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171010 04/16/2009
CITY OF CARMEL, INDIANA ONE CIVIC SQUARE CARMEL, INDIANA 46032 VENDOR: 362321 Page 1 of 1 NATIONAL SALVAGE & SERVICE CORP PO BOX 300 CHECK AMOUNT: $536,433.57 CLEAR CREEK IN 47426 CHECK NUMBER: 171010 CHECK DATE: 4/16/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER 902 4460847 AMOUNT DESCRIPTION 2 536,433.57 HEARTHVIEW OLD TOWN ;APPLICATION and CERTIFICATE for PAYMENT DOCUMENT G702 To: City of Carmel, IN Redev. Comm. One City Square Carmel, IN 46032 From: National Salvage & Service Corp. P.O. Box 300 Clear Creek, IN 47426 Contract For: Below Grade Removals Project: Parcel 47, Carmel Arts District Lofts Below Grade Removals ATTN: Bruce Stauffer Application No: 2 App. Date: March 19, 2009 Period to: Project Nos: Contract Date: December 18, 2008 Distribution to: ® OWNER Z CONSTRUCTION MGR. Z ARCHITECT Z CONTRACTOR ❑ OTHER rat CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net Change By Change Orders 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE 5. RETAINAGE: a. 10% of Completed Work b. of Stored Material TOTAL RETAINAGE 6. TOTAL EARNED LESS RETAINAGE 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE 418,000.00 596,037.30 1,014,037.30 1,014,037.30 101,403.73 0.00 101,403.73 912,633.57 376,200.00 536,433.57 101,403.73 ✓Ij�/ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 0.00 0.00 Total approval this Month 596,037.30 0.00 TOTALS $ 596,037.30 $ 0.00 NET CHANGES by Change Order $ 596,037.30 TORGO SOFTWARE http7 /www.torgo.net ©1996 -200d ALL RIGHTS RESERVED The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONT By: R: Na nal Salvage & Service Corp. raig y, Project Mana Date: March 19,'2009 tys.v State of: Indiana County of: Monrpes.- a Subscribed and sworn before me this 19th day of ; March 2009. Craig Bentley, Project Manager, personally appeared before me, the undersigned notary. public, and provided satisfactory evidence of identification to be the person. do signed this document in my presence and swore or affirmed to me that the contents of this`docurpent - are truthful and accurate to the best of his /her knowledge and belief. t • Notary Public�i �� if �ohh ^- Lli•,vy. My Commission expires: 0-74;c05/ ENGINEER'S GE4TIFICATE FOR PAYMENT In accordance with -ne Contract Documents, based on on -site observations and the data comprising this application, the Engineer certifies to the Owner that to the best of the Engineer's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED (Attach explanation if amount certified differs from the amount applied for. Initial all figures on this Application a' = on the Continuation Sheet that are changed to conform to the amount certified.) ENGINEE By: Date: 3f3(/� This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. CONTINUATION SHEET G703 PROJECT: Parcel 47, Carmel Arts District National Salvage & Service Corp. Page 1 of 1 Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION NUMBER: 2 APPLICATION DATE: March 19, 2009 PERIOD TO: PROJECT NUMBER: A B C D E F G H I Item # Description of Work Scheduled Value Work Completed Materials Stored & Used Prior + Current Total Completed and Stored To Date % Balance to Finish Retainage From Previous Application(s) This Period 1 Base Bid - Mobilization 6,160.00 6,160.00 0.00 6,160.00 100.00 0.00 616.00 2 Base Bid - Bond 8,400.00 8,400.00 0.00 8,400.00 100.00 0.00 840.00 3 Base Bid - Site Preparation 2,000.00 2,000.00 0.00 2,000.00 100.00 0.00 200.00 4 Base Bid - Excavation 106,080.00 106,080.00 0.00 106,080.00 100.00 0.00 10,608.00 5 Base Bid - T & D 295,360.00 295,360.00 0.00 295,360.00 100.00 0.00 29,536.00 6 CO #1 - Contaminated Soil Removal 232,500.00 0.00 232,500.00 232,500.00 100.00 0.00 23,250.00 7 CO #2 - UST 500 -1000 Gallons 4,000.00 0.00 4,000.00 4,000.00 100.00 0.00 400.00 8 CO #2 - Foundation Removal / Disposal 19,637.04 0.00 19,637.04 19,637.04 100.00 0.00 1,963.70 9 CO #2 - Water Removal 4,100.00 0.00 4,100.00 4,100.00 100.00 0.00 410.00 10 CO #2 - Drain Excavation 2,550.26 0.00 2,550.26 2,550.26 100.00 0.00 255.03 11 CO #3 - Contaminated Soil Removal 333,250.00 0.00 333,250.00 333,250.00 100.00 0.00 33,325.00 12 CO #4 - Contaminated Soil Removal 0.00 13 CO #4 - VFW Contaminated Area Exc. 0.00 14 CO #4 - Water Removal 0.00 GRAND TOTAL: 1 1,014,037.301 418,000.001 596,037.301 1,014,037.301 100.001 0.001 101,403.73 A =Line Item Number B =Brief Item Description C =Total Value of Item D =Total of D and E From Previous Application(s) (If Any) E =Total Work Completed For This Application F= Materials Purchased and Stored for Project G =Total of All Work Completed and Materials Stored for Project H= Remaining Balance of Amount to Finish I= Amount Withheld from G tL TORGO SOFTWARE http:hWww.torgC et 01996 -2008 ALL RIGHTS RESERVED • - APPLICATION and CERTIFICATE for PAYMENT DOCUMENT G702 To: City of Carmel, IN Redev. Comm. One City Square Carmel, IN 46032 From: National Salvage & Service Corp. P.O. Box 300 Clear Creek, IN 47426 Contract For: Below Grade Removals Project: Parcel 47, Carmel Arts District Lofts Below Grade Removals ATTN: Bruce Stauffer Application No: 2 App. Date: March 19, 2009 Period to: Project Nos: Contract Date: December 18, 2008 Distribution to: ® OWNER ® CONSTRUCTION MGR. IN ARCHITECT CONTRACTOR ❑ OTHER CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net Change By Change Orders 3. CONTRACT SUM TO DATE 4. TOTAL COMPLETED AND STORED TO DATE 5. RETAINAGE: a. 10% of Completed Work b. of Stored Material TOTAL RETAINAGE 6. TOTAL EARNED LESS RETAINAGE 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE 418,000.00 596,037.30 1,014,037.30 1,014,037.30 101,403.73 0.00 101,403.73 912,633.57 376,200.00 536,433.57 101,403.73 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 0.00 0.00 Total approval this Month 596,037.30 0.00 TOTALS $ 596,037.30 $ 0.00 NET CHANGES by Change Order $ 596,037.30 TORGO SOFTWARE http://www.torgo.net ©1996 -2008 ALL RIGHTS RESERVED The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTR ToR: t National Salvage & Service Corp. aig Bent ' otec er By: tM. Date: March'19, 2009/ State of: Indiana County of: Monroe , Subscribed and sworn before me this 19th day of Mach , 2009 Craig Bentley, Project Manager, personally appeared before me, the:.undersigned notary public, and provided satisfactory evidence of identification to be the person`whousigried this; document in my presence and swore or affirmed to me that the contents of this'document'are truthful and accurate to the best of his /he knowledge and belief. j Notary Public: `� � r tJ�yyr My Commission expires: 0-1/09 // ENGINEER'S,2ERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising this application, the Engineer certifies to the Owner that to the best of the Engineer's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED ito -7 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on this Application an the Continuation Sheet that are changed to conform to the amount certified.) ENGINEER; By: Date: 3/3/4T9 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. CONTINUATION SHEET G703 PROJECT: Parcel 47, Carmel Arts District National Salvage & Service Corp. Page 1 of 1 Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification is attached. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION NUMBER: 2 APPLICATION DATE: March 19, 2009 PERIOD TO: PROJECT NUMBER: A B C D E F G H I Item # Description of Work Scheduled Value Work Completed Materials Stored & Used Prior + Current Total Completed and Stored To Date % Balance to Finish Retainage From Previous Application(s) This Period 1 Base Bid - Mobilization 6,160.00 6,160.00 0.00 6,160.00 100.00 0.00 616.00 2 Base Bid - Bond 8,400.00 8,400.00 0.00 8,400.00 100.00 0.00 840.00 3 Base Bid - Site Preparation 2,000.00 2,000.00 0.00 2,000.00 100.00 0.00 200.00 4 Base Bid - Excavation 106,080.00 106,080.00 0.00 106,080.00 100.00 0.00 10,608.00 5 Base Bid - T & D 295,360.00 295,360.00 0.00 295,360.00 100.00 0.00 29,536.00 6 CO #1 - Contaminated Soil Removal 232,500.00 0.00 232,500.00 232,500.00 100.00 0.00 23,250.00 7 CO #2 - UST 500 -1000 Gallons 4,000.00 0.00 4,000.00 4,000.00 100.00 0.00 400.00 8 CO #2 - Foundation Removal / Disposal 19,637.04 0.00 19,637.04 19,637.04 100.00 0.00 1,963.70 9 CO #2 - Water Removal 4,100.00 0.00 4,100.00 4,100.00 100.00 0.00 410.00 10 CO #2 - Drain Excavation 2,550.26 0.00 2,550.26 2,550.26 100.00 0.00 255.03 11 CO #3 - Contaminated Soil Removal 333,250.00 0.00 333,250.00 333,250.00 100.00 0.00 33,325.00 12 CO #4 - Contaminated Soil Removal 0.00 13 CO #4 - VFW Contaminated Area Exc. 0.00 14 CO #4 - Water Removal 0.00 GRAND TOTAL: 1,014,037.301 418,000.001 596,037.301 1,014,037.301 100.001 0.001 101,403.73 A =Line Item Number B =Brief Item Description C =Total Value of Item D =Total of D and E From Previous Application(s) (If Any) E =Total Work Completed For This Application F= Materials Purchased and Stored for Project G =Total of All Work Completed and Materials Stored for Project H= Remaining Balance of Amount to Finish 1= Amount Withheld from G TORGO SOFTWARE http:i /www.torg'6 net ©1996 -2008 ALL RIGHTS RESERVED WAIVER OF LIEN Date: March 19, 2009 To All Whom it may Concern: Whereas, National Salvage & Service Corporation (CONTRACTOR) has been employed by the City of Carmel, Indiana Redevelopment Commission (OWNER) to furnish SERVICES for the premises known as Parcel 47, Carmel Arts District Lofts Below Grade Removals, Carmel, Indiana, The undersigned, for and in consideration of payments in the amount of ($536,433.57) Five hundred thirty six thousand four hundred thirty three and 57/100 dollars for supplies or services and other goods and valuable consideration, the receipt whereof is hereby acknowledged, does hereby waive and release any and all lien, and claim or right to lien on said above described building and premises under the Statutes of the State of Indiana, relating to Mechanics' Liens, on account of labor or services, material, fixtures or apparatus heretofore furnished to this date by the undersigned for the above described premises. National Salvage & Service Corporation (Co ration/Co any Name) of Authorized epresentative) Craig Bentley, Project Manager (Title) Affix Corporate Seal Imo **--- National Salvage & Service Corp. Date: March 19, 2009 From: To: Project: National Salvage & Service Corp. P.O. Box 300 Clear Creek, IN 47426 City of Carmel, Indiana Redevelopment Commission One City Square Carmel, IN 46032 ATTN: Bruce Stauffer of Keystone Construction Corporation Parcel 47, Carmel Arts District Lofts Below Grade Removals Pay Application #2 Contaminated Soil Removal per contract UST: 500 - 1000 Gallons per contract Foundation Removal / Disposal per contract Water Removal per contract Drain Excavation per contract Addt'I Contaminated Soil Removal per contract Total Work Completed This Period Less: Retainage of 10% Units Quantity Unit Price Ton 6000 $38.75 Each 4 $1,000.00 Ton 288.78 $68.00 Gal 2050 $2.00 LS 1 $2,550.26 Ton 8600 $38.75 Work Completed This Period $232,500.00 $4,000.00 $19,637.04 $4,100.00 $2,550.26 $333,250.00 $596,037.30 $59,603.73 Current Payment Due $536,433.57 P.O. Box 300 Clear Creek, IN 47426 Presjibed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL City Form No. 201 (Rev. 1995) 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 / /'a4 7 / 1-4 c - Purchase Order No. Po 6� 3U0 Terms 0722K y 72 Date Due Invoice Date Invoice Number Description (or note attached invoice(s) or bill(s)) Amount 1/4 3 Z �24. A n� Z —7 7 3-30/33-6-7 v rti Total 3-34733.57 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 VOUCHER NO. WARRANT NO. 300 (0 52„ `f 7/ $ S34,3 ,5/ ON ACCOUNT OF APPROPRIATION FOR 0 4/�.'6U8 y7 PO# or DEPT. # INVOICE NO. ACCT #!TITLE ALLOWED 20 IN SUM OF $ Board Members AMOUNT I hereby certify that the attached invoice(s), or Z 4'16& FY? 5-36;1335j bill(s) is (are) true and correct and that the Cost distribution ledger classification if claim paid motor vehicle highway fund materials or services itemized thereon for which charge is made were ordered and received except Title