HomeMy WebLinkAbout214356 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 00351429 Page 1 of 1
ONE CIVIC SQUARE M.K.BETTS ENGINEERING INC CHECK AMOUNT $4,957.90
,� ?a CARMEL, INDIANA 46032 PO BOX 2533
ANDERSON IN 46018 CHECK NUMBER: 214356
CHECK DATE. 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
609 5023990 4 700 00 1052 02
609 5023990 7 4, 257 90 OTHER EXPENSES
APPLICAflON AND C-TRITIFICATE FOR PAYMENT Al � 1)(Y-►-JAIENT (]-02 oristrij, imos un ieverse side) 1"Alt C)Nf ()I l"(.l:)
itK) City of Carmel pRt )IEC-f Wel-Ts 27 & 28 HO Seven (7) I-)isiril,wit-ii) to
One Civic Square Corm-act: 77
Carmel, TM 4603_2 PIRK-0 -1*(-) 09/30/12 F! AlUll-WILCY
Cj C I-)N I-R Al,_I-0 K
Fr'(*-),,I l0 jr,JTR.-�,LJCIR) kil-I ORCHITPA)
M K Betts Engineering I'hOIECT III )
& Contracting, Tnc
FC)r-1TR,-(_-1 F(-)R Invoi-ce Ho .1.2-122 07 CCMTI:A( -I DAIT
�ppllcatloll is made tor Payment as below III Conflection \V1111 lllt� Colillaci
N T 11 A C-JO G"�' A P P I I C"ATI 0 N F1._ R PAY M f N T '(-milintiation Sfice[, AIA I-Jocimierit 6703, is at(ciched
844,162.00
11116 'ONTRACT SUM
)fuxv l j,"W'i'ARY I ANAL C
$ _tZO 0
1311111u�)E� 10)rldeft� appm, ed in '\I_)L)ITI( r,I t) DLDLJCTION�) 2 Net change by Change Orders A67.00
prwlous rlwnthS by I-w.11el 3 CONTRACT SUNA TO DATE (Line 1 -L2) $ _L,014,_6Z9 00
T _f�' 4 TOTAL COMPLA-ED & STORED TO DATE __8_L5,6 679 00
;ppruvekj tills I`tollill )Column C oil G703)
tlurnl,er
j 5 "Xo o i C n i p I e I e d Wort,
--_z 3783 95
c ,1 $1.65 ,985 00 (Coitirrin D+ E on G703)
FF) 3-FD 7 4 ,482 00 -0- 1) _0__ X, of Stored Material $ -0-
--
(Column 1: on G703)
Rtf laillage (Line Sa+sh oI
0-0 -0- Tillal in Cohimn I or G'103) %
43,783 95
'I'l Ch'WIQe lj\ chaot't� C)ldef!' + $170,467 00 6 TOPA. EARNED LESS RET41NAGIE ___831 895 05
The undelsv)ed Cmilrak tor ccnlnes that w, [lie hest of the Fontrai Iors I'llowledge (t.inc -A less Line 5
imorrilaiiu[-, �fld billet the cii, t-i i-d h,,, (his -',Pplwaticm ior Payment li-is been 7 I,ESS I1r(FVjOuS CERT11:11CATES FOR 827,637 15
Cn'1)pl':l�-_'C1 11-1 1,L'Aclant '� " 111) the Cum(at_[ 1-InCLII'llefItS Illat all jillollil(S ha ,c I)eefj PAYMENT (Line 6 from prior (_cfiIh( cite)
paid b-, the Comra(_mr tnr for "vilic.1) pre"inus Ceillil(-atcs lot 111"'llit-t-it were 8 CHIMENT PAYMENT Dl 4,257 90
iS5ued and pa,,merms rr_i erred firm) the C),ner and Ihm Clirrem payllleIll sllm�li 9 11,k[ANC-f- TO IAMSH, PLUS RETAINAGE 182,733 95
1-hareln a 01.AV Litle- (Line, 3 less Line 6)
-1 Ijc]A_anLi Com it\, (A H Li d L so 11
if 1, Berrs fin,,�j_neeu_i.ng I ait, or
Stihsciihed and sworn to before me this 30th day of Sept , 2012
t,.I(--)Iary Pul-dic 7s�
R,, Date - Sept 30, 2012. t-Ay Commission expires Octnbei. _'8 , 2015
AAK)UNT CLRTIFIED t
Cr-RT1H(.ATF_ FOR PAYMFNT I'Awich Cq)1allalion anlnont cet-tified ditrers ituni the to")
In accordance\ iih [lie I cjmra� i Dn,_tmients h�secl on on site obsec"allolls and Ille '\kCHITECT
data comprisirlu the ahcj\c application the ''rcllilect Cerlities to the Cj%"Iler Illat (0 Ille /,C)_:5-(--2—
best I-)I I he =f(-h I I ek-I S 1-nnv�'ledge j 11 to r fila I it'.)(I and he I I e[ I li e wo,I., has as p rogressed as Date
