HomeMy WebLinkAbout176620 09/01/2009 CITY OF CARMEL, INDIANA VENDOR: 105285 Page 1 of 1
ONE CIVIC SQUARE GAYLOR ELECTRIC INC CHECK AMOUNT: $103,599.25
i° CARMEL, INDIANA 46032 PO BOX 3757
`p CARMEL IN 46082 CHECK NUMBER: 176620
CHECK DATE: 9/1/2009
DEPARTMENT AC COUNT PO N UMBE R INVOICE NUMBER AMOUNT DESCRIPTION
902 4460807 17 4,280.05 PERFORMING ARTS CENTE
902 4460807 18 99,319.20 PERFORMING ARTS CENTE
TM
Document G7021CMa —1992
Application and Certificate for Payment Construction Manager- Adviser Edition
TO OWNER: City of Carmel PROJECT: Energy Center Parcel 7C APPLICATION N0: 18 Distribution to:
PERIOD TO 07/31/09 OWNER
Camel, IN 46032 91051802
Electrical CONSTRUCTION MANAGER
FROM CONTRACTOR: Gaylor, Inc. VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT
11711 N. College Ave., Ste 150
Carmel, IN 46032 PROJECT NOS: I CONTRACTOR
VIA ARCHITECT: Shiel Sexton FIELD
CONTRACT FOR:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and
Application is made for payment, as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the
Continuation Sheet, AIA Document G703, is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous
947700.00 Certificates for Payment were issued and payments received from the Owner, and that current
1. ORIGINAL CONTRACT SUM payment sho herein is n dt
2. Net change by Change Orders 45492.00 CONTRACT
3. CONTRACT SUM TO DATE (Line I 2),,.,....... 993192.00 By: 2 Date: 07/28109
4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 993192.00 State of: Indiana
5. RETAINAGE: County of: Hamilton
a• 0 %16f Completed Work Subscribed and sworn to "before
(Column D E on G703) 0.00 me this 28& f July 2009
b. 0 of Stored Material Notary Public:
(Column F on 6703) 0.00 My Commissio xpires: 6/21/2012
Total Retainage (Lines 5a 5b or Total in Column I of G703) 0.00 CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on -site observations and the data comprising
6. TOTAL EARNED LESS RETAINAGE 993192.00 this application, the Construction Manager and Architect certify to the Owner that 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 893872'80 accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT
(Line 6 from prior Certificate) CERTIFIED.
8. CURRENT PAYMENT DUE
99319.20 AMOUNT CERTIFIED
9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs front the amount applied. Initial a71 figures on this
Application and on the Continuation Sheet that are changed to conform with the amount certified.)
(Line 3 less Line 6) 0.00 CONSTRUCTI MR:
By: L Date: 7 30 d
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT:
Total changes approved in previous months by Owner By: Date: 3 'I
Total approved this Month This Certificate is egotia e. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS named herein. 1 ce "payment and acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order 45492.00
the Owner or factor under this Contract.
CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
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.
TM
AIA Document G702 /CMa -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 ten 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.
SL Subcontract Billing Report
For Work Invoiced From 07131109 to 07131109
E
'-12805-011
Job: 2805- Eneray Center -Carmell Vendor: 2935 GAYLOR ELECTRIC
Item Units UM Unit Cost Amount Unitsl% Amount Units/% Amount
1 Electrical LS 947,700.00 100-00% 947,700.00 0,00% 0.00
Total Contract Items 947.700.0C 947,700.00 0.00,
Change Orders
2 CCR 1003 Electricity for LS 1,532.00 100.00% 1,532.00 0.00% 0.00
Dewatering Pumps
3 Electricity for Dewatering LS 2,443.00 100.00% 2,443.00 0.00% 0.00
Pumps
4 CCR 2001 Boiler LS -1,625.0 C 100.00% -1,625.00 0.00%
Combustion Air Modifications
5 CCR 2002 Added Pull LS 1,322.00 100.00% 1,322.00 0.00% 0.00
Stations
6 CCR 2005 Photocell on LS 415.0 C 100,00% 415.00 0.00% 0.00
Type CI-E Fixture
7 CCR 2006 Added Strobe in LS 845.00 100.00% 845.00 0.00% 0.00
Restroom 104
8 CCR 201 ASI #004 LS 2,379.00 100.00% 2,379.00 0.00% 0.00
Revised Water Treatment
System
9 CCR #1011- Extended LS 18.499.0C 100,00% 18,499.00 0.00% 0.00
Electrical Warranties
10 CCR #2000 Door Hardware LS -1,485.00 100.00% -1,485.00 0.00% 0.00
Modifications
11 CCR #3013 RCP #EC-007 LS 5,043.0 C 100.00% 5,043.00 0.00% 0.00
Exterior Light Rough-Ins
12 CCR #3013 Shift Conduit LS 1,531.00 100.00% 1,531.00 0.00% 0.00
Penetration for Exterior
Lighting
13 CCR #3014 ESI #EC-004 LS -2,103.00 100.00% -2,103.00 0.00% 0.00
Modify Courtyard Electrical
14 CCR #2020 Eliminate Load LS -5,667.00 100.00% -5,667.00 0.00% 0.00
Bank
15 Duke Energy LS 18,204.00 100.00% 18,204.00 0.00% 0.00
Accommodations
Courtyard
16 ELECTRICAL LS 634.00 100.00% 634,00 0.00% 0.00
17 CP 47 AT&T Setup LS 3,213.0 C 100.00% 3,213.00 0.00% 0.00
18 CP 51 AT&T Invoice 4117 LS 313.00 100.00% 313.00 0,00% 0.00
5116
19 CP 56 AT&T Invoice 6/17 LS 312.0 C 100.00% 312.00 0.00% 0.00
6116
20 CP 58 AT&T thru August LS 284.00 100.00% 284.00 0.00% 0.00
21 Deduct for Amount Applied to LS -597.0 C 100.00% -597.00 0.00% 0.00
Allowance
Total Change Order Items 45,492.00 45,492.00 0.00
Subcontract Totals: 993,192.00 993,192.00 0.00
rojects Pagel 07/30/09 07:42:08 TM_
SI-SubBillingReport.rpt
SL Subcontract Billing Report
For Work Invoiced From 07/3/109 to 07/31/09
Total Billings: 993,192.00 0.00
Unpaid Retainage: 0.00 •99,319.20
Discounts: 0.00 0.00
Net Billings: 993,192.00 99,319.20
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Date Format MM /DD/YY SLSubBillingReport .rpt
Pape 2 of 3
To: City of Carmel Project: Energy Center Parcel 7C Application 18
Carmel, IN 46032 Contract For: Electrical Application Date: 7/28/2009
Gaylor Job 91051802 Period Ending: 7/31/2009
From: Gaylor, Inc.
11711 N. College Ave Architects
Suite 150 General Contractor
Carmel, IN 46032
APPLICATION FOR PAYMENT CONTINUATION SHEET
A B C D E F G H I
ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL CP BALANCE TO RETAINAGE
N0. DESCRIPTION OF WORK VALUE WORK THIS PERIOD MATERIALS STORED TO DATE (G /C) FINISH (C -G) 0.00%
1 General Conditions (Mobilization) Material 9,500.00 9,500.00 0.00 0.00 9,500.00 100.00% 0.00 0.00
2 General Conditions (Mobilization) Labor 15,500.00 15,500.00 0.00 0.00 15,500.00 100.00% 0.00 0.00
3 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
4 Insurance Material 11,850.00 11,850.00 0.00 0.00 11,850.00 100.00% 0.00 0.00
5 Insurance Labor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
6 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
7 Bond- Material 15,750.00 15,750.00 0.00 0.00 15,750.00 100.00% 0.00 0.00
8 Bond-Labor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
9 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
10 Feeder Conduit Material 97,500.00 97,500.00 0.00 0.00 97,500.00 100.00% 0.00 0.00
11 Feeder Conduit Labor 45,000.00 45,000.00 0.00 0.00 45,000.00 100.00% 0.00 0.00
12 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
13 Feeder Wire Material 65,400.00 65,400.00 0.00 0.00 65,400.00 100.00% 0.00 0.00
14 Feeder Wire Labor 54,500.00 54,500.00 0.00 0.00 54,500.00 100.00% 0.00 0.00
15 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
16 Branch Conduit LghUPwr /Systems Material 35,700.00 35,700.00 0.00 0.00 35,700.00 100.00% 0.00 0.00
17 Branch Conduit LghUPwr /Systems Labor 27,500.00 27,500.00 0.00 0.00 27,500.00 100.00% 0.00 0.00
18 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
19 Branch Wire LghUPwr /Systems Material 19,500.00 19,500.00 0.00 0.00 19,500.00 100.00% 0.00 0.00
20 Branch Wire LghUPwr /Systems Labor 17,500.00 17,500.00 0.00 0.00 17,500.00 100.00% 0.00 0.00
21 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
22 Wiring Devices Material 2,000.00 2,000.00 0.00 0.00 2,000.00 100.00% 0.00 0.00
y 23 Wiring Devices Labor 1,500.00 1,500.00 0.00 0.00 1,500.00 100.00% 0.00 0.00
24 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
25 Engine Genset Transfer Sw. Material 194,500.00 194,500.00 0.00 0.00 194,500.00 100.00% 0.00 0.00
26 Engine Genset Transfer Sw. Labor 6,500.00 6,500.00 0.00 0.00 6,500.00 100.00% 0.00 0.00
27 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
28 Gear Material 182,000.00 182,000.00 0.00 0.00 182,000.00 100.00% 0.00 0.00
29 Gear Labor 18,300.00 18,300.00 0.00 0.00 18,300.00 100.00% 0.00 0.00
30 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
31 Lighting Material 22,657.00 22,657.00 0.00 0.00 22,657.00 100.00% 0.00 0.00
32 Lighting Labor 18,900.00 18,900.00 0.00 0.00 18,900.00 100.00% 0.00 0.00
33 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
34 Systems Material 21,500.00 21,500.00 0.00 0.00 21,500.00 100.00% 0.00 0.00
35 Systems Labor 8,643.00 8,643.00 0.00 0.00 8,643.00 100.00% 0.00 0.00
36 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
37 Temporary Material 7,500.00 7,500.00 0.00 0.00 7,500.00 100.00% 0.00 0.00
38 Temporary Labor 14,500.00 14,500.00 0.00 0.00 14,500.00 100.00% 0.00 0.00
39 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
40 Closeout Material 1,500.00 1,500.00 0.00 0.00 1,500.00 100.00% 0.00 0.00
41 Closeout Labor 2,500.00 2,500.00 0.00 0.00 2,500.00 100.00% 0.00 0.00
42 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
Page 3 of 3
To: City of Carmel Project: Energy Center Parcel 7C Application 18
Carmel, IN 46032 Contract For: Electrical Application Date: 7/28/2009
Gaylor Job 91051802 Period Ending: 7/31/2009
From: Gaylor, Inc.
11711 N. College Ave Architects
Suite 150 General Contractor
Carmel, IN 46032
43 Allowance (CAD Drawings) 5,000.00 5,000.00 0.00 0.00 5,000.00 100.00% 0.00 0.00
44 Allowance (Electrical Consumption) 25,000.00 25,000.00 0.00 0.00 25,000.00 100.00% 0.00 0.00
45 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
46 CHANGE ORDER #1 3,975.00 3,975.00 0.00 0.00 3,975.00 100.00% 0.00 0.00
47 CHANGE ORDER #4 (Taken out of contract) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
48 CHANGE ORDER #2 845.00 845.00 0.00 0.00 845.00 100.00% 0.00 0.00
49 CHANGE ORDER #3 (1,625.00) (1,625.00) 0.00 0.00 (1,625.00) 100.00% 0.00 0.00
50 CHANGE ORDER #4 1,322.00 1,322.00 0.00 0.00 1,322.00 100.00% 0.00 0.00
51 CHANGE ORDER #5 415.00 415.00 0.00 0.00 415.00 100.00% 0.00 0.00
52 CHANGE ORDER #6 2,379.00 2,379.00 0.00 0.00 2,379.00 100.00% 0.00 0.00
53 CHANGE ORDER #7 18,499.00 18,499.00 0.00 0.00 18,499.00 100.00% 0.00 0.00
54 CHANGE ORDER #8 (1,485.00) (1,485.00) 0.00 0.00 (1,485.00) 100.00% 0.00 0.00
55 CHANGE ORDER #9 6,574.00 6,574.00 0.00 0.00 6,574.00 100.00% 0.00 0.00
56 CHANGE ORDER #10 (2,103.00) (2,103.00) 0.00 0.00 (2,103.00) 100.00% 0.00 0.00
57 CHANGE ORDER #11 (5,667.00) (5,667.00) 0.00 0.00 (5,667.00) 100.00% 0.00 0.00
58 CHANGE ORDER #12 18,204.00 18,204.00 0.00 0.00 18,204.00 100.00% 0.00 0.00
59 CHANGE ORDER #13 4,159.00 4,159.00 0.00 0.00 4,159.00 100.00% 0.00 0.00
TOTALS: $993,192.00 $993,192.00 $0.00 $0.00 $993,192.00 100.00% $0.00 $0.00
AFFIDAVIT AND WAIVER OF LIEN
(X) FINAL PARTIAL (X) PAYMENT TO FOLLOW
State of Indiana
County of Hamilton SS Date 7/28/09
Dan Spence being duly sworn, states that he /she is the Project Manager of Gaylor, Inc. having
contracted with Shiel Sexton to furnish materials and /or labor for the project known as:
Carmel City Center Energy Center Parcel 7C and does, hereby further state on behalf of the
aforementioned subcontractor:
(Partial Waiver) that the partial balance due from the contract is the sum of
Receipt of which is hereby acknowledged; or
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.
