HomeMy WebLinkAbout178085 10/14/2009 r+ CITY OF CARMEL, INDIANA VENDOR: 358944 Page 1 of 1
ONE CIVIC SQUARE CENTRAL ENGINEERING CONSTRUCT, �I
s. is CARMEL, INDIANA 46032 3862 N COMMERCIAL PARKWAY C�ECK AMOUNT:. $3,538.00
GREENFIELD IN 46140 CHECK NUMBER: 178085
ar
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIP
106 R5023990 19616 6120 3,538.00 FOUNDERS PARK PHASE 1
APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT
TO (OWNER): PROJECT: Founders Park Infrastructure Phase 1 APPLICATION NO. 9 DISTRIBUTION TO:
Carmel/ Clay Board of Parks and Recreation OWNER XX
Attn.: Mark Westermeier
1411 East 116th Street VIA (ARCHITECT): PERIOD TO: 9/21/20091 09
Carmel, IN 46032
VET
0
FROM: Central Engineering &Construction Associates, Inc. ARCHITECT'S e T D 5 2009
3862 N. Commercial Parkway PROJECT NO:
Greenfield, IN 46140 16 "It
CONTRACT FOR: SITE IMPROVEMENTS CONTRACT DATE: 22- May -08
Application made for Payment, as shown below, in connection
CONTRACTOR'S APPLICATION FOR PAYMENT with the contract.
Continuation Sheet is attached.
CHANGE ORDER SUMMARY
1. ORIGINAL CONTRACT SUM $1,015,718.00
Change Orders approved in ADDITIONS DEDUCTIONS 2. Net Change by Change Orders $33,885.00
previous months by owner 3. CONTRACT SUM TO DATE $1,049,603.00
TOTAL 49,985.00 16,100.00 4. TOTAL COMPLETED STORED TO DATE $1,049,603.00
Approved this Month (Column G)
No. Date Approved 5. RETAINAGE:
a. of Completed Work $54,227.20
(Column D +E)
b. of Stored Material
(Column F) $0.00
TOTALS 49,985.00 16,100.00 Total Retainage (Line 5a +5b) or $54,227.20
Net Change by Change Orders (Total in Column 1)
$33,885.00 6. TOTAL EARNED LESS RETAINAGE $995,375.80
The undersigned Contractor certifies that to the best of the Contractor's (Line 4 less Line 5 Total)
knowledge, information, and belief the Work covered by this Application 7. LESS PREVIOUS CERTIFICATES FOR $991,837.80
for Payment has been completed in accordance with the Contract Docu- PAYMENT (Line 6 from prior Certificate)
ments, that all amounts have been paid by the Contractor for Work for 8. CURRENT PAYMENT DUE $3,538.00
for which previous Certificates for Payment were issued and payments 9. BALANCE TO FINISH, PLUS RETAINAGE $54,227.20
received from the Owner, and that current payment shown herein is (Line 3 less Line 6)
now due.
CONTRACTOR: CENTRAL ENGINEERING CONSTRUCTION ASSOC., INC.
C, State of: Indiana County of: Hancock
Q
BY: DATE: 1 1211 Subscribed and S om to before me this Z t day of September 2009
Karen Horth Powers, President Notary Public: vjj-.,`
My Commission Expires: April 21, 201
AMOUNT CERTIFIED
ARCHITECT'S CERTIFICATE FOR PAYMENT (Attached explanation if amount certified differs from the
amount applied for.) ��1
In accordance with the Contract Documents, based on on -site observa- ARCHITECT: �p�. �i c z
tions and the data comprising the above application, the Architect certifies
to the Owner that to the best of the Architect's knowledge, information, By: Date: 1 R,Z5,
and belief the Work has progressed as indicated, the quality of the Work is This Certificate in not negotiable. The AMOUNT CERTIFIED is
is in accordance with the Contract Documents, and the Contractor is payable only to the Contractor named herein. Issuance, pay
entitled to payment of the AMOUNT CERTIFIED. ment and acceptance of payment are without prejudice to any
rights of the Owner or Contractor under this contract.
CONTINUATION SHEET AIA DOCUMENT G703 PAGE 2 OF 2 PAGES
PROJECT: FOUNDERS PARK INFRASTRUCTURE PHASE I APPLICATION NO- 9
Job: 437 APPLICATION DATE: 21- Sep -09
PERIOD TO: 21- Sep -09
ENGINEER'S PROJECT NO..
A B C D E F G H I
WORK COMPLETED MATERIALS TOTAL
FROM PRESENTLY COMPLETED BALANCE RETAINAGE
ITEM DESCRIPTION OF WORK SCHEDULED PREVIOUS THIS STORED AND STORED TO (IF VARIABLE)
NO. VALUE APPLICATION PERIOD (NOT IN TO DATE (G C) FINISH RATE
(D E) D OR E) (D +E +F) (C G)
1 Mobilization 40,806.00 40,806.00 40,806.00 100% 0.00 4080.60
2 Construction Staking 14,086.00 14,086.00 14,086.00 100% 0.00 1408.60
3 Clearing 55,307.00 55,307.00 55,307.00 100% 0.00 5530.70
4 Earthwork 289,035.00 289,035.00 289,035.00 100% 0.00 28903.50
5 Erosion Control 38,151.00 38,151.00 38,151.00 100% G.001 3815.10
6 Sanitary Sewer 35,110.00 35,110.00 35,110.00 100% 0.00 3511.00
7 Storm Sewer 104,921.00 104,921.00 104,921.00 100% 0.00 10492.10
8 Concrete Curbs /Sidewalk 177,447.00 177,447.00 177,447.00 100% 0.00 17744.70
9 Asphalt Paving 138,189.00 138,189.00 138,189.00 100% 0.00 13818.90
10 Seeding 82,038.00 78,500.00 3,538.00 82,038.00 100%1 0.00 8203.80
11 Bonds Insurance 40,628.00 40,628.00 40,628.00 100% 0.00 4062.80
12 Change Order #1: Asphalt 7,100.00 7,100.00 7,100.00 100% 0.00 710.00
Concrete Curb /Sidewalks 9,000.00 9,000.00 9,000.00 100% 0.00 900.00
13 Change Order #2: Lime Stat 23,560.00 23,560.00 23,560.00 100% 0.00 2356.00
Change Order #3:
14 asphalt material increase 26,425.00 26,425.00 26,425.00 100%1 0.00 2642.50
Retainage reduction per
contract I 1 1 50733.10
TOTALS: $1,049,603.00 $1,046,065.00 $3,538.00 $0.001 $1,049,603.00 100% $0.001 $54,227.20
PERCENT: 99.66%1 0.34% 0.00%1 100.00% 0.00%
AFFIDAVIT AND WAIVER OF LIEN
Final Partial Payment to Follow
STATE OF INDIANA
County of HANCOCK
Karen Horth Powers being duly sworn states that she/he is the President of Central En ing eering
Construction Associates, Inc. having contracted with the Carmel/Cla y Board of Parks and
Recreation to furnish certain materials and/or labor as follows Site Improvement for a Project
known as Founders Park Infrastructure Phase I located in Carmel, IN 46032 and owned by
the Carmel /Clay Board of Parks and Recreation and does further state
PARTIAL WAIVER: that the balance due from the owner is the sum of Three Thousand Five
Hundred Thirty -Eight and 00 /100 Dollars ($3,538.00)
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 owner is the sum of Dollars
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 of said premises any and all
lien or claim whatsoever on the above described property and improvements thereon on account
of tabor 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 within the se e of this affidavit and waiver.
Karen Horth Powers
President
Title
Witness My Hand and Notarial Seal, this Z I S� day of S e- 2009.
Notary Public
Li -Ching Wu
Notary Public Printed Signature
My Commission Expires
April 21, 2016
County of Residence
Ham i lton
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'I Job: 000437 Founders. Contractor: CENTRAL`;ENb CON ST "RS5PC, ,IIVG Pay Peri "od.: x.8/23%09
Carmel, IN GREENFIELD, IN 46140 Employers Id 35- 1866624
s_o w- o- Y Emplt�ye P 1 Hours Worked 7h i a Pro I ect I PAY Y JOB EARN I FED I STATE 1 UN DED 1 TOT I NET
Information 1 MON TUE WED THUR`' FRI SRT SUN TOTALf RATEIaTOT ERRNi FI7CR1 LOCALI MISC I' DED I PRY
°LW ;LT_Z, _DONALD_
ST 3.00 2.50 5.50 29.00. 159.50 126.73 40.92 30.50
OT .00 .00 1203.50 92.07 12.04 .00 30.50 901.24
Operator- Craftsman DEP 0
a
2RIAUL FRE tl
FI 7- 23
5T 8.00 8.00 16.00 29.00 464.00 121.03 30.90 .52
OT .00 .00 928.00 70.98 14.99 .00 23.52 666.58
lj Operator Craftsman DEP 1
BL-AK: -EY -CL- -I STON
ST 8.00 8.00 16.00 29.00 464.00 150.20 39.44 29.40
OT 00 00 1160-00 88.74 4 19. 14 00 29.40 833.08
I ze Operator- Craftsman DEP
T M
i
2 BlZAY .JESGIE E i
1 ey .v f rent
2r 1 ST 8.00 8.00 16.00 22.90- 366.40 88.75 32.31 31 28.51
DT .00 .00 950.35 72.70 15.68 .00 28.51 712.40
T31 ---SEX
Laborer-Craft sman DEP 0
p S
t3
b T o" t a 1s Hours d d0 s E "ar =n�ngs e -lo�.r
I
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nATE 09/02/0')
1, KAREN HDRTH POWERS, PRESIDENT da hereby state:
j (i) T hat I pay or supera se the
yedT "y. AL ENG GONST ASSOC, INC on th,e. (building,
or wank) For.inders Park ;that during ,the payroll per od 8/� /09 8l '9/09 ,al.l 1, P on empl ;Dyed on said pr o'aect,
i have been paid the full weekly w a rne.d, that nv rebates hive ba`;en or�fwzll -;:be made
or on behalf of said (Cori tractor o St_ibcontractor) CENTRAL ENG CONST ASSOC, INC from the full weekly wages earned by any person,
and that no ded have been made either directly or indirectly from the full wages earned by any person
o ecr star y of Labot
ther— than— peYmissitr es}u a ions, ar> a is le p7, iss,ed by the S'
e'I coder the Copeland Act, as amended(4'8 Stet 948`;63 5tat 1,05,7_5tt 5tat 357,4 U,S C 7Ec)and +fraesprisbed below:
s Uniforms, Savings Decir ct. HCALTH GREM•I.UM., Ini;t':i,ati'a.`n Fee':HealtFr /Wel +fare '11f 4
r— E✓h S rzFsport mr.nas ra.ive,Cash Advance,P'RETAX DENTAL,Pc;litical,AFLAC AFTER TAX,Epec,Initiation Fee,Disbility Ins,
G�,rnishment2.Irns Fringe Dc ?d,AFLAC PRETAX ,Dr_ies,Garnishment,HEALTH SA:VINGS,Loan Re- -Payment
rolls otherwise 'i_nder :this'contr.act.
Y P =Y q r e -to bp: submitted_ for the above per iad ar apcort ect 'and scomple,e,thit
I the wage rates for laborers and •mechanics'con•tainedathpne n are nortz less -khan t:he ap ":1'ic b '1e ,wage r.a'tes corataine'd..,.sia_::ari
determination incorporated into the r^ nntrar} h e ,T; 5c� or'; er °sin or each laborer or mechanic conform
;5 7 with the work performed.
T any a r e 1 sh p
s ere in a ono fide apprentaee' sp ogres registered with a
It° State a renticeshi a enc recd nixed, by the Eureaii of A' rentacesh';i rn[i tr�Fnin Llnated`Stat'es De rt�neritk of ":'Labor "or if; no :5tch
PP 3 Y P 9 Y g PP P P._
z:
reco gnized arenc exists in a State are :x
.21 r eglstered' wxth''fliP•Ari r'prf per h
(4) That
IN �I��i R� �Ixf7t9tIED- F'L�1N5; Fi71VDS; yC7E�F#ZIIG r
I n addition to the basac hoyrly wage r ^rtes paid to eacta' laborer otr meclarriF l�,s in the,a)ro:ve reFerenced.p.yr,oll,'.,
payments of fringe benefits as listed in the cantr act 'have been or wily be made to appropriate pr grams fo the
benefit of such employees, except as noted in Section 4(c) below.
b) W FRI GE SENEFIT5
AV,`
•3r t
lsz I�I Each laborer or mechartsc lasted in thebave r eferenc�d payroli has been paird, as xndl'cted o,n the:' p�yt o'l an amount
sa n_ELS- 1B55— t�an_tha S�Lm 1L the applicaFi'1a I�a'a °ir•Fn'r'r'i� wages r`at¢ nS: °,ic fha ".r�m'ririnF of Pfi %t -a
�P. =r•aniii r�atit fr�
-z� as listed in the contract, except as noted in Section 4(c) below.
95 (c) EXCEPTIONS
.G
a I (CRAFT) EXCEPTJON I
EXPLA
NATIONz
sal I
r
I `o 1
1 46 I I I
1 I 33 �l5' *h
1 y e c� h n 'a$ .e K R N, a` x s t s...• 1 X40
ISt ]_RP- f3laLk_5 r -.4� tf ks 5 "Goa t'i �,..'r"s°C £fr p y.� i'i,• t A r� .E` dY¢ a r t }tt"_'u`^ 'km, y'1s
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54 NAME AND TITLE I TURE` 1
'�.y w ,,Iy, y h r 'P L rt} a w7 •ry 'F
1 y 1 1-. 3,', K' Y I S ll�:" Y, `'I d. "Z�3. •[44 `^r w 1c. t _Y ]'i
55
.,.s .r e a. r+ r�+ri '..K
t P' 5 1 v -f�F -:i i t iY p.. Y r �iai _1 a.& L
se 1 KAREN HDRTH POWERS, F':RESIDENT v ��.r
sr 1 b M
I WILLFUL FAL. I
I P'RC3SECUT I ON. SEE SECT I DN '100 1 OF T I TLk 1 8 AND SECT'I ON 231 OF :T I TLi= i Di TIdE UN I TEp STATE�a CODE.
THE
l
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
358944 Central Engineering Construction Assoc., Inc. Terms
3862 N Commercial Parkway
Greenfield, IN 46140
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9121109 6120 App 9 Founders Park 19616 p 3,538.00
Total 3,538.00
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.
358944 Central Engineering Construction Assoc., h Allowed 20
3862 N Commercial Parkway
Greenfield, IN 46140
In Sum of
3,538.00
ON ACCOUNT OF APPROPRIATION FOR
106 Park Impact Fee Fund
PO# or INVOICE NO. CCT #/TITLI AMOUNT Board Members
Dept
19616 F 6120 5023990 3,538.00 1 hereby certify that the attached invoice(s), or
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
7 -Oct 2009
Signature
3,538.00 Accounts Payable Coordina
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund