HomeMy WebLinkAbout175899 08/06/2009 CITY OF CARMEL INDIANA VENDOR: 356934 Page 1 of 1
ONE CIVIC SQUARE SIGNATURE CONSTRUCTION LLC
CHECK AMOUNT: $71,803.45
CARMEL, INDIANA 46032 720 3RD AVE SW
CARMEL IN 46032 CHECK NUMBER: 175899
CHECK DATE: 816/2009
DEP A CCOUN T PO NUMBER INVOICE NUMBE AM OUNT D ESCRIPTIO N
902 4460920 1 7,635.94 GENERAL SITE ENGINEER
902 4460919 1.1 9,600.12 RESIDENTIAL LOFTS /RET
902 4460918 1.2 9,600.13 THEATER SUPPORT SPACE
902 4460916 1.3 7,635.94 SITE UTILITY WORK
902 4460913 1.4 15,464.15 GARAGE /PARKING STRUCT
902 4460911 1.5 7,635.93 MAIN THEATER
4460921 1.6 9,600.13 UNDERGROUND DETENTION
a 902 4460805 4 4, 190.69 RETAIL SITE #5
902 4460867 8 440.42 INDIANA DESIGN CENTER
APPLICATION AND CERTIFICATION FOR PAYMENT A/A vocuMENTG702 PAGE ONE OF 2 PAGES2
TO OWNER: CRC at City of Carmel PROJECT: Carmel City Phase 7C -9 Residi APPLICATION NO: invoice I I Distribution to:
One Civic Square Signature costs =OWNER
Carmel Indiana 46032 ARCHITECT
PERIOD TO: 06/22/2009 =CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design
Signature Construction Services LLC
720 3rd Avenue S.W. PROJECT NOS:
Carmel, Indiana 46032
CONTRACT FOR: CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best ofthe Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet, AIA Document 6703, is attached. 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.
I. ORIGINAL CON 'I RAC 'I SUM S 9,600.12
2. Net change by Change Orders 0.00 CONTRACTOR:
3. CON'I'KAC'1' SUM 10 DATE (Line 1 ±2)
4. '1 O'TAL COMPLETED K S'I'OKED'1'O
By: a�f,� Date: Z ,7, U�
5. RE'I'AINAGE: t e warne,Vice President
a. 0 otCompleted Work 0 Subscribed and sworn to before me this a 1 day of June, 2009
TC D E on 0703) aJP'
b. of Stored Material NOTARY LINDA BUCHANAN
20. Hancock County
o umn r' on 6703) SEAL My Commission Expires
i otai tcetamage (Lines �,a Do or '•'EOdi August 20, 2011
Total in Column I of G703) 0.00 ,r
6. TOTAL EARNED LESS RE'IA1NAGE 9 In accordance with the Contract Documents, based on on -site observations and the data
(Line 4 Less Line 5 'Total) comprising the application; the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CEK'I'IFICA'I'ES FOK Architect's knowledge, intormation and belief the Work has progressed as indicated,
PAYMENT (Line 6 from prior Certificate) 0.00 the quality of the Work is in accordance with the Contract Documents, and the Contractor
S. CURRENT PAYMENT' DUE S 9,600.12 is entitled to payment of the AMOUNT' CERTIFIED.
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6) AMOUNT' CERTIFIED
(Attach ex4aon amount certified differs from tee anunmt upplied. Initial all figures on this
ota changes approve Applicatio Conti ar bn Sheet then a n re changed to cunjori with the umounr certified.) in previous months by Owner ARCHI'TE
Total approved this Month By: Date: 6 3 0
TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
l 01 llac LUi uameu uciciu. issuance, payuicui auu nccepmucc Ui payuicui a1c wuuuui
NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
SIGNATURE CONSTRUCTION LLC
720 3rd Avenue, S. W.
