Loading...
HomeMy WebLinkAboutCHANCE BROS. MARBLE & TILE -001874 -4/20/2011 Transmittal Sheet Page 1 Carmel Redevelopment Comm Chance Bros. Marble & Tile, I Check: 1902 114 W McCarty St Date: 5/19/2011 Indianapolis, IN 46225 Vendor: CHANCE1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 1 61 9,200.00 139.75 0.00 0.00 139.75 Application 1 2 61 78,600.00 7,860.00 0.00 0.00 7,860.00 Application Two 4 61 22,000.00 2,200.00 381.45 0.00 1,818.55 Application four 7 61 2,371.00 2,371.00 0.00 0.00 2,371.00 Application 7 112,171.00 12,570.75 381.45 0.00 12,189.30 Transmittal Sheet Page 1 Carmel Redevelopment Comm . , �.-- Chance Bros. Marble & Tile, I � -vim -ck: 1874 114 W McCarty St .\--° •.t .3.�" Date: 4/20/2011 Indianapolis, IN 46225 ` ,4-5;:-.,6,'' Vendor: CHANCEL At Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 1 61 9,200.00 139.75 0.00 0.00 `' 139.75 Application 1 2 61 .00 7,860.00 7,618.30 0.00 ,rd 241.70 Application Two p�Ck 5.4`44 43'. n 7)( �. --�-�- 2.1 92 70.613( (78;60 9,740.00 9,740.00 0.00 0.00_,, 9,740.00 Application 1 for Cafe Buildou ----"J 4 61 22,000.00 2,200.00 2,121.70 0.00 Erg 78.30 Application four 7 61 vi s.9 73 9 2,371.00 ek 2,371.00 0.00 0.00 "�- 2,371.00 Application 7 121,911.00 22,310.75 9,740.00 0.00 12,570.75 CARMEL REDEVELOPMENT COMMISSION 0 018 7 4 Chance Bros. Marble & Tile, I Check: 1874 114 W McCarty St Date: 4/20/2011 Indianapolis, IN 46225 Vendor: CHANCE1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid See Transmittal Sheet for check detail. 121,911.00 22,310.75 9,740.00 0.00 12,570.75 '6-- T;HISTCHECKIHASIAQCO LYORED]B'AC KGRO UND7ANDICONTAINSIM ULTi1P.LEISEC ORITiY/F.EATiURESEISEEIBWC KIF.ORIDETAILESI11.1116 SyDp J y �'' is I PPS S�04 Carmel Redevelopment Commission REGIONS 0 01>8 7.4 I CI 30 West Main Street i Suite 220 ' 20-1421/740 i o;ARM c Carmel, IN 46032 l J I STRI t 4y, I_ U1�, J ,--4t:.. .,0 ,.~ 1874' f 2.. -- _, DATE /AMOUNT / ',' I ..{ s r._s.. . ************ 4/20/2011 ` . 12;570.75 PAY THE SUM OF TWELVE THOUSAND FIVE HUNDRED SEVENTY. DOLL A "S ND'75 CENT . 1 TO THE - i'i 1 ORDER'" ,5 '' - '.r 1 `{ °F `' °Chance Bros. Marble & Tile, I-p\ ' W a`' n 41i!PS :- 1 ,�_ �1 It Pfl rick put:uutl:rqgsu!p3LLEL5 Sparks' 3FU rst4uLorLk uo uwr.o!OrLio o ‘,; ! L;;;;;: z.,L;;I:o ,...Law.fos;;"o p ;: Sikifteit4.1S,;;11.131KINi c33:)x3 MOT4 alLSI1Sii1111.1V.:4.3• k I cf.kl TN() '-,N TO.ONVNIJ dO W.:AS ION 00 v • Transmittal Sheet Page 1 Carmel Redevelopment Comm Chance Bros. Marble &Tile, I Check: 1874 114 W McCarty St Date: 4/20/2011 Indianapolis, IN 46225 Vendor: CHANCE1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 1 61 9,200.00 139.75 0.00 0.00 139.75 Application 1 2 61 78,600.00 7,860.00 7,618.30 0.00 241.70 Application Two 2-1 92 9,740.00 9,740.00 0.00 0.00 9,740.00 Application 1 for Cafe Buildou 4 61 22,000.00 2,200.00 2,121.70 0.00 78.30 Application four 7 61 2,371.00 2,371.00 0.00 0.00 2,371.00 Application 7 121,911.00 22,310.75 9,740.00 0.00 12,570.75 * AIA::� TM Document G702/CMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: Distribution to: CITY OF CARMEL- REDEVELOPMENT COMMISSION EIGHT(RETAINAGE) 1 CIVIC SQUARE PERIOD TO: 03/30/11 OWNER ❑ CARMEL, IN 46032 CARMEL PERFORMING ARTS CERAMIC TIWNSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ Chance Bros. Marble&Tile, Inc. PROJECT NOS: . I / CONTRACTOR ❑ 114 W. McCarty St., VIA ARCHITECT: CSO ARCHETECTS FIELD ❑ CONTRACT Foi !anapolis, IN 46225 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 221495.00 payment shown herein is now due. 2. Net change by Change Orders $ -25129.00 CONTRACTOR: Chance Bros. Marble&Tile, Inc. 3/30/2011 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 196366.00 By: .i_ _i►i� Date: 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 196366 Q0 State o : Indiana P \/.1, - 5.RETAINAGE: County of: Marion Ai , t a. 5 %of Completed Work 0.00 Subscribed and sworn to before " (Column D+E on 0703) $ me this 30T�ay of �I A H 2010 ` �. b. %of Stored Material Notary Public: Le�� $'y't' .• (laplumn F on G703) $ 0.00 My Commission expires: V.Ye.2/i(P -K, .r j;' Total Retainage(Lines 5a+5b or Total in Column I of G703). $ n nn CERTIFICATE FOR PAYMENT ' , ; In accordance with the Contract Documents, based on on-site observations:and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 196366.00 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 186547.70 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 39! 8.CURRENT PAYMENT DUE $ 9818.30 AMOUNT CERTIFIED $ l'atb® 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attack explanation if amount certified differ.from the amount applied. Initial all figures on this 0.00 Application and of e Continuation f_ct tl, t care changed to conform with the am tint certified.) (Line 3 less Line 6) $ CONS 7 UCTIO A/14': . By �s . .'t,‘,:I/— Date: fl © ii CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC IT. • Total changes approved'in previous months by Owner $ 0.00$ -17500.00 By: te',' j` "1 Date: O-4 tts, Total approved this Month $ 0.00 $ -7629.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00 $ -25129.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ -25129.00 the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. _Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. --N.....00:=AIA Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition, 1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of-the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal.the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own 0703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on MA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed. To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. ."` .. TM ® Document G703 - 1992 Continuation Sheet AIA Document G702TM,Application and Certification for Payment, APPLICATION NO: CARMEL PERFORMING ARTS 40632 containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below,amounts are stated to the nearest dollar. 3/30/2011 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO:CERAMIC TILE A B C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE FROM PREVIOUS COMPLETED SCHEDULED PRESENTLY % TO RETAINAGE ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G=C) FINISH (If variable rate) NO. (D+E) (Not inDorE) (TDODATF) (C-G) CERAMIC TILE MOBILIZATION 500.00 500.00 0.00 0.00 500.00 100% 0.00 0.00 BOND 1,800.00 1,800.00 0.00 0.00 1,800.00 100% 0.00 0.00 ALLOWANCE#2 20,000.00 20,000.00 0.00 0.00 20,000.00 100% 0.00 0.00 ALLOWANCE#6 5,000.00 5,000.00 0.00 0.00 5,000.00 100% 0.00 0.00 C.O.#1 (2,500.00) (2,500.00) 0.00 0.00 •(2,500.00) 100% 0.00 0.00 C.O.#2 (15,000.00) (15,000.00) 0.00 0.00 (15,000.00) 100% 0.00 0.00 C.O.#3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 C.O.#4 (7,629.00) (7,629.00) 0.00 0.00 (7,629.00) 0.00 0.00 0.00 BASEMENT R.R.S.: LABOR 3,800.00 3,800.00 0.00 0.00 3,800.00 100% 0.00 0.00 MATERIAL 5,900.00 5,900.00 0.00 0.00 5,900.00 100% 0.00 0.00 PLENUM RRS LABOR 30,400.00 30,400.00 0.00 0.00 30,400.00 100% 0.00 0.00 MATERIAL 45,600.00 45,600.00 0.00 0.00 • 45,600.00 100% 0.00 0.00 NORTH BOX TIER . LABOR 17,600.00 17,600.00 0.00 0.00 17,600.00 100% 0.00 0.00 MATERIAL 26,400.00 26,400.00 0.00 0.00 26,400.00 100% 0.00 0.00 • GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM-1992.Copyright©1963, 1965, 1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. . %! ® TM Document G703 - 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702TM,Application and Certificate for Payment,is to be used in conjunction with ALA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local ALA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA.Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done. Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect actual construction costs. A B C D E F G H I WORK COMPLETED TOTAL ,MATERIALS BALANCE. ITEM 'SCHEDULED FROM PREVIOUS PRESENTLY 5 ND D STORED NO TO RETAINAGE DESCRIPTION OI'WORK A VALUE APPLICATION TIIIS PERIOD STORED NO (D+£) (Ain rn Dar£) TO DATE (G-C) FINISH(C-G) Ili,unable rage) ID+E+F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS&MISC.CONC 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 . 10,000 40,000 65,000 AIA Document G703T"-1992.Copyright©1963,1965,1966,1967,1970,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING: This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. r Document G703 TM 1 99 2- Continuation Sheet . AIA Document G702TM,Application and Certification for Payment, CARMEL PERFORMING ARTS APPLICATION NO: PG#2 containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS COMPLETED PRESENTLY % TO RETAINAGE ITEM DESCRIPTION OF WORK AND STORED VALUE NO. APPLICATION THIS PERIOD STORED TO DATE (G_C) FINISH (If variable rate) (D+E) (Not inDorE) (D+E+F) (C—G) NORTH ORCHESTRA LOW LABOR 10,000.00 10,000.00 0.00 0.00 10,000.00 '00% 0.00 0.00 MATERIAL 15,000.00 15,000.00 0.00 0.00 15,000.00 "00% 0.00 0.00 BALCONY HIGH LABOR 16,000.00 16,000.00 0.00 0.00 16,000.00 '00% 0.00 0.00 MATERIAL 23,495.00 23,495.00 0.00 0.00 23,495.00 100% 0.00 0.00 • • TCSilALND TOTAL 196,366.00 196,366.00 0.00 0.00 196,366 00 100% 0.00 0.00 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM—1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Alike Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. 1/4 Document G7031M- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702TM,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner.Procedures for their use are covered in AIA Document A201 TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify • the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed • G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA.Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document 6702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application). Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect-actual construction costs. A D C' D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE CO6IPLETED ITEM SCHEDULED FROM PREVIOUS PRESENTLY °o TO RETAINIGE NO DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G-CI FINISH (If variable rare) ID TO +El (Mx' l0 DarEl DATE (C-G) +E+F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS&MISC.CONC 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703T"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING: This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. 4 =- r= Document G702/CMa TM - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition . • TO OWNER: PROJECT: APPLICATION NO: Distribution to: CITY OF CARMEL-REDEVELOPMENT COMMISSION SEVEN 1 CIVIC SQUARE PERIOD TO:.. 03/25/11 OWNER 121 CARMEL, IN 46032 CARMEL PERFORMING ARTS CERAMIC TISONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ Chance Bros. Marble&Tile, Inc. PROJECT NOS: / / CONTRACTOR ❑ 114 W. McCarty St., VIA ARCHITECT: CSO ARCHETECTS FIELD ❑ CONTRACT Mlitnapolis, IN 46225 ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 221495.00 payment shown herein is now due. 2.Net change by Change Orders $ -25129.00 CONTRACTOR: Chance Bros. Marble&Tile, Inc: 3/23/2011 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 196366.00 By: �t.1,__ - .„_ �� - Date: 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 196366.00 State of: Indiana •:. ' 5.RETAINAGE: County of: Marion F,; r a. 5 %of Completed Work 398-18.30 Subscribed and sworn to before , (Column D+Eon G703) $ me this 23 ay of; :. CH 2O10ylr{ b. %of Stored Material 0.00 Notary Public: Q� -)-J c�I- a 1 31-4 �-t ar 3 i,1,.., t�olumn F on G703) $ My Commission expires: .?/07.1/( Q r- S 7�) Total Retainage(Lines 5a+Sb or Total in Column I of G703).. $ 9818.30 CERTIFICATE FOR PAYMENT , , (:*f.,-` ` ' In accordance with the Contract Documents, based on on-site observations and the.clata comprising 6.TOTAL EARNED LESS RETAINAGE $ 186547.70 this application, the Construction Manager and Architect certify to the Owrierthat to.the best of their (Line 4 Less Line 5 Total) knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 183795.25 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE • $ 9759 45 AMOUNT CERTIFIED $ 2152As 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs om I e amount applied.Initial all figures on this Application and o the Continuation S •'t tl•t are .hanged to conform with the at #unt c•rtified.) 9818.30 (Line 3 less Line 6) $ CON •UCTIO=`'(.=G i ' BY: !►_,t, :111�-S!��``►. ■ m Date: 0 • CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC ��y"� Total changes,approved in previous months by Owner $ ' 0.00 $ '17JO3.00 By: ' =y Date: 041 t ill, Total approved this Month $ 0.00 $ -7629.00 This Ce ifi"'e is not negotiable. The AMOUNT CERTIFIED is-payable-Only to the Contractor TOTALS $ 0.00 $ -25129.00 named herein. Issuance, payment and decep[ance of payment are without prejudice to any rights of NET CHANGES by Change Order $ -25129.00 the Owner or Contractor under this Contract. • CAUTION: You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702/CMaTM—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. "Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. 'x4 A Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Projeci.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. - AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed. To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. *1AIA® Document G703 TM - 1992 Continuation Sheet • AIA Document G702TM,Application and Certification for Payment, GAHMEL PEHI-OHMING AR I S APPLICATION NO: SEVEN containing Contractor's signed certification is attached. APPLICATION DATE: 3/23/2011 In tabulations below,amounts are stated to the nearest dollar. 3/25/2011 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % TO RETAINAGE ITEM DESCRIPTION OF WORK AND STORED NO. VALUE APPLICATION THIS PERIOD STORED TO DATE (G+C) FINISH (If variable rate) (D+E) (Not ill DorE) (D+E+F) (C-G) CERAMIC TILE J MOBILIZATION 500.00 500.00 0.00 0.00 500.00 100% 0.00 25.00 BOND 1,800.00 1,800.00 0.00 0.00 1,800.00 100% 0.00 90.00 ALLOWANCE#2 20,000.00 10,000.00 10,000.00 0.00 20,000.00 100% 0.00 1,000.00 ALLOWANCE#6 5,000.00 5,000.00 0.00 0.00 5,000.00 100% 0.00 250.00 C.O.#1 (2,500.00) (2,500.00) 0.00 0.00 (2,500.00) 100% 0.00 (125.00) C.O.#2 (15,000.00) (15,000.00) 0.00 0.00 (15,000.00) 100% 0.00 (750.00) C.O.#3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 C.O.#4 (7,629.00) 0.00 (7,629.00) 0.00 (7,629.00) 0.00 0.00 (762.90) BASEMENT R.R.S.: LABOR 3,800.00 3,800.00 0.00 0.00 3,800.00 100% 0.00 190.00 MATERIAL 5,900.00 5,900.00 0.00 0.00 5,900.00 100% 0.00 295.00 PLENUM RRS LABOR 30,400.00 30,400.00 0.00 0.00 30,400.00 100% . 0.00 1,520.00 MATERIAL 45,600.00 45,600.00 0.00 0.00 45,600.00 100% 0.00 2,280.00 NORTH BOX TIER LABOR 17,600.00 17,600.00 0,00 0.00 17,600.00 100% 0.00 880.00 MATERIAL 26,400.00 26,400.00 0.00 0.00 26,400.00 100% 0.00 1,320.00 GRAND TOTAL , CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent --possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. * ATit® = '„ Document G703 TM- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702TM,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner.Procedures for their use are covered in AIA Document A201 TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA.Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done. Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect actual construction costs. A B C D F F G Ii I WORK COMPLETED. TOTAL MATERIALS BALANCE ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED % TO RETAINAGE NO DESCRIPTION OF WORE; VALUE APPLICATION THIS PERIOD STORED AND STORED (G-C1 EINISII (/�nnaFle role) (D El (A rS,In DoEl TO DATE (C- GI (D+E+F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5 000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS e,MISC.CONC 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703TM-1992.Copyright©1963,1965,1966,1967,1970,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING: This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. @ ' =,® Document G703 TM - 1992 Continuation Sheet AIA Document G702TM,Application and Certification for Payment, GARMEL PEHl-OHMINU AR IS S APPLICATION NO: PG#2 containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS COMPLETED PRESENTLY % TO RETAINAGE ITEM DESCRIPTION OF WORK AND STORED NO. VALUE APPLICATION THIS PERIOD STORED (G-C) FINISH (!f variable rate) (D+E) (Not inDorE) TO DATE (C C) (D+E+F) NORTH ORCHESTRA LOW LABOR 10,000.00 10,000.00 0.00 0.00 10,000.00 100% 0.00 500.00 MATERIAL 15,000.00 15,000.00 0.00 0.00 15,000.00 100% 0.00 750.00 BALCONY HIGH LABOR 16,000.00 16,000.00 0.00 0.00 16,000.00 100% 0.00 800.00 MATERIAL 23,495.00 23,495.00 0.00 0.00 23,495.00 100% 0.00 1,174.75 • TOTAL GRAND TOTAL 196,366.00 193,995.00 2,371.00 0.00 196,366.00 100% 0.00 9,818.30 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. ' AIA Document G703T"—1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright - Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent --possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. • Document G7O3TM.- 1992 Instructions Continuation Sheet .GENERAL INFORMATION Purpose and Related Documents.AIA Document G702T51,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner.Procedures for their use are covered in ALA Document A201 TA1,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any ALA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The ALA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA.Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F. Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done. Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect actual construction costs. A 13 C D E F G 11 I WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED ITEM SCHEDULED FROM PREVIOUS PRESENTLY / TO RETAINAGE NO DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (0-C) FINISH (If variable rate) (D+E( (Not m Dor E) TO DATE (C- G) (D+Er F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS 5 MISC.CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703T"-1992.Copyright©1963,1965,1966,1967,1970,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING: This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org.