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HomeMy WebLinkAbout172814 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 00351208 Page 1 of 1 ONE CIVIC SQUARE EDWARDS ELECTRICAL MECHAIIIA HECK AMOUNT: $8,290.26 CARMEL, INDIANA 46032 23-50 N SHADELAND AVE INDIANAPOLIS IN 46219-1736 CHECK NUMBER: 172814 CHECK DATE: 612712009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460846 4 8,290.26 4TH GATEWAY/RANGELTNE tv ei A A TM on," Do ument G7021GMa —1992 Application and Certificate for Payment Construction Manager- Adviser Ed ition TO OWNER: Carmel Redevelopment Commission PROJECT: Carmel Gatewav Site 4 APPLICATION NO: 4 Distribution to: One Civic Square PERIOD T0: OWNER Indianapolis, IN 46032 4/30/2009 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT El Edwards Electrical Mechanical 2350 N Sliadeland Avenue PROJECT NOS: l 1 CONTRACTOR El Indianapolis, IN 46219 -1736 VIA ARCHITECT: FIELD CONTRACT FOR: E] CONTRACTOR'S APPLICATION FOR PAYMENT Th e 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 30 966.00 Certificates for Payment were issued and payments received from the Owner, and that current 1. ORIGINAL CONTRACT SUM payment shown herein is now due. 2. Net change by Change Orders 8 500.00 C 70 ards Electric chars' 1 3. CONTRACT SUM TO DATE (Line 1 ±2) I By. Date: y a 5 -C1 I 4. TOTAL COMPLETED STORED .TO (Column G on G703) 39,466.00 State of: Indiana Edwards Job No: 0104 08 -0621 5. RETAINAGE: County of. Marion Invoice No: 996019 a. 10 -00 of Completed Work Subscribed and sworn to before (Column D E=on 0703) 1,884.10 me this 2(5' day of April 2009 b. Lo- 0.0 =%a of Stored Material Notary Public: (Column F on G703) 2,062.50. My Commission expires: Total Retaina (Lines 5a 5b or Total in Column I ofG703) 3,946.60 CERTIFICATE FOR PAYMENT 35,519.40 In accordance with the Contract Documents, based on on -site observations and the data comprising 6. TOTAL EARNED LESS RETAINAGE 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 27,229.14 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 8,290.26 AMOUNT CERTIFIED I s 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs frotn the amount applied. Initi l all figures on this Application and e Continuation Sheet that are changed to'c ©nform with the amount certified.) (Line 3 less Line 6) 3,946.60 ✓,1(J. CONST UCT N M R: Date: By: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner 8 By: Date: 4(p(00 Total approvedthis,Month This Certificate is not negotiable: 'The AMOUNT CERTIFIED is payable only to -o the Contractor TOTALS 8500-00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor• under this Contract. NET CHANGES by Change Order 8,500.00 CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be4bscured. AIA Document G7021CMa 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. 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 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/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 0aia.org. C. Completing the G7021CMa 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 applicatr665..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 I 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 shouVbe incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 /CMa. le� E. Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager an rchitect on AIA DociOnt G702/CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The completed form contains the name an dress of the Contractor. Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G7021CMaT 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 AIO 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 Document G703 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION -NO: 4 containing Contractors signed certification is attached. APPLICATION DATE: 4/25/2009 In tabulations below', amounts are stated to the nearest dollar. Use Column.] on Contracts where variable retainage for line items may apply. PERIOD TO: 4/30/2009 ARCHITECT'S PROJECT NO: A B C' D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE PRESENTLY COMPLETED RETAINAGE SCHEDULED FROM PREVIOUS TO TI`EM DESCRIPTION OF WORK STORED AND STORED (IF VARIABLE VALUE APPLICATION THIS PERIOD (G C) FINISH NO. (NOT IN TO DATE C G) RATE) (D E) D OR E) (D +E +F) 0010 General Conditions. 2,500.00 2,500.00 2,500.00 100.00 250.00 0020 Light Fixtures /Lamps 22,500.00 3,375.00 19,125.00 22,500.00 100.00 2,250.00 0030 Panel 2,000.00 500.00 1,500.00 2,000.00 100.00 200.00 0040 General Power Material 3,966.00 2,379.60 1,586.40 3,966.00 100.0.0... 396.60 0001 Change Order #1 8,500.00 4,250.00 4,250.00 8,500.00 .100.00 850.00 Totals 39,466.00 9,629.60 9,211.40 20 625':00 39,466.00 100.00 3,946.60 CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original Mures that changes will not be obscured. AIA Document G703TM 1992. Copyright O 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The Ameri66r 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 co pyplght violations of AIA Contract Documents, e-mail The American Institute of Architects' legal c, counsel, copyright@aia.org. ((/J' =Vi Document G703"- 1992 instructions 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 AI.A. 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 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. aia.org. COMPLETING G703 -1992 Heading. This information should be completed in a manner consistent with similar infomTation 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 (colunuis D E from the previous application). Values from column l= (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 H. Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column 1. 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 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, The following is an example of a COWhIliatiO17 Sheet for work in progress. Please note that dollar amounts shown below are jbr illusirative purposes onhv, and are not intended io reflect actual construction costs. A D C D J r P G I I WORK COMPLETED MAI ERIALS 101AL ALANCE PRESL'N CO,\IPLn_ RETA IMAGE ITEM SCHEDULED 1 R0 \1 APPLICATION (11; VAR1.lB L E DESCRII'['LOn'OF N'ORK STORED AND STORED Y. NO VALUE APPLICATION THIS PERIOD (NOT 3,N TO DATE (O +CI FIN'1.511 RATE) (U +E) 1) OR E) (n +ErF) )C 1 MORILIZA77ON 5,000 5,000 0 0 5,000 100 0 2 STUMPREMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 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 C 0 0 0 5,000 6 PAVING, UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING, LOWER DRIVE 20,000 0 0 0 0 0 20,000 6 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 1 105,000 1 20.000 1 10,000 1 10,000 1 40,000 65,000 AIA Document G703 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 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. Edwards Job 0104 -08 -0621 Invoice 996019 AFFIDAVIT AND WAIVER OF LIEN Final Partial Payment to 'Follow State of Indiana, County of Marion SS: Michael R. Schmoll (Name of Officer) being duly sworn states that he is the C.O.O. (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 Gatewa Site 4 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 Eight Thousand Two Hundred Ninety and 26 /100 Dollars ($8,290.26) 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 Dollars 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 e< <pressed 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 i undersigned for said project, and within the scope of this affidavit and waiver. J 0 Edwards Electrical Mechanical, Inc. By itle C.O.O. (Firm) (Authorized Representative) WITNESS MY HAND AND NOTARIAL SEAL, this 25"' day of April 2009. 11 1 ,1 1 11", 1 A 6- v I Z /(Notary Public) My Commission Expires November 11, 2010 Printed Nancy J. Schrader Residing in Hendricks County 5 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. 23 5 d ,U_ Terms l aio f i�;rr� o/, `s 1 7 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) y13z' /e G 7f°�liQa S� "tom yg 2gc 2G Total 0. 22-� 1 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 IN SUM OF 2 2 9U, n ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or X 742 yvl�� �29� z� 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 l� 209 Signature nirantnr of Operations Cost distribution ledger classification if Title claim paid motor vehicle highway fund