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Home My WebLink About210177 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 356231 Page 1 of 1 ONE CIVIC SQUARE YARDBERRY LANDSCAPING EXCAVAMK AMOUNT: $21,500.00 CARMEL, INDIANA 46032 9940 SOUTH too WEST o� `o ANDERSON IN 46017 CHECK NUMBER: 210177 CHECK DATE: 6/20/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 211 4462865 26530 6778 —AA 21,500.00 DEMO KIRK PARCEK o Document 6702 —1992 Application and Certificate for Payment TO OwNi x: PROJECT: APPJCATM NO: I DbbMnat ta: a4►.eL- is -ot.t. �urt.t� A L�-r►,� C►Ty of PER}ODT OKMk 13 koa_ l L u tJ o t s �T 1 Ot�T� 1 d rrl CONTRACT FOR: ARQUTECT: 0 FROM VIA CONTRACT DATE: CTOR: LR r lv5c �x� C o ARCHITECT: PROJECT tNG& CONTitACTOR O e�sy�tz+zy t a oil FRD: 0 C)Ay 5 1000 L.) 1-rr1D� I Ol amo CONTRACTOR'S APPLICATION FOR PAYMENT U CL»ar catiG&S that to Ebe beu or e& Ca=acWz and bchd the Work covered by this A-y7b== fbr Psyn= has b= ia_a000 AppEcanon is made far pa)aau, as shown below, m oc=ccdnn myth the Cnatzaa.. the Cantraa Doc,arnmM that aD am== lmv be= pzd by the Qo srto[ f0[ WG& for Cow3r ion Sheri, ALA Document G70, is attachrd. Qiudr pr-i= Ca Xxau s for Pa}ment nut issuad and payments rc=%vd f the Omer, and 1.OiZ) KAL CONTRACT SUM S di, ejQ shad drat payvoatt sheerer hrrcip is now &r- 2. Net change try Cfiange Orden S O. CONTRACT t 3. CONTRACT SUN TO DATE (lac 1 3 2)._--._ S 91, 507 y_ B Dste: I oL 4. TOTAL COWL= 6 STORED TO DATE (Column G on GTD3) S X1,500- State Of I �plPrnlP► 5. RETAIIAU C,ommty of n 1 p D tSO� >L D S6 of Conipictnd Wort Sabsaz3nlEnd swam to before (Cal-arm D E on G iO3) S Oy me this C, l` day of 01 OI i a Q of stoma Mafcsial I J S ue (Column F on 6703) S ().00 Notary Public- 1 1 Total Retamagc (Lines 52 5b or Total in Catr= i of G S_ G OJ MY Commission Cq aOt 0 6. TOTAL EARN 'E) LESS RETANAGE S a �sco ARCHITECT'S CERTIFICA E FOR PAYMENT (LLLx 4 Less Line S Tex zl) In a mdxn t wish the Cc=xa Do= based on ®-site ob=r%=ons and the dais cottlpdsing 7. LESS PREVfDUS CERTW -RTES FOR PAYMENT S p p0 this apilicanoo, the Aram cuff= to the Oman that to the best of the ArchhoWs I=slcdgr, (line 6'fro n pncx Glm ficamc) mform,== ant) belief the Wow has lnvgrcsscd as indicated, the quality of the Wtsdc i in aomrdzn= oath the Conma Doaurcnm and the Cbcnw a u ccmkd to payment d the B.. CURRENT PAYMINT D al ,500 AbiOUIUCERTUUD. 3. &DANCE Tq FNSK UKXUDNG RETARLAZE (Line 3 less Lane 6) S 00 a=ch -wIaaariwr if tznq� dff—fi— the anwwdW&A 6riria7allfgawas ApF cw'dm and on zhc Ccrmurartan Shed drev am c hmaged m cm fa s wizb Me rsaVW) MAN GE ORDER SUNT)�LARY ADDMONS DEDUMONS ARCH7LCT: oezl d= Seri in rr;%icus Ltnnths by Oamrr S Q' 0 By Dal= ot?J zpprov this 1`lood, S D S O This C�afi� is twt trg auahlc The P.?.iGLT?17' CF1tTY1 is ps�abk ply to me Cmcacs� TOTALS 5 t). S 0 S Cctnu acxnr under this Cma,.c�tance of payment art aitham p>tjn�ee ib auy ti�ta o[ ALA. Dou meet WC2L —1342 Copyrigbi O 1932 and 1942 by Th jkme can hZ121ft d AtdffiWtL. An rkjbu 1ebwwad. VAArdlr:G, This 4rjA' Dover ur7 b Voiced by LLS. CapgxpY ft Lau ant! htV Treat_ Urc3rj I vepra,= an ce dL&-- iiUan rt Srzs AtA` Dcrv� or a:ri porton of M ccay ran31 e1 vev -e av] and erlm'nsf pmrl6es, "tr9 be proeaet.'red 10 rir alxx=ma eY.zr.t oom td-- vn :'sr Ma taw. Tres d cxvrn *sus p try AN s.z a at og2a -19 en a5?S2t)OS melee ('Drtter Mal [=721246 2 vdtS� exp}rro ern Vlr2t;t.' arzl Is tYt itx resale. LLx► Nph=s- (4726B8463) PARTIAL PAYMENT ESTIMATE PROJECT: Page of City of Carmel Residential Structure and Site Demolition for the former Kirk Parcel at 106th Street and the future Illinois Street