Loading...
HomeMy WebLinkAbout178519 10/26/2009 CITY OF CARMEL, INDIANA VENDOR: 00351208 Page 1 of 1 ONE CIVIC SQUARE EDWARDS ELECTRICAL MECHANICAbHECK AMOUNT: $3,946.60 CARMEL, INDIANA 46032 2350 N SHADELAND AVE INDIANAPOLIS IN 46219 -1736 CHECK NUMBER: 178519 CHECK DATE: 10!2612009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460848 5 3,946.60 4TH GATEWAY /RANGELINE i _AIA TM Lk q Document G7021CMa —1992 C�b�. i 1D Application and Certificate .far Payment Construction Manager Adviser Edition TO OWNER: Carmel Redevelopf em Commission PROJECT: Carmel Gatewav Site 4 APPLICATION N0: 5 Distribution to: One Civic Square PERIOD T0: OWNER 11 lndianapohs,]N 46032 G130/2009 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA CONSTRUCTION MANAGER:. CONTRACT DATE: ARCHITECT Edwards Electrical Mechanical PROJECT NOS: CONTRACTOR 2350 N. Shadeland Avenue 1 l El Indianapolis, IN 46219 -1736 VIA ARCHITECT: FIELD CONTRACT FOR: The unders Contractor certifies that to:the best of the Contractor's knowledge, CONTRACTOR'S APPLICATION FOR PAYMENT g g 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 30,966.00 Certificates for Payment were issued and payments received from the Owner, and that current 1. ORIGINAL CONTRACT SUM 2. Net Change by Change Orders 8,500.00 CONTRACTOR: Edwa Electrica eclrnical 3. CONTRACT SUM TO DATE (Line 1 „2) 39,466:00 By: Date: 1D 4. TOTAL COMPLETED STORED TO DATE (Column G on G703) 39,466.00 State of: I iana Edwards Job No: 0104 -08 -0621 5. RETAINAGE: County of: Ma Invoice No 996302 a. of Completed Work Subscribed and sworn to before (Column D+ E on G703) me this 25 day of "Id In 2 b. of Stored Material Notary Public: (Column'F on G703) My Commission expires: Total Retainag m e (Lines 5a 5b or Total in Column I of G703) a00 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising 6. TOTAL EARNED LESS RETAINAGE 39,466.00 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 b the Work 1 indicated, the quality of the Work is in 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 35,519.40 accordance with the Contract A��� d the o entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED• J013 8. CURRENT PAYMENT DUE 3,946.60 AMOUNT CERTIFIED x..90. (o 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differ��,,f mr i rnt applied. Initial all figures on this Application a don the Continuation Sheet t77a` r h r Monform with the amount certified.) 00 (Line 3 less Line 6) 0. CONSTRUCTIO GER:© B ftA/lyq D n ❑LABOI7 ONLY CHANGE BORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC b C1 Total changes approved in previous months by Owner By: 9(3( j Total approved this Month This CE sate is not negotiable :''The AMOUNT CERTIFIED is payable only to the Contractor TOTALS 00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of 8 500.00 the Owner or Contractor under this Contract. WT CH��EES by Change Order 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 G7021CMaTm.- 1992. Copyright 1992 by The American Institute of Architects. All rights reserved. WARNING: This Al a 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. AIA TM Document G7021CMa 1992 Instructions Application and Certificate for Payment Construction Manager- Adviser Edition A. General information AIA Document G7021CMa, 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 A2011CMa, 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 1CMa, 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 G7021CMa Form After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AIA Document G7021CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The Contractor should sign G7021CMa, 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 A2011CMa. They should then initial all figures on G7021CMa and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G7021CMa 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 G7021CMa, 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 driginal 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 applicatron)..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 rnusi 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 G7021CMa form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives shell be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A2011CMa. 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 1CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The completed form contains the name an6 ddress of the Contractor. Payment should not be made to any other party unless specifically indicated on G702/CMa. _1 4' AIA Document G702 /cMaT"A 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 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. Document G703 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO 3 containing Contractors sianed certification is attached. APPLICATION DATE: 6/25/2009 In tabulations below, amounts are stated to the nearest dollar. Use Column t on Contracts where variable retainage for line items may apply. PERIOD TO: 6/30/2009 AR CHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED TO RETAINAGE ITEM DESCRIPTION OF WORK STORED AND STORED ([F VARIABLE NO VALUE