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172478 05/13/2009
CITY OF CARMEL, INDIANA VENDOR: 361087 Page 1 of 1 i 0 ONE CIVIC SQUARE OLD NATIONAL TRUST CO CARMEL, INDIANA 46032 ATTN: DAVID CROW CHECK AMOUNT: $4,004.00 1 MAIN STREET 38 CHECK NUMBER: 172478 EVANSVILLEIN 47708 CHECK DATE: 5/13/2009 D EPART MENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION 853 5023990 24 4,004.00 OTHER EXPENSES ''c Page 1 of 4 To: CarmellClay Board of Parks and Recreation Project: Monon Family Recreation Center A f 1 V pplication 2d I 750 3rd Avenue, S.W. Suite 100 ED Carmel, Indiana 46032 Contract For: BP 4 MC Electrical Application Date: 3/25/2009 MAY 009 7 Y Gaylor Job 1252530 Period Ending: 3/3112009 t— 1 iJ J From: Gaylor, Inc. 91073701 17225 Kraft Court Architects M l t Noblesville, IN 46060 General Contractor APPLICATION FOR PAYMENT Application is made for Payment, as shown below, in connection CHANGE ORDER SUMMARY with the Contract. A Continuation Sheet, with a Schedule of Values breakdown, is attached. TOTAL CHANGE ORDERS APPROVED ON PREVIOUS APPLICATIONS ADDITIONS DEDUCTIONS 1. ORIGINAL CONTRACT SUM $2,998,700.00 CHANGE ORDER DATE APPROVED 2. Net change by CHANGE ORDERS $487,111.00 Change Order 01 $11,934.00 Change Order 03 4,000.00 3. CONTRACT SUM TO DATE $3,485,811.00 Change Order 04 35,156.00 Change Order 05 254,672.00 4. TOTAL COMPLETED STORED TO DATE $3,485,811.00 Change Order 06 8,676.00 Change Order 07 $1,061.00 5. RETAINAGE: Change Order 08 11,233.00 Change Order 09 1,807.00 10.00% of completed wort: $8,504.00 Change Order 10 37,704.00 Change Order 11 9,782.00 0.00 of stored material $0.00 Change Order 12 37,634.00 Change Order 13 14,400.00 TOTAL RETA[ NAGE $8,504.00 Chagne Order 14 85,040.00 6. TOTAL EARNED LESS RETAINAGE $3,477,307.00 t/ 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $3,441,271.00 8. CURRENT PAYMENT DUE.....,. $36,036.00 9. BALANCE TO FINISH, PLUS RETAINAGE $8,504.00 u TOTALS: 500,106.00 $12,995.00 NET CHANGE BY CHANGE ORDERS: $487,111.00 The undersigned Contractor certifies that to the best of the Contractor's knowledge, the State of: Indiana Work covered by this Application for Payment has been Completed in accordance with County of: Hamilton the Contract Documents and that current payment shown herein is now due. Subscribed and sworn to before me this 25th day of March 2009 Notary Public. Ch I R. Gia zzi By: Date: 25- Mar 09 Name: Andrew Foreman My Commission expires on: 09/13/16 Title: Project Manager �/Q Q County of Residence: Hamilton UY faL, Cgs 4� Page 2 of 4 To: Carmel /Clay Board of Parks and Recreation Project: Monon Family Recreation Center Application 24 760 3rd Avenue, S.W., Suite 100 Carmel, Indiana 46032 Contract For: BP 4 MC Electrical Application Date: 3/2512009 Gaylor Job 1252530 Period Ending: 3/31/2009 From: Gaylor, Inc. 91073701 17225 Kraft Court Architects Noblesville, IN 46060 General Contractor APPLICATION FOR PAYMENT- CONTINUATION SHEET A B C D E F G H E ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL CP BALANCE TO RETAINAGE N0. DESCRIPTION OF WORK VALUE WORK THIS PERIOD MATERIALS STORED TO DATE (G1C) FINISH (C -G) 10.00% 1 Bonds 59,974.00 