Carmel, Indiana 46032
Invoice 1
6/22/09
Carmel City Phase 7C -9 Residential Lofts
Carmel, Indian
WORK BALANCE
I COMPLETED RETAINAGE PREVIOOS TOTAL COMPLETED TO ORIG INAL BUDGE Co mmitted
DESCRIPTION THIS PERIOD WITHHELD APPLICATIONS TO DATE FINISH BUDGET ADJUSTMENTS Cost
General Requirement:
Testing and Inspecting 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Project Management 0.00 0.00 478.92 0% 0.00 478.92 478.92
Site Supervision 0.00 0.00 6,066.41 0% 0.00 0.00 6,066.41 6,066.41
Site Safety Director 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Design Drawings 0.00 0.00 1 0% 0.00 0.00 1,090.61 1,090.61
Sanitary Facilities 0.00 0.00 0.00 0% 0.00 1600 0.00 0,00
Field Office 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Temporary Electric 0.00 0.00 375.00 0% 0.00 0.00 375.00 375.00
Office Supplies 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Temporary Telecommunications 0.00 0.00 44.59 0% 0.00 0.00 44.59 44.59
Temporary Water 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Tools and Equipment 0.00 0.00 526.48 0% 0.00 0.00 526.48 526.48
Jobsite Trailer 0.00 0.00 1,018.11 0% 0.00 0.00 1,018.11 1,()18.11
Field Engineering and Surveying 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Health and Safety 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Waste Disposal 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Final Clean 0.00 0.00 0.00 T 0% 0.00 0.00 0.00 0.00
Constructin Management Fee 0.00 0.00 0.00 0.00 1 0% 0.00 0.00 0.00 5.00
0.00 0.00 0.00 9,600.12 I 0% 0.00 0.00 9,600.12 9,600.12
I I I
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A AND CER TIFICA TION FOR PAYM ENT AIA DOCUMENTG702 PAGE ONE OF 2 PAGES2
TO OWNER: CRC at City of Carmel PROJECT: Cannel City Phase 7C -6VOG APPLICATION NO: Invoice 4 I 1 Distribution to:
One Civic Square Signature costs =OWNER
Carmel Indiana 46032 ARCHITECT
PERIOD TO: 06/22/2009 =CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design
Signature Construction Services LLC
720 3rd Avenue S.W. PROJECT NOS:
Carmel, Indiana 46032
CONTRACT FOR: CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and beliefthe Work covered by this Application for Payment has been
Contimiation Sheet, AIA Document 6703, is attached, 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.
I. ORIGINAL CON 'I' RAC 'I' SUM 7,635.94
Z. Net change by Change Orders 0.00 CON 'FRAC'FOR:
3. CON 'I' RAC 'I SUM'I'0 DATE (Line I 2)
4. 'f 0 '1'AL COMPLETED STORED 10
By: Date:
5. RE I AINA6E: e V,4n, rest ent
a. 0 of Completed Work 0 Subscribed and sworn to bet ore me this 'i day of June, "2009
o u LINDA BUCHANAN
mn D +Eon 6703)
=aa•• 4i,
b. of Stored Material Hancock County
o
M Commission Expires
umn P on 6703) y p'
I otat tterunage tt.mes �a Do or AugUSt 20, 2011
Total in Column I of G703) 0.00
6. 't'U'I AL EARNED LESS RE AINAGE In accordance with the Contract Documents, based on on -site observations and the data
(Line 4 Less Line 5 Total) comprising the application, the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CL'R'f'IHCA'I'US I�UK Architect's knowledge, information and belief the Work has progressed as indicated,
PAYMENT' (Line 6 from prior Certificate) 0.00 the quality of the Work is in accordance with the Contract Documents, and the Contractor