(Final Waiver) that the final balance due from the contract is the sum of
Ninety -Nine Thousand Three Hundred Nineteen Dollars and Twenty Cents 99,319.20
Receipt of which is hereby acknowledged; or
X) the payment of which has been promised as the sole consideration for this Affidavit and
Final Waiver of Lien which shall become effective upon receipt of such payment.
THEREFORE the undersigned waives and releases unto the Owner /Contractor 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 any claim or right to a lien on account of any work performed or material furnished to the undersigned
for said project and with the scope of thi s ffidavit and waiver.
Gaylor, Inc. By Project Manager
WITNESS BY HAND AND NOTARIAL SEAL, this 28th day of Jam, 2009
My Commission Expires: 06/21/2012 cll�
Chasi ynn tAhburn
Residing in Marion County
SL Subcontract Billing Report
For Work Invoiced From 07/01109 to 07/30/09
Subcontract 2805 011 Electrical
Job: 2805- Energy Center -Carmel Vendor: 2935 GAYLOR ELECTRIC
Item Units UM Unit Cost Amount Units1% Amount Units/% Amount
1 Electrical LS 947,700.00 100.00% 947,700.00 0.06% 596.61
Total Contract Items 947,700,00 947,700.00 596.61
Change Orders
2 CCR 1003 Electricity for LS 1,532.00 100.00% 1,532.00 0.00% 0.00
Dewatering Pumps
3 Electricity for Dewatering LS 2,443.00 100.00% 2,443.00 0,00% 0.00
Pumps
4 CCR 2001 Boiler LS -1,625.00 100.00% 1,625.00 0.00% 0.00
Combustion Air Modifications
5 CCR 2002 Added Pull LS 1,322.00 100.00% 1,322.00 0,00% 0.00
Stations
6 CCR 2005 Photocell on LS 415.00 100.00% 415.00 0.00% 0.00
Type C1 -E Fixture i
7 CCR 2006 Added Strobe in LS 845.00 100.00% 845.00 0.00% 0.00
Restroom 104
8 CCR 2011 ASI #004 LS 2,379.00 100.00% 2,379.00 0.00% 0.00
Revised Water Treatment
System i
9 CCR #1011 Extended LS 18,499.00 100.00% 18,499.00 0.00% 0.00 I
Electrical Warranties
10 CCR #2000 Door Hardware LS -1,485.00 100.00% 1,485.00 0.00% 0.00
Modifications i
11 CCR #3013 RCP #EC -007 LS 5,043.00 100.00% 5,043.00 0,00% 0.00
Exterior Light Rough -Ins
12 CCR #3013 Shift Conduit LS 1,531.0 100.00% 1,531.00 0.00% 0.00
Penetration for Exterior
Lighting j.
13 CCR #3014 ESI #EC -004 LS 2,103.00 100.00% 2,103.00 0,00% 0.00
Modify Courtyard Electrical i
14 CCR #2020 Eliminate Load LS -5,667.00 100.00% 5,667.00 0.00% 0.00
Bank
15 Duke Energy LS 18,204.0 100.00% 18,204.00 0.00% 0.00 't
Accommodations
Courtyard
16 ELECTRICAL LS 634.00 100.00% 634.00 100.00% 634.00
17 CP 47 AT &T Setup LS 3,213.00 100.00% 3,213.00 100.00% 3,213.00
18 CP 51- AT &T Invoice 4117 LS 313.00 100.00% 313.00 100.00% 313.00
5116
19 CP 56 AT &T Invoice 5/17 LS 312.00 100.00% 312.00 100.00% 312.00
6/16
20 CP 58 AT &T thru August LS 284.00 100.00% 284.00 100.00% 284.00
21 Deduct for Amount Applied to LS -597.00 100.00% 597.00 100.00% 597.00
Allowance
Total Change Order Items 45,492.00 45,492.00 4,159.00
Subcontract Totals: 993,192.00 993,192.00 4,755.61
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Date Format MM /DD/YY SLSubBillingReport .rpt
SL Subcontract Billing Report
For Work Invoiced From 07/01/09 to 07/30/09
Total Billings: 993,192.00 4,755.61
Unpaid Retainage: 99,319.20 475.56
Discounts: 0.00 0.00
Net Billings: 893,872.80 4,280.05
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Qate Format MM/DD /YY SLSubBillingReport .rpt
I
Document G7021CMa TM -1992
Application and Certificate for Payment Construction Manager- Adviser Edition
TO OWNER: City of Carmel PROJECT: Energy Center Parcel 7C APPLICATION N0: 17 Distribution to:
PERIOD TO 07/31/09 OWNER
Carmel, IN 46032 91051802
Electrical CONSTRUCTION MANAGER
FROM CONTRACTOR: Gaylor, Inc. VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT
11711 N. College Ave., Ste 150
Carmel, IN 46032 PROJECT NOS: CONTRACTOR
VIA ARCHITECT: Shiel Sexton
FIELD
CONTRACT FOR:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and
Application is made for payment, as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the
Continuation Sheet, AIA Document G703, is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous
947700.00 Certificates for Payment were issued and payments received from the Owner, and that current
1. ORIGINAL CONTRACT SUM ......I........................ payment sho herein is no R du
2. Net change by Change Orders 45492.00 CONTRACTO
3. CONTRACT SUM TO DATE (Line I 2), 993192.00 By: a Date: 07/28/09
4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 993192.00 State of: Indiana
5. RETAINAGE County of: Hamilton
a. 10 of Completed Work Subscribed and sworn to before
(Column D E on G703) 99319.20 me this 28 t o ly 2009
b. 10 of Stored Material Notary Public:
(Column F on G703) 0.00 My Commission expires: 6/ 21/2012
Total Retaina (Lines 5a 5b or Total in Column I of G703) 99319.20 CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on -site observations and the data comprising
6. TOTAL EARNED LESS RETAINAGE 893872.80 this application, the Construction Manager and Architect certify to the Owner that 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
889592.75 accordance with the Contract Documents, and the Contractor is entitled to LESS PREVIOUS CERTIFICATES FOR PAYMENT payment of the AMOUNT p y
(Line 6 from prior Certificate) CERTIFIED.
8. CURRENT PAYMENT DUE I s 4280.05 AMOUNT CERTIFIED
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) 99319.2 CONSTRUCTION MAN
By: Date: 30 0
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT:
Total changes approved in previous months by Owner gy. Date: 1
Total approved this Month This Certifica not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS named h ere i suance and acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order 45492.00 the Owner o Contractor under this Contract.
CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured.
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.
11 Document G702/CMa"m- 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 ten 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.
Page 2 of 3
To: City of Carmel Project: Energy Center Parcel 7C Application 17
Carmel, IN 46032 Contract For: Electrical Application Date: 7/28/2009
Gaylor Job 91051802 Period Ending: 7/31/2009
From: Gaylor, Inc.
