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Home My WebLink About204254 12/06/2011 CITY OF CARMEL, INDIANA VENDOR: 365624 Page 1 of 1 ONE CIVIC SQUARE HIS CONSTRUCTORS INC h CARMEL, INDIANA 46032 5150E 65TH STREET SUITE B CHECK AMOUNT: $52,671.01 INDIANAPOLIS IN 46220 -4817 CHECK NUMBER: 204254 CHECK DATE: 12/6/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 211 4462300 25806 3 52,671.01 WESTWOOD DRIVE BRIDGE CONSTRUCTION PROJECT INVOICE DATE: November 22, 2011 COMPANY NAME: HIS Constructors, LLC AND ADDRESS 5150 East 65` Street, Suite B Indianapolis, Indiana 46220 TELEPHONE NO.: (317) -284 -1195 FAX NO.: (317) -284 -1185 PROJECT NAME: Hamilton County Bridge 289 Westwood Drive over Mitchner Ditch PROJECT NO.: 11 -08, INVOICE NO.: 3 TOTAL EARNINGS TO DATE: 121,824.54 MINUS 10% RETAINAGE: 12,182.45 TOTAL EARNED MINUS RETAINAGE: 109,642.09 MINUS PREVIOUS PAYMENTS: 56,971.08 TOTAL AMOUNT DUE: 52,671.01 Dan Greskamp Construction Manager City of Carmel Application and Certificate For Payment Page I To Owner: CITY OF CARMEL Project: CITY OF CARMEL BRIDGE 289 Application No: 3 Date: 11/01/2011 BOARD OF PUBLIC WORKS SAFETY WESTWOOD DRIVE OVER ONE CIVIC SQUARE MITCHENER DITCH Period To: 10/31/11 CARMEL, IN 46032 CARMEL, IN Architects From HIS CONSTRUCTORS, INC. Contractor Project No: (Contractor): 5150 E. 65TH STREET Number: Job 110025 Contract Date: SUITE B INDIANAPOLIS, IN 46220 -4817 Via (Architect): Phone: 317 284 -1195 Contract For: Contractor's Application For Payment Change Order Summary Additions Deductions Original contract sum 154,800.02 Change orders approved in previous months by owner Net change by change orders 0.00 Date Contract sum to date 154,800.02 Number Approved Change Total completed and stored to date 121,824.54 orders approved Reta i nag e this month 10.0% of completed work 12,182.45 Totals 0.0% of stored material 0.00 Net change by change orders Total retainage 12,182.45 The undersigned Contractor certifies that to the best of the Contractor's knowledge, Total earned less retainage 109,642.09 information, and belief the work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor Less p revious certificates of p ayment 56 971 .08 for work for which previous Certificates for Payment were Issued and payments received from P P y the Owner, and that current payment shown herein is now due. Current sales tax Contractor: ArS�CUC s I `u1C By: Date: 7.000% of taxable amount 0.00 I State of: County of: Current sales tax 0.00 Subscribed and sworn to, before me s i day of (year). notary l Current payment due 52,671.01 My commissionexpir� Balance to finish, including retainage 45,157.93 i f Architect's Certificate for Payment In accordance. witFi the Contract Documents, based on on -site observations and the data Architect 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 Indicated, the quality By: Date: of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the Amount CertiFed. This Certification is not negotiable. The Amount Certified is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Amount Certified: Contract. i i f I Application and Certificate For Payment- page 2 To Owner: CITY OF CARMEL Application No: 3 Date: 11/01/11 Period To: 10/31/11 From (Contractor): HIS CONSTRUCTORS, INC. Contractor's lob Number: 110025 Project: CITY OF CARMEL BRIDGE 2 Architect's Project No: Work Completed Work Completed Completed and Stored To Date i Previous Application ThIs Period Item Unit Contract Scheduled Number Description Price Quantity UM Value Quantity Amount Quantity Amount Quantity Amount Retention Memo 01 001 CONSTRUCTION ENGINEE 2,400.0000 1.00 LS 2,400.00 50.00% 1,200.00 50.00% 1,200.00 100.00 2,400.00 100.0 240.00 RING 002 MOBILIZATION AND OEM 7,800.0000 1.00 LS 7,800.00 100.00 7,800.00 0.00% 0.00 100.00% 7,800.00 100.0 780.00 OBILIZATI ON 003 CLEARING RIGHT OF WA Y 5,718.2000 1.00 LS 5,718.20 100.00% 5,718.20 0.00% 0.00 100.00% 5,718.20 100.0 571.82 004 TEMPORARY IN-STREAM SILT 1,000.0000 1.00 LSU 1,000.00 .35 350.00 .00 0.00 .35 350.00 35.0 35.00 BASIN 005 EXCAVATION COMMON 55.0000 138.00 CYS 7,590.00 .00 0.00 83.00 4,565.00 83.00 4,565.00 60.1 456.50 006 EXCAVATION WATERWAY 45.0000 25.00 CYS 1,125.00 .00 0.01) .00 0.00 .00 0.00 0.0 0.00 007 EXCAVATION FOUNDATI ON 35.0000 52.00 CYS 1,820.00 .00 0.00 .00 0.00 .00 0.00 0.0 0.00 UNCLASSIFIED i 006 TEMPORARY SILT FENCE 2.7500 300.00 LFT 825.00 .00 0.00 .00 0.00 .00 0.00 0.0 0.00 i UNDISTRIBUTED 009 AGGREGATE FOR END BE NT 70.0000 22.60 CYS 1,562.00 43.00 3,010.00 -20.40 1,428.00 22.60 1,582.OD 100.0 158.20 BACKFILL 010 COMPACTED AGGREGATE 53 30.0000 168.00 TON 5,040.00 .00 0.00 181.71 5,451.30 181.71 5,451.30 108.2 545.13 BASE 011 HMA SURFACE TYPE A 119.0000 42.00 TON 4,998.00. .00 0.00 3210 3,819.90 32.10 3,819.90 76.4 381.99 012 HMA INTERMEDIATE TYPE A 106.0000 57.00 TON 6,042.00 .00 0.00 59.61 6,318.66 59.61 6,318.66 104.6 631.87 013 HMA BASE TYPE A 88.0000 70.00 TON 6,160.00 .00 0.00 65.98 5,804.48 85.96 5,804.48 94.2 580.45 014 BENCHMARK 500.0000 1.00 EAC 500.00 .00 0.00 1.00 500.00 1.00 5DO.00 100.0 50.00 i 015 BURIED TIMBER GUARDRAIL 1,300.0000 4.00 EAC 5,200.00 DO 0.00 4.00 5,200.00 4.00 5,200.00 100.0 520.00 END SECTION INS 016 TIMBER GUARDRAIL IN STALL 41.0000 96.00 LFT 3,936.00 .00 0.00 96.00 3,936.00 96.00 3,936.00 100.0 393.60 ONLY 017 TIMBER BRIDGE RAIL INSTALL 48.0000 84.00 LFT 4,032.00 .00 0.00 84.00 4,032.00 84.00 4,032.00 100.0 403.20 j ONLY 018 GEOTEXTILES 2.5000 390.00 SYS 975.00 .00 0.00 .00 0.00 .00 0.00 0.0 0.00 i 019 RIPRAP CLASS 1 24 DEPTH 35.0000 263.00 TON 9,205.00 .00 0.00 61.00 2,135.00 61.00 2,135.00 23.2 213.50 020 SEED MIXTURE R 47.0000 8.00 LBS 376.00 .00 D.DO .00. 