8. CURKENT PAYMENT DUE is entitled to payment of the AMOUNT' CER'I'IbIED.
9. BALANCE'I'O FINISH, INCLUDINU REI AINAGE
(Line 3 less Line 6) AMOUN'l CEK'flh'IED 4
(Attach explanation J amount certified differs from the amount applied. himal ull figures on this
otal changes approved Application and ontl ,ontinuation Sheet that are changed to conform with the amount certi/ied
in previous months by Owner ARCI-11 'FLC'I': G
Total approved this Month By: .SA—.-- Date: (30�b�1
TOTALS $0.00 $0.00 This Certificate js not negotiable. The AMOUNT CERTIFIED is payable only to the
wuuacwi uanicu ueiau. isauaucc, payuicui auu accclnaucc ui pa) ate wnuuut
NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
i
APPLICATION AND CERTIFICATION FOR P AYMENT A 1 DOCUMENTC702 PAGE ONE OF 2 PAGES2
TO OWNER: CRC at City of Carmel PROJECT: Carmel City Phase 7C -10 Gene APPLICATION NO: Invoice I l Distribution to:
One Civic Square Signature costs =OWNER
Carmel Indiana 46032 =ARCHITECT
PERIOD TO: 06/22/2009 =CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design
Signature Construction Services LLC
720 3rd Avenue S.W. PROJECT NOS:
Carmel, Indiana 46032
CONTRACT FOR: CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best ofthe Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet, AIA Document 6703, is attached. 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.
I. ORIGINAL CON 'I RAC 'I' SUM 7,635.94
2. Net change by Change Orders 0.00 CON 'FKAC'FOR:
3. CON'TRAC'I SUM TO DATE (Line I t 2)
4. 'I'UTAL COMPLETED S'I'OKED'1'0 S 7,635.94
By: Date: Z f/
5. KETAINAGE: Steve Warne,Vice 1 t
a. 0 of Completed Work 0 Subscribed and sworn to before me this >2 day of June, 2009
o umn D+ E on U703)
o. P AY >.'ye LINDA BU EDE
nornar Hancock Cou
TC_oTu_mn F' on G703) My Commission b. of Stored Material Cou I otal Ke[alnage (Lines )a or •ro Au ust 20, 2
Total in Column I of G703) 0.00
6. '1011AL EARNED LESS KETAINAGE In accordance with the Contract Documents, based on on -site observations and the data
(Line 4 Less Line 5 'Total) comprising the application, the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CERT'IFICA'TES FOR Architect's knowledge, information and belief the Work has progressed as indicated,
PAYMENT' (Line 6 from prior Certificate) 0.00 the quality of the Work is in accordance with the Contract Documents, and the Contractor
S. CURRENT PAYMENT' DUE 7,635.94 is entitled to payment of the AMOUN T CEK•IIPIED.
9. BALANCE TO FINISH, INCLUDING KETAINAGE
(Line 3 less Line 6) AMOUNT CEK'I'll -IED 7
(AUuch explmt c if utnoun! certified d Jfers from the uniount uppliecl. in
l all figures on this
ota changes approve Application rn I nil C'u au lion Sheet that are changed to cunfiunt with the uuwura certified.)
in previous months by Owner ARCHI'I' C'I':
Total approved this Month By: l/" Date: /�bC1
TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
wuuacivi naumu ucicau. issuance, Payment Hilo acceptaucc vi paymcui aic wnuuut
NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
SIGNATURE CONSTRUCTION LLC
720 3rd Avenue, S. W.
