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Home My WebLink About168503 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 360193 Page 1 of 1 ONE CIVIC SQUARE HARCO ASPHALT PAVING CHECK AMOUNT: $14,891.68 CARMEL, INDIANA 46032 1650 HARCO WAY INDIANAPOLIS IN 4621 CHECK NUMBER: 168503 SON CHECK DATE: 2/4/2009 DEPARTME ACC OUNT PO NUMBER INVO N UMBER AMOUNT DE SCRIPTION 203 R4462200 5222 2 13,090.93 SIDEWALK IMPROVEMENTS 211 R4462200 5222 2 1,800.75 SIDEWALK IMPROVEMENTS r" 4 CONSTRUCTION PROJECT INVOICE DATE: January 26, 2009 COMPANY NAME: Harco Asphalt Paving Inc. AND ADDRESS 1650 Harco Way Indianapolis, Indiana 46217 TELEPHONE NO.: (317)- 791 -6700 FAX NO.: (317) -791 -7570 PROJECT NAME: Carmel Drive Adams Street Path Project City of Carmel PROJECT NO.: 08 -04 PURCHASE ORDER: 19134 INVOICE NO.: 2 (FINAL) Construction pay items as per Progress Pay Estimate No. 2 as shown on the attached invoice for work completed between the dates August 13, 2008 to September 24, 2008, TOTAL EARNINGS TO DATE: 99,695.84 RETAINAGE: 0.00 MINUS PERVIOUS PAYMENTS 84,804.16 TOTAL NOW DUE: 14,891.68 f f an Greskamp Construction nager C r City of Carmel t AFFIDAVIT AND WAIVER OF LEIN ti FINAL XX PARTIAL WHEREAS, HARCO ASPHALT PAVING INC. 1650 Harco Way, Indianapolis, IN 46217 (Contractor) has been heretofore employed by Crossroads Engineers to furnish certain material, supplies 'Carmel Drive Adams St. Path hereinafter collectively referred to as the "premises and WHEREAS, the undersigned is duly authorized to execute this Waiver of Lien for and on behalf of the Contractor. Now, therefore, the Contractor, for NINETY NINE THOUSAND SIX HUNDRED NINETY FIVE DOLLARS AND 84/100 ($99,695.84) herby waives and releases the Owner of the Premises and the Company from any acid all rights and in consideration of the receipt of lien or claims of whatsoever kind or character on or against the Premises or the improvements located thereon on account of any and all labor, supplies, equipment or material furnished for, in connection with or incorporated in the Premises by the Contractor on or before the date hereof; represents and warrants that no other person or has any right to a lien or claim on account of any labor worked performed or material, supplies or equipment furnished by, to or through the Contractor, on or before the date hereof, and agrees to indemnify, defend and hold the Owner and The Company harmless from and against any and all claims or lien for any labor, material or services furnished or in connection with or incorporated on the Premises by through or to the Contractor prior to the date hereof. This Waiver of Lien is given in order to induce the Company to pay the amount indicated above, and upon receipt of such amount by the Contractor, this release may be recorded, becomes valid, enforceable and of full effect. Harca Asphalt Paving,In Byf�� Paul G. Harding, President STATE OF Indiana) ss. COUNTY OF Marion) Before me, a Notary Public in and for said County and State, personally appeared Paul G. Harding, who acknowledged the execution of the foregoing Waiver of Lien, and who, having been sworn, stated that the representation therein contained are true. Witness my hand and Notarial Seal this 5 day Decem Notary Public Cynthia L. Sartain County of Residence: Hamilton Commission Expires 9/20/2009 APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER ADV EDITION N AIA DOCUMENT G702/CMa PAGE ONE OF PAGES 2 IL TO OWNER: CROSSROADS ENGINEERS PROJECT: CARMEL DRIVE 1 ADAMS ST. PATH APPLICATION NO.: 2 Distribution to: 3417 SHERMAN DRIVE PERIOD TO: 412212009 OWNER BEECH GROVE, IN 46107 Final PROJECT NOS.: CONSTRUCTION MANAGER FROM CONTRACTOR: Harco Asphalt Paring Inc CONTRACT DATE: ARCHITECT 1650 HARCO WAY CONTRACTOR INDIANAPOLIS, IN 46217 VIA CONSTRUCTION MANAGER: 0 CONTRACT FOR ASPHALT VIA ARCHITECT: CD CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the contractor's knowledge, infor- cd Application is made for payment, as shown below, in connection with the Contract. mation and belief the Work covered by this Application for Payment has been completed Continuation Sheet, AIA Document G703, is attached. in accordance with the Contract Documents, that all amounts have been paid by the try Contractor for Worts for which previous Certificates for Payment were issued and pay E ments received from the Owner, and that current payment shown herein is now due. I— 1. ORIGINAL CONTRACT SUM 97,895.09 CONTRACTO� ASPHALT VING 2. Net change by Change Orders 1,800.75 3. CONTRACT SUM TO DATE (Line 1 t 2) 99,695.84 B Date: 1/23/2009 4. TOTAL COMPLETED b STORED TO DATE $99,695.84' (Column G on G703) State of: INDIANA m County of: MARION 7 5. RETAINAGE: Subscribed and sworn to be" a. 0% of Completed Work me this day of 2� (Columns D E on G703) b. of Stored Material (Column Fan G703) Notary Public: Total Retainage {Line 5a 5b or My Commision expires: Total In Column I of G703) C ERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE 99,695.134 (Line 4 less Line 5 Total) In accordance with the Contract Documents, based on on -site observations and the data comprising this application, the Construction Manager and Architect certify to the Owner 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT that to the best of their knowledge, information and belief the Work has progressed as (Line 6 from prior Certificate) 84,804,16 indicated, the quality of the Work is in accordance with the Contract Documments, and p the Contractor is entitled to payment of the AMOUNT CERTIFIED. C? 8. CURRENT PAYMENT DUE 14 9 Q AMOUNT CERTIFIED 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied far_ Initial (Line 3 less Line 6) all figures on this Application and on the Continuation Sheet that are changed to Ih confrom to the amount certified) fl- CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS CONSTRUCTION MANAGER: In I i Total changes approved in By: Date: m reviuos months by Owner 5,802.15 5(4,001.40) ARCHITECT: m Total aep rowed this Month By: Date: �m TOTALS 5,802.15 4,001.40 This Certificate is not negotiable. The AMOUNT CERTIFIED Is payable only to the Con (U NET CHANGES by Change Order 1,500.75 tractor named herein. Issuance, payment and acceptance of payment are without i N prejudice to any rights of the Owner or Contractor under this Contract. AtA DOCUMENT G702'CMa APPLICATION AND CERTFrATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION 1942 EDITION• AIA O 1492 Cr THE AMERICAN INSTrRITE OF ARCHrrECTS, 1745 NEW YORK AYE, N.W. WASHINGTON, DC 20005.5292 G702tCMa 1992 CONTINUATION SHEET AIA DOCUMENT G703 (Instruction on reverse side) PAGE 2 OF 2 PAGES AIA DOCUMENT G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: 2 n Cont ractor's signed CertiFcation is attached. HARCO ASPHALT PAVING INC APPLICATION DATE: 1/2312009 In tabulations below, amounts are stated to the nearest dollar. CARMEL DRIVE 1 ADAMS ST. PATH PERIOD TO: V23=09 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECTS PROJECT NO: A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL 0% BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G T C) TO FINISH APPLICATION STORED AND STORED (C G) r� (D E) (NOT IN TO DATE N DORE (D+E+F) 1 MOBILIZATION DEMOBILIZATION $2,659.50 $2,659.50 $0.00 $0.00 $2,659.50 100% $0.00 $0.00 0 2 MAINTENANCE OF TRAFFIC $1,773.00 $1,773.00 $0.00 $0.00 $1,773.00 100% $0.00 $0.00 3 CLEARING RIGHTOF WAY $11,642.70 $11,642.70 $0.00 $0.00 $11,642.70 100% $0.00 $0.00 4 LINEAR GRADING FOR PATH $6,672.60 $6,672.60 $0.00 $0.00 $6,672.60 100% $0.00 $0.00 5 3" DIAMETER TREE, RELOCATE $235.40 $236.40 $0.00 $O.OD $236.40 100% $0.00 $0.00 6 STRUCT., SANITARY MANHOLE, RECO $2,364.00 $2,364.00 $0.00 $0.00 $2,364.00 100% $0.00 $0.00 7 HMA SURFACR FOR PATH $18,840.60 $18,840.60 $0.00 $0.00 $18,840.60 100% $0.00 $0.00 8 HMA INTER. FOR PATH $25,203.42 $25,203.42 $0.00 $0.00 $25,203.42 100% $0.00 $100 9 COMPACTED AGG. NO, 53, BASE $13,328.15 $13,328.15 $0.00 $0.00 $13,328.15 100% $0.00 $0.00 10 4" CONCRETE SIDEWALK $851.04 $851.04 $0.00 $0.01) $851.04 100% $0.00 $0.00 r` 11 CONCRETE CURB RAMP, TYPE G $12,056.45 $12,056.45 $0.00 $0.00 $12,056.45 100% $0.00 $0.00 12 ITEM DELETED $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 13 EROSION CONTROL MEASURES $1,140.63 $1,140.63 $0.00 $0.00 $1,140.63 100% $0.00 $0.00 14 MULCHED SEEDING $1,126.60 $1,126.60 $0.00 $0.00 $1,126.60 100% $0.00 $0.00 15 0 $0.00 $0 -00 $0A0 $0.00 $0.00 0% $0.00 $0.00 16 overage on #7 .9D $94.20 $94.20 $0.00 $0.00 $94.20 100% $0.00 $0.00 17 DEDUCT#8 ($3,020.17) ($3,020.17) $0.00 $0.00 ($3,020.17) 0% $0.00 $0.00 O 18 DEDUCT #9 ($744.83) ($744.83) $0.00 $0.00 ($744.83) 0% $0.00 $0.00 19 CHANGE ORDER #1 $5,707,95 $5,707.95 $0.00 $0.00 $5,707.95 100% $0.00 $0.00 20 credit #5 ($236.40 ($236.40) $0.00 $0.00 ($236.40) 0% $0.00 $0.00 0 21 $0.00 $0 -00 $0.00 $0.00 $D.00 0% $0.00 $0.00 LL 22 $0 -00 $0.00 $0.00 $0.00 $D.DO 0% $0.00 $0.00 lzr 23 0 $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 ro CS) 24 0 $0.00 $0.00 $0.00 $0 -00 $0.00 0% $0.00 $0.00 0) 25 $0.00 $0.00 $0.00 $0.00 $0100 0 $0.001 $0.00 CD CD $99,695.84 $99,695.84 $0.00 $0.00 $99,695.84 100 $0.00 $0.00 1u N 1 AIA DOCUMENT G703 APPLICATION AND CERTQ3CATE FOR PAYNIENT MAY 1933 EDITION AIA 0 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 KEW YORK Q AVENUE, N.W., WASHINGTON, D. C. 200065292 G703 -1992 r Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Harco Asphalt Paving Purchase Order No. 1650 Harco Way Terms Indianapolis, IN 46217 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Pay App #2 G- DFOve./Adarns Street Paths 14,891.16 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. 20 Clerk- Treasurer 1 WHER NO. WARRANT NO. ALLOWED 20 Harco Asphalt ^Raving IN SUM OF 1650 Harco Way Indianapolis, IN 46217 $14,8 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 5222 -01 Pay App #2 203- R446220 13,090.93 bill(s) is (are) true and correct and that the 5 materials or services itemized thereon for which charge is made were ordered and received except 20 2?Z&s,,� Signature Cost distribution ledger classification if Itle claim paid motor vehicle highway fund