212127 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 00353347 Page 1 of 1
ONE CIVIC SQUARE ATLAS EXCAVATING INC
CARMEL, INDIANA 46032 4740 SWISHER ROAD BLDG A CHECK AMOUNT: $61,075.88
WEST LAFAYETTE IN 47906
CHECK NUMBER: 212127
CHECK DATE: 8128/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
610 5023990 NO. 5 61, 075 . 88 OTHER EXPENSES
APPLICATION FOR PAYMENT NO. 5
To: CITY OF CARMEL,IN (OWNER)
From: ATLAS EXCAVATING,INC. (CONTRACTOR)
Contract:
Project: COLLEGE AVENUE WATER TRANSMISSION MAIN-CARNIEL,IN
OWNER's Contract No. 66E ENGINEER's Project
For Work accomplished through the date of: 7/31/2012
1 Or iginal Contract Price: $ 1,421,157.50
2 Net change by Change Orders and Written Amendments(+or
3 Current Contract Price(1 plus 2): $ 1,421,157.50
4 Total completed and stored to date: $ 1,758,515.35
5 Retainage(per Agreement):
0.57%%of completed Work $ 10,000.00
including stored material
Total Retainage: $ 10,000.00
6 Total completed and stored to date less retainage(4 minus 5): $ 1,748,51535
7 Less previous Application for Payments: $ 1,687,439.47
8 DUE THIS APPLICATION(6 NIML S 7): $ 61,075.88
Accompanying Documentation:
CONTRACTOR'S Certification:
The undersigned CONTRACTOR certifies that(1)all previous progress payments received from OWNER on account of
Work done under the Contract referred to above have been applied on account to discharge CONTRACTOR's legitimate
obligations incurred in connection with Work covered by prior Applications for Payment numbered 1 through 4 inclusive; (2)
title of all Work,materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for
Payment will pass to OWNER at time of payment free and clear of all Liens,security interests and encumbrances(except such
as are covered by a Bond acceptable to OWNER indemnifying OWNER against any such Lien,security interest or
encumbrance);and(3)all Work covered by this Application for Payment is in accordance with the Contract Documents and
not defective.
Dated July 30,2012 Atlas Excavating, Inc.
CONTRACTOR
r•
By:
Tina Dillon,President
State of Indiana -rTLi
County of Tippecanoe ���� �'�, ........,
—a S
Subscribed and sworn to before me this 30th 4-�:-"e° e '•• O
day of - July,20112/' QI _ h�N r, O
Seoi�b//cam z�
� F
Notary P lic Elizabeth A.Golden,, '•:gyp_ 3
My Commission expires: April 10,2013
Payment oft AMOU
e NT DUE THIS APPLICATION is recommended
By: _ By:
EN INFER(Authorized Signature) OWNER(Authorized Signature)
Title: Title:
Date: S Date:
EJCDC No. 1910-8-E (1996 Edition)RUS-WEP(2000)
Prepared by the Eni—s Joint Contraa Documents Committee and endorsed by The Associated General Contractors of America and the Construction Specification Institute.
Contract ID:
Contractor: Atlas Excavating,Inc.
4740 Swisher Road Estimate No: 5 Estimate Date: 07/31/2012
Estimate Period:07/01/2012 To 07/3112012 Due Date: 08/30/2012
West Lafayette,IN 47906 Contract Price: 1,421,157.50
Bidder ID:
Contract:
Submit To: COLLEGE AVE-CARMEL INDIANA
This Estimate To Date
Line No Item No Description Unit Bid Quantity Unit Price Quantity Amount Quantity Amount
1a 1a Mobilization LS 1.000 .0000 1.000
2 2 Audio-Video Recording LS 1.000 500.0000 1.000 500.00
3a 3a 36-Inch Class 250 DIP Water Main LF 3,500.000 265.0000 3,685.000 976,525.00
3b 3b Additional 36-in. DIP 45 deg. Fittings EA 4.000 8,000.0000