Carmel, Indiana 46032
Invoice 1
6/22/09
Carmel City Phase 7C -10 Gen Site Engineering
Carmel, Indiana
WORK BALANCE
COMPLETED RETAINAGE PREVIOUS T C OMPLETED TO ORIGINAL BUDGET Co mmitted
DESCRIPTION THIS PERIOD WITHHELD APPLICATIONS TO DATE r FINISH BUDGET ADJUSTMENTS Cost
General Requirement:
Testing and Inspecting 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Project Management 0.00 0.00 478.92 0% 0.00 478.92 478.92
Site Supervision 0.00 0.00 6,066.41 0% 0.00 0.00 6,066.41 6,066.41
Site Safety Director 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Design Drawings 0.00 0.00 1,090.61 0% 0.00 0.00 1,090.61 1,090.61
Sanitary Facilities 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
1 Field Office 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Temporary Electric 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Office Supplies 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Temporary Telecommunications 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.110
Temporary Water 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Tools and Equipment 0.00 0.00 0.00 0`k 0.00 0.00 0.00 0.00
Jobsite Trailer 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
f Field Engineering and Surveying 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Health and Safety 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Waste Disposal 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Final Clean 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Constructin Management Fee 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
I f
C 0.00 0.00 0.00 7,635.94 0% 0.00 0.00 7,635.94 7,635.94
1
I
1
J
APPLICATIO AN D CERTIFICA FOR P AIA DOCUMENTG702 PAGE ONE OF 2 PAGES2
TO OWNER: CRC at City of Carmel PROJECT: Carmel City Phase 1 P 110 APPLICATION NO: Invoice 4 4 I Distribution to:
One Civic Square Signature costs =OWNER
Carmel Indiana 46032 ARCHITECT
PERIOD TO: 06/22/2009 =CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design
Signature Construction Services LLC
720 3rd Avenue S.W. PROJECT NOS:
Carmel, Indiana 46032
CONTRACT FOR: CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. intormation and belietthe Work covered by this Application for Payment has been
Continuation Sheet, AIA Document 6703, is attached. completed In accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work tot which previous Certificates for Payment were issued and
payments received from the Owner, and that current payment shown herein is now due.
1. UKI6INAL CUN'I'KAC'I SUM S 65,896.72
2. Net change by Change Orders 0.00 CON'I'KAC'l 7
3. CONT'KAC'I' SUM FO DATE (Line 1 t 2)
4. '1'UTAL COMPLE'T'ED STURED'1'0 48,421.15 q
By: Date: 6a
5. RETAINAUE: eve Warne, Vice President J
a. 0 of Completed Work 0 Subscribed and sworn to betore me this 'a M day of June, 2009
TC_oFu_m_n D E on 6703)
b. %ot Stored Material op". ?y'•.
LINDA BUCHANAN
o mnn F on 6703 NOTARY
Hancock County
I otal Ketamage (Lines Da )o or i_LSEAL My Commission Expires
Total in Column I of G703) 0.00 t 20,2011
a l- aw;�q
6. '101 AL EARNED LESS RE 'I AINAUE 48,421.15 In accordance with the Contract Documents, based on on -site observations and the data
(Lme 4 Less Line 5 Total) comprising the application, the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CERTIFICATES t•'OK Architect's knowledge, information and beliet the Work has progressed as indicated,
PAYMENT' (Line 6 from prior Certificate) 44,230.46 the quality of the Work is in accordance with the Contract Documents, and the Contractor
8. CURRENT PAYMENT' DUE 4,190.69 is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE 10 FINISH, INCLUDING KE'IAINAGE
(Line 3 less Line 6) AMOUNT' CERI'1FTED If g
(Attach expl uv if conount certified differs from the amount applied. Initial all figures on this
ola changes approve Apph nia and rnlhe Conti ion J'h'et lhut are chunged to confirrrn with the umount cerlified.J
in previous months by Owner ARCHI'I' 'C'I':
Total approved this Month By: Date: d�3�r 09
TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
wnuucwl uuuleu ucicul. Issuance, Payuieuc auu acccp¢mce uI Payulcul U,c %VIUMUI
NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
SIGNATURE CONSTRUCTIO LLC
720 3rd Avenue, S. W.
Carmel, Indiana 46032
Invoice 4
6/22/09
Carmel City Phase 1 P110
Carmel, Indiana
Total Work R ETAINAGE B ALAN C E
Scheduled Completed W ITHHEL D PREVI TOTAL COMPLETED TO
DESCRIPTION Value This period THIS PERIOD APPLICATIONS TO DATE FINISH
Gen Requ irement:
Testing and Inspecting 3,000.00 1,387.51 0.00 0.00 1,387.51 46% 1,612.49
Project Management 6,000.00 0.00 0.00 5,932.81 5,932.81 99% 67.19
Site Supervision 16,153.85 2,159.05 0.00 15,902.85 18,061.90 112% (1,908.05)
Site Safety Director 1,333.33 0.00 0.00 0.00 0.00 0% 1,333.33
Design Drawings 5,000.00 644.13 0.00 594.80 1,238.93 25% 3,761.07
Sanitary Facilities 1,248.00 0.00 0.00 0.00 0.00 0% 1,248.00
Field Office 1,512.00 0.00 0.00 0.00 0.00 0% 1,512.00
Temporary Electric 225.00 0.00 0.00 0.00 0.00 0% 225.00
Office Supplies 225.00 0.00 0.00 0.00 0.00 0% 225.00
Temporary Telecommunications 225.00 0.00 0.00 0.00 0.00 0% 225.00
Temporary Water 225.00 0.00 0.00 0.00 0.00 0% 225.00
I Tools and Equipment 600.00 0.00 0.00 0.00 0.00 0% 600.00
Project Signage 100.00 0.00 0.00 0.00 0.00 0% 100.00
Field Engineering and Surveying 5,000.00 0.00 0.00 0.00 0.00 0% 5
Health and Safety 1,000.00 0.00 0.00 0.00 0.00 0% 1
Waste Disposal 1,083.75 0.00 0.00 0.00 0.00 0% 1,083.75
Final Clean 1 0.00 0.00 0.00 0.00 0% 1
Constructin Management Fee 21,965.79 0.00 0.00 21,800.00 21,800.00 99% 165.79
65,896.72 4,190. 69 00 44,230.46 48,421.15 1 73't 17,475.57
1
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APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 1 PAGES
TO OWNER: Carmel Redevelopment Commission PROJECT: Parcel 67 APPLICATION NO: Draw�Nutnber #8 1 Distribution to:
One Civic Square City Project 26236 Signature costs =OWNER
Carmel Indiana 46032 Robert Indiana Street Work ARCHITECT
PERIOD TO: MOP /22/2009, =CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: 0 4
Signature Construction LLC
720 3rd Avenue S.W. PROJECT NOS:
Carmel, Indiana 46032
CONTRACT FOR: CONTRACT DATE: October, 2008
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet, AIA Document G703, is attached. 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.
1. ORIGINAL CONTRACT SUM 30,460.00 0
2. Net change by Change Orders CONTRACT
3. CONTRACT SUM TO DATE (Line I t 2) 30,460.00
4. TOTAL COMPLETED STORED TO DATE 28,366.26
By: Date: Z_ �0
5. RETAINAGE: teve arse Vice President
a. 0 of Completed Work Subscribed and sworn to before me this _tea day of 6�0
(Column D E on G703)
b. of Stored Material "�P P a LINDA BUCHANAN
Column F on G703 .'NOTARY'.
*�A� Hancock County
is
Total Retainage (Lines 5a 5b or s. S� My Commission Expires
Total in Column I of G703) 0.00 ARCHITECT'S CERTIFICATE FOR PA. Pd /Augus
6. TOTAL EARNED LESS RETAINAGE 28,366.26 In accordance with the Contract Documents, based on on -site observations and the data
(Line 4 Less Line 5 Total) comprising the application, the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge, information and belief the Work has progressed as indicated,
PAYMENT (Line 6 from prior Certificate) 27,925.84 the quality of the Work is in accordance with the Contract Documents, and the Contractor
8. CURRENT PAYMENT DUE 440.42 is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH, INCLUDING RETAINAGE 2,093.74
(Line 3 less Line 6) AMOUNT CERTIFIED 440.42
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach exp ?nati n if a ce rtified differs from the amount applied. Initial all figures on this
Total changes approved Applicati n nthe onti uation et that are changed to conform with the amount certified.)
in previous months by Owner ARCHI E
Total approved this Month By: Date: MID J-
TOTALS $0.00 $0.00 This CertiVc to is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
NET CHANGES by Change Order L $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT G702 -APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 01992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006 -5292
Users may obtain validation of this document by requesting a completed AIA Document D401 Certification of Document's Authenticity from the Licensee.
