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Home My WebLink About168593 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 00351429 Page 1 of 1 ONE CIVIC SQUARE M .K. BETTS ENGINEERING INC CHECK AMOUNT: $124,924.74 CARMEL, INDIANA 46032 ANDERSON IN 46018 CHECK NUMBER: 168593 CHECK DATE: 2/4/2009 DEPARTMENT ACCOUNT P NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 654 R5023990 S10726 14 124,924.74 CONSTRUCTION I A PPLICATION AND CERTIFICATE FOR PAYMENT AIA DOC UMENT 6 702 (Instructions on reverse side) RACE ONE OF PAGES TO (OWNER): City of Carmel PROJECT: Blower /Electrical Modification APPLICATION NO: Fourteen( 1 Pi)stribution to: One Civic Square Contract 60 E. OWNER Carmel, IN 46032 PERIOD TO: 12 -31 -08 C ARCHITECT CONTRACTOR FROM (CONTRACTOR): VIA (ARCHITECT): ARCHITECT'S C M. K. Betts Engineering PROJECT NO: C Contracting, Inc.. CONTRACT FOR: Invoice No. 07 -262. 14 CONTRACT DATE: is made CONTRACTOR'S APPLICATION FOR PAYMENT Continuation n Sheet, Doc ument G703niss att ched connection with the Contract. CHANGE ORDER SUMMARY 1. ORIGINAL CONTRACT SUM `6 2, 349 ,000.00 Change Orders approved in I ADDITIONS DEDUCTIONS 2. Net change by Change Orders 295,205.00 previous months by Owner 3. CONTRACT SUM TO DATE (Line 1 2) 2, TOTAL 4. TOTAL COMPLETED STORED TO DATE 2, Approved this Month (Column G on G703) Number Date Approved 5. RETAINAGE: CO# 1 a. of Completed Work $302 815.00 7,610.00 (Column D E on G703) b. of Stored Material (Column F on G703) Total Retainage (Line 5a 5b or TOTALS $302 7,610.00 Total in Column I of G 703) 132,210.25 Net than e by Change Orders $295,205.00 6. TOTAL EARNED LESS RETAINAGE 2 161 218.60 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 Certificate) 2 036 293 .86 paid by the Contractor for Work for which previous Certificates for Payment were 8. CURRENT PAYMENT DUE S 124 issued and payments received from the Owner, and that current payment shown 9. BALANCE TO FINISH, PLUS RETAINAGE 482,986.40 herein is now due. (Line 3 less Line 6) CONTRACT M. K. Betts Engineering Contracting, Inc. State or Indiana County of: 1`ladison Subscribed and sworn to before me this 31st day of Dec. 2008 Notary Pub Ii Bv- Date: December 31, 2008 My Commission expires: October 28 2015 ARCH ECT'S 4 FOR PAYMENT AMOUNT CERTIFIED...... cer b (Attach explanation i amount t cer certified d iffers iirers from rom t he amount applied roc) In accordance with the Contract Documents, based on on -site observations and the ARCHITECT: 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 Bv: -Date: S indicated, the quality of the Work is in accordance with the Contract Documents, and This Certificate is not negotiable. The AINIOUNT CERTIFIED is payable only to the the Contractor is entitled to payment or the AMOUNT CERTIFIED. Contractor named herein. Issuance payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT 6702 .-�PPLICATK-N AND CERTIFICATE. FOR PAY.VE,N'T AWAY NHi EDITION .AIA' c 1981 THE vCTlri:lr r iF :R( HIIF(:T'; t'; l°. aiw �.•F`;I:I .,'.nr:GTi7 U i �iu i,. (,711"3 19ti1 CONTINUATION SHEET AIA D OCU M E NT 0703 Ca rmel Contract 6 0 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Fourteen 14) Contractor's signed Certification is attached. APPLICATION DATE: December 31 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 12 -01 -08 Use Column I on Contracts where variable retainage for line items may apply. TO: 12 31 ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED T OTAL COMPLETED ITE,tiI DESCRIPTION OF WORK SCHEDULED This Application lication AND STORED BALANCE RE7AINAGE ^:o. VALUE TO FINISH Previous TO DATE (G =C) Applications Work in Place Stored Materials (D +E+F) (C —G) (not in D or E) 1. Mobilization, Bond Insurance 75,000.00 68,000.00 5,000.00 -0- 73,000.00 98 2,000.00 2. Generator Pad Platfori 40,000.00 40,000.00 -0- -0- 40,000.00 100 -0- 3. Generator 272,000.00 272,000.00 -0- -0- 272,000.00 100 -0- 4. Launder Covers 160,000.00 160,000.00 -0- -0- 160,000.00 100 -0- 5. Switch Gear Building 39,000.00 39,000.00 -0- -0- 39,000.00 100 -0- 6. Masonry 78,000.00 61,800.00 16,200.00 -0- 78,000.00 100 -0- 7. Roofing Sheetmetal 14,000.00 14,000.00 -0- -0- 14,000.00 100 -0- 8. Doors, Frames Hardware 16,000.00 16,000.00 -0- -0- 16,000.00 100 -0- 9. Aeration Tank Work 40,000.00 