I n d I ca i e 1-1 11 ic qualm ()i i Iii e\V,)r 1- is in a c L I-)r Cl 11)C a%"I(h I I I e C o Il(I a I:t E)C)C t I III e I I t 1; and This n0I oegotiallie The ANIC)UNI, C1,10(11-11:17) is J._)ayahle liffly 10 tilt,
the is enntled I,, panlcnl , f the '.i-AC)UNT CERTIFIED Coi,tracwi named herein issllall'e payment and accellialwe t'4 payllit,)[at t-Wilil'All
prejudice lo ariv lights Of Ille C)� liEr u: C'JI1Ir7lCI()r under tills Coillra'l
kIA 001 U t[H-1 C7U Ii. FL)k l"') ib I LL_Hh(_)r.1 1910
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 11/1/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/1/2012 7 $4,25790
1 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 Ac e r
VOUCHER # 122650 WARRANT # ALLOWED
351429 IN SUM OF $
M K. BETTS ENGINEERING & CONTRF
P O Box 2533
Anderson, IN 46018
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
7 07-1052-01 $4,25790
co P0
Voucher Total $4,25790
Cost distribution ledger classification if
claim paid under vehicle highway fund
j�ppj_ICATIONAND CH-MIACM-F I.-OR PAYMENT
- 1`40 Four (4) DismI.AitiOn to
City Carmel pjZC)JE( Gray Road Booster Station ion APPLICATION
One Civic Square Carme.l., TH OWNER
Came]-, Till z16032 l'Biol--) TO 09/27/12 r, ARCHII ECI
C(-)NI'R,,%(--TOR
-ON E-
'0� .,CTnR)
N K Berl--s E'nel-neerIng
& ConLracr:1-rig, 'Eric
MR Trivoi-ce No 12-126 04 CONffft-,,C-f UTTE
ifionismadeiorl"lavrnem as shown helow in connection v,i(h (lie Cm Ir
VIV ' Al- VOR PA it I C Contirmation Shcel, Alk Doctimerit G70:1, is a(lidick-I
%f SliNiP 14,Rl( *1 ORIGINAL CONTRACT SUM 5 — 117,890 00
Change Order april"0114:d ill ! Net chinge by C11311ge Orders � --8,126 00
pr „ic,us 'CU , , J- UITI(-)�IS
months b; ner 3 St IM TO DATE (Line 2) � --126 015-0-0--
In-M. COMPLETED At SYORED TO D-kYE $ __12 6 015 00
,.,pF()Ve(l this
CC)#2 + $ 3,975 00 -0-
T(-j i $ 8, 125 -0-
,IL( charige 1)�, Chang,-- Orjjc�rs + $ 8 125 00
lhe undersigned Contra,-tor certifies that to the hest of the Contractors knowledge
il-li0l'Watioll and behei the \,Vcrk ct),,ered by this 1,pplication for Payment has been LESS PREVIOUS CERTIFICATES FOR
,-C;MjjIt]ied in au-wcjance wilh Ihe c-ontract Docufnents that all aniotints have been PAYMENT $ 125 ,315 00
p,iid [,. thr Contractor for \A/ork rnj k.,Jw-h P revious Certificates for l:iaynient were CURRENT PAYMENT DUE 700.00
j�5(11-d 31)d P6,'Mems rec,�i,ed frl)ni the Owner and that current payment shoe HALkNC-f TO HNISI-if PLUS RET-kINAGE —0—
ht:rtfil" is no", due
I T P CT 0 R 1•1 V P,e L L s E ng i i e a i-J.n s, c)n r i:a r- n S c State olf Indl.ana Cmlnn of • adisc-in
5mbs(.riljed and sworn to before me this 27th day tit Sept 2012
r.,i(-)tai-y Pohlic
-112 F)ate Sept 27, 2012
My Commission expires October 28, 201[5
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 0 Box 2533 Terms
Anderson, IN 46018 Due Date 11/1/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/1/2012 4 $70000
1 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 icer
VOUCHER # 122651 WARRANT # ALLOWED
351429 IN SUM OF $
M K. BETTS ENGINEERING & CONTRF
P O Box 2533
Anderson, IN 46018
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
4 07-1052-02 $70000
,c� CCU N rd e O o/
Voucher Total $70000
Cost distribution ledger classification if
claim paid under vehicle highway fund