11711 N. College Ave Architects
Suite 150 General Contractor
Carmel, IN 46032
APPLICATION FOR PAYMENT CONTINUATION SHEET
A B C D E F G H I
ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL CP BALANCE TO RETAINAGE
N0. DESCRIPTION OF WORK VALUE WORK THIS PERIOD MATERIALS STORED TO DATE (G /C) FINISH (C -G) 10.00%
1 General Conditions (Mobilization) Material 9,500.00 9,500.00 0.00 0.00 9,500.00 100.00% 0.00 950.00
2 General Conditions (Mobilization) Labor 15,500.00 15,500.00 0.00 0.00 15,500.00 100.00% 0.00 1,550.00
3 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
4 Insurance Material 11,850.00 11,850.00 0.00 0.00 11,850.00 100.00% 0.00 1,185.00
5 Insurance Labor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
6 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
7 Bond Material 15,750.00 15,750.00 0.00 0.00 15,750.00 100.00% 0.00 1,575.00
8 Bond-Labor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
9 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
10 Feeder Conduit Material 97,500.00 97,500.00 0.00 0.00 97,500.00 100.00% 0.00 9,750.00
11 Feeder Conduit Labor 45,000.00 45,000.00 0.00 0.00 45,000.00 100.00% 0.00 4,500.00
12 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
13 Feeder Wire Material 65,400.00 65,400.00 0.00 0.00 65,400.00 100.00% 0.00 6,540.00
14 Feeder Wire Labor 54,500.00 54,500.00 0.00 0.00 54,500.00 100.00% 0.00 5,450.00
15 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
16 Branch Conduit LghUPwr /Systems Material 35,700.00 35,700.00 0.00 0.00 35,700.00 100.00% 0.00 3,570.00
17 Branch Conduit Lght/Pwr /Systems Labor 27,500.00 27,500.00 0.00 0.00 27,500.00 100.00% 0.00 2,750.00
18 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
19 Branch Wire LghUPwr /Systems Material 19,500.00 19,500.00 0.00 0.00 19,500.00 100.00% 0.00 1,950.00
20 Branch Wire LghUPwr /Systems Labor 17,500.00 17,500.00 0.00 0.00 17,500.00 100.00% 0.00 1,750.00
21 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
22 Wiring Devices Material 2,000.00 2,000.00 0.00 0.00 2,000.00 100.00% 0.00 200.00
23 Wiring Devices- Labor 1,500.00 1,500.00 0.00 0.00 1,500.00 100.00% 0.00 150.00
24 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
25 Engine Genset Transfer Sw. Material 194,500.00 194,500.00 0.00 0.00 194,500.00 100.00% 0.00 19,450.00
26 Engine Genset Transfer Sw. Labor 6,500.00 6,500.00 0.00 0.00 6,500.00 100.00% 0.00 650.00
27 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
28 Gear Material 182,000.00 182,000.00 0.00 0.00 182,000.00 100.00°% 0.00 18,200.00
29 Gear Labor 18,300.00 18,300.00 0.00 0.00 18,300.00 100.00% 0.00 1,830.00
30 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
31 Lighting Material 22,657.00 22,657.00 0.00 0.00 22,657.00 100.00% 0.00 2,265.70
32 Lighting Labor 18,900.00 18,900.00 0.00 0.00 18,900.00 100.00% 0.00 1,890.00
33 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
34 Systems Material 21,500.00 21,500.00 0.00 0.00 21,500.00 100.00% 0.00 2,150.00
35 Systems Labor 8,643.00 8,643.00 0.00 0.00 8,643.00 100.00% 0.00 864.30
36 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
37 Temporary Material 7,500.00 7,500.00 0.00 0.00 7,500.00 100.00% 0.00 750.00
38 Temporary Labor 14,500.00 14,500.00 0.00 0.00 14,500.00 100.00% 0.00 1,450.00
39 0.00 0.00 0.00 0.00 0.00 0.00°% 0.00 0.00
40 Closeout Material 1,500.00 1,500.00 0.00 0.00 1,500.00 100.00°% 0.00 150.00
41 Closeout Labor 2,500.00 2,500.00 0.00 0.00 2,500.00 100.00% 0.00 250.00
42 0.00 0.00 0.00 0.00 0.00 0.00°% 0.00 0.00
Page 3 of 3
To: City of Carmel Project: Energy Center Parcel 7C Application 17
Carmel, IN 46032 Contract For: Electrical Application Date: 7/28/2009
Gaylor Job 91051802 Period Ending: 7/31/2009
From: Gaylor, Inc.
11711 N. College Ave Architects
Suite 150 General Contractor
Carmel, IN 46032
43 Allowance (CAD Drawings) 5,000.00 4,403.39 596.61 0.00 5,000.00 100.00% 0.00 500.00
44 Allowance (Electrical Consumption) 25,000.00 25,000.00 0.00 0.00 25,000.00 100.00% 0.00 2,500.00
45 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
46 CHANGE ORDER #1 3,975.00 3,975.00 0.00 0.00 3,975.00 100.00% 0.00 397.50
47 CHANGE ORDER #4 (Taken out of contract) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00
48 CHANGE ORDER #2 845.00 845.00 0.00 0.00 845.00 100.00% 0.00 84.50
49 CHANGE ORDER #3 (1,625.00) (1,625.00) 0.00 0.00 (1,625.00) 100.00% 0.00 (162.50)
50 CHANGE ORDER #4 1,322.00 1,322.00 0.00 0.00 1,322.00 100.00% 0.00 132.20
51 CHANGE ORDER #5 415.00 415.00 0.00 0.00 415.00 100.00% 0.00 41.50
52 CHANGE ORDER #6 2,379.00 2,379.00 0.00 0.00 2,379.00 100.00% 0.00 237.90
53 CHANGE ORDER #7 18,499.00 18,499.00 0.00 0.00 18,499.00 100.00% 0.00 1,849.90
54 CHANGE ORDER #8 (1,485.00) (1,485.00) 0.00 0.00 (1,485.00) 100.00% 0.00 (148.50)
55 CHANGE ORDER #9 6,574.00 6,574.00 0.00 0.00 6,574.00 100.00% 0.00 657.40
56 CHANGE ORDER #10 (2,103.00) (2,103.00) 0.00 0.00 (2,103.00) 100.00% 0.00 (210.30)
57 CHANGE ORDER #11 (5,667.00) (5,667.00) 0.00 0.00 (5,667.00) 100.00% 0.00 (566.70)
58 CHANGE ORDER #12 18,204.00 18,204.00 0.00 0.00 18,204.00 100.00% 0.00 1,820.40
59 CHANGE ORDER #13 4,159.00 0.00 4,159.00 0.00 4,159.00 100.00% 0.00 415.90
TOTALS: $993,192.00 $988,436.39 $4,755.61 $0.00 $993,192.00 100.00% $0.00 $99,319.20
AFFIDAVIT AND WAIVER OF LIEN
FINAL (X) PARTIAL (X) PAYMENT TO FOLLOW
State of Indiana
County of Hamilton SS Date 7/28/09
Dan Spence being duly sworn, states that he /she is the Project Manager of Gaylor, Inc. having
contracted with Shiel Sexton to furnish materials and /or labor for the project known as:
Carmel City Center Energy Center Parcel 7C and does, hereby further state on behalf of the
aforementioned subcontractor:
(Partial Waiver) that the partial balance due from the contract is the sum of
Four Thousand Two Hundred Eighty Dollars and Five Cents 4,280.05
Receipt of which is hereby acknowledged; or
x) 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.
(Final Waiver) that the final balance due from the contract is the sum of
Receipt of which is hereby acknowledged; or
the payment of which has been promised as the sole consideration for this Affidavit and
Final Waiver of Lien which shall become effective upon receipt of such payment.
THEREFORE the undersigned waives and releases unto the Owner /Contractor 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 any claim or right to a lien on account of any work performed or material furnished to the undersigned
for said project and with the scope of this affidavit and waiver.
Gaylor, Inc. By 5 Project Manager
WITNESS BY HAND AND NOTARIAL SEAL, this 28th day of July, 2009
My Commission Expires: 06/21/2012 CIX�_
Chasity LyAAKishburn
Residing in Marion County
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Purchase. Order No.
711 C��r /�r%a��P Sl/s�� Terms
Z4I Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7�Ile �7 �4f
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited sam
with IC 5- 11- 10 -1.6.
,20
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
��3 5'99 ,2s
ON ACCOUNT OF APPROPRIATION FOR
a/0
2 �i'y�o� d�
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
X
17 3;28D bill(s) is (are) true and correct and that the
/8 yY6::;�ec' 7 g93/S 20 materials or services itemized thereon for
which charge is made were ordered and
received except
Q
Q'
a°
Director
l
Cost distribution ledger classification if
claim paid motor vehicle highway fund