The URL can be used to link to this page

Home My WebLink AboutSIGNATURE CONSTRUCTION, LLC -002562 -12/22/2011 CARMEL REDEVELOPMENT COMMISSION 002562 Signature Construction, LLC Check: 2562 720 3rd Ave., SW Date: 12/22/2011 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4*2 893.48 893.48 0.00 0.00 893.48 App 4 on site Amenities LaFeve 16-2 7,278.18 7,278.18 0.00 0.00 7,278.18 App 2 on P112 Motor Court Vene 8,171.66 8,171.66 0.00 . - 0.00 8,171..66 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Carmel PROJECT: Site Amenities APPLICATION NO Invoice#4 4-1/ Distribution to: Carmel Indiana 46032 Lai-ever Signature costs OWNER ARCHITECT PERIOD TO: 11/21/2011 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT:Pedcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Carmel,Indiana 46032 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,A1A Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM $ 28,290.00 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1±2) $ 28,290.00 4. TOTAL COMPLETED R.STORED TO $ 25,835.96 By: `- j Date: ///2/ ' / 5. RETAINAGE: I'•omas E.h�o'ntz,President �/ • day of G J' 2 e f t! omtobeforemethis -- a. 0 /o of Completed Work $ — 0 Subscr red ands y ----- :.-,. ..:., P� (Column D+Eon G703) b . g LINDA .BUCHANAN ^�TA� Ha:Gm:ck Coun b. %of Stored Material $ ., sea ,.;.t ML Coission Ex (Column F on G703) "..SEA .''` y A t 20,201glres Total Retainage(Lines 5a+5b or i u9 Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYM 1 6. TOTAL EARNED LESS RETAINAGE $ 25,835.96 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 24,942.48 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 893.48 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 2,454.05 —�� (Line 3 less Line 6) AMOUNT CERTIFIED $ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount ertified differs from the amount applied.Initial all figures on this Total changes approved Application. : . •Continu,,Lion Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCI-IITEC ,: 1 ■ Total approved this Month By: ,��Ij, Date: 2 TOTALS $0.00 $0.00 This Certificate i.not negotiable. The AMOUNT CERTIFIED is payable nnly to toe l ontracior names herein.issuance,payment and acceptance of payment ar• without NET CHANGES by Change Order $0.00 prejudice to .• rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT-1992 EDITION-AIA 01992 THE AMERICAN INSTITUTE OF ARCHIT ' S,173.NEW YORK AVE.,N W.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Do .ment's . th 'city rom the Licensee. ,age CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and /or labor as follows: Construction Management Services for a project known as Site Amenities, located at Carmel, Indiana and owned by the Carmel Redevelopment Commission and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of eight hundred ninty-three dollars and forty-eight cents ($893.48) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC T mas E. ontz, President ' Subscribed and sworn to before me this: 1.200-..3l a°/1 Notary Public: ..{dh ..,, LINDA G.BUCHANAN ` ';,:TA Hancock County My CAU9UStZO,ommission ZO1 Expires SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 4 11/21/11 P112 Site Amenities - Lafever Carmel, Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO Committed NO. WORK VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH Cost General Requirements: Site Supervision 13,145.00 13,145.00 0.00 0.00 13,145.00 100% 0.00 13,145.00 Meetings 1,000.00 0.00 278.62 0.00 278.62 28% 721.38 278.62 Construction Management Fee 14,145.00 11,797.48 614.86 0.00 12,412.34 88% 1,732.67 12,412.34 28,290.00 24,942.48 893.48 0.00 25,835.96 91% 2,454.05 25,835.96 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Carmel PROJECT:Pt 12 Motor Court APPLICATION NO invoice tt 2 Distribution to: Carmel Indiana 46032 Veneer Signature costs OWNER ARCHITECT PERIOD TO: 11/21/2011 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pcdcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Carmel, Indiana 46032 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received front the Owner,and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM $ 21,000.00 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1±2) $ 21,000.00 4. TOTAL COMPLETED&STORED TO $ 17,200.32 By: AIIM.,./ r Date: 7/ L.f �/ 5. RETAINAGE: T.omas -. Teontz,President a. 0 %of Completed Work $ 0 Subsc bed and s orn to before me this c2( day of ,tJGti• a0 I. ;,";a+'."e,••-., LINDA G.BUCHANAN (Column D+Eon G703) ; "NARY' Hancock County b. %of Stored Material $ . ,„,...S8Ar;?= My Commission Expires (Column F on G703) ''Of August 20,2019 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 17,200.32 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 9,922.14 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 7,278.18 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 3,799.68 (Line 3 less Line 6) AMOUNT CERTIFIED $ 1 1161\5 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amoun.certified differs from the amount applied.Initial all figures on this Total changes approved Application and the-eo in s ion Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECT: (, / Total approved this Month By: ( �1,'1� Date: TOTALS $0.00 $0.00 This Certificate is n t\tegotiable. The AMOUNT CERTIFIED is payable only to the Lontractor amed erein.issuance,payment and acceptance of payment ar.wumiut NET CHANGES by Change Order $0.00 prejudice to a ghts of the Owner or Contractor under this Contract. AIA DOCUMENT G702-APPLICATION AND CERTIFICATION FOR PAYMENT-1992 EDITION•AIA •01992 THE AMERICAN I . TE OF ARCHITECTS,1735 NEW YORK AVE.,N W.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Ce ' cati• of Document's Authenticity from the Licensee. „,,,,090, 46r,,,___, /i/ °/1( fie CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and /or labor as follows: Construction Management Services for a project known as P112 Motor Court Veneer, located at Carmel, Indiana and owned by the Carmel Redevelopment Commission and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of seven thousand two hundred seventy-eight dollars and eighteen cents ($7,278.18)the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC . T .mas E. ,oontz, President Subscribed and sworn to before me this: /'o d- a/f j /I Notary Public: %? (, y81i,-A-4■—) .....��, LINDA G.BUCHANAN Hancock County My Commission Expires August 20,2019 SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 2 11/21/11 P112 Motor Court Veneer - 12036 Carmel, Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO Committed NO. WORK VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH Cost General Requirements: Site Supervision 10,500.00 7,719.64 1,883.18 0.00 9,602.82 91% 897.18 9,602.82 Construction Management Fee 10,500.00 2,202.50 5,395.00 0.00 7,597.50 72% 2,902.50 7,597.50 21,000.00 9,922.14 7,278.18 0.00 17,200.32 82% 3,799.68 17,200.32 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 ( 7174- (-02 ,e S fif c ✓> Ste. ,/(er cd s, LL C- Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) it-2(-// 2 0/2 fro7Le - (.4,-/- 7.7c9,- .1 t (i 2.. ?fie Total 8) / 7/.66 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct a e ►'t-a a e in accordance• with IC 5-11-10-1.6. r , 20 ! ( " w .surer VOUCHER NO. WARRANT NO. ALLOWED 20 q 1r' Co17-5 0 7-'&/7 SP K∎4< 5) �G IN SUM OF $ $ g, / 7( - &C, ON ACCOUNT OF APPROPRIATION FOR 9o2. Board Members PO# r INVOICE NO. ACCT#/TITLE AMOUNT hereby certify invoice(s),DEPT.# I hereb certif that the attached invoices , or 902 2 �/�/(�c G S" 7 27 4? bill(s) is (are) true and correct and that the 9e2 'f y�ll��GS .53,18 materials or services itemized thereon for which charge is made were ordered and received except /2 — 7 20 1/ ignature Executive Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund Carmel Redevelopment Commission