0.00 .00 0.00 0.0 0.00 021 FERTILIZER 2,100.0000 .10 TON 210.00 .00 0.00 .00 0.00 .00 0.00 0.0 0.00 022 MULCHED SEEDING T 3.0000 212.00 SYS 636.00 .00 0.00 .00 0.00 .00 0.00 0.0 0.00 UNDISTRIBUTED 023 TEMPORARY EROSION CO 4.0000 212.00 SYS 848.00 .00 0.00 .00 0.00 .00 0.00 0.0 0.00 NTROLBLANKEf 024 MOBILIZATION AND OEM 265.0000 2.00 EAC 530.00 .00 0.00 1.00 265.00 1.00 265.00 50.0 26.50 Call. ZATION FOR SEED 025 END BENT DRAIN PIPE 6 13.0000 80.00 LFT 1,040.00 75.00 975.00 .00 0.0o 75.00 975.00 93.8 97.50 DIAMETER r 026 SAW CUT JOINT 13.0000 49.00 LFT 637.00 .00 0.00 40.00 520.00 40.00 520.00 81.6 52.00 i 027 PILING STEEL H PILES HP 65.0000 520.00 LFT 33,800.00 312.00 20,280.00 .00 0.00 312.00 20,280.00 60.0 2,028.00 i 12X53 I Application and Certificate For Payment page 3 To Owner: CITY OF CARMEL Application No: 3 Date: 11/01/1 Period To: 10/31/11 From (Contractor): HIS CONSTRUCTORS, INC. Contractor's Job Number: 110025 Project: CITY OF CARMEL BRIDGE 289 Architect's Project No: Work Completed Work Completed Completed and Stored To Date Previous Application This Period Item Unit Contract Scheduled Number Description Price Quantity UM Value Quantity Amount Quantity Amount Quantity Amount Retention Memo 028 EPDXY COATED REINFOR 1.2000 3434.00 LBS 4,120.80 4140.00 4,968.00 .00 0.00 4140.00 4,968.00 120.6 496.80 CING STEEL 029 CONCRETE A SUBSTRU 950.0000 21.20 CYS 20,140.00 20.00 19,000.00 1.20 1,140.00 21.20 20,140.00 100.0 2,014.00 CTURE 030 STRUCTURAL MEMBRANE 30.0000 150.00 SYS 4,500.00 .00 0.00 150.00 4,500.00 150.00 4,500.00 100.0 450.00 WATERPROOFING 031 WS 17 X 4'-0 CONCRETE 7.0000 924.00 SFT 6,468.00 .00 0.00 924.00 6,468.00 924.00 6,468.00 100.0 646.80 BOX BEAMS INSTA 032 SURFACE SEAL 1,150.0000 1.00 LS 1,150.00 0.00% O.OD 0.00% 0.00 0.00% 0.00 0.0 0.00 033 FIELD TILE UNDISTRI BUTEO 15.0000 20.00 LFT 300.00 .00 0.00 .00 0.00 .00 0.00 0.0 0.00 034 CONSTRUCTION SIGN TYPE 130.0000 8.00 EAC 1,040.00 .DD 0.00 8.00 1,040.00 8.00 1,040.00 100.0 104.00 A 035 CONSTRUCTION SIGN TYPE 70.0000 2.00 EAC 140.00 .00 0.00 2.00 140.00 2.00 140.00 100.0 14.00 B 036 STANDARD BARRICADE TYPE 13.0000 48.00 LFT 624.00 '.00 0.00 48.00 624.00 48.00 624.00 100.0 62.40 IIIA 037 STANDARD BARRICADE TYPE 14.0000 48.00 LFT 672.00 .00 0.00 48.00 672.00 48.00 672.00 100.0 67.20 1118 038 DETOUR ROUTE MARKER 140.0000 7.00 EAC 960.00 .00 0.00 7.00 980.00 7.00 980.00 100.0 98.00 ASSEMBLY 039 ROAD CLOSURE SIGN AS 160.0000 4.00 EAC 640.00 .00 0.00 4.00 640.00 4.00 640.00 100.0 63.99 SEMBLY 800 LOAD AND TRANS WOOD RAIL 0.0000 1.00 LS 0.01 0.00% 0.00 0.00 0.00 0.00% 0.00 0.0 0.00 PIECES 900 OVERHEAD 0.0000 1.00 LS 0.01 0.00% 0.00 0.00% 0.00 0.00% 0.00 0.0 0.00 Total 164,800.02 63,301.20 58,523.34 121,824.54 12,182.45 Application Total 154,800.02 63,301.20 58,523.34 121,824.54 12,182.45 I i i 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 HIS Constructors, LLC Purchase Order No. 5150 East 65th Street Suite B Terms Indianapolis, IN 46220 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11122111 3 Westwood Bridge over Mitchner Diteh Genstruct Total 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- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 HIS Constructors, LLC IN SUM OF 5150 East 65t S Suite B Indianapolis, IN 46220 $52,671.01 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 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 2580 3 211-4462300 $52,671.01 which charge is made were ordered and received except 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund