174558 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 356231 Page 1 of 1
ONE CIVIC SQUARE YARDBERRY LANDSCAPING EXCAV CHECK AMOUNT: $151,003.17
CARMEL, INDIANA 46032 9940 SOUTH 100 WEST
ANDERSON IN 46017 CHECK NUMBER: 174558
CHECK DATE: 7/8/2009
DEPA RTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUN DESCRIPTION
902__ 4460873 1 56,430.00 DIRT WORK
9 °02 4460873 2 94,573.17 PARCEL 5 STREETSCAPE
-ASP P LI CATION A CERTIF I CATE FOR PAYMENT A 1 DOCUMENT 0702 (Instructions on reverse side) P rt ON[
TO (OWNER): I`FI� pF L Nantec- PROIECF: fH�.C�� �3 ��zrn�L QPPLICATtON NO: Di
CrTJ CL�i7cR. IJ�CJ�C,T �OwNER
PERIOD TO 5- 13 -1 O ARCHITI
O CONTR,-
FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S O
Yardberry Landscape Excavating PROJECT NQ.
9940 S. 1000 W.
CONTRACt Fo�nderson, IN. 40017 'CO NTRACT DAT S-
Application is made for Payment, as shown below, in connection with the Co
CONTRACTORS APPLICATION FOR PAYMENT Continuation Sheet, ALl Document 6703, is attached.
CHANGE ORDER SUMMARY 1 ORIGINAL CONTRACT SUM S
Change Orders approved in ADDITIONS DEDUCTIONS 2. Net change by Change Orders S t z
previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 2) S I�JSZ CI t
TOTAL 4. TOTAL COMPLETED STORED TO DATE S 11x 7S I 30
Approved this Month
(Column G on 6703)
S. RETAINAGE:
Number Date Approved a. _L.li x of Completed Work S l.'r1 5 13
(Column D E on G703)
b. L� x of Stored Material S 0. 00
(Column F on 6703)
Total Retainage (Line Sa +Sb or
TOTALS (.G(1 (3. OJ Total in Column I of G703) S Ih `3 t>
Net than c b Change Orders 1 6. TOTAL EARNED LESS RETAINAGE S I Sf 1 1
The undersigned Contractor certifies that to the best of the Contractor's knowledge, (Line 4 less Line 5 Total)
information and belief the Work covered by this Application for Payment has been 7• LESS PREVIOUS CERTIFICATES FOR
completed in accordance with the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Cer,ificate) S
paid by the Contractor for Work for which previous Certificates for Payment were B. CURRENT PAYMENT DUE S t1 4, 5 1 X"
issued and payments received from the OG, ner, and that current payment shown BALANCE TO FINISH PLUS RETAINA
9 GE S
herein is now due. (Line3 less Line 6)
I V
CONTRACTOR: State of: DI IAA 0A C
County of: {7D /5
Subscribe and sworn to before me. thi t 3 day of 1�k4�9
Notary Pudic: k,t;f Gsfi y
By: 4 Date: M Commission e
Y p
AMOUNT CERTIFIED S 5 7 3 n
ARCHITECT'S CERTIFICATE FOR PAYMENT (Attach expla ti on if amount certified differs from the amount app1 ied fors
In accordance with the Contract Documents, based on on -site observations and the ARCHITE
data comprising the above application, the Architect certifies to the Owner that to the
best of the Architect's knowledge, information and belief the Work has progressed as a DaIc:
Indicated, the quality of the Work is in accordance with the Contract Documents, and This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only
the Contractor is entitled to payment of the AMOUNT CERTIFIED. Contractor named herein. Issuance, payment and acceptance of payment arc
Prejudice to any rights of the Owner or Contractor under this Contract.
AIA no CUMrNT C7C'2 APPLICATION AND CF RTIFICArl FOR PnYMLNT MAY 1953 EDITION AIA e- 1953
C, 7
CONTINUATION SHEET A/A DOCUMENT 0703 (Instructions on reverse side) PACE OF PAGES
AIA Document G702, APPLICATION AND CERTIF :CATE FOR PAYMENT, containing APPLICATION NUMBER:
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. PERIOD TO:
Use Column I on Contracts where variable retainage for line items may apply ARCHITECT'S PROJECT NO:
A B C D E F G H
ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL BALANCE RETA!NAGE
NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G C) TO FINISH
APPLICATION STORED AND STORED (C G)
(D +EI (NOT IN TO DATE
D OR E) (D E F)
l�
ic
1
3
jo,OB� 3 d f d7�
I 9
p J
AIA DOCUMENT 6703 APPLICATION AND CERTIFICATE FOR PAYMENT MAY 1983 EDITION AIA' C. 1983
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE. N.W. WASHINGTON D_C. Jpppb 6703 -1983
t
Yardberry Landscape Excavating Invoice
9940 South 1000 West
Anderson, .1N 46017
Date invoice#
5/13/2009 6509 -AA
BiN To
CITY OF CARMEL PERIMETER BACKFILL
Description Amount
APPLICATION FOR PAYMENT 42 94,573.17
THANK YOU FOR YOUR BUSINESS
Total $94,573.17
Prescribed by Slate 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
a V9 i12 Purchase Order No.
4 /0 �G Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
C 5 �i �'TSfq P f�/ S 7�r 1, 7
s�
b i
�1
1
J
Total
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same i accordance
r tk with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED
IN SUM OF
99y� s o� o V
0/ 7
73.i7
ON ACCOUNT OF APPROPRIATION FOR
0,�73
Board Members
DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
9vz Z y��� 73 y 57.E l7 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
0 g
Si ture
Direcor of Oper
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Document G702"' -1992
Application and Certificate for Payment
TO a4YhER G 4 F ekq a PROJECT; L 7 eme L APWCATIO?f N(} won to:
PERIOD TO: y/- aX 0 5 (MNE3t E�
CONTRACT F()P, l AR C UMCT:
FROM VIA CONTRACT DATE:
CONTRACTtarZ: 2r/hc_ 3� ARClliT:CT: PROJECT NOS: CotiTRACit)R p'
FIELD: C)
G 9 p, spa o GvJSI` Cam'
�i Ul2 07HEIL❑
CONTRACTOR'S APPUGATION FOR PAYMENT T= und=m Cm== tam U14 tD d1t best of the C*=&= S b3owiedgr- inia�
and bchd the Wort covered by this Applxz* m far Pa),= has bean mmp]ered w wm dan¢
Apphcaton is made for pay==4 as shown below, fit oo=tc Cvm vmth the Cnuftm wrch the COmtrac! Doc mt mM that 0 arnasmts hm-e bem paid by des Contracmr for Wort fc,
Cnua=am ShccL AIA Documml G703, is aL wbed. '%ti(h pm Cat6ca¢cs for Nyment UTre issued and payments rxei zd ftntn the Ow=, sad
1. CRrO iU CONTRACT SUM S 9 9 Ow c== paymcni shotsn brrein is now dnv-
2. Net change by Cttange Orders 5 O DOKTRACTt►
3. CONTRACT SUM TO DATE (line 1 t 3)---- S S. 94 By DCu �j O2 D=:
4. TOTAL COWL= b STORM D TO DATE (C Imm G Om G7G3) S 62, 70 0 Ste of
5, rZETAWAG£: CamUyoF In 174 "V
a /0% of Complemd Wca9c c cS e tmd swr w before L 1 o D S