3c 3c Additional 36-in. DIP 22.5 deg. Fittings EA 1.000 7,200.0000
3d 3d Additional 36-in. DIP 11.25 deg. Fittings EA 1.000 6,500.0000
3e 3e Additional 36-in,Joint Restraints EA 12.000 950.0000
3f 3f 36-in.Polyethylene Liner LF 3,500.000 1.5000 3,685.000 5,527.50
3g 3g 16-Inch Connection @ Congressional Parkwz LS 2.000 12,000.0000 2.000 24,000.00
3h 3h Water Main Connection EA 1.000 1,000.0000 1.000 1,000.00
4 4 36-Inch Butterfly Valve EA 3.000 20,000.0000 4.000 80,000.00
5 5 Hydrant Assembly on 36-Inch Main EA 4.000 29,000.0000 5.000 145,000.00
6 6 48-Inch Bored Steel Casing for Carrier Pipe LF 135.000 595.0000 135.000 80,325.00
7 7 Special Backfill CY 4,500.000 13.0000 5,295.000 68,835.00
8a 8a 6-Inch Concrete Driveway SY 50.000 33.0000 19.000 627.00
8b 8b 4-Inch Concrete Walk SY 10.000 80.0000
8c 8c Handicap Ramp for Path SY 30.000 85.0000 40.500 3,442.50
8d 8d Curb and Gutter LF 680.000 20.0000 179.000 3,580.00
9a 9a Aggregate Base(8-in.&5-in.) CY 670.000 30.0000 705.000 21,150.00
9b 9b 4-Inch Bituminous Leveling Course(Street) TON 640.000 86.0000 696.020 59,857.72
9c 9c 1.5-Inch Bituminous Wearing Course(Street) TON 320.000 94.0000 371.750 34,944.50
9d 9d 3-Inch Bituminous Leveling Course(Path) TON 20.000 100.0000 32.000 3,200.00
9e 9e 1-Inch Bituminous Wearing Course(Path) TON 6.000 185.0000 10.670 1,973.95
10 10 Dewatering LS 1.000 .0000 1.000
11a 11a Seed&Mulch(INDOT,Type U,Section C-02 SY 1,500.000 1.5000 2,140.000 3,210.00
Contract ID:
Contractor: Atlas Excavating, Inc.
4740 Swisher Road Estimate No: 5 Estimate Date: 07/31/2012
Estimate Period: 07/01/2012 To 07/31/2012 Due Date: 08/30/2012
West Lafayette,IN 47906 Contract Price: 1,421,157.50
Bidder ID:
Contract:
Submit To: COLLEGE AVE-CARMEL INDIANA
This Estimate To Date
Line No Item No Description Unit Bid Quantity Unit Price Quantity Amount Quantity Amount
11b 11b 2"Sugar Maple Trees EA 3.000 450.0000
11c 11c Tree Removal(8 inch diameter or greater) EA 3.000 1,200.0000 3.000 3,600.00
12 12 Topsoil CY 430.000 20.0000 430.000 8,600.00
13 13 Erosion Control LS 1.000 500.0000 1.000 500.00
14a 14a 12-inch Storm Sewer LF 20.000 35.0000 20.000 700.00
14b 14b Catch Basin EA 1.000 1,500.0000 1.000 1,500.00
15a 15a Stop Bar Marking LF 55.000 13.0000 55.000 715.00
15b 15b 4-Inch Stripe Marking LF 950.000 1.2500 2,747.920 3,434.90
15c 15c Only Marking EA 1.000 200.0000 1.000 200.00
15d 15d Arrow Marking EA 3.000 150.0000 3.000 450.00
16 16 Record Documentation LS 1.000 1,000.0000 1.000 1,000.00
17 17 Stored Material(Deduct amount) LS 1.000 -58,000.0000 1.000 -58,000.00
18 18 Stored Materials(Onsite) LS 1.000 .0000
19 19 FD#1 -Additional Tree Removal LS 1.000 1,000.0000 1.000 1,000.00
20 20 FD#2-Change Orders for Bore/Utilities LS 1.000 41,536.7000 1.000 41,536.70
21 21 FD#3-Lowering of Pipe Under Congression, LS 1.000 114,711.0600 1.000 114,711.06
22 22 FD#4-Remove&Replace the Forcemain at LS 1.000 2,705.0500 1.000 2,705.05
23 23 FD#5-Additional Cost for Milling Machine Al LS 1.000 4,800.0000 1.000 4,800.00
24 24 FD#6-Additional Overtime Work for Chlorin(LS 1.000 11,511.5900 1.000 11,511.59
25 25 FD#7-20"Line-Pennsylvania Ave(Labor/E LS 1.000 44,777.0000 1.000 44,777.00
26 26 FD#8-12"Water Connection LS 1.000 19,940.2000 1.000 19,940.20 1.000 19,940.20
Contract ID:
Contractor: Atlas Excavating, Inc.
4740 Swisher Road Estimate No: 5 Estimate Date: 07/31/2012
Estimate Period: 07/01/2012 To 07/31/2012 Due Date: 08/30/2012
West Lafayette, IN 47906 Contract Price: 1,421,157.50
Bidder ID:
Contract:
Submit To: COLLEGE AVE-CARMEL INDIANA
This Estimate To Date
Line No Item No Description Unit Bid Quantity Unit Price Quantity Amount Quantity— Amount
27 27 FD#9-20"Drill&Connect LS 1.000 41,135.6800 1.000 41,135.68 1.000 41,135.68
Estimate To Date
Total: 61,075.88 1,758,515.35
Retainage: .00 141,895.41
Amount Paid: 1,167,643.17
Current Amount Due: 61,075.88 448,976.77
MATERIAL RECORD-COLLEGE AVENUE-CARMEL
Est.No. 5 Sheet 1 of 1
From 7/1/2012 to 7/31/2012
Atlas Excavating. Inc. 4740 Swisher Road,West Lafayette, IN 47906
(Contractor) (Address)
Received Used To Invoice Unit
Material ITEM# To Date Date On Hand Prices Value Stored Invoice#
36 TJ PR250 DI PIPE 30 1174 1174 0 $ 129.25 $ 4421538
36 TJ PR250 DI PIPE 30 570 570 0 $ 129.25 $ 4552256
16 TJ FIELD LOK 350 GASKET 36 2 2 0 $ 339.00 $ 4552256
36 TR FLEX PR240 DI PIPE 50 199 199 0 $ 183.90 $ 4571864
36 TJ PR250 DI PIPE 30 1173 1173 0 S 129.25 $ 4564896
36 TR FLEX PR240 DI PIPE 50 233 233 0 $ 183.90 $ 4564896
16 TJ CL50 PR350 DI PIPE 36 81 81 0 $ 45.45 S 4564896
12 TJ PR350 DI PIPE 36 40 40 0 $ 26.35 $ 4564896
6 TJ PR350 CL50 DI PIPE 50 100 100 0 $ 12.85 $ 4421608
36 MEGALUG MJ RESTR 30,40,50 32 32 0 $ 877.00 $ 4421608
1X6 T-HEAD B&N COR BLUE 30,40,50 720 720 0 $ 11.00 S 4421608
10GA COPPER SOLID WIRE 30 7 7 0 S 105.00 S 4421608
81"X110'POLY WRAP 35 30 30 0 $ 130.90 S 4421608
36X16 MJ TEE 30 1 1 0 $ 12,125.00 $ 4421608
16 MEGALUG MJ RESTR. 30,36 8 8 0 S 123.00 S 4421608
16"COR-BLUE MEGALUG ACC F 30,36 8 8 0 $ 65.00 S 4421608
16X12 MJ REDUCER CP DI 36 2 2 0 $ 366.00 $ 4421608
12 MEGALUG MJ REST. 36,50 32 32 0 $ 68.00 S 4421608
12"COR-BLUE MEGALUG ACC 36,50 32 32 0 $ 40.00 $ 4421608
12X12 MJ TEE 36 2 2 0 S 473.00 S 4421608
12 MJ SLEEVE 36 2 2 0 S 230.00 S 4421608
16 83211-23 MJ BFV OL 2" 36 2 2 0 $ 1,974.00 S 4421608
564-S VALVE BOX ASSY DOM 36,40,50 11 11 0 $ 132.00 S 4421608
ALIGNMENT CAP 36,40,50 11 I 1 0 S 19.00 $ 4421608
36 MJ BUTTERFLY VLV ON PRA 40 3 3 0 S 10,922.00 S 4421608
A423 5'CARMEL-NOBLESVILL S 50 2 2 0 $ 2,063.00 S 4421608
6 A2360-23-9020 MJ RW GV 50 5 5 0 $ 507.00 $ 4421608
6 MEGALUG MJ REST 50 20 20 0 $ 21.00 S 4421608
6"COR-BLUE MEGALUG GV AC 50 15 15 0 $ 29.00 $ 4421608
12 MJ 45 BEND 50 5 5 0 S 250.00 $ 4421608
12X6 MJ REDUCER 50 5 5 0 $ 156.00 S 4421608
6"COR-BLUE MEGALUG GV ACC 50 5 5 0 $ 29.00 S 4421608
36X12 b4J TEE 50 1 1 0 $ 11,867.00 S 4421608
STEEL CASING-48"ODX.625"W 60 120 120 0 $ 148.58 $ TP109038-01
STEEL CASING-48"ODX.625'R 60 22 22 0 $ 228.50 $ TP109097
36 TR FLEX GRIPPER RLNG 34 6 6 0 $ 852.00 $ 4583605
Value of Material on Hand..... $0.00
Prescribed by State Board of Accounts
Form No.301(Rev.1995) ACCOUNTS PAYABLE VOUCHER
—1-
r, TO
" ADDRESS
Invoice Date Invoice Number Item Amount
I hereby certify that the attached invoice(s), 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
119
Signature Title
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.
, 19 �kj,- -
fficer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
NO.
CARMEL, INDIANA
�nCRvA4Favor of
Total Amount of Voucher $
Deductions
S (0 (075 8
c 1092-09
Amount of Warrant $
Month of 19
VOUCHER RECORD Acct.
No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Main nance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS•SYSTEMS 1-800-382-8702 325