40,000.00 -0- -0- 40,000.00 100 -0- 10. Valves 1.0,000.00 10,000.00 -0- -0- 10,000.00 100 -0- 11.. Blower Bldg Phase 1 90,000.00 90,000.00 -0- -0- 90,000.00 100 -0- 1.2. Blower Bldg Phase 11 35,000.00 6,128.26 27,871.74 -0- 34,000.00 98 1,000.00 1.3. Pipe Insulation 5,400.00 -0- -0- -0- -0- 00 5,400.00 14. Acoustical Ceilings 21,000.00 -0- -0- -0- -0- 00 21,000.00 1.5. Roll Up Doors 7,100.00 2,367.00 4,733.00 -0- 7,100.00 100 -0- 16. Signs Fire Extinguishers 1,500.00 70- -0- -0- -0- 00 1,500.00 17. Instrumentation 90,000.00 23,121.30 -0- -0- 23,121.30 26 66,878.70 AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA' U 1978 THE Ati', RICAN INSTITUTE OF ARCH4TECTS, 1735 NE� YORK: AVE., N.W.. WASHINGTON. D.C. 23006 G703 1978 •.r t' CONTINUATION SHEET AIA DOCUME 0703 Carmel Contract 60 PAGE OF P AGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Fourteen 14) Contractor's signed Certification is attached. APPLICATION DATE: December 31, 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 12 -01 -08 Use Column I on Contracts where variable retainage for line items may apply. TO: 12 31 08 ARCHITECT'S PROJECT NO: A B C D E F G H I WO COMPLETED TOTAL COMPLETED ITEM DESCRIPTION OF WORK SCHEDULED This Application AND STORED /o BALANCE RETAINAGE `:o. VALUE Previous TO DATE (G G C) TO FINISH Applications Work in Place Stored Materials (D +E +F) C —G) (not inlD or E) 18, Control Commissioning 56,000.00 -0- 0 0 -0- 00 56,000.00 19. Software Allowance 25,000.00 7,552.58 -0- -0- 7,552.58 31 17,447.42 20. HVAC 92,000.00 80,333.00 -0= -0- 80,333.00 88 11,667.00 21. Electrical 1124,000.00 1022,453.97 38,500.00 -0- ,060,953.97 95 63,046.03 22. Painting 13,000.00 8,684.00 -0- -0- 8,684.00 67 4,316.00 23. Miscellaneous 45,000.00 29,000.00 10,500.00 -0- 39,500.00 88 5,500.00 CO#1 Change Order No. 1 1. Eliminate EUH04,5,6 7,61.0.00 7,610.00 -0- -0- 7 100 -0- 2. Suspended Solids Meter 110 4,992.00 4,500.00 -0- -0- 4,500.00 91 492.00 3. PMQII Meter Plant Feed 7,357.00 7,357.00 -0- -0- 7,357.00 100 -0- 4. Addition PMQII Metering 3,445.00 3,445.00 -0- -0- 3,445.00 100 0 5. Misc. Electrical Blower Building 508.00 508.00 -0- =0- 508.00 100 -0- 6. Solar Drying Supplemental Heat 282,955.00 166,500.00 22,120.00 -0- +188,620.00 67 94,335.00 7. Electrical Prat to Aeartion 1,679.00 1,485.00 -0- -0- 1,485.00 89 194.00 AIA DOCUMENT G703 CONTINUATION SHEET APRIL 3978 EDITION AIA'� CU 1978 THE A,t'.ERIC'.N INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.. WASHINGTON, D.C. 1 _0006 G703 1978 CONTINUATION SHEET AIA DOCUMENT G7 PAGE OF P AGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing APPLICATION NUMBER: Fourteen (14) Contractor's signed Certification is attached. APPLICATION DATE: December 31 2008 In tabulations below, amounts are stated to the nearest dollar. PERIOD FROM: 12 -01 -08 Use Column I on Contracts where variable retainage for line items may apply. TO: 12 31 -08 ARCHITECT'S PROJECT NO: A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED TOTAL COMPLETED This Application AND STORED ea BALANCE RETAINAGE o. VALUE Previous TO DATE jG C TO FINISH Applications Work in Place Stored Materials Ip +E +Fl (C—G) (not in D or E) 8. Remove Concrete Lining Aeration Tank #10 500.00 500.00 -0- -0 500.00 100 -0- 9. Condenser Support Trenwa 1,185.00 1,185.00 -0- -0- 1,185.00 100 -0- 10. Metal Halide Lights Fixture "C" 194.00 194.00 -0- -0 194.00 100 -0- 2644,205.00 2168,504.11 124,924.74 -0- 2293,428.85 87 350,776.15 132,210.2 AIA DOCUMENT G703 CONTINUATION SHEET APRIL 1978 EDITION AIA'' U 1978 THE A,.;ERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 2000, G703 1978 Prescribd by (Rev. Fi ACCOUNTS PAYABLE VOUCHER rm N 301 1995) TO ADDRESS Invoice Date Invoice Number Item Amount 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 ,19 Signature Title 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. 19 i r Title J r Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS SANITATION DEPARTMENT ACCT. CARMEL, INDIANA No. Favor Of Total Amount of Voucher Deducti ns Amount of Warrant Month of 19 Acct. VOUCHER RECORD No. Collection System Operation Plant Commercial General Undistributed Ir Construction Depreciation Reserve Stock Accounts Merchandise Total Allowed Board Members Filed ROYCE FORMS •SYSTEMS 1- 800 -382 -8702 325