HomeMy WebLinkAboutBROADY-CAMPBELL, INC. -001886 -5/9/2011 CARMEL REDEVELOPMENT COMMISSION 001886
.Broady-Campbell, Inc. Check: 1886
2115 Dr. A.J. Brown Ave. Date: 5/9/2011
Indianapolis, IN 46202 Vendor: BROADY-
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paic
10 4,219.20 4,219.20 0.00 0.00 4,219.2C
Application 10
4,219.20 4,219.20 0.00 0.00 4,219.2C
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- ' Application and Certificate for Payment
TO OWNER: REI PROJECT: VILLAGE ON THE GREEN BLD APPLICATION NO: 10 Distribution to:
CUST# REI3 11711 N PENNSYLVANIA PERIOD TO: 03/16/2011 OWNER ❑
STREET SUITE 200 09-123
CARMEL IN 46032 CONTRACT FOR:
ARCHITECT ❑
FROM CONTRACTOR: BROADY-CAMPBELL,INC. VIA ARCHITECT: CONTRACT DATE: 11/17/2009 CONTRACTOR ❑
2115 Dr.A.J.Brown Ave. PEDCOR DESIGN GROUP
PROJECT NOS: FIELD ❑
Indianapolis,IN 46202
VILLAGE ON THE GREEN BLD JOB# 29080 OTHER ❑
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information
Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance
with the Contract Documents, that all amounts have been paid by the Contractor for Work for
Continuation Sheet,is attached. 818,620.00 which previous Certificates for Payment were issued and payments received from the Owner, and
1.ORIGINAL CONTRACT SUM $ 24,660.00 that current payment shown herein is now due.
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2. Net change by Change Orders $ CONTRACTOR: Broady-Campbell, Inc.
843,280.00
3.CONTRACT SUM TO DATE(Line 1 ±2) $ By: /4 . ( Date: 3-16-2011
843,280.00
4.TOTAL COMPLETED&STORED TO DATE(Column G on 603LS1).... $ State of: Indiana
5. RETAINAGE: County of: Marion
9.96
a. %of Completed Work 84,027.50 Subscribed and sworn to before
(Column D+Eon 603LS1) $ me this 16th day of March 2011
b. .00 %of Stored Material
0.00
(Column F on 603LS1) $ Notary Public:
84,027.50 My Commission expires: 5-5-2016
Total Retainage(Lines 5a+5b or Total in Column I of 603LS1) ... $
6.TOTAL EARNED LESS RETAINAGE $ 759,252.50 ARCHITECT'S CERTIFICATE FOR PAYMENT
(Line 4 Less Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data comprising
755,033.30 this application, the Architect certifies to the Owner that to the best of the Architect's knowledge,
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ information and belief the Work has progressed as indicated, the quality of the Work is in
(Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the
8.CURRENT PAYMENT DUE $ �� AMOUNT CERTIFIED.
9. BALANCE TO FINISH, INCLUDING RETAINAGE 84,027.50 • AMOUNT CERTIFIED $ 92_M. 2-e'
(Line 3 less Line 6) $ (Attach explanation if amount certified differs from the amount applied.Initial all figures on this
Application and on the Continuation Sheet that are changed to conform with the amount certified.
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT:
25,30 .00 u.u0 9/37) f
Total changes approved in previous months by Owner $ $ By: , ealligt.i... Date:
8,580.00 9,225.u0
Total approved this Month $ $
TOTALS $ 337885.00 $ 9,22 .0.0 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor
24,660.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of
NET CHANGES by Change Order $ the Owner or Contractor under this Contract.
REORDER FORM NO.604LS1
INSTRUCTION SHEET
604LS1 and 603LS1
A. GENERAL INFORMATION
a. Purpose and Related Documents
604LS1,Application and Certificate for Payment, is to be used in conjunction with 603LS1, Continuation Sheet. These documents are
designed to be used on a Project where a Contractor has a direct Agreement with the Owner.
B. COMPLETING THE 7604LS1 FORM:
After the Contractor has completed 603LS1,Continuation Sheet,summary information should be transferred to 604LS1,Application and
Certificate for Payment.
The Contractor should sign 604LS1, have it notarized and submit it,together with 603LS1,to the Architect.
The Architect should review 604LS1 and 603LS1 and, if they are acceptable,complete the Architect's Certificate for Payment on 604LS1.
The Architect may certify a different amount than that applied for. The Architect should then initial all figures on 604LS1 and 603LS1 that
have been changed to conform to the amount certified and attach an explanation. The completed 604LS1 and 603LS1 should be forwarded
to the Owner.
C. COMPLETING THE 603LS1 FORM:
Heading: This information should be completed to be consistent with similar information on 604LS1,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 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 dividinu 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 603LS1 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
604LS1 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.
D. MAKING PAYMENT
The Owner should make payment directly to the Contractor based on the amount certified by the Architect on 604LS1,Application and
Certificate for Payment. The completed form contains the name and address of the Contractor. Payment should not be made to any
other party unless specifically indicated on 604LS1.
E. EXECUTION OF THE DOCUMENT
Each person executing the Agreement should indicate the capacity in which they are acting(i.e., president, secretary, partner,etc.)and the
authority under which they are executing the Agreement. Where appropriate, a copy of the resolution authorizing the individual to act on
behalf of the firm or entity should be attached.
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Continuation Sheet AIA Document G703-1992 (Instructions on reverse side.) Page 1 of 1
AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 10
containing Contractor's signed Certification, is attached. APPLICATION DATE: 03/16/2011
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: 03/16/2011
ARCHITECT'S PROJECT NO: 09-123
A B C D E F G H I
WORK COMPLETED
MATERIALS TOTAL BALANCE RETAINAGE
ITEM SCHEDULED PRESENTLY COMPLETED % TO DESCRIPTION OF WORK FROM PREVIOUS (IF VARIABLE)
NO. VALUE STORED AND STORED (G +C) FINISH
APPLICATION THIS PERIOD (NOT IN TO DATE (C-G) RATE)
(D + E) D OR E) (D+E+F)
01 GENERAL CONDITIONS 34,300.00 34,300.00 34,300.00 100.00
02 BRICK LABOR 103,200.00 103,200.00 103,200.00 100.00
03 BRICK MATERIAL 75,1 40.00 75,140.00 75,140.00 100.00
04 STONE LABOR 133,370.00 133,370.00 133,370.00 100.00
05 STONE MATERIAL 155,800.00 155,800.00 155,800.00 100.00
06 BLOCK LABOR 111,050.00 11 1,050.00 11 1,050.00 100.00
07 BLOCK MATERIAL 62,000.00 62,000.00 62,000.00 100.00
08 GRANITE LABOR 38,300.00 38,300.00 38,300.00 100.00
09 GRANITE MATERIAL 87,360.00 87,360.00 87,360.00 100.00
10 BOND 8,100.00 8,100.00 8,100.00 100.00
11 ALLOWANCE 10,000.00 10,000.00 10,000.00 100.00
12 CO# 1 3,865.00 3,865.00 3,865.00 100.00
13 CO#2 5,090.00 5,090.00 5,090.00 100.00
14 CO#3 16,350.00 16,350.00 16,350.00 100.00
15 CO#4 6,350.00 6,350.00 6,350.00 100.00
16 CO#5 -9,225.00 -9,225.00 -9,225.00 100.00
17 CO#6 2,230.00 2,230.00 2,230.00 100.00
JOB TOTALS : 843,280.00 833,925.00 9,355.00 .00 843,280.00 .00 84,027.50
G703-1992
INSTRUCTION SHEET
AIA Document G703-1992
Continuation Sheet
GENERAL INFORMATION
Purpose and Related Documents.AIA Document G702,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,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 Insititute of Architects'legal counsel,
copyright @aia.org.
COMPLETING THE G703 FORM
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 Protect 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 El
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 materialsireviously 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.
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