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Home My WebLink AboutSMOCK FANSLER CORPORATION -002124 -7/25/2011 CARMEL REDEVELOPMENT COMMISSION 002124 Smock Fansler Corporation Check: 2124 2910 W Minnesota Street Date: 7/25/2011 Indianapolis, IN 46241-4541 Vendor: SMOCKFA1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2-11 4,635.00 4,635.00 0.00 0.00 4,635.00 App 11 on P111 Pavers 4,635.00 4,635.00 . 0.00 0.00 4,635.00 • AIA Type Document Application and Certification for Payment Page 1 of 2 TO(OWNER):CARMEL REDEVELOPMNT COMMISSION PROJECT:P. 111 PAVERS APPLICATION NO: 11 DISTRIBUTION TO: 30 W.MAIN ST. PERIOD TO:6/30/2011 CARMEL,IN 46032 _OWNER —ARCHITECT _CONTRACTOR FROM(CONTRACTOR):Smock Fansler Corporation VIA(ARCHITECT): ARCHITECTS 2910 W.Minnesota Street PROJECT NO: Indianapolis, IN 46241 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT 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 completed in accordance with the Application is made for Payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Type Document is attached. Certificates for Payment were issued and payments received from the owner,��,{Iuthidfuruupiqi �\\� current payment shown herein is now due. 0-Ci\RY pO 1.ORIGINAL CONTRACT SUM $ 805,860.00 •: •' ....6,..,/ 23,800.00 CONTRACTOR: Smock Fansler Corporation 2.Net Change by Change Orders $ 2910 W.Minnesota Street Indianapolis, IN 46241 `� -: 3.CONTRACT SUM TO DATE(Line 1 +2) $ 829,660.00 SE ,[� L y -_ •4.TOTAL COMPLETED AND STORED TO DATE $ 829,660.00 By: Date: ` //O/-• _-- T.M.FANSLER / CEO r°1'T P 5.RETAINAGE: % State of:IN '/. OF IND�P��"�� a. 10.00 /o of Completed Work $ 82,966.00 n,rri�iiimi1`��p�a� County of: MORGAN b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before me this /2 Day of ,4e 20/7 Total retainage(Line 5a+5b) $ 82,966.00 Notary Public: y;„/�My Commission Expires: / j 774)/(2n// 6.TOTAL EARNED LESS RETAINAGE $ 746,694.00 (Line 4 less Line 5 Total) ARCHITECT'S CERTIFICATE FOR PAYMENT 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,based on on-site observations and the data com- 742,059.00 prising the above application, the Architect certifies to owner that to the best of the Architect's (Line 6 from prior Certificate) $ knowledge,information and belief the Work has progressed as indicated,the quality of the work 8.CURRENT PAYMENT DUE $ 4,635.00 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE b " (Line 3 less Line 6) $ 82,966.00 AMOUNT CERTIFIED $ (Attach explanation if a •unt certified differs from the amount applie .Initial all figures on this CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Application and•• •• tinuation Sheet that are changed to conform to the amount certified.) Total changes approved in ARCHI T: i11' 2 previous months by Owner 23,800.00 0.00 By: .�� Date: �(> Total approved this Month 0.00 0.00 This Ce ' cate I. not negotiable. The AMOUNT CERTIFIED is payable only t the Contractor '1\* named herein. ssuance,Payment and acceptance of payment are ut prejudice to any TOTALS 23,800.00 0.00 rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order 23,800.00 /,. ; _� (,4Y/'64'01 AIA Type Document Application and Certification for Payment Page 2 of 2 TO(OWNER):CARMEL REDEVELOPMNT COMMISSION PROJECT:P. 111 PAVERS APPLICATION NO: 11 DISTRIBUTION 30 W.MAIN ST. PERIOD 70:6/3012011 TO: CARMEL,IN 46032 _OWNER _ARCHITECT CONTRACTOR FROM(CONTRACTOR):Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S 2910 W.Minnesota Street PROJECT NO: Indianapolis, IN 46241 CONTRACT FOR: CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED _._ °e BALANCE RETAINAGE 1 MOBILIZATION 10,000.00 10,000.00 0.00 0.00 10,000.00 100.00 0.00 1,000.00 2 FIELD ENGINEERING 10,000.00 10,000.00 0.00 0.00 10,000.00 100.00 0.00 1,000.00 3 ASPHALT BASE 165,400.00 165,400.00 0.00 0.00 165,400.00 100.00 0.00 16,540.00 4 UNIT PAVERS 620,460.00 620,460.00 0.00 0.00 620,460.00 100.00 0.00 62,046.00 5 CHANGE ORDER#1 10,300.00 5,150.00 5,150.00 0.00 10,300.00 100.00 0.00 1,030.00 6 CHANGE ORDER#2 13,500.00 13,500.00 0.00 0.00 13,500.00 100.00 0.00 1,350.00 REPORT TOTALS $829,660.00 $824,510.00 $5,150.00 $0.00 $829,660.00 100.00 $0.00 $82,966.00 c: AFFIDAVIT AND WAIVER OF LIEN [ j Final [X] Partial [X] Payment to Follow State of Indiana County of Marion T.M. Fansler , being duly sworn states that he is the CEO of SMOCK FANSLER CORP. having contracted with: Carmel Redevelopment Commission_ to furnish certain labor, materials, and/or services as follows: Misc. Construction for a project known as: SFC#10-081 P. 111 Pavers located at Carmel,IN and does hereby state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the owner the sum of: ($4,635.00) Four Thousand Six Hundred Thirty Five Dollars and No/100 [ ] receipt of which is hereby acknowledged;or [X] the payment of which has been promised as the sole considertion 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($0.00) [ ] receipt of which is hereby acknowledged;or [ ] 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 l7" /" itle CEO T.M.Fansler WITNESS MY HAND AND NOTARIAL SEAL,this 17th day of June 2011. , °O1PRY p�ei•��i// Melissa J, Bish fi4/2 Not a ublic = : S.Lj . My commission expires November 30, 2016_ Residing in Morgan County ''%gTFpF INO�A�1>-• \` L�iia;I;4;ii111411W"�1p0\