The URL can be used to link to this page

Home My WebLink About171085 04/16/2009 ,a f CITY OF CARMEL, INDIANA VENDOR: 356934 Page 1 of 1 r ONE CIVIC SQUARE SIGNATURE CONSTRUCTION LLC CARMEL, INDIANA 46032 720 3RD AVE SW CHECK AMOUNT: $7,184.32 CARMEL IN 46032 o CHECK NUMBER: 171085 CHECK DATE: 411612009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460805 1 6,207.44 RETAIL SITE #5 902 4460807 5 33.50 PERFORMING ARTS CENTE 902 4460867 5 943.38 INDIANA DESIGN CENTER a. s APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 1 PAGES TO OWNER: Carmel Redevelopment Commission PROJECT: Parcel 67 APPLICATION NO 1 Distribution to: One Civic Square City Project 26236 Signature costs =OWNER Carmel, Indiana 46032 Curb Construction =ARCI- IITECT PERIOD TO: q 03/23/09 =CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: 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 undersi Contractor certifies that to the best of the Contractor's knowled 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 2,205.00 2. Net change by Change Orders 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE (Line 1 t 2) 2,205.00 4. TOTAL COMPLETED STORED TO DATE 2,171.50 By: Date: 3 Z 5. RETAINAGE: Tom Koo Pres dent a. 0 of Completed Work Su scribed sworn to before me this day of (Column D E on G703) b. of Stored Material (Column F on G703) Total Retainage (Lines 5a 5b or Total in Column I of G703 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE 2,171.50 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) 2,138.00 the quality of the Work is in accordance with the Contract. Documents, and the Contractor 8. CURRENT PAYMENT DUE 33.50 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE 33.50 �I (Line 3 less Line 6) (w AMOUNT CERTIFIED 33.50 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Total changes approved Application and he C nuation Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHTTEC" Total approved this Month By: Date: 09 TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named neretn. 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 ®1992 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. 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 Purchase Order No. 72 Gr�G��a�P Ski Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3 /z 31 Total 33 5 0 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 �ij0 C�� c� ZL IN SUM OF 2 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT EPT. her certi I hb that the attached invoice or D 'Y a0 2 5 -Y6 7 5o 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 Si;are Title Cost distribution ledger classification if claim paid motor vehicle highway fund APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 1 PAGES TO OWNER: Carmel Redevelopment Commission PROJECT: Parcel 67 APPLICATION NO Draw;N44er, #5 1 Distribution to: One Civic Square City Project 26236 Signature costs =OWNER Carmel, Indiana 46032 Rangeline StreetScapes =ARCHITECT PERIOD TO: I= f 03%23/09; OCONTRAC "fOR FROM CONTRACTOR: VIA ARCHITECT: 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. I. ORIGINAL CONTRACT SUM 27,015.00 2. Net change by Change Orders 3,232.30 CONTRACTOR: 3, CONTRACT SUM TO DATE ([..me 1 t 2) 30,247.30 4. TOTAL COMPLETED STORED TO DATE 22,921.40 r By: C hate: 5. RETAINAGE: I Koontl President a. 0 of Completed Work Subsc� ibed and vorn to before me this day of (Column D E on G703) b. of Stored Material (Column F on G703) Total Retainage (L,ines 5a 5b or Total in Column I of G703) 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE 22,921.40 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) 22,779.40 the quality of the Work is in accordance with the Contract Documents, and the Contractor 8, CURRENT PAYMENT DUE 142.00 1� is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE 7,325,90 p/ AMOUNT 3 less Line 6) pv AMOUNT CERTIFIED 142.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach esplan n if amount certified differsfrom the amount applied. Initial all figures on this Total changes approved Applicotio and nthe Con uation Sheet that are changed to conform x ith the amount certified.) Pf in previous months by Owner ARCI-II" nCT: tV Total approved this Month By: Date: 3 3r TOTALS $0.00 $0.00 This Certificate 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 $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, DO 20006 -5292 Users may obtain validation of this document by requesting a completed AIA Document D401 Certification of Document's Authenticity from the Licensee. PFescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (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 L.LC Purchase Order No. 720 3�� Sc� Terms 03 Z Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) b 1' Total Oa 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 VOU HER NO. WARRANT NO. ALLOWED 20 IN SUM OF �2D 3- /��P•, s�y /S`2 _U6' ON ACCOUNT OF APPROPRIATION FOR T 0 96 2 /yy� o $G 7 Board Members PO# or D PT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or 4�2 Ae'y�o8 7 ly2.00 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 09 Q" C��)- I n Signa re L� V 6- p4 n�,? Title Cost distribution ledger classification if claim paid motor vehicle highway fund APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES2 TO OWNER City of Carmel Redevelopment Co PROJECT: Carmel City Phase I PI 10 APPLICATION NO Draw Numbe I Distribution to: Signature costs =OWNER =ARCHITECT PERIOD TO: 03125/2009 OCONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design 0 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 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. I. ORIGINAL CONTRACT SUM S 65,730.93 2. Net change by Change Orders S 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE (Line I f 2) 65,730.93 4. TOTAL COMPLETED STORED TO 6,207.47 f rubscibed C Date; 5. RETAINAGE: Koontz, President t� a, 0 of Completed Work 0 d sworn to before me this ry day of December, 2005 (Column D E on G703) K of Stored Material F_ BUCH ANAN County (Column F on G703) .Hancock (9unty Total Retainage (Lines 5a 5b or M y Commission Expires Total in Column IofG7o3) 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT augustzo,2o�1 6. TOTAL EARNED LESS RETAINAGE 6,20T47 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 T LESS PREVIOUS CERTIFICATES 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. CURRENT PAYMENT DUE 6,207.47 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE 59,523.46 (Line 3 less Line 6) AMOUNT CERTIFIED CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach esplan or if amount cert fed differs from the amount applied. Initial all figurer on this Total changes approved 4ppltcntion rd o the Contin tton Sheet that are changed to conform with the amount certified) in previous months by Owner ARCHIT T: /y p Total approved this Month By: Date: Jf-3f V J TOTALS $0,00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor namea herein. issuance, payment and acceptance of payment are without NET CHANGES by Change Order $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 ®1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE.. NW, WASHINGTON, DC 200o6 -529 Users may obtain validation of this document by requesting a completed AIA Document D401 Certification of Document's Authenticity from the Licensee. SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice 1 3/25/09 Carmel City Phase f P110 Carmel, Indiana f WORK BALANCE COMPLETED RETAINAGE PREVIOUS TOTAL COMPLETED TO ORIGINAL BUDGET Committed DESCRIPTION THIS PERIOD WITHHELD APPLICATIONS TO DATE FINISH BUDGET ADJUSTMENTS Cost General Requirement: J Testing and Inspecting 3 ,000.00 0.00 0.00 0.00 0% 0.00 0.00 O.flO 0.00 Project Management 6,000.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Site Supervision 16, 153. 0.00 0.00 0.00 I 0% 0.00 0.00 0.00 0.00 Site Safety Director 1,333.33 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Design Drawings 5,000.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Sanitary Facilities 1,248.00 0.00 0.00 0.0 0 0.00 0.00 0.00 0.00 Field Office 1,512.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Temporary Electric 225.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Office Supplies 225.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Temporary Telecommunications 225.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Temporary Water 225.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Tools and Equipment 600.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Project Signage 100.00 0.00 0.00 0. oo 0% 0.00 0.00 0.00 0.00 Field Engineering and Surveying 5,000.00 0.00 0.00 0.00 0 1 /0 0.00 0.00 0.00 0.00 Health and Safety 1,000.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Waste Disposal 1,083.75 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Final Clean 1,000.00 0.00 0.00 0.00 0% 0.00 0.00 0.00 0.00 Constructin Management Fee 21,800.00 0.00 0.00 6,207 .47 1 28% 15,592.53 21,800.00 0.00 21,800.00 65,730.93 0.00 0.00 6,207. 47 15,592.53 21,800.00 0.00 21,800.00 Y Prescribed by Sate 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 Purchase Order No. 7 2 0 �fUP S.G/ Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3/ 2 o P fi Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in ac ordance with IC 5- 11- 10- 1.6.' 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR ,Xi"l� Board Members INVOICE NO. ACCT #/TITLE AMOUNT DEPT I hereby certify that the attached invoice 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 Signa e ft O Cost distribution ledger classification if Title claim paid motor vehicle highway fund APPLICATION AND CERTIFICATION FOR PAYMENT AJA DOCUMENTG7oz PAGE ONE OF I PAGES TO OWNER: Carmel Redevelopment Commission PROJECT: Parcel 67 APPLICATION NO: Draw Number 45. 1 Distribution to: One Civic Square City Project 26236 Signature costs =OWNER Carmel, Indiana 46032 Robert Indiana Street Work ARCHITECT PERIOD TO: 03/23/09 CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: 0 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 undersi Contractor certifies that to the best of the Contractors knowled 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. L ORIGINAL CONTRACT SUM 30,460.00 2 Net change by Change Orders 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE (Line 1 t 2) 30,460.00 4. TOTAL COMPLETED STORED TO DATE 20,823.93 Byocribedand Date: l �y 5. RE"I'AINAGE: President T a. 0 !a of Completed Work Su m to before me this K day of (Column D E on G703) LINDA SUCH ANAN b. !o of Stored Material TAY Hancock County (Column F on G703) s� My Commission Expires Total Retainage (Lines 5a+ 5b or Total in Column I of G703) 0.00 ARCHITECT'S CERTIFICATE FOR PAYME 6. TOTAL EARNED LESS RETAINAGE 20,823.93 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) 20,022.55 the quality of the Work is in accordance with the Contract Documents, and the Contractor 8. CURRENT PAYMENT DUE 801.38 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE 9,636.07 (Line 3 less Line 6) AMOUNT CERTIFIED 801.38 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explart ro ifamounl certified differs from the amount applied. /initial all figures on this Total changes approved AppliC.or nd 11he Co luaI' Sheet thnt are changed to conform with the amount certified.) in previous months by Owner ARCHIT T: Total approved this Month By: Date: 71 z ([,A TOTALS $0.00 $0.00 This Certificate 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 $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. Presclfbed 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 �j� LGc Purchase Order No. O fir. S. �rJ., Terms �6G 3 2 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) r� w -x Rl� yY Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in acco-rdance with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR Gj� Board Members PO# or DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or gd 6- y1 5 'e.7 39 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 CA i Siignat e Title Cost distribution ledger classification if claim paid motor vehicle highway fund