(ooh mtD +EooG IW) S 6• 70 =the 2 -2— d; of A
b. l? of Slorai Material
(ColnrznFonG (13) S No
7o�i R era rag (I.inees 5a 5`u «Total in Cahmm.l of 0+703)_ S 6; z -2 0 MY
fi, TOTAL EARNE) LESS TZETAINAGE S SE4, c/30 ARCHITECT'S CE MFICATEFORPAYMENT
(Ant 4 E .CSS line 5 Tots!) In 79 cca dmot wish the Conran Do= mts, based on as site otucttarioas and the 3xta oou;=ng
7. LESS PREVIOUS CERTMATES FOR PAYMENT S this .,1he A-hu a =ff= to the Ov6= t hat to iht best of the Amhiteci's bumledgm,
(lire 6 from pnor CafXxwr) mformaLm ansl belief the Wort bas prog=cd as mfficzwcd the gm1ky of the Wow is m
-Dancer= —1h the Cameras DocaQSxam Md the Ca=w= is ec=kd to paymcut of the
IL CURRENT PAYMERT DUE 5 S jI1 Abf0I7NTCE RTTF1]ED-
!L BALANCE TO FNMFs IMaJJD@GRETAINACsE ANOWCERTMtED.��_ S S& 4W t~
(fine 3 less line S l 76 g J U (A t -YrU c,d Viers from the anwxd gptcd &idalaUf on this
Applic� mid Canri7uran Shea dim arc drmrgcd m a4b= wuh the d rw= mr4k&)
`M ORDER SUMM.MARY ADDIM0.115 DI=DUCTSD: LS ARCMTE T: l j
oW tied m ims ttromlis O S s By- v D=
ow -i this NiOC6 S S
Corals s d 1 This Cafi&= is sot negouahlr- Ibr AMOUNT CE_R'IM D is MMbk Only w d. C=I.=
Et CETAN GF_S b _Pe OrO3cr S v o ranzid hmmin tsmmnr- paymc>tt and act�m
tcc of paymtar ere aztbom ptcju&m to rmy rights of
me Own= ac coauu= Mvi this Ck0t xt
ALA D=mncrd G7Z t ttXL Ca"r#ytet Q 1952 ad 19SZ by 11v Aim ksEal& ri Artt Ai rs;sts re%E wmL C4At3r.ZLZG: Th1s s,1 a :)0cvn 4 to gry -c1vd by U.S. Cc p;TWI Loa' and
kY"�r Trdu. reprv=cran cc disTMltataij vl ALA` Dcur-avQ a axy Por dcn of iL riy fez& Cr �^�r�s c!�!! 2M a1M!;W �Z�2s. and va Ea prosac'�Y to tie ED
�'TC
extzm p9 to der Mo tan. Th s d en bras by AA Lail -r,. E t 09'29:19 on Q&-Z 2 M trdar 0.10 HcOOW12124-8 2 eNs
�w cn sfm)05. and h r no resle. a
LLxa FtoEr_L
CONTINUATION SHEET AIA DOCUMENT C70 (Instructions on reverse side) PA"E OF PAGES
AIA Document G702, APPLICATION AND CERTIF :CATE FOR PAYMENT, containing APPLICATION NUMBER:
Contractor's signed Certification is attached. APPLICATION DATE:
In tabulations below, amounts are stated to the nearest dollar. PERIOD TO:
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:
A B C D E F C H I
ITEM DESCRIPTION OF WORK
;HEDULED WORK COMPLETED MATERIALS TOTAL h BALANCE RETA!tiACE
NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G C) TO FINISH
APPLICATION STORED AND STORED IC z G)
(D E) (NOT IN TO DATE
D OR (D +E +F)
1j Z2 p�.�,o� �yoa G X700 o y7 s i:4 0 y2o
7
gso c U a o 0 o G�S Gb
ci
X3
�760 e-1
AIA DOCUMENT 0703 APPLICATION AND CERTIFICATE FOR PAYMENT MAY 1983 EDITION AIA• 1983
THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006 6703 -1983
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
c `��c�y'//' c Purchase Order No.
9 95'4 /Oao Terms
6 t /v yCo 61 7 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I 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
20 6
Dire&g g ratio ns
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund