE $`35,037-48 is entitled to payment of the AMOUNT' CERTIFIED. 9. BALANCE 7'U FINISH, INCLUDING RETA1NAUE T5 (Line 3 less Line 6) AMOUNT CER'T'IFIED S s5 .0-55-41 (Attach expla ation tj' !anti certi i djjjers from the amount applied Initial oli figures on this total changes approve Application nd ont I Cony ua n bee III are changed to conform wi U1 the amount certified.) in previous months by Owner ARC I "1': Total approved this Month Fay: Date: .3)'97109 TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the t omractor namem nerem. issuance, payment anu acceptance or payment are wtmouc NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1092 EDITION AIA i®1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N W., WASHINGTON, DC 20006 -5292 Users may obtain validation of this document by requesting a completed AIA Document D401 Certification of Document's Authenticity from the Licensee. `r G703 CONTINUATION SHEET Page 2 of 2 To: From: Project: Application No. 8 gn Carmel Redevelopment Commission siature Construction LLC Parcel 5B Application Date: 4/21/08 One Civic Square 720 3rd Avenue S.W. Phase I Carmel City Center Period To: 4/21/08 Carmel, Indiana 46032 Carmel, Indiana 46032 Motor Court Engineer's Project No. A B C D E F G H I Work Cam leted Materials Total Presently Completed Balance Retainage Item Scheduled From Previous Stored and Stored 'h To If g Description of Work Value Application This Period (Not in To Date (G /C) Finish Variable D or E) (D +E +F) (C -G) 101 General Requirement 132,109.09 83,228.73 1,321.09 0.00 84,549.82 64% 47,559.27 8,454.98 Bonding 113,675.00 113,675.00 0.00 0.00 113,675.00 100 0.00 11,367.50 Insurance 25,000.00 25,000.00 0.00 0.00 25,000.00 100 0.00 2,500.00 102 Existing Conditions 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 103 Concrete 2,170,090.00 1,511,104.00 37,605.00 0.00 1 71 621,381.00 154,870.90 104 Masonry 50,000.00 0.00 0.00 0.00 0.00 0% 50,000.00 0.00 105 Metals 19,368.00 0.00 0.00 0.00 0.00 0% 19,368.00 0.00 106 Wood, Plastics and Composites 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 107 Thermal and Moisture Protection 68,430.00 4,000.00 0.00 0.00 4,000.00 6 9 6 64,430.00 0.00 108 Openings 6,100.00 0.00 0.00 0.00 0.00 0 9 6 6,100.00 0.00 109 Finishes 26,360.00 0.00 0.00 0.00 0.00 0% 26,360.00 0.00 110 Specialties 0100 0.00 0.00 0.00 0.00 0$ 0.00 0.00 111 Equipment 0.00 0.00 0.00 0100 0.00 0 9 6 0.00 0.00 112 Furnishings 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 113 Special Construction 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 114 Conveying Equipment 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 121 Fire suppression 0.00 0.00 0.00 0.00 0.00 0 9 6 0.00 0.00 122 Plumbing 31,000.00 0.00 0.00 0.00 0.00 0% 31,000.00 0.00 123 Heating, ventilation AC 0.00 0.00 0100 0.00 0.00 0% 0.00 0.00 125 Integrated Automation 0.00 0.00 0.00 0.00 0.00 0$ 0.00 0.00 126 Electrical 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 127 Communications 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 126 Electronic Safety Security 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 131 Earthwork 89,640.00 0.00 0.00 0.00 0.00 0% 89,640.00 0.00 132 Exterior Improvements 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 133 Utilities 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 134 Transportation 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 140 Process Integration 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 141 Material Processing Handling Equip. 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 144 Pollution Control Equipment 0.00 0.00 0.00 0.00 O.OQ 0% 0.00 0.00 Construction Fee 110,090.91 1 61,650.91 (0.00) 0.00 61,650.91 56$ 48,440.00 6,165.09 2,841,863.00 1,798,658.64 38,926.09 0.00 1,837,584.73 65% 1,004,278.27 183,358.47 d 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 service rendered, by whom; rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee S7 qn 4 tore 664.r 4 �.o� C Purchase Order No. 9 r 3 /4 S w. Terms 6416 c l, T N 4&'p 3 Z Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3/277 o g P.� se Ma{b C 3 `!8 /i te r Total 3j` X33. (48 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in cc orce with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 S r9na�'vr� �onS�r- vc �a.•. LtC IN SUM OF 72o 3 �9tole-. Ca�,•�.�� r ev Y& &,r 3s► X33, 14 8 ON ACCOUNT OF APPROPRIATION FOR y4(eo$oS Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or �OZ '+'+Go 033 4g 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 0 Sig ture Title Cost distribution ledger classification if claim paid motor vehicle highway fund