HomeMy WebLinkAbout210940 07/17/2012 - CITY OF CARMEL, INDIANA VENDOR: 00351429 Page 1 of 1
ONE CIVIC SQUARE M.K. BETTS ENGINEERING INC
CARMEL, INDIANA 46032 PO BOX 2533 CHECK AMOUNT: $38,364.00
?` ANDERSON IN 46018
CHECK NUMBER: 210940
CHECK DATE: 7117/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
609 5023990 2 38, 364 . 00 OTHER EXPENSES
F '
APPLICATION AND CWERTIFICXCE FOR PAYMENT P,�cE ONE Of P�C;Es
TO (Ol^ANER): City of Carmel PROJECT: Gray Road Boos Ler Station APPLICATION NO: Two (2) Distribution to:
One Civic Square Carmel, IN G OWNER
Carmel, IN 46032 PERIOD TO: 05/31/12 ❑ ARCFIITECT
G CONTRACTOR
FROt,,i tCONTR.-\CTOR):
M. K. Betts Engineering L
& Contracting, Inc .
CONTRACT FOR: Invoice No. 12-126 .02 CONTRA4CT DATE:
CONTRACTOR'S OR'S APPLIC�ATIOI�l FOR PAYMENT ConApplication
li auafion Sheet,fAIA Documer, Gt7a3, is aitt�achzciconnectlon with the i_ontracl.
CH.;NCE ORDER 51.J&jf,iA,RY _ 1. ORIGINAL CONTRACT SUM .. .. .. . .. . . 117,890.00
— 8, 125.00
2. Net change by Change Orders . . . . ... . . . . . .. . . .. . . . b --
Change Orders approved in ADOITIOf�lS DEDUCTIOrlS 126 015.00
previous months by Oevner 3. CONTRACT SUM TO DATE (Line 1 =2) . . . . . .. . . . . .. . S
TOTAL TOTAL COMPLETED & STORED TO DATE . .. . . . . ... .. S 119,815.00
,pproveci this tilonth
Number Date Approved
C0#1 _ 1 $ 4 ,150.00 -0-
CO#2 t $ 3,975.00 -0-
_ TOT,115 + $ 8 ,125.00 -0-
`Jet change by Change Orders _ + $ 8, 125.00
The undersigned Contractor certifies that to the best of the Contractor's knowledge,
information and belief the Work covered by this Application for Payment has been LESS PREVIOUS CERTIFICATES FOR 81 ,451 .00
completed in accordance with the Contract Documents, that all arnounts have been PAYMENT . . . . . • . . 3 —
paid by the Contractor for Work for which previous Certificates for Payment were 38364.00
P Y CURRENT PAYMENT DUE . . . . . . .. . .. . . . . . . . . . . . .. .. 5 ____- � --
issues) and ayments received rroni the Owner, and that current payment Shown 6 ,200.00
P P-1 - tIAIANCE 70 FINISH, PLUS RE-fAINAGE . . . . . . . . .. . . . 5 --_--_-- —
herein is noW due.
CONTRr'.CTOR: 1.1. K. Betts Engineering & Contracting, Inc . State of: Indiana County ot: dafadf son 2012
Subscribed and sworn to before me this y y ,
Notary Public;
ny: __ Date: May 31 , 2012 Nkv Commission expires: October 28, 2015
I i
NA GE OF PAGES
APPLICATION NUMBER: Two (2)
Gray Road Booster Station APPLICATION DATE': May 31 , 2012
Carmel, III PERIOD FROM: 05-01-12
TO: 05=31-12
B C D E F j G H
ITEM t WORK WORK COMPLETED _-,r_
DESCRIPTIOr: OF WORE: SCHEDULED -------TOTAL COMPLETED BALANCE:::
rl VALUE This Application LAND STORED TO FINISH
Previous TO DATE (G- C:
Applications Work in Place Stored Materials 0+E+FI IC—Gi
(not in D or EI
1 . Excavation and
Backfill 3 ,500.00 2,000.00 1,500.00 —0— 3,500.00 100 —0-
2. Precast Vault 27,300.00 24,000.00 —0— —0— 24,000.00 88 3,300.00
3. Concrete 1 ,225 .00 1 ,000.00 225.00 —0— 1 ,225.00 100 —0-
4. Set Pump Cans & Pumps 2,300.00 2,300.00 —0— —0— 2 ,300.00 100 —0-
5 . Miscellaneous Metals 2 ,200.00 —0— —0— —0— —0— 00 2,200.00
6 . Piping 42 ,000.00 26,809.00 15,191 .00 —0— 42,000.00 100 —0-
7. Electrical 6,000.00 —0— 6,000.00 —0— 6,000.00 100 —0-
8 . HVAC 2 ,900.00 —0— 2,900.00 —0— 2,900.00 100 —0-
9. Painting 700.00 —0— —0— —0— —0— 00 700.00
10. Miscellaneous 1 ,375.00 —0— 1 ,375.00 —0— 1 ,375.00 100 —0-
11 . Valves 28,390.00 25,342.00 3,048.00 —0— 28,390.00 100 —0-
12. Additional 20" Butterfly
Valve + 4 ,150.00 —0— + 4 ,150.00 —0— + 4, 150.00 100 —0-
13. 16"xl2" Reducers for
Meter, Flg Pipe, Etc. 3,975.00 —0— + 3,975.00 —0— + 3,975.00 100 —0-
126,015.00 81,451.00 38,364.00 —0— 119,815.00 95 6 ,200.00
VOUCHER # 121513 WARRANT # ALLOWED
351429 IN SUM OF $
M.K. BETTS ENGINEERING & CONTRi
P.O. Box 2533
Anderson, IN 46018
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2 07-1052-02 $38,364.00
c(Doijec
Voucher Total $38,364.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
�I
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351429
M.K. BETTS ENGINEERING &CONTRACTING Purchase Order No.
P.O. Box 2533 Terms
Anderson, IN 46018 Due Date 7/10/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/10/2012 2 $38,364.00
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
Date doer