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HomeMy WebLinkAbout175902 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 00350511 Page 1 of 1 f ONE CIVIC SQUARE SMOCK FANSLER CORP CARMEL, INDIANA 46032 2910 W MINNESOTA ST CHECK AMOUNT: $6,577.30 INDIANAPOLIS IN 46241 CHECK NUMBER: 175902 CHECK DATE: 81612009 DEPARTMEN AC COUN T PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION 902 4460848 5 577.30 4TH GATEWAY /RANGEL,INE APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER ADVISER EDITION AIA DOCUMENT Cr702 /CMa (Ins €ructions on reverse side) PAGE ONF. or PAGtis TO OWNER: City of Carmel PROIEC Carmel Parcel. 48 Gateway Arch APPLICA'FION NO.: 5 Distribution to Les Olds, Director of CRC PERIOD 'T'O: 05/31/09 OWNER One Civic Square PROJECT NOS.: C0NSTRUCTI0N' Carmel, IN 46032 MANAGER FROM CONTRACTOR: Smock Fansler Corp. CONTRACT DATE: 12/23/08 ARCFIITECI 2910 W. Minnesota St. CONTRACTOR Indianapolis, IN 46241 VIA CONSTRUCTION ,NIANAGER: CONTRACT FOR: VIA ARCHITECT: The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- CONTRACTOR'S APPLICATION FOR PAYMENT m ation .and belief the Work covered by this Application for Payment has been completed Application is made for payment, as shown below in connection nrith the Contract. in accordance with the Contract Documents. that all amounts have been paid by the Continuation Sheet, AIA Document G703, is attached. Contractor for Work for which previous Certificates for Payment were issued and pay I. ORIGINAL CONTRACT SUM 71,675 ments received from the Owner, and that current payment shown herein is 11OW due. 2. Net Change By Change Orders. 6,157.44 CONTRACTOR: By: Date: 05/31/09 3, CONTRACT SUM TO DATE ([,me 1 2) S 77,832.44 state of: INDIANA 4. TOTAL COMPLETED &STORED TO DATE S 77,832.44 County of: MORGAN "�RY "`i, (COlmmn G on G702) 0 Subscribed and sworn to before 5. RETAINAGE: me this 31st day of May, 2009 a. of Completed Work (Columns D E on G703) Notary P /f 5�AL ublic: �r 7J b. of Stored Material mmission expires: 11/30/2016 My Co (COIUmiI F on 6703) Tot, Ibtal t in n Columnd of G7U or OrFIND`1PP`\��� CERTIFICATE FOR PAYMENT ieiiilTit 6. TOTAL EARNED LESS RETAINAGE .s 77,832.44 In accordance with the Contract Documents, based on on -site observations and the data (Line 4 less line 5 Total) comprising this application, the Construction ,Manage, and Architect certify to the Owner 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT that to the best of their knowledge. information and belief the Work has progressed as 69 599 rdance with the Contract DOCUmCntS, and (Line 6 from prior Certificate) S .19 indicated, the quality of the Work is in acco the Contractor is entitled to payment of' the AMOUNT CERTIFIED. 8. CURRENT PAYMENT DUE [S: 233 .25 AMOUNT CERTIFIED ..............................5 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanalion i/ amount certified drllers from the arnoimt applied for: Initial (Line 3 less Line 6) S 0.00 6tll on Ibis Application and ozr the Continzicrtion Sheet that abanged to conform to the ,imozint ce)- Q1led.