59,974.00 0.00 0.00 59,974.00 100.00% 0.00 5,997.40 2 Mobilization 20,000.00 20,000.00 0.00 0.00 20,000.00 100.00% 0.00 2,000.00 3 Demobilization 5,000.00 5,000.00 0.00 0.00 5,000.00 100.00% 0.00 500.00 4 Insurance 1 Safety 5,000.00 5,000.00 0.00 0.00 5,000.00 100.00% 0.00 500.00 5 Submittals 15,000.00 15,000.00 0.00 0.00 15,000.00 100.00% 0.00 1,500.00 6 0.00 0.00 13.00 0.00 0.00 0.00% 0.00 0.00 7 Temporary Labor 21,600.00 21,600.00 0.00 0.00 21,600.00 100.00% 0.00 2,160.00 8 Temporary Material 14,400.00 14,400.00 0.00 0,00 14,400.00 100.00% 0.00 1,440.00 9 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 10 ESCO General Conditions 2,555.00 2,555.00 0.00 0.00 2,555.00 100.00% 0.00 255.50 11 ESCO Submittals 13,840.00 13,840.00 0.00 0.00 13,840.00 100.00% 0.00 1,384.00 12 ESCO Sound Material 104,077.00 104,077.00 0.00 0.00 104,077.00 100.00% 0.00 10,407.70 13 ESCO Sound Labor 15,602.00 15,602.00 0.00 0.00 15,602.00 100.00% 0.00 1,560.20 14 ESCO Fire Alarm Material 42,790.00 42,790.00 0.00 0.00 42,790.00 100.00% 0.00 4,279.00 15 ESCO Fire Alarm Labor 9,744.00 9,744.00 0.00 0.00 9,744.00 100.00% 0.00 974.40 16 ESCO TID Material 158 158,340.00 0.00 0.00 158,340.00 100.00% 0.00 15,834.00 17 ESCO TID Labor 9,804.00 9,804.00 0.00 0.00 9,804.00 100.00% 0.00 980.40 18 ESCO Closeout 1,392.00 1,392.00 0.00 0.00 1,392.00 100.00% 0.00 139.20 19 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 20 Davis Security 139,545.00 139,545.00 0.00 0.00 139,545.00 100.00% 0.00 13,954.50 21 0.00 0.00 000 0.00 0.00 0.00% 0.00 0.00 22 Service Entrance Sub 10,000.00 10,000.00 0,00 0.00 10,000.00 100.00% 0.00 1,000.00 23 Service Entrance Material 45,650.00 45,650.00 0.00 0.00 45,650.00 100.00% 0.00 4,565.00 24 Service Entrance Labor 12,040.00 12,040.00 0.00 0.00 12,040.00 100.00% 0.00 1,204.00 25 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 26 Distribution Material 86,424.00 86,424.00 0.00 0.00 86,424.00 100.00% 0.00 8,642.40 27 Distribution Labor 84,960.00 84,960.00 0.00 0.00 84,960.00 100.00% 0.00 8,496.00 28 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 29 Generator Material 32,500.00 32,500.00 0.00 0.00 32,500.00 100.00% 0.00 3,250.00 30 Generator Labor 3,600.00 3,600.00 0.00 0.00 3,600.00 100.00% 0.00 350.00 31 0.00 0.00 0.00 0.00 0,00 0.00% 0.00 0.00 32 Payne Sparkman Dimming System 98,400.00 98,400,00 0.00 0.00 98,400.00 100.00% 0.00 9,840.00 33 Lutron Dimming System 223,080.00 223,080.00 0.00 0.00 223,080.00 100.00% 0.00 22,308.00 34 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 35 west Side 1st Floor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 36 Branch UG Material 14,500.00 14,500.00 0.00 0.00 14,500.00 100.00% 0.00 1,450.00 37 Branch UG Labor 5,800.00 5,800.00 0.00 0.00 5,800.00 100.00% 0.00 580.00 38 Wall RI Material 50,750.00 50,750.00 0.00 0.00 50,750.00 100.00% 0.00 5,075.00 39 Wall RI Labor 94,250.00 94,250.00 0.00 0.00 94,250.00 100.00% 0.00 9,425.00 40 OIH RI Material 43,500.00 43,500.00 0.00 0.00 43,500.00 100.00% 0.00 4,350.00 41 011-11 RI Labor 79,750.00 79,750.00 0.00 0.00 79,750.00 100.00% 0.00 7,975.00 G 42 Branch Wiring Material 21,750.00 21,750.00 0.00 0.00 21,750.00 