connection in Carmel, IN CONTRACTOR: ENGINEER: Project No.: Yardberry Landscape Excavating Estimate No. 1 9940 South 1000 West _I— Anderson, IN 46017 For Period to 06/05/2012 (SECTION 1) (10) (11) (12) Unit Total Previous Payments Current Payments Total To -Date Description Unit Quantity Price Cost Quantity Amount Quantity Amount Quantity Amount 1 Demolition and Removal LS 1 18,000.00 $18,000.00 0 0 1 18,000.00 1 18,000.00 2 Structural Backfill LS 1 3,500.00 $3,500.00 0 0 1 3,500.00 1 3,500.00 $0.00 0 0 0 0 $0.00 0 0 0 0 $0.00 0 0 0 0 $0.00 0 01 0 0 $0.00 0 01 0 0 $0.00 0 0 0 0 $0.00 0 0 0 0 $0.00 0 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 $0.00 0 0 0 TOTALS: $21,500.00 21,500.00 21,500.00 MONTHLY CERTIFICATION (SECTION 5) 5. CERTIFICATION OF CONTRACTOR According to the best of my knowledge and belief, I certify that all items and amounts on the face of this Periodic Estimate for Partial Payment are correct; that all work has been material supplied in full accordance with the requirements of the referenced Contract, and /or duly authorized deviations, substitutions, alterations, and /or additions; that the foregoing is a correct statement of the contract account up to and including the last day of the period covered by this Periodic Estimate, that no part of the 'Balance Due This Payment' has been and that the undersigned and his subcontractors have (check applicable line): a. x) Complied with all labor provisions of said Contract. b. Complied with all labor provisions of said Contract except in those instances where an honest dispute exists with respect to said labor provisior (if [b] is checked, describe briefly nature of dispute). Yardberry Landscape Co., Inc. BY: (Contractor) (Signatur f Authorized Representative) DATE: 06/05/12 TITLE: Owner 6. CERTIFICATION OF ENGINEER I certify that I have checked and verified the above and foregoing Periodic Estimate for Partial Payment, that to the best of my knowledge and belief it is a true and correct statement of wo and /or material supplied by the Contractor; that the work and /or material included in this Periodic Estimate has been observed by me and /or by my duly authorized representative or assist accordance with generally accepted Resident Project Representative practices, and that it has been performed and /or supplied in accordance with requirements of the referenced Contrac possible testing requirements, and that Partial Payment claimed and requested by the Contractor is correctly computed on the basis of work performed and /or material supplied to date. H our approval of this Periodic Pay Estimate does not constitute FINAL approval or acceptance of the labor performed or materials supplied by the Contractor. This final approval will be issi conditions of the General Conditions and other Specifications. SIGNED: SIGNED: (Engineer) (Construction Coordinator) DATE: DATE: 7. APPROVAL BY THE OWNER BY: TITLE: DATE: 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 Yardberry Landscape Excavating Purchase Order No. 9940 South 1000 West Terms Anderson, IN 46017 Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s) Amount 6/5/2012 6778 -AA Kirk Parcel Demo (Illinois St) 21,500.00 .f Total 21,500.00 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. Yardberry Landscape Excavating ALLOWED 20 9940 South 1000 West IN SUM OF Anderson, IN 46017 21, 500.00 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), or 26530 6778 -AA 211- 4462865 21500 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 elr'— 6/18/2012 Signat r Cost Distribution ledger classification if Title claim paid motor vehicle highway fund