APPLICATION THIS PERIOD (NOT IN TO DATE (G C) FINISH RATE) (D E) D OR E) (D +E +F) (C G) 0010 General Conditions 2,500.00 2,500.00 2,500.00 100.00 0020 Light Fixtures /Lamps 22,500.00 3,375.00 19,125.00 22,500.00 100.00 0030 Panel 2,000.00 500.00 1,500.00 2,000.00 100.00 0040 General Power Material 3,966.00 3,966.00 3,966.00 100.00 0001 Change Order #1 8,500.00 8,500.00 8,500.00 100:00 :Totals 39,4fi6.00 18,841.00 20,625.00 39,466.00 100.00 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 G703TM —1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AIA is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Al a 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. GAH TM Document G703 Mstuc fibres Continuation Sheet GENERAL INFORMATION Purpose and Related Documents. AIA Document G702, Application and Certificate for Payment, is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201, General Conditions of the Contract for Construction. Use of Current Documents. Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. 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 G703, 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 ALA 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. COMPLETING G703 -1992 Heading. This information should be completed in a manner consistent with similar information on AIA Document G702, Application and Certificate for Payment. Columns A, B C. These columns should be completed by identifying the various portions of the Project and their scheduled values 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 in the project that 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 Ff. 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 rctainage is permitted on a line -item basis. It need not be completed on projects where a constant rctainage 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 6702 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. Thefollowing is an example of a Continuation Sheet for vvork in progress. Please note that dollar amounts shown below are for ilhlstrative purposes onlp, and are not intended to reflect actual construction costs. A B C D E P C. H I WORK CO. PLETED N tAl E NTLY TOTAL COMPLETED BALANCE' 1'RfPNTLY RNTAINAGF ITEM SC FROM APPLICATION QUS (�F VARIABLE TO NO. UESCKIP'1'ION OF WORK VA1.UF. APPLICATION THIS S PERIOD (NOT IN AND STORED (C »C) FINISH (NT1N TO DA 1T RA'I'N) {D +17) DOR E) (D +1741') {C -O) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK £5,000 10,000 5 0o0 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS MISC. CONC, 5,000 0 0 0 0 0 5,000 6 PAVING. UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20000 0 0 C 0 0 20,000 S PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5.0D0 10 11 1 05,00 0 20 000 1 000 10 000 40 000 65,000 AIA Document G703TM 1992. Copyright 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 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 Ale 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. Edwards Job t1: 0104 -08 -0621 Invoice N: 996302 AFFIDAVIT AND WAIVER OF LIEN Final Partial Payment to Follow State of Indiana, County of Marion SS: Paul G. Morey (Name of Officer) being duly sworn states that he is the President (Title) of Edwards Electrical Mechanical, Inc. (Subcontractor /Supplier) having contracted with Keystone Construction Corporation (Contractor) to furnish certain materials and/or labor as follows: Electrical System (Description) for a project known as Carmel Gateway located at Carmel, Indiana and owned by Carmel Redevelopment Commission and does herby further state on behalf of the aforementioned subcontractor /supplier: (PARTIAL WAIVER) that there is due from the contractor the sum of Dollars receipt of which is hereby acknowledged, or the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned. (FINAL WAIVER) that the final balance is due from the contractor is the sum of Three Thousand Nine Hundred Forty -Six and 60/100 Dollars ($3,946.00) receipt of which is hereby acknowledged, or the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon 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, subject to limitations or conditions expressed herein, if any; 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 within the scope of this affidavit and waiver. Edwards Electrical Mechanical, Inc. By Title President (Firm) CnRepresentative} WITNESS MY HAND AND NOTARIAL SEAL, this 25` day of June, 2009. (N cry Pub ic) My Commission Expires November 11, 2010 Printed Nancy J. Schrader Residing in Hendricks County Prescribed by State Board of Accounts City Form No 201 nev. 199s) 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 Purchase Order No. 2 Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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. zo Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF 2 36`D IV 102-15� 1 6 3. 9y/_("'4 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or V'160&? 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 Signature Director of Operations Cost distribution ledger classification if Itle claim paid motor vehicle highway fund