100.00% 0.00 2,175.00 Page 3 of 4 To: Carmel/Clay Board of Parks and Recreation Project: Monon Family Recreation Center Application 24 760 3rd Avenue, S.W., Suite 100 Carmel, Indiana 46032 Contract For: SP 4 MC Electrical Application Date: 3125/2009 Gaylor Job 1252530 Period Ending: 3/3112009 From: Gaylor, Inc. 91073701 17225 Kraft Court Architects Noblesville, IN 46060 General Contractor 43 Branch Wiring Labor 47,130.00 47,130.00 0.00 0.00 47,130.00 100.00% 0.00 4,713.00 44 Devices Material 2,900.00 2,900.00 0.00 0.00 2,900.00 100.00% 0.00 290.00 45 Devices Labor 5,080.00 5,080.00 0.00 0.00 5,080.00 100.00% 0.00 508.00 46 Lighting Material 282,750.00 282,750.00 0 -00 0.00 282,750.00 100.00% 0.00 28,275.00 47 Lighting Labor 121,800.00 121,800.00 0.00 0.00 121,800.00 100.00% 0.00 12,180.00 48 System Cabling Material 7,250.00 7,250.00 0.00 0.00 7,250.00 100.00% 0.00 725.00 49 System Cabling Labor 17,400.00 17,400.00 0.00 0.00 17,400.00 100.00% 0.00 1,740.00 50 FA Devices Labor 5,080.00 5,080.00 0.00 0.00 5,080.00 100.00% 0.00 508.00 51 Pool Equipment Material 10,880.00 10,880.00 0.00 0.00 10,880.00 100.00% 0.00 1,088.00 52 Pool Equipment Labor 7,540.00 7,540.00 0.00 0.00 7,540.00 100.00% 0.00 754.00 53 Kitchen Equipment Material 2,100.00 2,100.00 0.00 0.00 2,100.00 100.00% 0,00 210.00 54 Kitchen Equipment Labor 8,120.00 8,120.00 0.00 0.00 8,120.00 100.00% 0.00 812.00 55 HVAC Equip Material 2,180.00 2,180.00 0.00 0.00 2,180.00 100.00% 0.00 218.00 56 HVAC Equip Labor 2,900.00 2,900.00 0.00 0.00 2,900.00 100,00% 0.00 290.00 57 0.00 0.00 0.00 0,00 0.00 0.00% 0.00 0.00 58 West Side 2nd Floor 0.00 0.00 000 0.00 0.00 0.00% 0.00 0.00 59 Branch UG Material 72,500.00 72,500.00 0,00 0.00 72,500.00 100.00% 0.00 7,250.00 60 Branch UG Labor 11,600.00 11,600.00 0.00 0.00 11,600.00 100.00% 0.00 1,160.00 61 Wall RI Material 20,300.00 20,300.00 0.00 0.00 20,300.00 100.00% 0.00 2,030.00 62 Wall RI Labor 37,700.00 37,700.00 0.00 0.00 37,700.00 100.00% 0.00 3,770.00 63 OIH R€ Material 31,900.00 31,900.00 0.00 0.00 31,900.00 100.00% 0.00 3,190.00 64 O/H RE Labor 31,900.00 31,900.00 0.00 0.00 31,900.00 100.00% 0.00 3,190.00 65 Branch Wiring Material 8,700.00 8,700.00 0.00 0.00 8,700.00 100.00% 0.00 870.00 66 Branch Wiring Labor 18,850.00 18,850.00 0.00 0.00 18,850:00 100.00% 0.00 1,885.00 67 Devices Material 1,160.00 1,150.00 0.00 0.00 1,160.00 100.00% 0.00 116.00 68 Devices Labor 2,030.00 2,030.00 0.00 0.00 2,030.00 100.00% 0.00 203.00 69 Lighting Material 116,300.00 116,300.00 0.00 0.00 116,300.00 100.00% 0.00 11,630.00 70 Lighting Labor 48,720.00 48,720.00 0.00 0.00 48,720.00 100.00°/ 0.00 4,872.00 71 System Cabling Material 2,900.00 2,900.00 0.00 0.00 2,900.00 100.00% 0.00 290.00 72 System Cabling Labor 8,960.00 6,960.00 0.00 0.00 6,960.00 100.00% 0.00 696.00 73 FA Devices Labor 2,030.00 2,030.00 0.00 0.00 2,030.00 100.00% 0.00 203.00 74 HVAC Equip Material 4,35000 4,350.00 0.00 0.00 4,350.00 100.00% 0.00 435.00 75 HVAC Equip Labor 6,960.00 6,960.00 0.00 0.00 6,960.00 100.00% 0.00 696.00 76 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.60 77 East Side 1st Floor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 78 Branch UG