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS CONSTRUCTION MANAGER: Total changes approved in B Date: previous months by Owner 25,450.00 ARCHI'T'ECT: Total approved this Month 19,792.56 19 7 9 2.5 6 By: Date. TO'T' 25,450.00 This Certificate is not negotiable. The AMOUNT CER'T'IFIED is payable onto to the Con NET CH, NGES by Change Order 5,657 tractor named herein. Issuance, pa��ment and acceptance of p:IynlcnC are without prejudice to any rights of the Owner or Connnactor under this Contract. AIA DOCUMENT G7021CMa APPI.ICP:CION AND CF.I2TIFI(:Al'E 1'OR PAYMENT CONSTRUCTION MANAGER- ADVISER EDITION 9 1 99 2 EDITION AIA ©1992 THE AIMERICAN INtirITU1'E OF ARCHITECTS, 1715 NGAK/ YORK AVGNUE, N.W., w Sl1iNGroN, D.0 211orIG -5292 WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 /CMa -1992 s CAUTION: You should use an original AIA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. NSTRUCTUON SHEET FOR /\|A DOCUMENT C70242111x, APPUCAI[OlJAND [EKTH|[AIE FOR P&\MENK C01\ STKDCT\0N 8}|T[0N A. GENERAL INFORMATION Co -�|A uoo/m`m (i7)�/�yx. Apy|icuuooxoJ (�coif c�`' c kyunc n�'moioo NxnxR�/^�.�x'[Uim o x`. is h, '*cd e njunui"u m/b x|x Do/voxx t G703. 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CoumoE:snw,hc,cdbc,x|n*yf:\`rkcoo4inwd x the bmcord`i/zpAicadon.iuc|oUmAcbwwh/"o(mxw/h|,inco,yonucd ,hc pooicu nk|dh wrz |ked.n the pwrk`usupNk,bou under >h'~duk\`n»:udyH,xcd (zAvmu F) Column F: un/,, :~,r m: r�|vc ,.f'uui,zUx pra nd? Smnd [or which [u?mon in ^ougix. Thr now oy the c"\om^ mu// h, ru, prn'x]L This r,|,c "`/c/w hod` m,/chx|s n,v| xo,n\ h`, vhid` Fnwmun 1, SxYm and `x/x.uvh^i`xx.m,/ io.rq^`mu'| xx,`/h, pn4ccl. m&npx!mouo> r|u0xo,rky,x,od/nxo,/uk .hr m,, o*b ill d/uu�000 [^m. /m/ od"mn, Only as mxo,u|;uo inm /hc PnU,o is /b"Ji. ,u|vc Jrdo'/cd {oyo tbi^k:okuuo and i/uo,oryxcd inuouduom Eivrock Cuw[dez,d—Thi` i'c,i"d Co G: sou.'hc* the `"m\"[oo|vmouo. x and R C,|m|,oc WcpcoxwNcu`mp|ucdh?di,iWo:/u|vmn O h;,``iomo C, Co M:Emub(1oUhcdif6rcoc,h,f wcc000|umoC(6,hc&dn1vx|vd and o,|umo0(T'xu/Comp|uoJ and Wood m|}u/,>. Co|umn k 110.nivmu is nom)aU7undon|7k`rum/ume *beu ,xnuN,,uuioue,ix p,,mhnd uux hnc'n,m hxvu", nc*d not bccomp|etcd on pn,iWoS "hc/cx 'on.x:U rcmio,8cisw//hhdu h^^m (he o,cuU cono,ctvwou^' Change Ordem:ahho"W'CbungcuuJo^umWbcowoqx`rxuub;changing die schedule oimiu`S cochumcxch,nglcOrder ivxddu} to thc Pmiro. rki» is not u"/muU? Vouc, [suoU?. Cbougr OWmsurc |io/cdocpxuu|y. rub,, on U'dro*o (1mj Km`` o/urrbcroJ"| the hawkmb,du|o. Ile xmnunt^[/hcooWvu!nx'mnod/uyodhyCh,oW,0moniumhccoor*Jioacxpyx� pby/� kvuumn on m' 6n/ /Cm, huzn Construction Change Directives: \m"uu*mx At di^pu.' rhu/ hx,r ho,o included Al [on^uooxx` cbung'-: ,bootu mo,, (]hxnye 0�us. aux.um/ on`uioioA in UyooMbou|4 hcdcuU *Wh x'o/u|uy m pxmNq`h D. MAKING PAYMENT Thc on,w' "hooN m,k, pu!m,o/ :/^xUV m the (Ao"'oux., based mw umoon' ocn/hoJ h! dhc 'Onumai'm SIxn`Prxm1 A,�hkcoouAu oou'mcm6"u2^CNIxAppx,ouon and (cnixuokr P,y/ncu,.['.nymc/mn Ldxim`. The ouq�('^omm`umnx��d"cmmQ and udd,o^ kit the [ouuocux 9xyn1�ur,*0u14111 hL:n`xd(- mxo�'m|x`Jwn)vuk�,,yu,h`un� /od/cu/*d on 6702/c*x 852 REQUEST FOR PAYMENT DETAIL Proje 080981 CARMEL P ARCEL 48, GATEW AR Invoice: 2582 Draw: APP00005 Period Ending Date: 5/31/2009 Detail Page 2 of 2 Pages Item ID Description Total Previously Work Presently Completed Balance Retainage Contract Completed Completed Stored And Stored Comp To Balance Amount Work This Materials To Date Finish Period 001 MOBILIZATION 5,000.00 5,000.00 5,000.00 100.00 002 CONCRETE 57,675.00 57,675.00 57,675.00 100.00 003 PAINT 4,000.00 4,000.00 4,000.00 100.00 004 LANDSCAPE PAVERS 5,000.00 5,000.00 5,000.00 100.00 005 CHANGE ORDER* 1 25,450.00 5,657.44 19,792.56 25,450.00 100.00 006 CHANGE ORDER 2 19,792.56 19,792.56 19,792.56 100.00 007 CHANGE ORDER 3 500.00 500.00 500.00 100.00 Totals 77,832.44 77,332.44 500.00 77,832,44 100.00 AFFIDAVIT AND 'WAIVER OF LIEN Final [X] Partial [X] Payment to Follow State of Indiana County of Marion T.M. Fansler being duly sworn states that he is the C.E.O. of SMOCK FANSLER CORPORATION having contracted with: City of Carmel to furnish certain labor, materials, and /or services as follows: Misc. Construction for a project known as: SFC #08 -098 Carmel Parcel 48, Gateway Arch 4 located at Carmel, Indiana and does hereby state on behalf of the aforementioned contractor: (PARTIAL WAIVER) that there is due from the owner the sum of: $0.00 receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due from the owner is the sum of $6 5( '7.30) Six Thousand Five Hundred. Seventy Seven Dollars and 30 /100 receipt of which is hereby acknowledged; or [X] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above described property and improvements thereon on account of Labor, Materials, and /or Services, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work performed, materials, or services furnished to the undersigned for said.project, and within the scope of this affidavit and waiver. SMOCK FANSLER CORP. By A itle C.E.O. T.M. Fansler st ������0"� �N RY�llP�U�������i WITNESS MY HAND AND NOTARIAL SEAL, this 31 day of May 2009. .tip, AL Melissa J. Bis op Not Public M commission expires 11/30/2016 Residing in Morgan Count IND�P�o� 0 My P g Y �ai�i�in .,;��,��i�u!il�,!;!;nv�a��` C) PC IINCE 1921 2910 West Minnesota Street Indianapolis, IN 46241.4541 Smock ]Fansler 317.248.8371 Tel C O P OR AT ION General Contrac turs�Engineers�Conslrucdon M—W,, 3 17.244.4507 Fax Date: 5/31/2009 OFFICIAL TRANSMITTAL TO: City of Carmel Redevelopment Commission One Civic Square Carmel, IN 46032 TO WHOM IT MAY CONCERN: We are sending to you the following C oble. 0-8098 Smock Msler Invoice 0-8098 Final Lien Waiver XX REMARKS Please contact Melissa Bishop with questions at Ext. 40 COPY TO: File Please notify us immediately if enclosures are not as noted. Quality Building frotn the Ground Up Since 1921 General Contractors C 2910 West Minnesota Street Engineers Indianapolis, IN 46241.4541 Smock �Fansl�r 11111.248,8371 Fax 317.244.4507 Construction Managers www.smockfansler.com May 31, 2009 City of Carmel Les Olds, Director of CRC One Civic Square Carmel, IN 46032 RE: Application 4 5 To Whom It May Concern: I submitted a revised application 4 with a dollar amount that was less than what was previously billed. You paid on the first billing that was sent to you instead of the revised billing. Therefore, I applied $1,655.95 to our retainage billing invoice which leaves you with a balance due of $6,577.30. Should you have any further questions, please do not hesitate to call me at the number listed above. Thank you, Melissa J. Bishop Accounts Receivable Quality Building from the Ground Up Since 1921 An Equal Opportunity Employer 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 co Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 577 -30 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. n 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 Joe S yy��5'S 57730 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 —/5`20 0.9 Signature Director of Operations Title Cost distribution ledger classification if claim paid motor vehicle highway fund