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Home My WebLink About176067 08/18/2009 CITY OF CARMEL, INDIANA VENDOR: 363264 Page 1 of 1 ONE CIVIC SQUARE GENERAL INTERIORS INC CHECK AMOUNT: $1,200.00 CARMEL, INDIANA 46032 4038 GUION LANE INDIANAPOLIS IN 46268 CHECK NUMBER: 176067 CHECK DATE: 8/18/2009 D A PO NUMBER INVOIC NUMBER AMO DESCRIPTION 902 4460807 3 i 1,200.00 RETAINAGE /ENR CNTR r SL Subcontract Billing Report For Work Invoiced From First to 07/22109 �r sU6 ontr"act: 2805 -012 EIFS Job: 2805- Energy Center Carmel Vendor: 2965 GENERAL INTERIORS C ontra ct�•F �To" Date P l r Phis ertod Item Units UM Unit Cost Amount Units/% Amount Units Amount 1 EIES LS 24,000.00 100.00% 24,000.00 100.00% 24,000.00 Total Contract Items 24,000.0 24,000.00 24,000.00 Subcontract Totals: 24,000.00 24,000.00 24,000.00 Total Billings: 24,000.00 24,000.00 Unpaid Retainage: 1,200.00 1 1,200.00 Discounts: 0.00 0.00 Net Billings: 22,800.00 22,800.00 98 SSC CMa Projects Page 1 07/22/09 12:47:46 PM Date Format MM /DD /YY SLSubBillingReport .rpt Im AIA Document G702 /CMa —1992 n I JUL 1 4 1009 Application and Cert ificate for•Pa Construction Manager- Adviser Edition t TO OWNER: CARMEL REDEVELOPMENT COMPROJECT: CARMEL ENERGY CENTER APPLICATION NO: 03 y.1 Distribution to: ONE CIVIC SQUARE PERIOD T0: 10/31/08:. OWNER CARMEL, IN 46032 CONSTRUCTION MANAGER VIA CONSTRUCTION CONTRACT<FOR ARCHITECT FROM GENERAL; INTERIORS, INC. MANAGER: SHIEL SEXTON CO, INC. CONTRACT DATE: CONTRACTOR X CONTRACTOR "4038 GUION LANE VIA ARCHITECT: PROJE CT" NOS: l FIELD INDIANAPOLIS, IN 46268 OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with.the Application is made for payment; as shown below, in connection with the Contract. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet, AIA Document G703, is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1. ORIGINAL CONTRACT SUM 24, 000.0 payment shown herein is now due. 2. Net change by Change Orders 0.0 CONTRACTOR: 3. CONTRACT SUM TO DATE (Line 1 2) 24,000.0 By: Date: 10/9/2 4. TOTAL COMPLETED STORED TO DATE Column:G'on G703 24, 000.0 State of: INDIANA 5. RETAINAGE: County of: MARION a• of Completed Work Subscribed and sworn to before (Column D E on G703) 0.00 me this 9TH day of OCTO b• of Stored Matenai Notary Public: (Column F onG703) My Commission pires 5/21/2009 Total Retamage (Lines 5a 5b or Total in Column I of G703)....$ 0.0 CERTIFICATE ..:FOR PAYMENT In accordance with' the Contract Documents, based on on -site observations and the -data comprising 6. TOTAL EARNED LESS RETAINAGE 24,000.0 this application, the Construction Manager and Architect certify to the Owner fhat•to the,best of their (Line 4 Less Line 5 Total) knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 22.800.0 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. (Line 6 from prior Certificate) I oz h 8. CURRENT PAYMENT DUE 1,200.00 AMOUNT CERTIFIED V 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) CONSTRUCTION MAN ER- By: Date: 3 RANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: r T otal changes approved in previous months by Owner By: Date: T otal approved this Month This Certificate is of tiable The "AMOUNT CERTIFIED is payable only to the Contractor TOTALS named herein. I a payment and acceptance of payment are without prejudice to any rights of the Owner or ctor,under this Contract d T CH"iiS y change Order AIA Document G702/CmaTM 1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are pe mitted to reproduce ten 00) copies of this document when completed. To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright @aia.org. TI VI Document G702/CIV`Ia -1992 Instructions Application and Certificate for Payment Construction Manager- Adviser Edition A. General Information AIA Document G702 /CMa, Application and Certificate for Payment, Construction Manager Adviser Edition, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner, but not as a constructor, and where multiple Contractors have direct Agreements with the Owner. Procedures for their use are covered in AIA Document A201 /CMa, General Conditions of the Contract for Construction, Construction Manager- Adviser Edition, 1992 Edition. B. Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of copies of a completed G702/CMa, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement (EULA). To report copyright violations of AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright @aia.org. C. Completing the G702/CMa Form After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AIA Document G702 /CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The Contractor should sign G702 /CMa, have it notarized and submit it, together with G703, to the Construction Manager and Architect. The Construction Manager and Architect should review G702 /CMa and G703 and, if they are acceptable, complete the Certificate for Payment on G702/CMa. The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201 /CMa. They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702/CMa and G703 should be forwarded to the Owner. D. Completing the G703 Form Heading: This information should be completed to be consistent with similar information on AIA Document G702/CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. Columns A, B C: These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed work covered by the previous application (columns D E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored (column F). Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed This Period). Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line -item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 /CMa. E. Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702/CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The completed form contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702 /CMaTM 1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten (10) copies of this document when completed. To report copyright violations of AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright @aia.org. AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF MARION r MARK WYATT of GENERAL INTERIORS, INC., being first duly sworn, says that he is the PROJECT MANAGER of GENERAL INTERIORS, INC. (hereinafter referred to as the "Company and is familiar with the facts herein stated. That said Company performed work and labor and /or furnished material for use, in the construction by SHIEL SEXTON CO., INC. (the General Contractor) of certain buildings, improvements and equipment on premises owned by CARMEL REDEVELOPMENT COMMISSION at CARMEL, IN That said Company has fully paid for all of said work, labor, material, machinery and equipment furnished by it or by its subcontractors or materialmen upon said premises, or furnished therefor. That the balance remaining due from the Contractor and unpaid to said Company is the sum of ONE THOUSAND TWO HUNDRED AND 00/100 DOLLARS ($1,200.00) and that upon the payment to it of said sum, it hereby waives all liens and claims against the said owner, its premises and property, and all claims against above name Company /Contractor and further, he represents that no other person or party has any right to a lien on account of any work performed or material furnished to said Company. Further affiant saith not. MARK R. WATT SWORN TO before me and subscribed in my presence this _9TH day of OCTOBER 2008. JOANNE DE FRANCE Notary Public County of Residence: HAMILTON Commission Expires: 5/21/2017 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 Z J��• -•ors A/ Purchase Order No. Terms 17� 26 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total aD 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 y�lo�v��l Tom. 'U S IN SUM OF j ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 9l/2 y{6Oro7 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 c� �9 20 D,y Signature Dire t: abons-- Cost distribution ledger classification if ItIe claim paid motor vehicle highway fund