220062 05/21/2013 a 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: $29,152.50
WEST LAFAYETTE IN 47906 CHECK NUMBER: 220062
CHECK DATE: 5/2112013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1 29, 152 . 50 OTHER ACCT RECEIVABLE
AIA Type Document
Application and Certification for Payment Pg 1 of 2
TO(OWNER):City of Carmel PROJECT. 12"Water Main Relocate APPLICATION NO: 1 DISTRIBUTION
One Civic Square TO:
Carmel, IN 46032 PERIOD TO:4/30/2013
_OWNER
_ARCHITECT
—CONTRACTOR
FROM(CONTRACTOR): Atlas Excavating, Inc. VIA(ARCHITECT): ARCHITECT'S
4740 Swisher Road
West Lafayette, IN 47906 PROJECT NO:
CONTRACT FOR:PO#W09790 CONTRACT DATE: 3/19/2013
CONTRACTOR'S APPLICATION FOR PAYMENT The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and
belief the work covered by this application for Payment has been completed in accordance with
Application is made for Payment,as shown below, in connection with the Contract. the Contract Documents,that all amounts have been paid by the Contractor for Work for which
Continuation Sheet,AIA Type Document is attached. previous Certificates for Payment were issued and payments received from the owner,and that
current payment shown herein is now due.
1.ORIGINAL CONTRACT SUM . . . . . . . . . . . . . . . . . . . .$ 22,315.00
2. Net Change by Change Orders . . . . . . . . . . . . . . . .$ 6,837.50 CONTRACTOR: Atlas Excavating, Inc.
4740 Swisher Road West Lafayette, IN 47906
3.CONTRACT SUM TO DATE (Line 1 +2), , , , , , , , , , , $ 29,152.50
4.TOTAL COMPLETED AND STORED TO DATE . . . . . . $ 29,152.50 By: r ,�• Date: ✓12(2 I
Tina Dillon / President
5. RETAINAGE:
a. .00%of Completed Work State of: IN
p $ 0.00
County of: Tippecanoe
b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before me this ELI utr � 20
Notary Public: NO Of 1
Total retainage(Line 5a+5b). . . . . . . . . . . . . . . . . . . . $ 0.00 � CoOWSSIOO Eq*n Feb 11,2021
My Commissio
I I I I
6.TOTAL EARNED LESS RETAINAGE. . . . . . . . . . . . . . $ 29,152.50
(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-
Line 6 from prior Certificate 0.00 prising the above application, the Architect certifies to owner that to the best of the Architect's
( p )' ' ' ' ' ' $ knowledge, information and belief the Work has progressed as indicated,the quality of the work
8.CURRENT PAYMENT DUE . . . . . . . . . . . . . . . . . . . . .$ 29,152.50 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the
AMOUNT CERTIFIED.
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6) $ 0.00 AMOUNT CERTIFIED. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
(Attach explanation if amount certified differs from the amount applied. Initial all figures on this
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Application and on the Continuation Sheet that are changed to conform to the amount certified.)
Total changes approved in ARCHITECT:
previous months by Owner 0.00 0.00 By: Date:
Total approved this Month 6,837.50 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
named herein. Issuance,Payment and acceptance of payment are without prejudice to any
TOTALS 6,837.50 0.00 rights of the Owner or Contractor under this Contract.
NET CHANGES by Change Order 6,837.50
AIA Type Document
Application and Certification for Payment Pg 2 of 2
TO(OWNER):City of Carmel PROJECT: 12"Water Main Relocate APPLICATION NO: 1 DISTRIBUTION
One Civic Square TO:
Carmel, IN 46032 PERIOD TO:4/30/2013 _OWNER
_ARCHITECT
—CONTRACTOR
FROM(CONTRACTOR): Atlas Excavating, Inc. VIA(ARCHITECT): ARCHITECT'S
4740 Swisher Road PROJECT NO:
West Lafayette, IN 47906
CONTRACT FOR:PO#W09790 CONTRACT DATE:3/19/2013
SCHEDULED PREVIOUSLY PREVIOUS COMP QTY/% COMP AMT STORED COMPLETED
ITEM DESCRIPTION PLAN QTY UNIT PRICE VALUE COMP QTY/% APPL THIS PERIOD THIS PERIOD MATERIAL AND STORED % BALANCE
1 12"Water Main Relocate- 1.000 22,315.0000 22,315.00 .000 0.00 1.000 22,315.00 0.00 22,315.00 100.00 .00
River Road over Elizabeth
Warren Drain
2 C/O#1 -EWA Material Cost 1.000 6,837.5000 6,837.50 .000 0.00 1.000 6,837.50 0.00 6,837.50 100.00 .00
REPORT TOTALS $29,152.50 $.00 $29,152.50 $29,152.50
$.00 $.00
Atlas Project No./Name: C13-08; 12"Water Main Relocation for River Road Culvert Replacement-Carmel,Indiana
Atlas Change Order No: EWA 1 -Material costs
Date Work Completed:
Description of Work:
Cost for materials only for length over run due to depth and slope needed to get new waterline low enough. Plan profile would not work,and the total length
had to be increased from 150'to 300'. We are requesting compensation for the materials only.
LABOR*
Trade Qty Ea Straight Hours Time& Hours Double Time Hours Extension
Time One Half Rates good through
Labor 1112 $ 40.26 $ 51.57 $ 62.88 $ April 1,2012-April 1,
Operator 103 $ 52.54 $ 67.67 $ 82.79 $ 2013
Foreman $ 66.72 $ 84.58 $ 102.47 $
EQUIPMENT•(Operator not included) MATERIALS
Description Qty Ea Hrly Rate Hours Extension Materials Used Qty Ea Rate Extension
Hitachi EX300 $183.15 $0.00 HD Supply 12"DR 11 DIPS Pipe 150 $ 19.80 $ 2,970.00
Hitachi ZX330 $183.15 $0.00 All Bore Drill Mud 1 $ 2,500.00 $ 2,500.00
Hitachi 7X450 $291.25 $0.00 $ -
JD 850D $486.55 $0.00 $
JD 450D LC $291.25 $0.00 $
Hitachi EX 120 $86.60 $0.00 $
JD 240 DLC $161.00 $0.00 $
JD 1350 $91.30 $0.00 $
JD 310 Backhoe $56.50 $0.00
JD 75C Excavator $73.05 $0.00 Small Tools Hours/Days Used Daily Rate Hourly Rate Extension
JD 75D Excavator $71.55 $0.00 14"Cut-off Saw $ 4.10 $ -
JD 544H $58.15 $0.00 2"Electric Pump $ 3.00 $
JD 544J $73.75 $0.00 2"Trash Pump $ 4.55 $
JD 624J $84.65 $0.00 3"Electric Pump $ 4.45 $
Cat 246 $47.75 $0.00 3"Trash pump $ 4.95 $
Cat D4 $85.60 $0.00 5.6 kw Generator $ 4.50 $
Cat D6 $140.75 $0.00 Air Compressor $ 12.65 $
Ingersoll Rand SD-100 $74.10 $0.00 Chain Saw $ 3.30 $ -
SD100 Roller $74.10 $0.00 Te 56 Hammer Drill $ 3.60 $
JD 7628 $145.15 $0.00 20-50 kw Generator $ 165.00 $
Directional Drill-1607(Case 6030) $104.30 $0.00 Manhole Box $ 137.00 $
Finn Hydroseeder T-60-T-II $22.70 $0.00 Pipe Laser $ 75.00 $ -
Pipe Van $30.00 $0.00 Trench Box $ 189.00 $ -
Pick up Truck $35.30 $0.00 Manhole Fan $ 24.00 $ -
Lowboy $190.00 $0.00 Core Drill $ 78.00 $ -
Hoe Pack for Compaction $26.12 $0.00 Rotating Laser $ 86.00 $ -
Sweepmaster Sweeper $31.45 $0.00 Stone Box $ 17.50 $
Billing Summary
Labor $
Equipment&Small Tools $ -
Material $ 5,470.00
Subcontractors $ -
Subcontractors Subtotal $ 5,470.00
Description Qty Ea Hrly Rate Hours Extension 15%Overhead $ 820.50
Vac Truck $ 200.00 $ 10%Profit $ 547.00
Triaxle Trucking $ 80.00 $ Total $ 6,837.50
$
$
*Any Equipment,subcontractors,small tools,etc.not listed
above will be added at time of submission
. R
r ti INVOICE# 6454195
` INVOICE INVOICE DATE 4103113
BRANCH ADDRESS
HDSWW-INDIANAPOLIS IN-E ACCOUNT# 081014
Branch-509 SALESPERSON BILL TRIBBLE
Local Service, Nationwide 7281 East 30th St
P.O. Box 1419 Indianapolis IN 46219 BRANCH# 509
Thomasville, GA 31799-1419 3171545-6088
;
• $2,970.00
Remit To:
HD SUPPLY WATERWORKS,LTD.
PO BOX 91036
427 1 PJIB 0.405 E00.15X 10840 0661175507 P1403450 0001:0001 CHICAGO, IL 60693-1036
1111111111!131111 II•(tlllllll11111111llll•i[lill1llil1l Shipped to:
ATLAS EXCAVATING LIFT STATION#17 REPLACEMENT
4740 SWISHER RD BLDG A AND RELATED IMPROVEMENTS PROJ.
WEST LAFAYETTE IN 47906-9782 TO FOLLOW
CARMEL, IN
CUSTOMER JOB- RIVERRD River Road 12"
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You.
We appreciate your prompt payment.
Date Ordered Date Shipped Customer PO No. Job Name Job No. Bill of Lading I Shipped Via 10rder Number
3129/13 4102/13 RIVER ROAD River Road 12" RIVERRD Our Truck 6454195
Product Code Description Quantity Quantity Back- Price Per Amount
Ordered Shipped Ordered
0940P1211B50 12"DR11 DIPS HDPE BLUE 50FT 150 150 19.8000 FT 2,970,00
APR
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This transaction is governed by and subject to HD Supply Waterworks standard terms Terms SubTotal
and conditions,which are incorporated herein by this reference and accepted.
To review these terms and conditions,please point your web browser to
http:ll waterworks.hdsupply.com/TandC/. NET 30 2,970.00
Frei ht Delivery Handlina Restock Misc. Tax e
• $2,970.00
HDSWW-INDIANAPOLIS IN-E THANK YOU FOR YOUR ORDER
Branch-509 VISIT e 6454195
7281 East 30th St WATERWORKS.HDSUPPLY.COM
Indianapolis IN 46219 FOR OTHER SERVICES OFFERED
0001:0001 Page 1 of 1
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
00353347
ATLAS EXCAVATING INC. Purchase Order No.
4740 SWISHER ROAD BLDG A Terms
WEST LAFAYETTE, IN 47906 Due Date 5/20/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/20/2013 1 $29,152.50
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
/Zo
Date O cer
VOUCHER # 131654 WARRANT # ALLOWED
00353347 IN SUM OF $
ATLAS EXCAVATING INC.
4740 SWISHER ROAD BLDG A
WEST LAFAYETTE, IN 47906
Carmel Water Utility
'ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1 01-1420-00 $29,152.50
Voucher Total $29,152.50
Cost distribution ledger classification if
claim paid under vehicle highway fund