City of Carmel
Parcel 67 Streetscape Indiana Design Center P12
City Project Number 26236 Robert Indiana Street Work
Budget Review and Distribution Request #8
Period Ending May 22, 2009
PROJECT BUDGET REVIEW SUMMARY
TOTAL WORK THIS PERIOD Current BALANCE Total
Scheduled COMPLETED RETAINAGE Payment PREVIOUS TOTAL COMPLETED TO Retainage
DESCRIPTION Value THIS PERIOD WITHHELD Due APPLICATIONS TO DATE FINISH Held
General Conditions /Requirements 46,150.00 0.00 0.00 0.00 45,688.50 45,688.50 99% 461.50 2,284.43
Existing Conditions /Selective Demo 8,770.00 0.00 0.00 0.00 8,770.00 8,770.00 100% 0.00 438.50
Concrete 24,430.00 0.00 0.00 0.00 24,430.00 24,430.00 100% 0.00 1,221.50
Meltal 2,190.00 0.00 0.00 0.00 2,190.00 2,190.00 100% 0.00 109.50
Specialties (signage) 5,570.00 5,570.00 0.00 5,013.00 0.00 5,570.00 100% 0.00 278.50
Electrical 41,640.00 0.00 0.00 0.00 41,223.60 41,223.60 99% 416.40 2,061.18
Earthwork 41,500.00 0.00 0.00 0.00 40,877.50 40,877.50 99% 622.50 2,043.88
Exterior Imporvements 70,650.00 0.00 0.00 0.00 68,883.75 68,883.75 98% 1,766.25 3,444.19
owner allowance credit (2,510.00) (2,510.00) 0.00 (2,510.00) 0.00
Utilities 63,700.00 0.00 0.00 0.00 63,700.00 63,700.00 100% 0.00 3,185 -.00
101 Signature's General Conditions 15,104.50 287.42 0.00 287.42 13,137.67 13,425.09 89% 1,679.41 0..00
124 Signature's Profit Overhead t3312,299.00 5,104.50 153.00 0.00 153.00 14,788.17 14,941.17 99� 163.33 0.00 r Total 3,500.42 0.00 2,943.42 323,689.19 329,699.61 99% 5,109.39 15,066.67
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUA4ENTC702 PAGE ONE OF 2 PAGES2
TO OWNER: CRC at Citv of Carmel PROJECT: Carmel City Phase 7C -8 Tent c APPLICATION NO: Invoice n I 1 Distribution to:
One Civic Square Signature costs OWNER
Carmel Indiana 46032 �ARCHITECT
PERIOD TO: 06/22/2009 =CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design
Signature Construction Services LLC
720 3rd Avenue S.W. PROJECT NOS:
Carmel, Indiana 46032
CONTRACT FOR: CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Application for Payment has been
Continuation Sheet, AIA Document 6703, is attached. completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor tar Work for which previous Certificates for Payment were issued and
payments received from the Owner, and that current payment shown herein is now due.
I. ORIGINAL CON 'I'KACf SUM 9,600,13
2. Net change by Change Orders 0.00 CON'FKAC'I'OR:
3. CUNTRAC F SUM'1'O DA'Z'E (Line 1 t 2) 9
4. TOTAL COMPLETED STORED 10
By: Date: Z O
5. KE'FAINAUE: teve arne, ice President
a. 0 of Completed Work 0 Subscribed and sworn to betore me this a2 day of June, 2009
o umn D E on 0703) a'�a ryB LINDA BUCHANAN
b. of Stored Material �T Hancock County
o umn F on G703) SEAL My Commission Expires
otal K Da (Lines )n or 1
9 `O Allan t 20, 2011
Total in Column I ofG703) 0.00
6. 'IO I'AL EARNED LESS Rb'TAINAGE 9 In accordance with the Contract Documents, based on on -site observations and the data,
(Line 4 Less Line 5'1'otal) comprising the application, the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CEK'I'IFICA'I'ES FOR Architect's knowledge, information and belief the Work has progressed as indicated,
PAYMENT' (Line 6 from prior Certificate) 0.00 the quality of the Work is in accordance with the Contract Documents, and the Contractor
8. CUKKEN'I' PAYMENT DUE 9,600.13 is entitled to payment of the AMOUNT CLK'I'IHED.
9. BALANCE 10 FINISH, INCLUDING RE'FAINAGE
(Line 3 less Line 6) AMOUNT CEK'I'IFIED G
(Attach eeplunuli r amount cert vied differs from the amount applied. Initial all figures oil this
ota changes approve Application a onlh Catalina ton )'heel that ure changed to conform with the untount cerlilied.J
in previous months by Owner ARCHI'I'EC'
Total approved this Month By: C v Date: 0
TOTALS $0.00 $0.00 This Certificate is Aot negotiable. The AMOUNT CERTIFIED is payable only to the
wuu acwt "a eu IIet CIII.'s,u,ol payinclit auu acccptaucc ut payment ate wnuuut
NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
SIGNATURE CONSTRUCTION LLC
720 3rd Avenue, S. W.
Carmel, Indiana 46032
Invoice 1
6/22/09
Carmel City Phase 7C -8 Tent Space 2 Theater Support
Carmel, Indiana
WORK BAL
COMPLETE RETAINAGE PREVIOUS TOTAL COMPLE T ORIGINAL BUDGET Committed
DESCRIPTION THIS PERIOD WITHHELD APPLICATIONS TO DATE FINISH BUDGET ADJUSTMENTS Cost
General Requirement:
Testing and Inspecting 0.00 0.00 0.00 0% 0. 00 0,00 0.00 .(A
Project Management 0.00 0.00 478.92 0% 0.00 478.92 478.92
Site Supervision 0.00 0.00 6,066.41 0% 0.00 000 6,066.41 6,066,41
Site Safety Director 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
1 Design Drawings 0.00 0.00 1,090.61 0% 0.00 0.00 1,090.61 1,(1')11.(,1
Sanitary Facilities 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Field Office 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Temporary Electric 0.00 0.00 375.00 0% 0.00 OAO 375.00 375,00
Office Supplies 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Temporary Telecommunications 0.00 0.00 44.59 0% 0.00 0.00 44.59 44.59
Temporary Water 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Tools and Equipment 0.00 0.00 526.49 0% 0.00 0.00 526.49 526.49
Jobsite Trailer 0.00 0.00 1,018.11 0% 0.00 0.00 11018.11 1,018.11
Field Engineering and Surveying 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Health and Safety 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Waste Disposal 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Final Clean 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
Constructin Management Fee 0.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00
0.00 0.00 0.00 9,600.13 0% 0.00 0.00 9,600.13 9,600.13
1
L
f
APPL
TO Owl APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 2
TO OWNER: CRC at City of Carmel PROJECT: Carmel City Phase 7C -I Main APPLICATION NO: Invoice 1 1 Distribution to:
One Civic Square Signature costs =OWNER
FROM i Carmel Indiana 46032 ARCHITECT
DESCRIPTION
PERIOD "I'O: 06/22/2009 =CONTRACTOR
General Eequiremeot: FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design
Testing and Inspecting
Project Management Signature Construction Services LLC O
CONTI site supervision 720 3rd Avenue S.W. PROJECT NOS:
site Safety Director Carmel, Indiana 46032
CON Design Drawings CONTRACT DATE:
Applicat
sanitary Facilities CONTRACT FOR'.
Field Office
Connnn: Tempos CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
office supplies Application is made for payment, as shown below, in connection with the Contract. information and beliet the Work covered by this Application for Payment has been
Temporary T elecommunication[ Continuation Sheet, AIA Document 6703, is attached. completed in accordance with the Contract Documents, that all amounts have been paid by
Temporary Water
1. Oltl( Tools and Equipment the Contractor for Work for which previous Certrticates for Payment were issued and
2. Net Jobsite Trailer payments received from the Owner, and that current payment shown herein is now due.
3 CO Field Engineering and Survey
4. 'tOI Eealth and safety 1. UKIGINALCUN'fKAC'1 SUM 7,635.93
waste Disposal 2. Net change by Change Orders 0,00 CON 'I'KAC'IUK.
Final Clean 3. CON 'I RAC)' SUM '1'0 DATE (Line 1 t 2) 7,635- 93
5, KE'1 Conseructin Management Fee
4. "I'U1'AL CUMPLt- I'ED 8 S "I'UKED'I'U 1,635.
E a.
r Py'. Date: Z Q
t b I 5. REI'AINAGE. eve arne, Vice President
a. 0 of Completed Work U Subscribed and sworn to before me this as day of CD June, 2009
o utin D E on 0703)
kA. a LINDA BUCHANAN
b. of Stored Material
r Hancock County
rgrna
o umn F on G703) MY Commission Expires
6. '1'U" t otai t<etainage tunes �,a �u or
0, 2011
Total in Column 1 of G703) 0.00
7. LE:
6. '1'O'I'AL EARNED LESS KE'I'AINAGE S In accordance with the Contract Documents, based on on -site observations and tf e data
PA (Line 4 Less Line 5 'fetal) comprising the application, the Architect certifies to the Owner that to the best "ot.'ttre
8. CU
7, LESS YKEVIOUS CEK'I'IFICA'I'ES FUK Architect's knowledge, information and belief the Work has progressed as indicated,
1) EA
PAYMENT (Line 6 from prior Certificate) S 0.00 the quality of the Work is in accordance with the Contract Documents, and the Contractor
8. CURRENT PAYMENT DUE S /,635.93 is entitled to payment of AMOUNT CEK'I IF (ED.
9. BALANCE 10 FINISH, INCLUDING RE 'I AINAGE
o (Line 3 less Line 6) AMOUNT CEK'11FIED 7
ml
t (Allach expinnufion if cu un cer•ItJied oil Jers frunr the unxuml app /red. lnilial all figures on this i To
ota changes approve Appliculion and onth Con(i nation INut are changed to conform with the umuunr cerliJied.J
TC m previous months by Owner ARCHI'I EC 1:
Total approved this Month By: 0_1_� Date:
NI
TO'T'ALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
�mniacwi uawcu neimu. issuance, paymcutauu accepiducc m Paymmu are wuuout
NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract.
4:
krescrib by State Board of Accounts
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL oice 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
',r�c /.'o,� �C Purchase Order No.
720 �i�/� S. �U Terms
C� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9 67
L l //0
I2 210- ?c —/0 76`3x
6 122/6 9 �O 7c g
6/2 2 9 1,2
%C _G 7 3s g5'
(�12 2, Y 7C -3
6/203 /,s
9 13
Total 7(8a3 -`/S
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
Y`. KR NO. WARRANT NO.
ALLOWED 20
IN SUM OF
720
7
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
9erL 4�Go8G 7 Yo yz bill(s) is (are) true and correct and that the
�T S�y�GJ'os '1 materials or services itemized thereon for
P60 7,(,3519y which charge is made were ordered and
1 d 1 -V&6W� 16o i2 received except
Z/ 116 0 g/�
7 63 Srs'
20
am /S a�
2
o, APB
99 1)
Si
Director of Oper ations
)ution ledger classification if
Title
.t motor vehicle highway fund