Material 7.250.00 7,250.00 0.00 0.00 7,250.00 100.00% 0.00 725.00 79 Branch UG Labor 1,740.00 1,740.00 0.00 0.00 1,740.00 100.00% 0.00 174.00 80 Wall RI Material 15,230,00 15,230.00 0.00 0.00 15,230.00 100.00% 0.00 1,523.00 81 Wall RI Labor 28,280,00 28,280,00 0.00 0.00 28,280.00 100.00% 0.00 2,828.00 82 OIH RI Material 13,050.00 13,050.00 0.00 0.00 13,050.00 100.00% 0.00 1,305.00 83 O/H RI Labor 23,930,00 23,930.00 0.00 0.00 23,930.00 100.00% 0.00 2,393.00 84 Branch Wiring Material 6,530.00 6,530.00 0.00 0.00 6,530.00 100.00% 0.00 653.00 85 Branch Wiring Labor 14,140.00 14,140.00 0.00 0.00 14,140.00 100.00% 0.00 1,414.00 86 Devices Material 870.00 870.00 0.00 0.00 870.00 100-00% 0.00 87.00 87 Devices Labor 1,520.00 1,520.00 0.00 0.00 1,520.00 100.00% 0.00 152.00 86 Lighting Material 214,600,00 214,600.00 0.00 0.00 214,600.00 100.00% 0.00 21,460.00 89 Lighting Labor 54,670.00 54,670.00 0.00 0.00 54,870.00 100.00% 0.00 5,467.00 90 System Cabling Material 2,180.00 2,180.00 0.00 0.00 2,180.00 100.00% 0.00 218.00 91 System Cabling Labor 5,220.00 5,220.00 0.00 0.00 5,220,00 100.00% 0.00 522.00 92 FA Devices Labor 1,520.00 1,520.00 0.00 0.00 1,520.00 100.00% 0.00 152.00 93 HVAC Equip Material 2,180.00 2,180.00 0,00 0.00 2,180.00 100.00% 0.00 218.00 Page 4 of 4 To: Carmel /Clay Board of Parks and Recreation Project: Monon Family Recreation Center Application 24 760 3rd Avenue, S.W., Suite 100 Carmel, Indiana 46032 Contract For: BP 4 MC Electrical Application Date. 3/25/2009 Gaylor Job 1252530 Period Ending: 313112009 From: Gaylor, Inc. 91073701 17225 Kraft Court Architects tt: Noblesville, IN 46060 General Contractor 94 HVAC Equip Labor 2,900.00 2,900.00 0.00 0.00 2,900.00 100.00% 0.00 290.00 95 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 96 East Side 2nd Floor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 97 Branch UG Material 2,900.00 2,900.00 0.00 0.00 2,900.00 100.00% 0 .00 290.00 98 Branch UG Labor 870.00 870.00 0.00 0.00 870.00 100.00% 0.00 87.00 99 Wall RI Material 7,610.00 7,610.00 0.00 0.00 7,610.00 100.00% 0.00 761.00 100 Wall RI Labor 14,140.00 14,140.00 0.00 0.00 14,140.00 100.00% 0.00 1,414.00 101 O/H RI Material 6,530.00 6,530.00 0.00 0,00 6,530.00 100.00% 0.00 653.00 102 O/H RI Labor 11,960.00 11,960.00 0.00 0.00 11,960.00 100.00% 0.00 1,196.00 103 Branch Wiring Material 3,260.00 3,260.00 0.00 0.00 3,260.00 100.00% 0.00 326.00 104 Branch Wiring Labor 7,070.00 7,070.00 0.00 0.00 7,070.00 100.00% 0.00 707.00 105 Devices Material 440.00 440.00 0.00 0.00 440.00 100.00% 0.00 44.00 106 Devices Labor 760.00 760.00 0.00 0.00 760.00 100.00% 0.00 76.00 107 Lighting Material 32,953.00 32,953.00 000 0.00 32,95100 100.00% 0.00 3,295.30 108 Lighting Labor 5,470.00 5,470.00 0.00 0.00 5,470.00 100.00% 0.00 547.00 109 System Cabling Material 1,090.00 1,090.00 0.00 0.00 1,090.00 100.00% 0.00 109.00 110 System Cabling Labor 2,610.00 2,610.00 0.00 0.00 2,610.00 100,00% 0.00 261.00 111 FA Devices Labor 760.00 760.00 0.00 0.00 760.00 100.00% 0.00 76.00 112 HVAC Equip Material 4,350.00 4,350.00 0.00 0,00 4,350.00 100.00% 0.00 435.00 113 HVAC Equip Labor 6,530.00 6,530.00 000 0.00 6,530.00 100.00% 0.00 653.00 114 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 115 Change Order 01 (11,934.00) (11,934,00) 0.00 0.00 (11,934.00) 100.00% 0.00 (1,193.40) 116 Change Order 03 4,000.00 4,000.00 0.00 0.00 4,000.00 100.00% 0.00 400.00 117 Change Order 04 35,158.00 35,158.00 0.00 0.00 35,158.00 100.00% 0.00 3,515.80 118 Change Order 05 254,672.00 254,672.00 0.00 0.00 254,672.00 100.00% 0.00 25,457.20 119 Change Order 06 8,676.00 8,676.00 0.00 0.00 8,676.00 100.00% 0.00 867.60 120 Change Order 07 (1,061.00) (1,061.00) 0.00 0.00 (1,061.00) 100.00% 0,00 (106.10) 121 Change Order 08 11,233.00 11,233.00 0.00 0.00 11,233.00 100.00% 0.00 1,123.30 122 Change Order 09 1,807.00 1,807.00 0.00 0.00 1,807.00 100.00% 0.00 180.70 123 Change Order 10 37,704.00 37,704.00 0.00 0.00 37,704.00 100.00% 0.00 3,770.40 124 Change Order 11 9,782.00 9,782.00 0.00 0.00 9,782.00 100.00% 0.00 978.20 125 Change Order 12 31',634.00 37,634.00 0.00 0.00 37,634.00 100.00% 0.00 3,763.40 126 Change Order 13 14,400.00 14,400.00 0.00 0.00 14,400.00 100.00% 0.00 1,440.00 127 Change Order 14 85,040.00 45,000.00 40,040.00 0.00 85,040.00 100.00% 0.00 8,504.00 126 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 129 0.00 0.00 0.00 0.00 0.00 0,00% 0.00 0.00 130 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0,00 131 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 132 0.00 0.00 0.00 0.00 0,00 0.00% 0.00 0.00 133 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 134 0.00 0.00 0.00 0.00 0,00 0.00% 0.00 0.00 135 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 TOTALS: 3,485,811.00 $3,445,771.00 $40,040.00 $0.00 $3,485,811.00 100.00% $0.00 $348,581.10 REMIT TO: �d j G AVILO R P.O. BOX 3757 WE GLADLY ACCEPT Corporate Offices Carmel, IN Carmel, IN 46082 -3757 Visa MasterCard American Express 317.843.0577 Fax 317.848.0364 800.878.0577 http: /www.gaylor.com FED ID# 20- 3727689 Invoice 86767 Bill to: Job: 91073701 Geupel DeMars Hagerman, LLC Monon Site Lighting PO Box 502710 1235 Central Park Drive East Indianapolis, IN 46250 -7710 Carmel, IN 46032 Invoice 86767 Date: 03/25/09 Customer P.O. CWO #367 Payment Terms: NET 30 Salesperson: Customer Code: GEUDEM Remarks: Job 91073701 Pay App #24 (complete for CO 14) 11 t- nsiom Invoice is for electrical work completed for Change Order #14 40 ,040.00 Subtotal: 40,040.00 For questions on this invoice, call Lorena at 317 815 -3134. Total: 40,040.00 Less Retention: 4,004.00 Current Due: 36,036.00 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, 361087 Old National Trust Company Terms Attn: David Crow 1 Main Street 313 Evansville, IN 47708 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 3125109 24 Escrow payment for Gaylor pay application 24 4,004.00 Total 4,004.00 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. 361087 Old National Trust Company Allowed 20 Attn: David Crow 1 Main Street 313 Evansville, IN 47708 In Sum of 4,004.00 r. s ON ACCOUNT OF APPROPRIATION FOR 853 Gift Fund PO# or INVOICE NO kCCT #fTITLI AMOUNT Board Members Dept 853 24 5023990 4,004.00 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 -May 2009 Signature 4,004.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund